Inadequate Intake Research Articles

Assessing the relative validity of a web-based self-administered 24-hour dietary recall in a Canadian adolescent’s population

BackgroundHealthy eating habits at a young age are crucial to support growth and development and good general health. In this context, monitoring youth dietary intakes adequately with valid tools is important to develop efficient interventions and identify groups that are more at risk of inadequate intakes. This study aimed to assess the relative validity of the self-administered web-based 24-h dietary recall (R24W) for evaluating energy and nutrient intakes among active adolescents.MethodsParticipants were invited to complete one interviewer-administered 24-h dietary dietary recall and the R24W on up to three occasions within one month. A total of 272 French-speaking active adolescents aged 12 to 17 years from the province of Québec were invited to complete three R24W and one interview-administered 24-h recall. Student’s t-test and correlations were conducted on sex-adjusted data. Percent differences, cross-classification (percentage of agreement), weighted Kappa and Bland-Altman plots were calculated.ResultsMean (SD) energy intake from the R24W was 8.8% higher than from the interview-administered 24-h dietary recall (2558 kcal ± 1128 vs. 2444 kcal ± 998, p < 0.05). Significant differences in mean nutrient intake between the R24W and the interview-administered 24-h dietary recall ranged from 6.5% for % E from fat (p < 0.05) to 25.2% for saturated fat (p < 0.001), i.e., higher values with R24W. Sex-adjusted correlations were significant for all nutrients except for % E from proteins and thiamin (range: 0.24 to 0.52, p < 0.01). Cross-classification demonstrated that 36.6% of the participants were classified in the same fourth with both methods, 39.6% in the adjacent fourth, and 5.7% misclassified. Bland-Atman plots revealed proportional bias between the two methods for 7/25 nutrients. Completing at least two recalls with the R24W increased the precision of intake estimates.ConclusionThese data suggest that the R24W presents an acceptable relative validity compared to a standard interview-administered 24-h recall for estimating energy and most nutrients in a cohort of French-speaking adolescents from the province of Québec.

Mandatory large-scale food fortification programmes can reduce the estimated prevalence of inadequate zinc intake by up to 50% globally

Large-scale food fortification (LSFF) can increase dietary micronutrient intake and improve micronutrient status. Here we used food balance sheet data from the Food and Agriculture Organization of the United Nations to estimate current country-specific prevalences of inadequate zinc intake. We assessed the potential effects of improving existing LSFF programmes for cereal grains or implementing new programmes in 40 countries where zinc deficiency is a potential public health problem. Accounting for LSFF programmes as currently implemented, 15% of the global population (1.13 billion individuals) is estimated to have inadequate zinc intake. In countries where zinc deficiency is a potential public health problem, the implementation of high-quality mandatory LSFF programmes that include zinc as a fortificant would substantially increase the availability of zinc in the national food supply, reducing the estimated prevalence of inadequate zinc intake by up to 50% globally. Investments in strong LSFF programmes could have a substantial impact on population zinc status.

Osteosarcopenia in women with rheumatoid arthritis: association with nutritional status and physical condition

Objective: to evaluate nutritional status, muscle strength, functional status of skeletal muscles and physical activity (PHA) and their relationship with the osteopenic body composition phenotype in women in post menopause with rheumatoid arthritis (RA). Material and methods. The case-control study included 134 women in post menopause with RA, 52 of them had osteosarcopenia (OSP) according to densitometry and 82 had no decrease in bone mineral density (BMD) and muscle mass (mean age 62.0 ± 7.2 and 59.6 ± 7.5 years, respectively; p &gt; 0.05). A clinical and laboratory examination as well as tests to assess muscle strength and functional status were performed. The MNA-SF and IPAQ questionnaires were used to determine nutritional status and physical activity. Results and discussion. Malnutrition was found in 51.9 % of patients, and low and average levels of PHA were found in 5.8 and 50.0 % of patients with OSP, respectively. Factors associated with OSP were identified: nutritional status according to MNA-SF &lt; 12 points (odds ratio, OR 2.52; 95 % confidence interval, CI 1.10–5.77; p = 0.029), dietary calcium intake &lt; 500 mg/day (OR 3.23; 95 % CI 1.49–7.01; p = 0.003), 25(OH)D level &lt; 30 ng/ml (OR 4.55; 95 % CI 1.86–11.16; p = 0.001), moderate PHA &lt; 1 hour per day (OR 2.67; 95 % CI 1.06–6.75; p = 0.037), walking &lt; 1 hour per day and &lt; 4 hours per week (OR 3.25; 95 % CI 1.26–8.38; p = 0.015 and OR 3.17; 95 % CI 1.19–8.46; p = 0.021, respectively). Conclusion. Reduced nutritional status was found in 51.9 % and average or low levels of PHA in 55.8 % of patients with OSP. The risk of OSP development was increased by low nutritional status, inadequate dietary calcium intake, low vitamin D levels, short duration of daily moderate exercise, and inadequate daily and weekly walking time.

Bioavailability of Australian pre-schooler iron intakes at specific eating occasions is low

PurposePoor bioavailability may contribute to iron deficiency among children in high-resource countries, but iron bioavailability of Australian pre-schooler diets is unknown. This study aimed to estimate the bioavailability of Australian pre-schooler iron intakes across the day and by eating occasions to identify optimal timing for intervention, by using five previously developed algorithms, and to estimate the proportion of children with intakes of absorbable iron below the requirements.MethodsDietary data of children aged 2 to < 6 y (n = 812) from the 2011–12 National Nutrition and Physical Activity Survey were collected via two 24-h recalls. Usual food and nutrient intakes were estimated via Multiple Source Method. Phytate, polyphenol, and heme iron values were sourced from international databases or the literature. Five previously published algorithms were applied to observed dietary data to estimate iron bioavailability and calculate the prevalence of children with intakes of absorbable iron below requirements.ResultsPre-schooler daily iron bioavailability was low (2.7–10.5%) and corresponded to intakes of 0.18–0.75 mg/d of absorbable iron. The proportion of children with inadequate intakes of absorbable iron ranged between 32 and 98%. For all eating occasions, dinner offered iron of the greatest bioavailability (4.2–16.4%), while iron consumed at breakfast was of the lowest bioavailability (1.2–5.6%).ConclusionFuture strategies are required to improve intakes of bioavailable iron for pre-schoolers to prevent the risk of deficiency. These strategies could include the encouragement of concomitant consumption of enhancers of iron absorption with iron-rich sources, particularly at breakfast.

Nutritional considerations with antiobesity medications.

The improved efficacy and generally favorable safety profile of recently approved and emerging antiobesity medications (AOMs), which result in an average weight reduction of ≥15%, represent significant advancement in the treatment of obesity. This narrative review aims to provide practical evidence-based recommendations for nutritional assessment, management, and monitoring of patients treated with AOMs. Prior to treatment, clinicians can identify preexisting nutritional risk factors and counsel their patients on recommended intakes of protein, dietary fiber, micronutrients, and fluids. During treatment with AOMs, ongoing monitoring can facilitate early recognition and management of gastrointestinal symptoms or inadequate nutrient or fluid intake. Attention should also be paid to other factors that can impact response to treatment and quality of life, such as physical activity and social and emotional health. In the context of treatment with AOMs, clinicians can play an active role in supporting their patients with obesity to improve their health and well-being and promote optimal nutritional and medical outcomes.

Outcomes of Percutaneous Endoscopic Gastrostomy in Huntington's Disease at a Tertiary Center.

Clinically assisted nutrition and hydration via percutaneous endoscopic gastrostomy (PEG) is a therapeutic option to ameliorate the difficulties associated with enhanced catabolism, weight loss, and dysphagia in Huntington's disease (HD). The objective is to provide insights into demographics, staging (Shoulson-Fahn), complications, weight trajectories, and survival rates in people with HD (pwHD) who underwent PEG. This retrospective study included 705 consecutive pwHD who attended our HD clinic between July 2006 and March 2024, of whom 52 underwent PEG. A control group (n = 52), comprising pwHD without PEG, were closely matched for sex, stage, age, CAG length, and disease burden score at PEG. The study was registered as a service evaluation at the National Hospital for Neurology and Neurosurgery. PEG prevalence was 15.0% (n = 52/347) among manifest pwHD: 4.8% (n = 3/62) for Stage 3; 33.3% (n = 16/48) for stage 4; and 44.1% (n = 30/68) for stage 5. Commonest indications were dysphagia, weight loss, and inadequate oral intake. Complications included chest infection, tube dislodgement, and peristomal and skin infections. Modeling of weight trajectories after PEG found no difference between PEG and non-PEG groups. Mortality rate was 34.6% (n = 18/52) in the PEG and 36.5% (n = 19/52) in the non-PEG groups (P = 0.84). Treatment duration (until study endpoint or death) was 3.48 years (interquartile range = 1.71-6.02; range = 0.23-18.8), with 65.4% (n = 34/52) alive at the study endpoint. PEG in pwHD at-risk for weight loss may help slow weight loss. Prospective studies are required to strengthen PEG decision-making in pwHD. PEG survival was much longer than other dementias, highlighting the need to consider PEG independently in pwHD.

Modeling the Contribution of Multiple Micronutrient Fortification of Salt to Daily Nutrient Intake Among the Ethiopian Population

BackgroundSalt is an affordable commodity and has wide coverage regardless of economic and social status and, hence, could be suitable vehicle for multiple micronutrient fortification. ObjectivesThis study aimed to simulate the contribution folic acid and zinc fortification of iodized salt to nutrient intake among the Ethiopian population. MethodsThe 2013 Ethiopian National Food Consumption Survey and various food composition tables were used to estimate baseline individual-level micronutrient intake. Usual intake was estimated using the Simulating Intake of Micronutrients for Policy Learning and Engagement macro tool. Discretionary salt consumption was calculated from total salt intake estimated using urinary sodium excretion. Fortificant addition rates were set to obtain maximum nutrient intake while simultaneously constraining that population with intake above the tolerable upper intake level to <5%. Addis Ababa and Somali (N = 2271), the regions with relatively the lowest and highest micronutrient deficiency prevalence in Ethiopia, were selected. ResultBaseline median intake of Zn was below the estimated average requirement for all demographic groups. Inadequate Zn intake ranged from 73% to 99%, the highest prevalence being observed among women in lower class of wealth quintiles from Somali region. Dietary folate inadequacy was as low as 2% among men in Addis Ababa but almost all (99%) women from Somali region had inadequate folate intake. Calculated discretionary salt intake was 7.5 g/d for adult men and women and 3.4 g/d for children. With addition 0.8 mg Zn and 30 μg of folic acid per gram of salt, multiple salt fortification is estimated to reduce Zn inadequacy by 38 percentage points in urban areas and19 percentage points in rural areas. Modeled reduction in folate inadequacy were 18% in urban areas and 22% in rural areas. ConclusionsMultiple salt fortification could be an effective approach to address micronutrient adequacy in Ethiopia given efficacious, technological, and economical feasibility.

THE THE ROLE OF NUTRITIONAL STATUS ON HEMOGLOBIN LEVELS IN ADOLESCENTS

Background: Adolescents were one of the strong foundations for the future of the nation because of their role in development and progress of the country. Healthy physical and psychological conditions will form a strong and resilient adolescent character which is affected by adequate nutritional intake. So that if nutrients are not sufficient, it can cause disturbances in metabolic processes. Inadequate intake of nutrients such as protein and iron will aggravate the occurrence of anemia and lead to malnutrition. Indirectly, nutritional status will also affect the occurrence of anemia. Objectives: This study was to examine the relationship between nutritional status and adolescent hemoglobin levels. Methods: This study was an analytic study with Cross Sectional approach. Respondents were 46 students of SMP PGRI 01 Bantur in Malang regency conducted in August 2023. Independent variable was nutritional status using weight, height and Body mass index (BMI) and dependent variable was anemia using hemoglobin level. BMI was calculated using formula weight divided by height square. The analysis used both univariate and bivariate analysis. Bivariate analyzed using Spearman rank correlation test. Results: Results showed 76,1% adolescents classified normal nutritional, 19,6% overweight and 2,2% underweight and obese. The hemoglobin level, 86,9% normal and 13,1% anemia. Based on the results of statistical tests using rank spearman test, the p value = 0.044 less than 0,05. It means there was a significant correlation between nutritional status and anemia. Conclusion: There is a relationship between nutritional status with Hb levels in adolescents. Enrichment of nutritional intake will give big impact on nutritional and anemia status among adolescents.

Diabetes Mellitus and Fluid Imbalance: The Need for Adequate Hydration.

The effect of hydration in modulating metabolic disease risk is a comparatively recent concept. Diabetic patients are at increased risk of dehydration due to osmotic diuresis. Undiagnosed or undertreated hyperglycemia may lead to electrolyte imbalance and elevated renal burden of glucose excretion, which may alter fluid reabsorption in the kidney. Also, the presence of one or more contributory factors, such as inadequate fluid intake, strenuous exercise, high temperatures, alcohol consumption, diarrhea, acute illnesses, fever, nausea, and vomiting, may put diabetic patients at increased risk of dehydration and electrolyte imbalance. Certain antidiabetic agents used by diabetic patients may cause fluid retention/deficits and/or electrolyte abnormalities in a few patients. Thus, drinking ample amounts of water and fluids with appropriate electrolyte composition is important to prevent dehydration. Successful management of dehydration in patients with diabetes is an unmet need and can best be accomplished by maintaining adequate hydration status.

Lactose malabsorption and intolerance in older adults.

Lactose malabsorption and intolerance are very common conditions. However, their optimal approach, including the diagnostic assessment, remains a matter of debate, especially in advanced age. In this brief review, we focused on current knowledge, concerns, and impact in clinical practice of lactose malabsorption and intolerance in elderly. Older adults are at high risk of malnutrition, owing to frequent occurrence of cognitive impairment, loss of appetite, dysphagia, and poor oral health. A significant decrease in the consumption of dairy products may lead to inadequate intake of high-quality protein and minerals, with a consequent impact on muscle and bone health. Testing for lactose malabsorption may be challenging in older adults, if not useless. Instead, a detailed clinical evaluation should always be pursued to identify both lactose intolerance and all confounding factors mimicking the same clinical picture. The management of lactose malabsorption and intolerance in older adults deserves a personalized approach. Because of the importance of maintaining an adequate nutritional status in this age group, efforts should be put forth to avoid excessively restrictive diets.

Kegiatan Skrining Pemeriksaan Hemoglobin dan Hematokrit terhadap Penyakit Anemia pada Kelompok Lanjut Usia di Panti Werda Hana

Anemia in the elderly is a common condition characterized by a decrease in red blood cells or hemoglobin levels, causing various health problems. Anemia is defined as a hemoglobin level below 13 g/dL in men and 12 g/dL in women. Various factors, such as inadequate nutritional intake, chronic inflammation, and kidney disease, often cause anemia in this population. Untreated anemia impacts quality of life, increases hospitalization rates, the risk of falls, and cognitive decline, and is independently associated with higher mortality from cardiovascular stress. This activity uses the PDCA (Plan-Do-Check-Action) method to screen and treat anemia in elderly participants Hana Nursing Home. We conducted complete blood tests on 61 respondents to evaluate their hematological profile. The blood test results revealed an average hematocrit of 36.15% for the participants, and anemia in 11 (18.03%) men and 19 (31.15%) women. Routine hemoglobin screening and effective management are essential for early detection and intervention, thereby improving the quality of life of the elderly. Keywords: Anemia, Elderly, Hemoglobin, Hematocrit

A Comprehensive Examination of the Nutritional Sufficiency of Vegan Recipes Widely Available in the Market

The popularity of plant-based and vegan diets has experienced significant growth in recent years. While adhering to a vegan diet has been linked to various health benefits, it is important to note that certain essential vitamins and minerals, such as vitamins B12 and D, calcium, and iron, may be insufficient in an exclusively plant-based diet. Prolonged inadequate intake of these nutrients can lead to nutritional deficiencies and potentially increase the risk of adverse health outcomes. To further investigate this matter, we conducted a study in which we analyzed a one-week meal plan consisting of vegan recipes from Forks Over Knives (FOK), an organization that advocates for a low-fat, whole-food, vegan diet as a means to prevent or reverse chronic diseases. Through a detailed examination of the meal plan. Based on the evidence derived from this analysis, it is imperative for vegans and their healthcare providers to be cognizant of the potential nutrient deficiencies and associated health consequences that may arise from following this type of diet.

Levels Of Nutritional Adequacy And Bioavailability Of Iron With The Incident Of Anemia In Pregnant Women In Gorontalo City

The level of adequate nutrition and iron availability in pregnant women can cause anemia, and inadequate food intake during pregnancy can affect Hb levels. The research formulation is about the incidence of anemia in pregnant women and whether there is a relationship between the level of adequate nutrition of energy, protein, vitamin A, vitamin C, iron, and bioavailability and the incidence of anemia in pregnant women. This research aims to analyze the level of adequacy and bioavailability of iron with the incidence of anemia in pregnant women. This type of observational research uses a cross-sectional design. This research was carried out at 10 Community Health Centers in Gorontalo City. The sample in this study consisted of 165 pregnant women using cluster random sampling techniques with bivariate analysis using the Chi-square test and multivariate analysis using the multinominal logistic regression test. The results of data analysis on the prevalence of anemia in pregnant women were 52.7%. The relationship between the level of nutritional adequacy and the incidence of anemia in pregnant women is energy ( P value = 0.029 ≤ α = 0.05), protein (P value = 0.045 ≤ α = 0.05), vitamin A ( P value = 0.108 ≥ α = 0 .05), vitamin C ( P value = 0.003 ≤ α = 0.05), Iron ( P value = 0.004 ≤ α = 0.05), bioavailability ( P value = 0.016 ≤ α = 0.05). There is a relationship between adequate levels of the nutrients energy, protein, vitamin C, iron, and iron bioavailability with the incidence of anemia in pregnant women, and there is no relationship between adequate levels of the nutrient vitamin A and the incidence of anemia in pregnant women. Pregnant women increase their need for good nutrition during pregnancy to prevent anemia.

Triple burden of malnutrition among Vietnamese 0·5-11-year-old children in 2020-2021: results of SEANUTS II Vietnam.

SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old. Cross-sectional survey. A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. 4001 children between 6 months and 11.9 years of age. Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI. SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.

Experimental Autoimmune Encephalomyelitis Influences GH-Axis in Female Rats.

Inflammation, demyelination, and axonal damage to the central nervous system (CNS) are the hallmarks of multiple sclerosis (MS) and its representative animal model, experimental autoimmune encephalomyelitis (EAE). There is scientific evidence for the involvement of growth hormone (GH) in autoimmune regulation. Previous data on the relationship between the GH/insulin like growth factor-1 (IGF-1) axis and MS/EAE are inconclusive; therefore, the aim of our study was to investigate the changes in the GH axis during acute monophasic EAE. The results show that the gene expression of Ghrh and Sst in the hypothalamus does not change, except for Npy and Agrp, while at the pituitary level the Gh, Ghrhr and Ghr genes are upregulated. Interestingly, the cell volume of somatotropic cells in the pituitary gland remains unchanged at the peak of the disease. We found elevated serum GH levels in association with low IGF-1 concentration and downregulated Ghr and Igf1r expression in the liver, indicating a condition resembling GH resistance. This is likely due to inadequate nutrient intake at the peak of the disease when inflammation in the CNS is greatest. Considering that GH secretion is finely regulated by numerous central and peripheral signals, the involvement of the GH/IGF-1 axis in MS/EAE should be thoroughly investigated for possible future therapeutic strategies, especially with a view to improving EAE disease.

Multiple environmental and nutritional effects of changing food consumption in urban and rural China

Driven by urbanization and increasing income, dietary changes are dramatic in China. Food consumption directly links environmental and human health, and an in-depth understanding on environment–health nexus is necessary to achieve their co-benefits. Previous studies mostly examine health outcomes through disease risks and premature deaths, overlooking the hidden hunger resulting from inadequate nutrients intakes. Here, we evaluated multiple dietary environmental and nutritional impacts as well as their linkages in urban and rural China for the period 1990–2020. The results showed that daily per capita water, land and carbon footprints are 1.25–1.61 m3, 1.67–2.23 g2, and 1.47–1.84 kg CO2eq. Fat, fiber and Ca were key nutrients influencing dietary nutritional quality. Dietary changes in China increased environmental effects, and increased intakes of both beneficial and restricted-intake nutrients. More importantly, adoption of Chinese Dietary Guidelines, Mediterranean diet, EAT–Lancet, WHO recommendations, and DASH dietary scenarios would increase environmental footprints by 33% and 48% on average compared with current urban and rural diets. It would improve nutritional quality, but increase intakes of restricted-intake nutrients. The complex trade-offs between dietary environmental and nutritional effects emphasize the need for formulating comprehensive dietary guidelines, and food waste reduction is a possible strategy for addressing the environment–health dilemma effectively.

#670 Clinical characteristics of sarcopenic obesity in hemodialysis patients

Abstract Background and Aims Sarcopenia is associated with all-cause mortality in older dialysis patients. Although obesity is a risk factor for a variety of diseases in the general population, obese hemodialysis patients have a survival advantage over lean patients. Some hemodialysis patients are obese but have reduced muscle mass, a condition known as sarcopenic obesity. The characteristics and diagnostic criteria for sarcopenic obesity in dialysis patients remain unclear. This study aims to determine the prevalence and clinical characteristics of patients at risk for sarcopenia or sarcopenic obesity. Method The dialysis centers involved in this study were four dialysis centers belonging to Seiei-kai Medical Corporation. Hemodialysis patients attending these facilities were included. Obesity was defined as a BMI of 25 kg/m2 or higher, and sarcopenia risk was described as a SARC-F questionnaire score of 4 or higher and a sit-to-stand test (SS-5) of 12 seconds or longer. Patients were classified as sarcopenic obese if they met both criteria. Patients classified as obese (OB) or sarcopenic obesity (SO) were compared for the following factors: age, history of dialysis, sex ratio, presence of diabetes, blood biochemical tests, Kt/V, nPCR, %CGR, number of falls in the past year, and symptoms using the Patients Reported Outcomes Measure (PROM). Results We analyzed the cross-sectional data of 622 patients attending our four dialysis centers. The prevalence of SO among all patients was 6% (34 patients), and OB was 26% (164 patients); Hb (10.9 ± 1.5 vs. 11.4 ± 1.2 g/dl; p=0.03), albumin (3.40 ± 0.3 vs. 3.63 ± 0.3 mg/dl; p&amp;lt;0.01) and nPCR (0.82 ± 0.16 vs. 0.91 ± 0.13 g/kg/day; p=0.01) were significantly lower in the SO group than in the OB group. Age (72.4 ± 9.2 vs. 32.9 ± 12.7 years; p&amp;lt;0.01) was higher in the SO group, and patients with a history of falls were significantly more likely to be in the SO group (59% vs. 29%; p&amp;lt;0.01). Symptom severity as measured by the PROM was also higher in the SO group. Conclusion This study showed that patients in the SO group were more likely to fall and had inadequate protein intake. In addition, patients in the SO group are older and have more severe PROM symptoms. Interventions to increase muscle strength and improve physical function should be considered for patients with SO. Nutritional support, treatment of individual symptoms, and exercise therapy will be necessary, and these interventions may be complex and challenging. We will design an observational study on the prognostic impact of sarcopenic obesity. A limitation of this study is that we used the SARC-F questionnaire and SS-5 rather than the AWGS criteria to assess sarcopenia, which may not have captured true sarcopenia.

Transcutaneous auricular vagus nerve stimulation may benefit from the addition of N-acetylcysteine to facilitate motor learning in infants of diabetic mothers failing oral feeds.

This study aims to determine if pretreating with enteral N-acetylcysteine (NAC) improves CNS oxidative stress and facilitates improvement in oromotor skills during transcutaneous auricular nerve stimulation (taVNS) paired with oral feedings in infants of diabetic mothers (IDMs) who are failing oral feeds. We treated 10 IDMs who were gastrostomy tube candidates in an open-label trial of NAC and taVNS paired with oral feeding. NAC (75 or 100 mg/kg/dose) was given by nasogastric (NG) administration every 6 h for 4 days, then combined with taVNS paired with 2 daily feeds for another 14 days. NAC pharmacokinetic (PK) parameters were determined from plasma concentrations at baseline and at steady state on day 4 of treatment in conjunction with magnetic resonance spectroscopic (MRS) quantification of CNS glutathione (GSH) as a marker of oxidative stress. We compared increases in oral feeding volumes before and during taVNS treatment and with a prior cohort of 12 IDMs who largely failed to achieve full oral feeds with taVNS alone. NAC 100 mg/kg/dose every 6 h NG resulted in plasma [NAC] that increased [GSH] in the basal ganglia with a mean of 0.13 ± 0.08 mM (p = 0.01, compared to baseline). Mean daily feeding volumes increased over 14 days of NAC + taVNS compared to the 14 days before treatment and compared to the prior cohort of 12 IDMs treated with taVNS alone. Seven IDMs reached full oral feeds sufficient for discharge, while three continued to have inadequate intake. In IDM failing oral feeds, NAC 100 mg/kg/dose every 6 h NG for 4 days before and during taVNS paired with oral feeding increased CNS GSH, potentially mitigating oxidative stress, and was associated with improving functional feeding outcomes compared to taVNS alone in a prior cohort. This represents a novel approach to neuromodulation and supports the concept that mitigation of ongoing oxidative stress may increase response to taVNS paired with a motor task.

Dietary nutrient intake study among older adults: baseline Malaysian pure study

IntroductionThe older adults (OA) is vulnerable to malnutrition, which may affect their health and quality of life. This study assesses the prevalence of deficiencies in dietary nutrients among the Malaysian OA stratified by residency, genders, socioeconomic status (SES) and body mass index (BMI).MethodologyA cross-sectional study was conducted, utilizing purposive sampling, recruiting 2,299 Malaysian people aged 60 years old and above who agreed to be interviewed via a comprehensive semi-quantitative food frequency questionnaire. The nutrients intake was calculated based on the Malaysian food composition and US Department of Agriculture food composition databases. Then, the nutrients intake was compared with the Malaysian Recommended Nutrients Intake guidelines, and the prevalence of deficiencies in dietary nutrients were calculated. The median (interquartile ranges) intakes of nutrients were compared between residency (urban and rural), genders (male and female), and SES (low and middle-high) using the Mann-Whitney U test. The differences in nutrient intake between BMI categories (underweight, normal, and overweight) were identified using the Kruskal-Wallis test followed by Dunn’s post hoc test.ResultsThe response rate was 70.3% (n = 2,299), predominantly were females (50.8%), received primary education (76.6%), were currently married (84.3%), were middle–high SES (57.7%), and had a normal BMI (59.8%). There was a notable inadequate intake prevalence of magnesium (100.0%), manganese (97.9%), zinc (95.6%), vitamin B6 (98.4%), potassium (91.0%), calcium (89.3%), vitamin B12 (80.2%), vitamin E (91.2%), and vitamin K (81.5%) among Malaysian OA. Additionally, significant differences were observed in nutrients intake levels across gender, residency, SES, and BMI within this population.ConclusionsThis study shows a high prevalence of dietary nutrients deficiency (> 80%) among the Malaysian OA, particularly for magnesium, manganese, potassium, zinc, vitamin B6, vitamin E, calcium, vitamin B12, and vitamin K. To improve the nutritional status of OA and safeguard against adverse health effects, it is necessary to formulate and execute strategies to enhance their dietary nutrient intakes. The strategies may involve intervention such as nutrient supplementation and promotion of consuming nutrient-rich foods.

Nutritional Challenges in Nursing Homes: Pilot Study on Macronutrient Intake and Status of Vitamins D and B12.

Older adults living in nursing homes (NH) are considered a population group that could be at risk in terms of nutrition, even more so than their community-dwelling peers. Evidence on the nutritional status of NH residents is scarce, as they are commonly excluded from population-based dietary studies. This is also the case in Slovenia. In the presented pilot study, we assessed the intake of macronutrients as well as the intake and status of vitamin D and vitamin B12 on a sample of NH and NH daycare center users to explore the need for a larger representative study. The pilot study included 37 participants from three Slovenian NH (20 participants) and their daycare centers (17 participants). Daycare centers offer daytime care services for older adults, where users are also provided with major meals during their stay. Intakes of energy and nutrients were estimated by three 24 h dietary records. Fasting blood samples were collected for the assessment of vitamin D and vitamin B12 status. Over 90% of the participants had daily energy and protein intakes below recommendations (reference values: energy intake: males 2100 kcal and females 1700 kcal; protein intake > 1 g/kg body mass). The males' median daily intakes of vitamin D were 1.7 µg (1.5 µg females), and 2.3 µg for vitamin B12 (2.0 µg females). None of the participants had adequate vitamin D intake (>20 µg), and 92.3% males and 87.5% females had inadequate vitamin B12 intake (<4 µg). The prevalence of vitamin D deficiency (serum 25-OH-D conc. < 30 nmol/L) was 100% among NH residents and 53% among NH daycare center users. The prevalence of vitamin B12 deficiency was found in 20% of NH residents. The study results highlighted that certain nutrients might be critical in this population, especially among NH residents; however, a more thorough investigation with the inclusion of other important markers of nutritional status should be performed on a larger, representative sample to support the development and implementation of appropriate public health interventions.