Intake Of Other Nutrients Research Articles

Food Consumption and Dietary Patterns of Local Adults Living on the Tibetan Plateau: Results from 14 Countries along the Yarlung Tsangpo River.

The distinct Tibetan regional diet is strongly influenced by the regional biogeography, indigenous traditions, popular religious beliefs and food taboos. In the context of the nutritional transition in Tibet, studies seldom report on the food consumption and dietary patterns of Tibetan residents. This is a cross-section study of 552 local adults (≥18 years old, 277 men and 275 women) living in 14 agricultural countries along the Yarlung Tsangpo River. Dietary intakes were assessed by a culturally specific FFQ and compared with the Chinese Dietary Pagoda (2016). Dietary Patterns were extracted by using PCA method. The binary logistic regression model was applied to assess the association between independent variables (genders, regions and age groups) and adherence to dietary patterns. With the exception of meat (100 ± 260 g/day) and soybean nuts (42 ± 12 g/day), which exceeded the recommended dietary intakes of CDP, the dietary intake of other foods were not up to the recommended value. In particular, the intake of aquatic products (2 ± 0.1 g/day), vegetables (90 ± 19 g/day), dairy products (114 ± 29 g/day), cereals (117 ± 27 g/day) and fruits (97 ± 25 g/day) were seriously inadequate, which were 95%, 70%, 62%, 53.2% and 51.5% lower than the recommended intakes, respectively. Four dietary patterns were identified. “Local traditional diet” was characterized by a high intake of tsampa (roasted highland barley flour), culturally specific beverages (sweet tea and yak buttered tea), potato and yak beef and was associated with female, rural and older adults (≥51 years old). The male, urban and 18~30 years old group had a higher adherence score with the “Han diet”, which was comprised of rice, pork, dumplings, eggs, milk and cabbage. The “Beverage diet”, which mainly include tsampa, chang (homemade barley wine) and sweet tea, was associated with the following group: female, urban and aged 18~30 years. The “Out-sourced diet” pattern, consisting of mainly rice, steam bread and some processed meat, was associated with being male, urban and 18–30 years of age. These findings indicate that the dietary practice of the Tibetan people still has strong local characteristics, but it is also undergoing a dietary transition with the penetration of the Chinese Han diet and the increased consumption of outsourced (processed) foods. The unbalanced dietary intake of Tibetan residents should be taken seriously by all parties.

Association Between Dietary Intake and Serum Uric Acid Levels in Kidney Transplant Patients

The aim of this study was to evaluate the association between dietary intake and uric acid (UA) levels in kidney transplant patients (KTPs). A cross-sectional study was performed with 113 KTPs. Dietary intake assessment was carried out thorough two 24-hour dietary recalls using the 5-step multiple pass method. We evaluated the intake of energy, carbohydrate, total protein, animal protein, vegetable protein, total fat, saturated fat, trans fat, monounsaturated fat, polyunsaturated fat, omega-3 and omega-6 fatty acids, cholesterol, total sugar, added sugars, total fiber, insoluble fiber, soluble fiber, alcohol, caffeine, fructose, glucose, lactose, sucrose, vitamin A, vitamin C, vitamin E, and calcium. The intake of several food groups (portions) was also evaluated. Hyperuricemia was classified as >7.0 and >6mg/dL for men and women, respectively. In odds ratio analyses, the individuals who ingested more vegetable protein (g/kg) and caffeine (mg) presented lower chance to have hyperuricemia. In linear regression, animal protein (g) intake was positively associated (β=0.011, P=.048), while vegetable protein (g/kg) intake was inversely associated (β=-2.45, P=.047) with serum UA. However, after a multiple linear regression including vegetable and animal protein intakes together, only vegetable protein intake remained associated with UA. The intake of other nutrients and portions of food groups was not associated with UA. All the analyses were adjusted for sex, age, hypertension, body mass index, glomerular filtration rate, use of medicines, and caloric intake misreporting. Vegetable protein and caffeine intakes were inversely associated with UA in KTPs.

Nutritional problems in smokers and passive smokers

Objective: active or passive tobacco use affects a high percentage of individuals and is associated with various health risks. The aim of this review was to look more closely at the nutritional problems that are specific of smokers, which may harm their health. Methods: a bibliographic search related to the topic. Results: smokers consume lower amounts of various foods, especially fruits, vegetables, cereals and dairy. As a result, their intake of vitamins, minerals, and phytochemicals is lower than that observed in non-smokers. Their consumption of meat, caffeine and alcohol is usually higher, and their activity lower than those of non-smokers, coexisting in smokers unhealthy behaviors that contribute to harming their health and quality of life. Oxidative stress and metabolic changes render the needs for some nutrients higher in smokers to achieve the same biochemical situation as in non-smokers. Recommended intakes of vitamin C have increased, but it will probably be necessary to also increase the intakes of other nutrients. In general, smokers suffer from deficiencies more frequently (vitamins C, E, β-carotene, B1, B2, B12, folic acid, calcium, magnesium, iron, iodine, etc.) than non-smokers. Passive smokers are also affected in their eating habits and nutritional status. Conclusions: the worse nutritional status of smokers can contribute to the appearance/worsening of various diseases associated with smoking (cardiovascular, cancer, cataracts, osteoporosis, etc.); therefore, nutritional surveillance and correction of nutritional deficiencies could represents health benefits for smokers and passive smokers, which should be considered in the future.

Predictors of Plasma Fluoride Concentrations in Children and Adolescents.

Despite increasing concerns about neurotoxicity of fluoride in children, sources of fluoride exposure apart from municipal water fluoridation are poorly understood. We aimed to describe the associations of demographics, drinking water characteristics, diet, and oral health behaviors with plasma fluoride concentrations in U.S. children. We used data from 3928 6–19-year-olds from the 2013–2016 National Health and Nutrition Examination Survey. We used a 24-h dietary recall to estimate recent consumption of fluoridated tap water and select foods. We estimated the associations of fluoridated tap water, time of last dental visit, use of toothpaste, and frequency of daily tooth brushing with plasma fluoride concentrations. The participants who consumed fluoridated (≥0.7 mg/L) tap water (n = 560, 16%) versus those who did not had 36% (95% CI: 22, 51) higher plasma fluoride. Children who drank black or green tea (n = 503, 13%) had 42% higher plasma fluoride concentrations (95% CI: 27, 58) than non-tea drinkers. The intake of other foods and oral health behaviors were not associated with plasma fluoride concentrations. The consumption of fluoridated tap water and tea substantially increases plasma fluoride concentrations in children. Quantifying the contribution of diet and other sources of fluoride is critical to establishing safe target levels for municipal water fluoridation.

Expert Opinion on Benefits of Long-Chain Omega-3 Fatty Acids (DHA and EPA) in Aging and Clinical Nutrition.

Life expectancy is increasing and so is the prevalence of age-related non-communicable diseases (NCDs). Consequently, older people and patients present with multi-morbidities and more complex needs, putting significant pressure on healthcare systems. Effective nutrition interventions could be an important tool to address patient needs, improve clinical outcomes and reduce healthcare costs. Inflammation plays a central role in NCDs, so targeting it is relevant to disease prevention and treatment. The long-chain omega-3 polyunsaturated fatty acids (omega-3 LCPUFAs) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are known to reduce inflammation and promote its resolution, suggesting a beneficial role in various therapeutic areas. An expert group reviewed the data on omega-3 LCPUFAs in specific patient populations and medical conditions. Evidence for benefits in cognitive health, age- and disease-related decline in muscle mass, cancer treatment, surgical patients and critical illness was identified. Use of DHA and EPA in some conditions is already included in some relevant guidelines. However, it is important to note that data on the effects of omega-3 LCPUFAs are still inconsistent in many areas (e.g., cognitive decline) due to a range of factors that vary amongst the trials performed to date; these factors include dose, timing and duration; baseline omega-3 LCPUFA status; and intake of other nutrients. Well-designed intervention studies are required to optimize the effects of DHA and EPA in specific patient populations and to develop more personalized strategies for their use.

FAKTOR-FAKTOR YANG MEMPENGARUHI PENGETAHUAN IBU MENYUSUI TENTANG CARA MENINGKATKAN PRODUKSI ASI

Mother's Knowledge of How to Increase Breast Milk Production is a mother's effort to increase milk production in order to be able to provide exclusive breastfeeding to her baby until the age of 6 months without intake of other foods or drinks. If a baby is not given breast milk and is replaced with other fluids / foods other than breast milk, the baby will not get immunity, and will be malnourished. In the absence of antibodies, the baby will be susceptible to various diseases and increase infant mortality. So that the knowledge of parents greatly affects the increase in breast milk production. The aim of this study is to determine the factors that affect the knowledge of breastfeeding mothers about how to increase breast milk production in the kramat teak sub-district health center, East Jakarta. Sampling using accidental sampling. The research instrument used a questionnaire. This research method uses umivariate analysis. The results of the study there is a significant or significant relationship between education and information owned by mothers, but there are two variables that have no significant or significant relationship, namely parity and family support.The importance of providing education or information on how to increase milk production.

Calcium, Phosphorus, and Niacin Intakes During Late Pregnancy Are Positively Associated with Maternal Bone Mineral Density: A Pilot Study

Abstract Objectives The adequate calcium intake during pregnancy on postpartum bone mineral density (BMD) and neonatal outcomes are unknown as results of recent intervention trials are inconsistent. We investigated the relationship between maternal nutrient intake and maternal BMD at delivery, newborn birth outcomes, and maternal bone loss during lactation in Korean mothers. Methods Thirty Korean pregnant women (mean age: 34 years) were enrolled before delivery. Maternal food and supplement intake and BMD were assessed twice: at delivery (T1) and at weaning or 6 months postpartum (T2). Third trimester and postpartum food intake was assessed by food frequency questionnaire at T1 and T2, respectively, and analyzed for intake of calcium and 22 major nutrients. Calcium intake was assessed as a continuous variable or categorized as < or ≥500 mg/d. Maternal lumbar spine (LS), femoral neck (FN), trochanter, and intertrochanter BMD were measured by dual energy X-ray absorptiometry. Birth length, birth weight, and head circumference of neonates were collected. Participants were categorized according to duration of lactation. General linear models were adjusted for covariates. Results Mean ± STD calcium intake was 905 ± 430 mg/d at T1 and 608 ± 227 at T2 (change: P = 0.05). Women with calcium intakes <500 mg/d had lower LS BMD at T1 (P = 0.026). No difference was detected at other study sites. Phosphorus and niacin intakes during the third trimester were positively correlated with T1 LS BMD (ß: 0.162 and 0.088, respectively; both P < 0.05). Birth weight and head circumference were negatively associated with T1 iron intake(ß: −9.065 and −0.0292, respectively; both P < 0.05). Intake of other nutrients during late pregnancy were not associated with maternal T1 BMD or neonatal outcomes. Among the 10 participants that completed the second visit, 6 women breastfed. Postpartum bone change was not associated with breastfeeding. Energy intake at T2 was negatively associated with change in FN BMD (ß: −0.007, P < 0.001). Postpartum intake of other nutrients was not associated with change of BMD at any site. Conclusions Intakes of calcium, phosphorus, and niacin during the third trimester are positively associated with maternal LS BMD, but not neonatal birth outcomes, in Koreans. Breastfeeding and postpartum calcium intake may not affect bone after birth. Funding Sources National Research Foundation of Korea.

Accuracy of 24-Hour Diet Recalls in Older Korean Women

Abstract Objectives Despite the wide use of 24-hour diet recalls, its validity has not been investigated in Korean women. The purpose of this study was to assess the accuracy of 24-hour diet recalls in older Korean women. Methods Twenty-two women (mean age: 55.1 years) participating in a 5-day controlled-feeding study were randomly selected and interviewed. Interviews were conducted according to the 5-step multiple-pass method and the protocol of the Korea National Health and Nutrition Examination Survey. Recalled food items were compared to provided foods and matched as: exact, close, or far. The proportion of foods consumed but not reported (exclusions), and number of intrusions (reported but not consumed) were investigated. Accuracy of recalled foods was also analyzed according to Korean food culture (rice, soup, kimchi, side-dish, sauce, snack, and drink). Duplicate meals were weighed, homogenized, and freeze dried. Nutrient content of recalls and recipes of provided food were analyzed by CAN-Pro 5.0 software. Food composites were analyzed for select minerals by inductively coupled plasma optimal emission spectrometer (ICP-OES). Data were analyzed by paired t-test or Wilcoxon Signed-Rank test. Results Among the foods reported, 74% were exact matches. When analyzed according to Korean food culture, kimchi (91%), followed by snacks (81%), side dishes (74%), rice (67%), and drinks (66%), had a higher proportion of exact matches than soup (59%) and sauces (13%). Sauce also had the highest rate of exclusions (21.6%). Only one intrusion happened during the study period (kimchi). The participants reported significantly lower intakes of sodium (mean difference: −1270.0 mg; P < .0001) and fat (mean difference: −11.5 g; P = 0.0003) compared to actual recipes analyzed by CAN-Pro software. Reported intake of other nutrients were similar to actual recipes. However, phosphorus, sodium, potassium, and iron intakes appeared greater when recipes were analyzed by CAN-Pro compared to analysis of duplicate diets by ICP-OES. Conclusions This study is the first to assess the accuracy of 24-hour recalls in Korean women. Older Korean women may accurately recall their dietary intake. However, the Korean nutrient analysis software may not accurately represent mineral intake. Further research in free-living individuals is required. Funding Sources The Ministry of Oceans and Fisheries, Korea.

Therapeutic Potential of Proanthocyanidins in Ulcerative Colitis in Remission.

A number of bioactive components of diet are indicated as potential dietary factors for the management of ulcerative colitis, while the recent study conducted in an animal model revealed that proanthocyanidins from grape seeds exert a broadly positive impact. The aim of the study was to verify the influence of dietary proanthocyanidins intake on the symptoms of ulcerative colitis in remission in human subjects. The study was conducted in a group of 55 participants (19 males, 36 females) in remission of ulcerative colitis confirmed based on both the Mayo Scoring system and Rachmilewitz index. Their habitual dietary intake of proanthocyanidins and intake recalculated per 1000 kcal of diet was assessed and it was verified whether they are associated with symptoms of ulcerative colitis. The energy value of diet and intake of other nutrients were analyzed as potential interfering factors. Participants declaring the presence of mucus in their stool compared with other participants were characterized by higher proanthocyanidins intake (142 vs. 75 mg; p = 0.0441) and intake per 1000 kcal (91 vs. 37 mg/1000 kcal; p = 0.0092), while for no other nutrient such association was stated. Participants declaring constipation compared with other participants were characterized by higher proanthocyanidins intake (214 vs. 82 mg; p = 0.0289) and intake per 1000 kcal (118 vs. 41 mg/1000 kcal; p = 0.0194). Similar association for constipation was observed in the case of energy value of diet and protein intake, but only for proanthocyanidins intake, it was confirmed in the logistic regression model (p = 0.0183; OR = 1.01; 95% CI 1.00–1.02). The positive influence of habitual dietary intake of proanthocyanidins was confirmed in the studied group of patients with ulcerative colitis in remission, as this intake may have increased the production of mucus, which is beneficial for intestinal healing, and may have reduced the frequency of bowel movements. However, further experimental human studies are necessary to confirm the potential influence of proanthocyanidins intake in patients with ulcerative colitis in remission.

Reductions to main meal portion sizes reduce daily energy intake regardless of perceived normality of portion size: a 5\u2009day cross-over laboratory experiment

BackgroundSmaller portions may help to reduce energy intake. However, there may be a limit to the magnitude of the portion size reduction that can be made before consumers respond by increasing intake of other food immediately or at later meals. We tested the theoretical prediction that reductions to portion size would result in a significant reduction to daily energy intake when the resulting portion was visually perceived as ‘normal’ in size, but that a reduction resulting in a ‘smaller than normal’ portion size would cause immediate or later additional eating.MethodsOver three 5-day periods, daily energy intake was measured in a controlled laboratory study using a randomized crossover design (N = 30). The served portion size of the main meal component of lunch and dinner was manipulated in three conditions: ‘large-normal’ (747 kcal), ‘small-normal’ (543 kcal), and ‘smaller than normal’ (339 kcal). Perceived ‘normality’ of portion sizes was determined by two pilot studies. Ad libitum daily energy intake from all meals and snacks was measured.ResultsDaily energy intake in the ‘large-normal’ condition was 2543 kcals. Daily energy intake was significantly lower in the ‘small-normal’ portion size condition (mean difference − 95 kcal/d, 95% CI [− 184, − 6], p = .04); and was also significantly lower in the ‘smaller than normal’ than the ‘small-normal’ condition (mean difference − 210 kcal/d, 95% CI [− 309, − 111], p < .001). Contrary to predictions, there was no evidence that the degree of additional food consumption observed was greater when portions were reduced past the point of appearing normal in size.ConclusionsReductions to the portion size of main-meal foods resulted in significant decreases in daily energy intake. Additional food consumption did not offset this effect, even when portions were reduced to the point that they were no longer perceived as being normal in size.Trial registrationProspectively registered protocol and analysis plan: https://osf.io/natws/; retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT03811210.

Changes in Dietary Intake in Pregnant Women from Periconception to Pregnancy in the Japan Environment and Children's Study: A Nationwide Japanese Birth Cohort Study.

Nutritional requirements increase during pregnancy. However, relatively few studies have examined longitudinal changes in dietary intake from periconception to pregnancy. Here, we investigated changes in the intake of food and nutrients, and compliance with dietary reference intakes (DRIs) in pregnant women. The Japan Environment and Children's Study, a nationwide multicenter prospective cohort study, included 30,373 pregnant women who answered a validated food frequency questionnaire repeatedly to assess changes in dietary intake in periconception and pregnancy. Energy-adjusted intakes of food groups and nutrients were described using the density method. The percentage of women not meeting DRIs was calculated. Of all foods groups examined, intake of food significantly increased from periconception to pregnancy for dairy products (mean difference 23.5g/1000kcal, 95% confidence interval [CI] 22.0-25.0g/1000kcal), confectionaries (2.0g/1000kcal, 1.8-2.2g/1000kcal), and soft drinks (1.3g/1000kcal, 0.3-2.3g/1000kcal). Of all nutrients examined, intake was significantly increased for calcium (mean difference 27mg/1000kcal, 95% CI 25-29mg/1000kcal), vitamin A (15 μgRE/1000kcal, 13-18g/1000kcal), and saturated fat (0.4% energy, 0.4-0.4% energy). The percentage of women not meeting DRIs increased for vitamin B group, vitamin C, saturated fat and salt. We found that energy-adjusted intakes of calcium, vitamin A, and saturated fat increased from periconception to pregnancy, while intake of other nutrients did not increase. The percentage of women not meeting DRIs increased for water-soluble vitamins, saturated fat, and salt.

Intake of Boiled Potato in Relation to Cardiovascular Disease Risk Factors in a Large Norwegian Cohort: The HUNT Study.

Overall potato consumption is positively associated with cardiovascular disease (CVD) risk factors, such as measures of adiposity. However, few studies have explicitly stated the preparation method of potatoes, which may impact these associations. We examined cross-sectional associations between self-reported dietary intake of boiled potatoes and levels of body mass index, waist circumference, blood pressure, and blood lipids among 43,683 participants in the HUNT Study, Norway in 2006–2008. All estimated associations were adjusted for possible imbalance in age, sex, physical activity, smoking, intake of other foods and alcohol between categories of boiled potato consumption. Overall, there were no large differences in mean levels of CVD risk factors between categories of boiled potato consumption. Compared to the reference group of individuals who consumed boiled potatoes less than once/week, those who reported eating boiled potatoes every day had slightly higher prevalence of high waist circumference (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.05–1.29), high triglycerides levels (OR 1.20, 95% CI 1.07–1.34), and metabolic syndrome (OR 1.17, 95% CI 1.03–1.33). In summary, consumption of boiled potatoes showed weak and small associations with the CVD risk factors under study, but the cross-sectional design prevents us from drawing any firm conclusions.

Portion size normality and additional within-meal food intake: two crossover laboratory experiments.

Reducing food portion size could reduce energy intake. However, it is unclear at what point consumers respond to reductions by increasing intake of other foods. We predicted that a change in served portion size would only result in significant additional eating within the same meal if the resulting portion size was no longer visually perceived as 'normal'. Participants in two crossover experiments (Study 1: n 45; Study 2: n 37; adults, 51 % female) were served different-sized lunchtime portions on three occasions that were perceived by a previous sample of participants as 'large-normal', 'small-normal' and 'smaller than normal', respectively. Participants were able to serve themselves additional helpings of the same food (Study 1) or dessert items (Study 2). In Study 1 there was a small but significant increase in additional intake when participants were served the 'smaller than normal' compared with the 'small-normal' portion (m difference = 161 kJ, P = 0·002, d = 0·35), but there was no significant difference between the 'small-normal' and 'large-normal' conditions (m difference = 88 kJ, P = 0·08, d = 0·24). A similar pattern was observed in Study 2 (m difference = 149 kJ, P = 0·06, d = 0·18; m difference = 83 kJ, P = 0·26, d = 0·10). However, smaller portion sizes were each associated with a significant reduction in total meal intake. The findings provide preliminary evidence that reductions that result in portions appearing 'normal' in size may limit additional eating, but confirmatory research is needed.

Adequacy of Nutrients Intake among Jordanian Pregnant Women in Comparison to Dietary Reference Intakes.

Objective: Maternal nutrition is considered an important pillar in the pregnancy outcomes for both mother and infant. A mother’s malnutrition and inadequate nutrient intake is associated with many undesirable pregnancy outcomes. Hence, assessing the nutritional status of the mother in the early stages of the pregnancy and preventing any inadequacy can preclude many health problems for both mother and infant. Therefore, this study aimed to assess the adequacy of nutrient intakes among Jordanian pregnant women as compared to their corresponding dietary reference intakes (DRIs). Methods: This cross-sectional study was conducted at a major University Hospital in Jordan. Three hundred pregnant women were invited to participate in the study and 286 agreed to participate. Fifty pregnant women were enrolled at week 9, then 96 pregnant women were at week 20 and 137 pregnant women were at week 30 of pregnancy. The participants completed the interview-based demographic questionnaire, pregnancy physical activity questionnaire, and quantitative food frequency questionnaire (FFQ). Results: The mean energy intake was 2768.9 ± 767.8 kcal/day and it was significantly higher in the 3rd trimester (p < 0.05). Women in the 3rd trimester consumed significantly more protein, carbohydrates, and sugar than women in the 1st and 2nd trimesters (p < 0.05). The pregnant women in the 3rd trimester consumed more sodium than women in the 1st and 2nd trimesters (p < 0.05). The vitamin K intake was significantly (p = 0.045) lower in the 2nd trimester than the 1st and 3rd trimesters. The calcium intake was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p = 0.021). The total micronutrient (vitamins B1, B2, B3, B6, B12, and D, calcium, and iron) intakes derived from dietary supplements and food sources throughout the 3 trimesters was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p < 0.05). The vitamin D, calcium, and iron intakes had the most significant increases between the 1st and 3rd trimesters (p < 0.001), while folic acid intake was significantly higher in the 1st trimester than the 2nd and 3rd trimester (p < 0.001). Most women exceeded the tolerable upper intake level (UL) for sodium in all trimesters, while 82% of women exceeded the UL of folic acid in the 1st trimester and from the supplement, not the diet. Conclusion: While the intake of some nutrients from food alone remains below the DRIs in the diets of pregnant women, the intake of other nutrients is above the UL. Raising the awareness of pregnant women about their diet and how a supplement intake can reduce the risk of inadequate intake for many micronutrients and improve their pregnancy outcomes is of great importance.

Displacement of Household Foods by Fortified Blended Flours versus Lipid-based Supplements in Complementary Feeding of Children Aged 6–23 Months in Burkina Faso (OR21-03-19)

ObjectivesLipid-based nutritional supplements (LNS) and fortified blended flours (FBF) are widely used to increase the nutrient density of children’s diets and improve their health, but studies of supplementation have shown relatively modest improvements in linear growth. One mediating factor could be displacement of other foods. This study used food frequency data from a supplementation trial that compared FBF to a lipid-based product. We hypothesized that FBFs, which are typically boiled and fed to the infant as porridge, would displace starchy staples more often than lipid-based supplements, which can be eaten directly by the child. MethodsWe re-analyzed data from a cost-effectiveness trial designed to compare impacts on anthropometry among infants aged 6–23 months in Burkina Faso of three FBFs versus one LNS. Using food frequency dietary data from a single 24-hour recall period from the original study (n = 1612 children, observed once over 18-month study period), we fit logistic regression models to estimate differences in intake of each food group (grains, legumes and nuts, dairy, flesh foods, fruits and vegetables, vitamin A rich foods, and eggs), and used linear models to test for differences in a diet diversity score between children who received FBF and those who received LNS. We also tested for differences in breastfeeding time using the sub-sample for which that outcome was observed (n = 193). ResultsChildren who consumed FBF were 54% less likely to consume the family’s cereal grains than those who were fed LNS (OR = 0.46; 95% CI: 0.29, 0.73). Intake of other foods, diet diversity and breastfeeding time did not differ significantly between the two study arms. ConclusionsFortified blended flours displaced the household’s own cereal grains more than lipid-based supplements did, with no difference in the child’s consumption of other more nutrient-rich family foods. Given limited stomach capacity and feeding time, providing fortified cereals can help improve children’s overall diet quality in settings where children would otherwise be fed nutrient-poor starchy staples. Funding SourcesUnited States Agency for International Development, Office of Food for Peace. Supporting Tables, Images and/or Graphs▪▪

The portion size effect and overconsumption – towards downsizing solutions for children and adolescents – An update

AbstractThe portion size effect (PSE), where more is eaten when large amounts are offered, is robust, reliable and enduring. Although it is not known what drives the PSE, amount served may act as a guide to how much should be eaten. Over time, consumers become accustomed to particular amounts of food as the ‘social norm’ and so large portion sizes are treated as typical. For children and adolescents who are forming eating habits, long‐term exposure to large portion sizes of snacks and meal items may encourage overconsumption. Therefore, offering smaller portions to suit the age and stage of children and young people should offer a potential solution to the PSE. We have developed a series of downsizing strategies to test the effect of providing smaller portions of snacks and meal items in pre‐school children, adolescents and families. One potential consequence of downsizing is that compensation may occur, in which smaller portion sizes drive intake of other foods. Therefore, in examining downsizing strategies, measures of compensation elsewhere in the meal or across the overall diet are important. Our studies indicate that it is both feasible and desirable to offer ‘me‐sized’, smaller portions for children to facilitate portion control as food preferences and eating habits are developed. However, strategies for young adults and adolescents are more challenging and require further investigation.

Low Dietary Protein Intakes and Associated Dietary Patterns and Functional Limitations in an Aging Population: A NHANES Analysis

ObjectiveTo investigate protein intakes across demographic characteristics in relation to dietary patterns and functional outcomes in older adults.DesignObservational and cross-sectional study.SettingNon-institutionalized participants from the 2005–2014 National Health and Nutrition Examination Survey.ParticipantsData from 11,680 adults were categorized into 51–60 years (n= 4,016), 61–70 years (n=3,854), and 71 years and older (n=3,810) for analysis.MeasurementsAdults were stratified by meeting or not meeting the protein recommendation (0.8 g/kg/d) to compare demographics, diet quality with Healthy Eating Index– 2015, functional limitations, and other dietary intakes. Dietary recalls were collected using the multiple pass method. Data analyses were weighted to create a nationally–representative sample.ResultsDietary protein intakes were significantly lower in older age groups, with up to 46% of the oldest adults not meeting the protein intake recommendation. Participants consuming protein below the recommended intake level had significantly poorer diet quality across all age groups (P<0.01), however, overall diet quality was better in older adults. Those not meeting the protein recommendation were more likely to have intakes of other nutrients below recommended levels. Those below the protein recommendation had significantly more functional limitations across all age groups, while grip strength was significantly lower in those over 70 years old.ConclusionLower protein intakes, and lower diet quality and physical functioning are related in an aging population. Meeting the protein recommendation was linked to better overall diet quality and may be protective of lean mass; therefore, evaluation of individual characteristics which may affect protein intakes is crucial in supporting older adults to meet their protein needs.

Symposium review: Re-evaluation of National Research Council energy estimates in calf starters

Provision of nutrients in appropriate amounts to meet nutrient requirements for growth, production, and reproduction is the basis for modern animal nutrition. Ration formulation systems predict nutrient requirements based on numerous inputs and then predict nutrient supply based on predicted intake and nutrient content of feeds. Energy systems are used to predict energy supply based on gross caloric content of feeds followed by adjustments for digestion and metabolism of ingested energy. Many models of energy supply use static coefficients of digestibility based on nutrient composition of feed. Other models partition digestion dynamically between ruminal and postruminal digestion but use static estimates of intestinal digestibility to predict energy supplied to the animal. In young calves, both ruminal fermentation and intestinal digestion are underdeveloped; therefore, existing models of energy supply might overestimate the energy available before complete gastrointestinal maturation. In a series of experiments, we reported that total-tract digestion of nutrients changes with advancing age and nutrient intake. Total-tract digestion was measured in calves from 3 to 16 wk of age when fed different amounts and types of milk replacers. Calves were also fed different types of calf starter for ad libitum consumption. Total-tract digestibility of protein, fat, neutral detergent fiber, and nonfiber carbohydrate (NFC) was used to calculate the metabolizable energy (ME) in starter. We used nonlinear regression to estimate the contribution of protein and fat from starter and milk replacer before weaning. Early in life, calculated ME of starter was low and increased with increasing intake of NFC. Cumulative intake of NFC was more highly correlated with changing ME values than other indices, including age, intake of milk replacer, or intake of other nutrients in starter. When calves consumed at least of 15 kg of NFC, ME calculated from digestibility measurements was similar to the ME calculated using National Research Council equations and indicated maturation of gastrointestinal digestion. Our data suggest that intake of NFC is critical to gastrointestinal maturation and the calf's ability to extract energy from calf starter.

Dairy Product Intake and Risk of Type 2 Diabetes in EPIC-InterAct: A Mendelian Randomization Study.

To estimate the causal association between intake of dairy products and incident type 2 diabetes. The analysis included 21,820 European individuals (9,686 diabetes cases) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study. Participants were genotyped, and rs4988235 (LCT-12910C>T), a single nucleotide polymorphism (SNP) for lactase persistence (LP) that enables digestion of dairy sugar, i.e., lactose, was imputed. Baseline dietary intakes were assessed with diet questionnaires. We investigated the associations between imputed SNP dosage for rs4988235 and intake of dairy products and other foods through linear regression. Mendelian randomization (MR) estimates for the milk-diabetes relationship were obtained through a two-stage least squares regression. Each additional LP allele was associated with a higher intake of milk (β 17.1 g/day, 95% CI 10.6-23.6) and milk beverages (β 2.8 g/day, 95% CI 1.0-4.5) but not with intake of other dairy products. Other dietary intakes associated with rs4988235 included fruits (β -7.0 g/day, 95% CI -12.4 to -1.7 per additional LP allele), nonalcoholic beverages (β -18.0 g/day, 95% CI -34.4 to -1.6), and wine (β -4.8 g/day, 95% CI -9.1 to -0.6). In instrumental variable analysis, LP-associated milk intake was not associated with diabetes (hazard ratioper 15 g/day 0.99, 95% CI 0.93-1.05). rs4988235 was associated with milk intake but not with intake of other dairy products. This MR study does not suggest that milk intake is associated with diabetes, which is consistent with previous observational and genetic associations. LP may be associated with intake of other foods as well, but owing to the modest associations, we consider it unlikely that this caused the observed null result.

Estimates of calf starter energy affected by consumption of nutrients. 2. Effect of changing digestion on energy content in calf starters

Apparent total-tract digestibility data from 3 published studies with calves from 0 to 4 mo of age were used to evaluate National Research Council (NRC; 2001) estimates of digestible energy (DE) and metabolizable energy (ME) in calf starters (CS). Calves (n = 83) or pens of calves (n = 24) were used in model development. In each study, 48 Holstein bull calves (2-3 d of age at initiation of each study) were fed varying amounts of milk replacer with CS and water for ad libitum consumption. Calf starters varied in nutrient composition and physical form (pelleted, textured, or mixed with 5% grass hay and fed as a total mixed ration). Apparent total-tract digestibility was measured at various ages. Feed and feces were collected from 20 calves per trial during 5-d collection periods during the first 56 d of each trial. In 2 studies, calves were grouped in pens (4 calves/pen) for a second 56-d measurement period. Fecal collections were repeated occasionally during the second period. Total-tract digestibilities (n = 207) of neutral detergent fiber, nonfiber carbohydrates (NFC), crude protein (CP), and fat were used to calculate ME in CS using equations from the 2001 Dairy NRC. Contributions of digestible CP and fat from milk replacer before weaning were estimated using nonlinear regression and removed from estimates of fat and CP digestibility in CS. Digestion of most nutrients in CS and calculated DE and ME in CS were low early in life and increased with increasing cumulative NFC intake. The natural logarithm of cumulative NFC intake, measured from d 0 to the end of each digestibility period, accounted for more variation in CS nutrient digestibilities, DE and ME estimates compared with daily NFC intake or intake of other nutrients, intake of milk replacer, or age of calf. Calculated ME values in CS were similar to those predicted by NRC after calves consumed approximately 15 kg of cumulative NFC or 28 kg of cumulative dry matter intake (assuming 53% NFC in CS). Current estimates of energy in CS fed to 4 mo of age may overestimate contribution of dry feed to overall energy metabolism in young calves.