Adequate Intake Research Articles

Dietary Behaviour of Pregnant Women in Ethiopia: The Missing Aspect of Care.

Background: Nutrition and adequate dietary intake during pregnancy strongly influence the health and well-being of the mother, as well as the physical and cognitive development of the unborn child. While previous studies have documented factors associated with the dietary behaviour of pregnant women in Ethiopia, a comprehensive overview is missing. Objective: The aim of this study was to close this research gap. Methodology: We conducted a mapping review, including 37 studies published between 2000 and 2022 in our analysis. Dietary behaviour refers to all phenomena related to food choice, eating behaviour and dietary intake. We used an innovative approach by integrating a socio-ecological framework with UNICEF's conceptual framework on maternal and child nutrition, which specifies multidimensional individual, underlying and enabling determinants associated with the nutritional status of women. Importantly, we integrated a focus on care for women and healthy environments. Results: A total of 68 factors were identified as influencing the dietary behaviour of pregnant women, with a focus on the intra- (31/68) and interpersonal (21/68) levels, while factors at the community (11/68) and the institutional levels (5/68) were scarce. Few studies investigated socio-cultural aspects, such as gender roles, decision-making power and workload of women, psychological factors and eating practices related to food taboos. None of the studies explored the influence of resources at the institutional level. Conclusions: This attests that the focus in maternal nutrition is still placed on the individual responsibility of women, instead of addressing the structural conditions that would enable women to access resources such as land, education and nutrition information.

Calcium deficiency and its implications for cardiovascular disease and cancer: Strategies for resolution via agronomic fortification.

Calcium (Ca) is a vital nutrient essential for structural development and signal transmission in both plants and animals. In humans, inadequate calcium intake has been correlated with various diseases, including osteoporosis, cardiovascular and cerebrovascular diseases, and cancer. In areas where plants serve as a main dietary source, calcium intake is significantly lower than the recommended adequate intake, notably in low- and middle-income countries (LMICs). Exploring the connections between calcium consumption and cardiovascular disease (CVD) and cancer has significant implications for public health, given that these two conditions are the primary contributors to global mortality. This study conducted a systematic review of existing literature to assess the evidence regarding calcium intake and its effect on blood pressure control, stroke prevention, and the controversial association with myocardial infarction. Furthermore, the preventive effect of calcium intake on tumor development, particularly in cancer prevention, was discussed. The study explores the potential of agronomic biofortification as a key strategy to enhance plant-based dietary calcium density and improve human health. By advocating for the incorporation of calcium-rich plants and plant-derived products, alongside appropriate calcium supplementation, the study emphasizes the economic and practical benefits of plants as a calcium source. This approach is aligned with global dietary patterns and socioeconomic disparities. The review also highlights the need for further research to better understand the mechanisms through which agronomic biofortification can increase dietary calcium intake and reduce the risks of CVD and cancer associated with calcium deficiency. Ultimately, this study aims to deepen our understanding of the complex relationship between calcium intake and health.

Daily Adequate Intake of Fruit and Vegetables and All-Cause, Cardiovascular Disease, and Cancer Mortalities in Malaysian Population: A Retrospective Cohort Study.

We investigated the relationship between daily adequate FV intake and risk of all-cause, cardiovascular disease (CVD), and cancer mortalities among Malaysian adults. Data from a total of 18,211 Malaysian adults aged 18 years and above whom participated in the National Health and Morbidity Survey 2011 were analyzed. The participants were followed up for approximately 11 years, and mortality data were ascertained through record linkages with the death registry from the Malaysian National Registration Department. Multiple Cox regression was applied to assess the association between daily adequate FV intake and risk of all-cause, CVD, and cancer mortalities, adjusting for sociodemographic, lifestyle, and health conditions. During the follow-up period, we observed a total of 1809 all-cause, 374 CVD, and 216 cancer mortalities. No significant association between daily adequate FV intake with all-cause mortality (adjusted hazard ratio (aHR): 1.01, 95% confidence interval (CI: 0.79-1.31), CVD mortality (aHR: 0.91, 95% CI: 0.57-1.47), and cancer mortality (aHR: 1.27, 95% CI: 0.74-2.17) were observed, even after excluding deaths that occurred in the first two years of observation. Further investigation on the type of FV intake and its preparation method with risk of mortality will provide a holistic insight into the causal relationship between FV intake and mortality.

Association between vitamin B2 intake and cognitive performance among older adults: a cross-sectional study from NHANES

The impact of vitamin B2 (riboflavin) intake on cognitive performance among older adults in the United States (US) remains inadequately understood. This study aimed to explore the association between vitamin B2 intake and cognitive performance among non-institutionalized elderly people in the US. Weighted logistic regression was used to evaluate the association between vitamin B2 intake and cognitive performance. Vitamin B2 intake was determined from the mean of two 24-hour dietary recall interviews. Three cognitive ability assessment tests, namely the Immediate Recall Test (IRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), were performed. Participants included all older adults over 60 who underwent cognitive scoring, with cut-offs defined based on the lowest quartile (25th percentile) for each test (the cut-offs for the three scores were 15.625, 12, and 33, respectively). Sensitivity analysis, including dose-response curves, subgroup analyses, interaction effects, per 1 standard deviation (SD), recommended dietary allowance (RDA), and residual energy model analysis, were performed to solidify the solid association between vitamin B2 and cognitive performance. A total of 2893 individuals aged over 60 were included, with a mean age of 69 (7) years, and 46% were men. There was a significant association between vitamin B2 intake and all three cognitive scores (IRT, Odds Ratio = 0.77, 95% confidence interval: [0.65,0.92]; AFT, 0.75, [0.64,0.88]; DSST, 0.72, [0.59,0.88]). Moreover, vitamin B2 intake above the RDA reduced the risk of low cognitive performance (IRT, 0.66, [0.46,0.93]; AFT, 0.83, [0.62,1.11]; DSST, 0.65, [0.45,0.92]) compared to intake below the RDA. Dose-response curves indicated that higher vitamin B2 intake was negatively associated with the risk of low cognitive performance. Physical activity may modify the association between vitamin B2 and cognitive performance. Vitamin B2 intake was positively associated with cognitive performance among older adults. Adequate vitamin B2 intake could help protect cognitive function.

Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity.

The rapid and widespread clinical adoption of highly effective incretin-mimetic drugs (IMDs), particularly semaglutide and tirzepatide, for the treatment of obesity has outpaced the updating of clinical practice guidelines. Consequently, many patients may be at risk for adverse effects and uncertain long-term outcomes related to the use of these drugs. Of emerging concern is the loss of skeletal muscle mass and function that can accompany rapid substantial weight reduction; such losses can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes. Available evidence suggests that clinical trial participants receiving IMDs for the treatment of obesity lost 10% or more of their muscle mass during the 68- to 72-week interventions, approximately equivalent to 20 years of age-related muscle loss. The ability to maintain muscle mass during caloric restriction-induced weight reduction is influenced by two key factors: nutrition and physical exercise. Nutrition therapy should ensure adequate intake and absorption of high-quality protein and micronutrients, which may require the use of oral nutritional supplements. Additionally, concurrent physical activity, especially resistance training, has been shown to effectively minimize loss of muscle mass and function during weight reduction therapy. All patients receiving IMDs for obesity should participate in comprehensive treatment programs emphasizing adequate protein and micronutrient intakes, as well as resistance training, to preserve muscle mass and function, maximize the benefit of IMD therapy, and minimize potential risks.

Validation of the minimum dietary diversity for women as a predictor of micronutrient adequacy among lactating women in Ethiopia.

The Minimum Dietary Diversity for Women (MDD-W) indicator is used as a proxy indicator for assessing micronutrient adequacy among women of the reproductive age group. Variations were observed in studies, and there was also a lack of evidence regarding the performance of this proxy indicator in Ethiopia, a country with diverse dietary consumption practices. This study aimed to validate the performance of the MDD-W in predicting micronutrient intake adequacy among lactating women in Ethiopia. A community-based cross-sectional study was conducted among randomly selected 457 lactating women in Northwest Ethiopia from February 2 to 18, 2023. A multistage sampling technique was used to select 457 study participants. A single multiphasic interactive 24-h dietary recall was used to collect dietary intake data. Ten food groups were used to compute the Minimum Dietary Diversity for Women, and the Mean Adequacy Ratio was used to assess nutrient intake adequacy. Spearman's rank correlation test, Cohen's kappa statistics, and ROC curve analysis were conducted. The optimal cutoff points for Minimum Dietary Diversity for Women were determined by selecting the points that maximized the Youden index. MDD-W had poor positive correlation (ρ = 0.19, p < 0.001) and poor predictive ability (AUC = 0.62, 95% CI: 0.56, 0.67) (p < 0.001) with the Mean Adequacy Ratio in determining micronutrient intake adequacy. The sensitivity and specificity of the MDD-W in the ≥5 food groups standard cutoff were 25.2 and 82.3%, respectively. The optimal cutoff point for MDD-W to predict micronutrient intake adequacy was ≥3 food groups. Minimum Dietary Diversity for Women had a poor correlation and poor predictive ability in predicting micronutrient intake adequacy. The variations noted in studies and differences from the Food and Agriculture Organization recommendations regarding the cutoff and level of performance of MDD-W in defining micronutrient adequacy warrant further investigation.

Nutrients, Diet Quality, and Dietary Patterns in Patients with Inflammatory Bowel Disease: A Comparative Analysis.

(1) Background: Diet plays an important role in the development of inflammatory bowel disease (IBD). There are a number of methods available to assess the diets of patients with IBD, including nutrients, dietary patterns, and various appraisal tools of diet quality. However, research on diet quality and dietary patterns in IBD populations is limited, and comparative evaluations of dietary intake in patients with IBD have not been performed. (2) Objectives: The aim of this study was to assess nutrients, the dietary patterns, and diet quality of patients with IBD and to investigate the relationship between dietary patterns, diet quality, and the adequacy of nutrient intake. (3) Methods: Three-day food records of 268 patients with ulcerative colitis (UC) and 126 patients with Crohn's disease (CD) were collected to estimate nutrients and food groups, while dietary quality was assessed using the Dietary Inflammation Index (DII) and Mediterranean Diet Score (MDS). Dietary patterns were derived using principal component analysis (PCA). Participants' nutrient intake, diet quality, and dietary patterns were compared. We used binary logistic regression to assess the relationship between dietary patterns (independent variable) and nutritional adequacy (dependent variable). (4) Results: In our sample, patients had inadequate energy, protein, and dietary fiber intake compared with Reference Nutrient Intake (RNI). Regarding micronutrients, intakes of potassium, zinc, selenium, vitamin A, vitamin C, vitamin E, sodium, calcium, iron, niacin, thiamin, and riboflavin were inadequate. Regarding food groups, the highest intakes were fruits, legumes, dairy products, and nuts. PCA revealed four dietary patterns, namely DP1, DP2, DP3, and DP4. Among UC patients, 96, 55, 69, and 48 patients adhered to DP1, DP2, DP3, and DP4 dietary patterns, respectively. Among CD patients, 41, 31, 34, and 20 patients complied with the dietary patterns of DP1, DP2, DP3, and DP4, respectively. There was no significant difference in dietary patterns between UC and CD patients. Compared with DP4 (high intake of mixed legumes and low intake of tubers), DP1 (high intake of cereals, tubers, vegetables and eggs) was more likely to ensure adequate intake of energy (OR, 2.96; 95% CI, 1.55, 5.62), protein (OR, 2.05; 95% CI, 1.06, 3.96), carbohydrates (OR, 3.55; 95% CI, 1.51, 6.59), thiamine (OR, 2.59; 95% CI, 1.36,4.93), niacin (OR, 2.75; 95% CI, 1.39, 5.42), phosphorus (OR, 2.04; 95% CI, 1.08, 3.85), zinc (OR, 2.43; 95% CI, 1.28, 4.63), and manganese (OR, 3.10; 95% CI, 1.60, 5.90), and DP2 (high intake of fruits, poultry, aquatic products, and nuts) was more likely to meet niacin requirements than DP4 (OR, 2.65; 95% CI, 1.28, 5.48). (5) Conclusion: This study clarifies our understanding of dietary intake, diet quality, and dietary patterns in adult patients with IBD. Future attention is needed to improve diet quality, emphasizing the importance of assessing and understanding patient dietary habits and increasing understanding of the factors that influence dietary intake in IBD in order to achieve optimal outcomes for patients with IBD.

125 Could yeast derivatives change beef cattle water intake in different scenarios?

Abstract Adequate water intake is linked to greater dry matter intake, heat loss, and productivity. To measure the water intake of beef cattle reared in groups, two experiments were carried out in Brazil (South East/Middle East) using water throughs coupled with scales (Intergado, Betim, Brazil) and RFID individual identification systems, allowing the recording of individual water intake of animals. In experiment 1, young bulls (n = 96; 105 d on feed - feedlot) were randomly assigned to four treatments: 1) Control, no yeast derivative; 2) AY – 7 g·animal⁻¹·d⁻¹, Autolyzed Yeast grown on sugarcane molasses (RumenYeast, ICC, Brazil); 3) YM – 3 g·animal⁻¹·d⁻¹, yeast rich in soluble Yeast Metabolites; 4) YB – 5 g·animal⁻¹·d⁻¹, Yeast Blend (live Yeast plus autolyzed Yeast). Diets (adaptation, growing, and finishing) x treatments were treated as fixed effects on the complete randomized design. In experiment 2, backgrounding bull calves (n = 32) reared on grazing and 710 g/d of protein supplements (90 d) were randomly assigned to two treatments: 1) Control, no yeast derivative; 2) AY – 7 g·animal⁻¹·d⁻¹, Autolyzed Yeast (RumenYeast), the means were subjected to ANOVA analyses. In both experiments, additives were inserted into the diet (mineral premix or supplement), animals were the experimental unit, and differences were declared significant at P &amp;lt; 0.05. Yeast derivatives increased (P &amp;lt; 0.05) water intake in both experiments (Figure 1). The average increment in water intake (L·animal⁻¹·d⁻¹ was 13.9%. Interestingly, the increment in relation to control was noted for all yeast derivatives and scenarios covered by the experiments (feedlot adaptation diet, feedlot growing diet, feedlot finishing diet, and grazing system). Until now, there seems to be no literature explanation for our findings. However, these results could help to explain the positive effects of yeast derivatives on rumen pH, protein microbial flow, and thermal stress since greater water intake increases the passage rate of rumen fluid and body heat loss. Statistical correlations may not be understood as a cause-consequence link. However, when dealing with a new question, correlations may give us a path to go on and investigate. Malheiros et al. (2023) noted a negative correlation between water intake and rumen dimethylamine. Autolyzed yeast can strongly decrease the concentration of rumen methylamines in cows facing subacute acidosis (Humer et al., 2018). Niacin metabolism should also be investigated since its supplementation enhances cows’ blood niacin levels and water intake. Yeast derivatives are rich in niacin, and autolyzed yeast supplementation can increase blood niacin and body heat loss during summer (Dias et al., 2018), probably increasing water need. In conclusion, yeast derivatives increased the water intake of beef cattle, and this finding adds to the understanding of how yeast derivatives supplementation benefits ruminants.

Health-Related Behaviors and Perceived Health Status According to Water and Sugar-Sweetened Beverage Intake in Korean Adolescents.

The objective of this study was to determine the relationship between water and sugar-sweetened beverage (SSB) intake, health behaviors, and self-perceived health status using data from the 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS). The subjects included in this analysis were 57,302 Korean adolescents from the 7th to 12th grades. The intake patterns of water and SSBs were categorized into four groups: Group I, adequate water intake (≥4 cups/day) and low frequency of SSB intake (≤1-2 times/week); Group II, adequate water intake and high frequency of SSB intake; Group III, inadequate water intake (<4 cups/day) and low frequency of SSB intake; Group IV, inadequate water intake and high frequency of SSB intake (≥3 times/week). Complex sample analyses were used for considering strata, clusters, and weights for samples. Significant differences were observed in the distribution of sociodemographic characteristics between the water and SSB intake groups. As grade levels increased or if students were female, there was a significant increase in the proportion of students characterized by low water intake and high consumption of SSB. Adolescents with healthier beverage habits, characterized by adequate water intake and low frequency of SSB consumption (Group I), generally abstained from smoking and alcohol, were more physically active, and maintained a desirable diet, reporting a better perceived health status. In contrast, those with higher SSB consumption and inadequate water intake (Group IV) were more likely to perceive their health as poor, with higher rates of smoking and alcohol use, lower physical activity levels, and poorer dietary habits compared to Group I. In conclusion, adolescents with desirable beverage consumption habits differed by sex and grade and they reported positive health behaviors and better overall health status. This suggests that there is a need for more active education and intervention in schools and families, as well as increased efforts by adolescents to promote healthy beverage habits.

Dietary protein intake and its association with physical fitness test among older adults with pre-sarcopenia and sarcopenia: A cross-sectional study.

Low protein intake and physical inactivity are factors that associated with muscle deterioration and poor physical performance among older adults. To assess the association between dietary protein intake and physical fitness tests among older adults with pre-sarcopenia and sarcopenia. A total of 110 older adults were recruited through a convenience sampling method. Data including sociodemography, anthropometry, body composition, medical history, and dietary protein intake were obtained through the interview-administered method. Most of the subjects have low household income (<RM 3030) (90%), Malay ethnicity (66.4%), and are married (64.5%). 74.55% of the subjects were pre-sarcopenic, whereas 25.45% were sarcopenic. Those with sarcopenia were mostly underweight (± 21.78 kg/m2), whereas those with pre-sarcopenia had a slightly higher Body Mass Index (BMI) (± 27.30 kg/m2). Both men and women did not meet the dietary protein requirement (± 43.86 g/ day) based on the Recommended Nutrient Intake (RNI) of 2017. Moreover, both pre-sarcopenic and sarcopenic subjects have reduced functional ability. Although no significant differences were found in the Short Physical Performance Battery (SPPB) score, those with sarcopenia had poorer physical performance than those with pre-sarcopenia (82.1% versus 69.5%). Apart from that, there was a significant association between the 2-min step test (2MST) and dietary protein intake among those with pre-sarcopenia (r-value = 0.252). In conclusion, lifestyle interventions among older adults are important, including ensuring adequate protein intake and encouraging appropriate physical activity to enhance muscle mass, strength, and performance to improve their daily life efficiency and quality of life.

The association between dietary zinc intake and osteopenia, osteoporosis in patients with rheumatoid arthritis

BackgroundDiet has been shown to be associated with rheumatoid arthritis (RA), of which osteoporosis is the most common and important complication, and zinc has been shown to inhibit the inflammatory response, but studies on the relationship between dietary zinc and osteoporosis in patients with RA are limited and inconclusive. In this study, we aimed to explore the relationship between dietary zinc intake and osteoporosis or osteopenia in patients with RA.MethodsData on RA patients were derived from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2010, 2013 to 2014, and 2017 to 2020. Weighted univariate and multivariate logistic regression models were performed to explore the association between dietary zinc intake and osteoporosis or osteopenia in RA patients. The relationship was further investigated in different age, body mass index (BMI), nonsteroidal use, dyslipidemia, diabetes, and hypertension population. All results were presented as odds ratios (ORs) and confidence intervals (CIs).ResultsIn total, 905 RA patients aged ≥ 40 years were included. After adjusting all covariates, higher dietary zinc intake was associated with lower odds of osteopenia or osteoporosis (OR = 0.39, 95%CI: 0.18–0.86) in RA patients. The relationship between dietary zinc intake ≥ 19.52 mg and lower odds of osteopenia or osteoporosis were also found in those aged ≥ 60 years (OR = 0.38, 95%CI: 0.16–0.91), BMI normal or underweight (OR = 0.16, 95%CI: 0.03–0.84), nonsteroidal use (OR = 0.14, 95%CI: 0.02–0.82), dyslipidemia (OR = 0.40, 95%CI: 0.17–0.92), diabetes (OR = 0.37, 95%CI: 0.14–0.95), and hypertension (OR = 0.37, 95%CI: 0.16–0.86).ConclusionHigher dietary zinc intake was associated with reduced incidence of osteopenia or osteoporosis in patients with RA. Further longitudinal and randomized trials are necessary to validate our findings and explore the underling mechanisms. Adequate dietary zinc intake may beneficial to the bone health in RA patients.

Muscle Strength and Phase Angle Are Potential Markers for the Efficacy of Multidisciplinary Weight-Loss Program in Patients with Sarcopenic Obesity.

Background/Objectives: Traditional weight-loss methods often result in the loss of both fat and muscle mass. For individuals with sarcopenic obesity (SO), additional muscle loss can exacerbate sarcopenia, leading to further declines in muscle strength and function, ultimately worsening quality of life. To mitigate this risk, weight-loss strategies should emphasize the preservation and building of muscle mass through adequate protein intake and tailored resistance training. This study aimed to evaluate changes in SO status following a 4-week multidisciplinary weight-loss intervention program in hospitalized patients with obesity. Methods: This study included adult patients with obesity (BMI > 30 kg/m2, aged 18-90 years). The SO diagnosis was performed using the handgrip strength (HGS) test and skeletal muscle mass (SMM) by bioelectrical impedance analysis (BIA) according to ESPEN/EASO-2022 guidelines. Results: A total of 2004 patients were enrolled, 64.8% female, with a mean age of 56 (±14) years and a BMI of 40.7 (±6.48) kg/m2. SO was present in 9.38% (188 patients) at baseline. At discharge, 80 patients (42.55%) were no longer classified as sarcopenic and showed significant improvements in HGS. The likelihood of resolving SO was not modified in patients with only phase angle (PhA) improvement (p-value = 0.141). Patients with HGS increment had a 65% probability to be No-SO at discharge and this probability, with the concomitant PhA increment, rose to 93% (p-value < 0.0001), indicating that functional changes and good nutrition status are crucial in improvement of SO. Muscle mass (MM) and SMMI remained unchanged in the studied cohort. Conclusions: Improvements in HGS and the PhA are potential markers for the efficacy of weight-loss programs tailored to patients with SO. These findings suggest that specific interventions focusing on these markers could be beneficial in managing SO patients.

Effect of passive smoking on birth weight in pregnant women with vitamin D deficiency living in Turkey: A case control study.

Although vitamin D deficiency in smokers has a greater risk of low birth weight than vitamin D deficiency or smoking alone, there is no study searching birth weight in vitamin D deficient passive smokers. We evaluated the effect of vitamin D deficiency on birth weight in active and passive smokers. Additionally, we aimed to determine the predictive role of vitamin D for low birth weight in smokers. The study was designed as a retrospective case control study. A total of 210 participants were divided into three groups: active smoking (n = 34), passive smoking (n = 79), and non-smokers (n = 97). Then passive smokers were divided into two subgroups as vitamin D ≥ 20 ng/mL (n = 23) and vitamin D < 20 ng/mL (n = 56). Sociodemographic, laboratory, and perinatal characteristics were recorded and compared between groups. Birth weight was higher in non-smokers as compared to active (p < 0.001) and passive (p = 0.001) smokers, and also in passive than active smokers (p = 0.023). In passive smokers, birth weight was lower in vitamin D < 20 ng/mL group (p < 0.001). Vitamin D were correlated with birth weight in all smokers (r = 0.653, p < 0.001), passive (r = 0.624, p < 0.001) and active smokers (r = 0.526, p = 0.001). Vitamin D ≤ 14 ng/mL predicted low birth weight with 100% sensitivity and 53.92% specificity in smokers (area under curve [AUC] = 0.773, p < 0.001), with 100% sensitivity and 63.5% specificity in passive smokers (AUC = 0.759, p < 0.001) while vitamin D ≤ 11 ng/mL predicted with 83.33% sensitivity and 71.43% specificity in active smokers (AUC = 0.774, p = 0.008). Vitamin D deficiency in smokers is associated with low birth weight. Although vitamin D supplementation is not routinely recommended in pregnant women, we suggest that it could be an option in preventing low birth weight in smokers, even passive ones, who do not have adequate dietary intake and have insufficient exposure to daylight.

Risk factors associated with early childhood diarrhea: a case-control study

Purpose This study aims to explore the link between prevalent risk factors for early childhood diarrhea, including hygiene, feeding, weaning practices and maternal education and the occurrence and severity of early childhood diarrhea in Saudi Arabia. Design/methodology/approach A case-control study was conducted, involving 98 mothers from the Eastern Region of Saudi Arabia (51 cases and 47 controls). Data were collected from both hospital and community sources. The collected data were statistically analyzed and depicted using descriptive statistics and frequency tables. Findings Demographic data revealed that 60% of mothers were housewives, 75% had normal deliveries and all babies were full term. In the study cohort, 44% of children aged one to two years. Four domains were compared: diarrheal management, hygiene, weaning and feeding practices. Diarrheal management was suboptimal in some cases: 29% increased fluid intake, 10% maintained adequate food intake, 50% sought medical advice, 58% were familiar with oral rehydration solutions and only 37% used them. Hygiene practices were deficient, with 35% using wipes or sanitizers, 64% handwashing before feeding and 52% adhering to the recommended 10-s duration. Controls exhibited better hygiene practices. Weaning practices were generally similar, with no significant differences between the two groups. Originality/value To the best of the authors’ knowledge, this is the first study to collectively report on the risk factors linked to early childhood diarrhea in Saudi Arabia. This study yields significant insights, highlighting the crucial role of managing diarrhea, educating mothers and implementing proper household practices in impacting the occurrence and severity of this perilous ailment.

Dietary and Lifestyle Management of Functional Hypothalamic Amenorrhea: A Comprehensive Review.

Functional Hypothalamic Amenorrhea (FHA) is a condition characterized by the absence of menstruation, which is increasingly affecting young women. However, specific recommendations for treating and preventing this condition are lacking. Based on a review of the available literature, this article provides practical and feasible dietary management recommendations for healthcare professionals and researchers in women's health and nutrition. It answers the question of what interventions and nutritional recommendations are necessary to restore menstrual function in women struggling with FHA. Physicians recommend an energy availability threshold of 30 kcal/kg FFM/day to prevent FHA. Also, energy availability below and above this threshold can inhibit LH pulsation and cause menstrual disorders. In addition, the risk of menstrual disorders increases with a decrease in the caloric content of the diet and the duration of the energy deficit, and women with FHA have significantly lower energy availability than healthy women. It is essential to ensure that adequate kilocalories are provided throughout the day (regular meals that are a source of proper glucose) to avoid a negative energy balance, as glucose has been proven to affect LH pulses and T3 and cortisol concentrations in the body. Dietary intervention should focus on increasing the caloric content of the diet, thus increasing energy availability and restoring energy balance in the body. Treatment and diagnosis should also focus on body composition, not just body weight. An increase in body fat percentage above 22% may be required to restore menstrual function. In women with FHA, even an increase in body fat mass of one kilogram (kg) increases the likelihood of menstruation by 8%. It is advisable to reduce the intensity of physical activity or training volume, while it is not advisable to give up physical activity altogether. It is also important to ensure adequate intake of micronutrients, reduce stress, and incorporate cognitive-behavioral therapy.

Current concept of osteoporosis diagnosis and treatment in children

Osteoporosis (OP) is a disease characterized by a decrease in bone strength, leading to an increased risk of fractures. Bone fragility in children may be due to genetic disorders, chronic underlying conditions or taking medications that negatively affect bone metabolism. The article considers the modern classification of OP in children, approaches to its diagnosis, the role of dual-energy X-ray absorptiometry for diagnosis.The main goal of OP prevention and treatment is to achieve a higher peak of bone mass, improve bone microarchitectonics, and, as in adults, reduce the risk of fractures, prevent skeletal deformities, improve mobility, independence and quality of life. Recommendations for lifestyle changes are presented, including adequate calcium intake and vitamin D, taking antiresorptive drugs, as well as prospective management of children with OP.

Self-Determination, Optimism, Social Support, Knowledge, and Skills Have a Positive Influence on the Oral Intake of Long-Stay Acute Patients: A Qualitative Study

BackgroundAlthough previous research has attempted to understand the barriers and enablers of oral intake in hospitalized patients, these studies have mainly focused on short-stay inpatients and lacked a theory-driven examination of the determinants that influence dietary behavior in the hospital. ObjectiveTo explore and compare the factors influencing adequate and poor oral intake in long-stay acute patients (admitted >14 days). DesignA qualitative descriptive study with semistructured interviews. Participants/settingTwenty-one adult inpatients (13 men, 8 women) admitted to 2 medical and 2 surgical wards at a tertiary hospital in Brisbane, Australia, during 2022, stratified by the Subjective Global Assessment. Analysis performed Transcripts were initially deductively analyzed against the Theoretical Domains Framework, and a reflexive thematic approach was used to create overall themes. ResultsOf the 21 included patients (median age = 68.0 years, IQR 34 years), 11 had adequate/improved intake and 10 poor/decreased intake. Six themes were identified to have influenced oral intake in long-stay patients: self-determination to eat; nutrition impact symptoms; foodservice characteristics and processes; nutrition-related knowledge and skills; social support; and optimism, emotions, and emotion regulation. Patients with adequate/improved oral intake were characterized by an autonomous motivation to eat. They had increased awareness about their nutritional status, knowledge, and skills about food for recovery, were more optimistic, and social support was an important enabler to eating. In contrast, patients with poor/decreased oral intake perceived nutrition impact symptoms and dislike of meals as the main barriers to eating in the hospital; however, they also expressed more negative emotions, reduced coping strategies, and decreased knowledge, skills, intrinsic motivation, and capabilities to eat. Social support was present but did not enable oral intake in this patient group. ConclusionsThis study provides novel insights into the factors that influenced oral intake in long-stay acute patients, highlighting the importance of patient-centered nutrition care, encompassing motivational interviewing techniques and collaboration from the multidisciplinary team to create a supportive environment that fosters autonomy and empowers patients to actively participate in their own nutrition and recovery.

Application of Antioxidants in Curing Respiratory and Pulmonary Disorders

Abstract: Since a couple of decades, respiratory ailments have emerged as a significant public health issue. Numerous primitive civilizations acknowledged the need to relieve the inflamed airways and nasal passages oxidants are a persistent danger to the lungs since they can be produced either intracellularly by metabolic processes (such as mitochondrial electron transfer during respiration or during phagocyte activation) or from another source such as tobacco smoking or air pollutants. It is likely to be advantageous to target oxidative stress with antioxidants or increase endogenous antioxidant levels in the treatment of COPD, asthma, and COVID-19. In trials on both human beings and animals, the administration of small antioxidants via the intratracheal, oral, and vascular routes exhibited only minimal therapeutic potential against short- and long-term oxidative stress. Lipids, proteins, and nucleic acids all respond to oxygen in quick and practical ways. For the ROS (reactive oxygen species) system to run properly, it requires adequate oxidation-reducing components, like vitamins and antioxidants intake. Numerous nutrients, including vitamins such as vitamin A, vitamin B etc., minerals (magnesium, zinc, and iron), flavonoids, and fatty acids, have prominent functions in reducing the likelihood of viral diseases and chronic lung disorders. In this review, the applications of antioxidants in the prevention of respiratory diseases are discussed along with some reported nutraceuticals being used in respiratory disease and patents. The applications of antioxidants in preventing and managing respiratory diseases are discussed in this review, shedding light on the importance of ongoing research in this field. Nutraceuticals, which combine the benefits of nutrition and pharmaceuticals, are also explored as potential solutions for respiratory health.

Prevalence of inadequate fruit and vegetable consumption and associated food choice motives among adults in an urban population in Kerala.

Existing literature does not account for food choice motives associated with the non-communicable disease risk factor of an unhealthy diet, primarily characterised by inadequate fruit and vegetable consumption, among adults residing in Kochi Municipal Corporation. Our study aims to measure the prevalence of inadequate fruit and vegetable consumption in this urban population and to identify priority food choice motives among individuals at risk. A community-based cross-sectional study was conducted among 300 adults (mean age 46 years, men 50%) selected by cluster sampling. Information on socio-demographic variables, diet, and food choice motives was collected through a pre-tested structured interview schedule. Binary logistic regression analysis was done to identify factors associated with inadequate fruit and vegetable consumption. In our study, 86% (95% CI: 82.07-89.93) of participants reported inadequate fruit and vegetable consumption. The food choice motives of "price" [aOR 2.99, 95% CI: 1.32-6.78], "health" [aOR 2.56, 95% CI: 1.08-6.24], and "sensory appeal" [aOR 2.20, 95% CI: 1.06-4.56] were found to be significantly associated with inadequate fruit and vegetable consumption per day (P < 0.05). The high prevalence of inadequate fruit and vegetable consumption in this urban community necessitates targeted and comprehensive educational campaigns that highlight the health benefits and sensory appeal of fruits and vegetables, as well as the affordability of seasonal produce, to ensure adequate intake of these foods.

Managing Injuries and Utilizing Protein: A Literature Review on Strategies for Enhancing Athletic Performance in Modern Sports Health

This study aims to assess the impact of protein utilization and injury management on enhancing athletic performance and recovery in modern sports. Utilizing a qualitative descriptive research model, the study involves a comprehensive review of literature from reputable scientific databases such as Scopus, ScienceDirect, and Google Scholar. Keywords such as "Injury Management," "Protein Utilization," and "Athletic Performance" guided the search for relevant studies. The analysis reveals that adequate protein intake and balanced nutrition are vital for muscle repair, reducing muscle damage, and accelerating recovery following injury or intense exercise. The findings emphasize that effective nutritional strategies not only support recovery but also contribute to injury prevention and overall performance improvement. Personalized nutrition plans tailored to individual needs and specific conditions, including those of athletes with spinal cord injuries or from various sports disciplines, are crucial for optimizing outcomes. The study highlights that integrating protein and nutritional strategies into training and recovery programs can significantly enhance athletic performance and reduce the risk of injuries. Effective injury management, coupled with appropriate protein utilization, plays a pivotal role in achieving better recovery rates and improving overall health. By adopting these evidence-based strategies, athletes can better meet their performance goals and enhance their overall well-being. This research underscores the importance of a comprehensive and personalized approach to nutrition and injury management in sports health, offering valuable insights for optimizing athletic training and recovery practices