Lower Food Intake Research Articles

The Effects of Green Tea on Diabetes and Gut Microbiome in db/db Mice: Studies with Tea Extracts vs. Tea Powder

Green tea extracts and tea catechins have been shown to prevent or alleviate diabetes. The present study tests the hypothesis that green tea leaves in powder form (GTP), which also contain fiber and other water non-extractable materials, are more effective than the corresponding green tea extracts (GTE) in impeding the development of diabetes in db/db mice. Female db/db mice were treated with a diet containing 1% of GTE, 2% of GTE, 2% of GTP (with the same catechin content as 1% GTE) or 1% GTP. The 1% GTE group had lower food intake, water consumption, body weight and fasting blood glucose levels than the control group, while 2% GTP did not have any significant effect. Dietary 1% GTE also preserved β-cell insulin secretion. However, 1% GTP increased food intake, water consumption and blood glucose levels. Microbiome analysis with 16S rRNA gene V4 sequencing showed that the gut microbiota was modified by GTE and GTP, and a few bacterial guilds were associated with blood glucose levels. In the Random Forest regression model, the leading predictor of metabolic outcome was food consumption, followed by changes in some bacterial guilds. The results illustrate the importance of food consumption and gut microbiota in affecting the progression of diabetes.

Assessment of the nutritional pattern in frailty syndrome dependent institutionalized elderly

Background: Problems of nutritional status are widespread, of which malnutrition occurs more frequently in vulnerable groups of the population, especially in the low-income elderly, including the institutionalized elderly. Material and methods: The study was performed on a group of 50 participants over the age of 65, from the nursing home; the nutritional status was assessed according to the Mini-Nutritional Assessment (MNA) score, the frailty syndrome (FS) was established based on Fried criteria and severity of FS – based on the Clinical Frailty Scale. The obtained data were statistically processed by using the “Statistica 6.0” software program. The difference was considered statistically significant with p <0.05. Results: The MNA score showed a positive correlation with reduced physical activity: r= 0.4*, between reduced physical activity and reduced walking speed: r= 0.66*, reduced physical activity and fatigue (lack of energy): r= 0.94* (p≤0.05). The cluster analysis revealed that against the background of the same food intake, body weight, mobility, neurological status can easily change, the phenomenon underlying the separation of the elderly in different clusters (1 and 2), while moderately low food intake in the last 3 months led to significantly reduced mobility, impaired neurological status (severe dementia or depression). Conclusions: This study reported that the elderly in the nursing home have an increased risk of malnutrition, being associated with nutritional pattern, such as: involuntary weight loss, the presence of neuropsychiatric disorders, decline in food consumption, affecting the quality of life.

Role of systemic inflammation in functional recovery, dysphagia, and 1-y mortality in heart failure: A prospective cohort study

ObjectivesThis study evaluated the relationship between systemic inflammation and clinical outcomes in people hospitalized with acute heart failure (AHF). MethodsWe prospectively enrolled people newly hospitalized with AHF after excluding those with concomitant infectious or inflammatory diseases. Systemic inflammation was evaluated using the modified Glasgow Prognostic Score (mGPS) at hospitalization, and participants were classified into low-grade and high-grade inflammation groups (mGPS 0–1 and 2, respectively). The primary outcome measure was functional recovery, evaluated using the Barthel Index gain. Secondary outcome measures were dysphagia at discharge and all-cause 1-y mortality after discharge. Multivariable analyses and Kaplan-Meier estimates were used to determine the association between systemic inflammation and study outcomes. ResultsA total of 184 participants (mean age, 79.1 y; 48.4% female, 51.6% male) were included; 148 (80.4%) and 36 (19.6%), respectively, had low-grade and high-grade inflammation. Participants with high-grade inflammation were significantly older, had lower body mass index and muscle strength, and had lower nutrient intake, swallowing status, and Barthel Index than those with low-grade inflammation. In multivariable analyses, mGPS was significantly associated with Barthel Index gain (β = −0.229, P = 0.004) and Food Intake Level Scale (odds ratio = 5.067, P = 0.034) at discharge; mGPS was associated with 1-y mortality after discharge (P = 0.003). ConclusionsBaseline systemic inflammation was negatively associated with improvements in physical function and dysphagia and with 1-y survival in people with AHF. These findings highlight the importance of focusing on the assessment of systemic inflammation to accurately predict the functional prognosis of people with AHF.

The Effect of Dietary Modification and Nutritional Education on Nutrition Care Process (NCP) for Increasing Dietary Intake, Body Weight, and Nutritional Status of Cancer Patients at Risk of Malnutrition and Malnourished in the Inpatient of Dharmais Cancer

Background: Cancer patients that are hospitalized often have problems with their nutrient intake. Low nutrient intake can be affected by malnutrition. In cancer patients, the intake of nutrients needs to be considered specifically in relation to the occurrence of metabolic changes that lead to decreased nutritional status. The objective of this study is to analyze the effect of dietary modification and nutritional education on nutrition care process (NCP) for increasing dietary intake, body weight, and nutritional status of malnourished cancer patients and cancer patients at risk of malnutrition.Methods: The study was a quasi-experiment with one-group pretest-posttest design. The population consisted of all new adult hospitalized cancer patients. The data were collected from July to September 2019. The statistical analysis used paired sample t-test. Dietary modification and nutritional education were given individually based on each nutrition problem of the patient and their nutritional needs.Results: There were 83 patients involved for the study. Most of the patients were female (61.4%), aged over 45 years (62.7%), graduated from high school (47%), were housewives (49.4%), and had clinical histories of no comorbidities (90.4%). Most of them had improvement in general condition (74.7%). The study showed significantly increasing dietary intake of energy (889.7 calorie), protein (36.4 gr), fat (49.3 gr), and carbohydrate (131.4 gr) (p = 0.000). The increasing percentage of nutrient intake to nutritional needs before and after intervention of NCP was 39.8 to 88.6% for energy, 44.4 to 104% for protein, 51 to 120% for fat, and 41.5 to 90.1% for carbohydrate. The average increase (but not significant related correlation) in body weight was 0.16 kg (p = 0.141) and body mass index 0.05 kg/m2 (p = 1.94). Conclusions: Dietary modification and nutritional education on NCP improve dietary intakes (energy, protein, fat, and carbohydrate) of cancer patients at risk of malnutrition and being malnourished.

Neurotensin secretion after Roux-en-Y gastric bypass, sleeve gastrectomy, and truncal vagotomy with pyloroplasty.

Neurotensin (NT) is released from enteroendocrine cells and lowers food intake in rodents. We evaluated postprandial NT secretion in humans after surgeries associated with accelerated small intestinal nutrient delivery, and after Roux-en-Y gastric bypass (RYGB) when glucagon-like peptide-1 (GLP-1) signalling and dipeptidyl peptidase 4 (DPP-4) were inhibited, and during pharmacological treatments influencing entero-pancreatic functions. We measured NT concentrations in plasma from meal studies: (I) after truncal vagotomy with pyloroplasty (TVP), cardia resection +TVP (CTVP), and matched controls (n=10); (II) after RYGB, sleeve gastrectomy (SG), and in matched controls (n=12); (III) after RYGB (n=11) with antagonism of GLP-1signalling using exendin(9-39) and DPP-4 inhibition using sitagliptin; (IV) after RYGB (n=11) during a run-in period and subsequent treatment with, sitagliptin, liraglutide (GLP-1 receptor agonist), verapamil (calcium antagonist), acarbose (alpha glucosidase inhibitor), and pasireotide (somatostatin analogue), respectively. (I) NT secretion was similar after TVP/CTVP (p=0.9), but increased vs. controls (p<0.0001). (II) NT secretion was increased after RYGB vs. SG and controls (p<0.0001). NT responses were similar in SG and controls (p=0.3), but early postprandial NT concentrations were higher after SG (p<0.05). (III) Exendin (9-39) and sitagliptin did not change NT responses vs placebo (p>0.2), but responses were lower during sitagliptin vs. exendin(9-39) (p=0.03). (IV) Pasireotide suppressed NT secretion (p=0.004). Sitagliptin tended to lower NT secretion (p=0.08). Liraglutide, verapamil, and acarbose had no effect (p>0.9). Neurotensin secretion is increased after surgeries associated with accelerated gastric emptying and lowered by pasireotide.

Nutritional status and determinants of malnutrition in institutionalized elderly people, provisional data

Nutrition is an important factor for health, physical and cognitive function, vitality, quality of life and longevity. Elderly people oft en have low food intake, induced by multifactorial causes, as a result, malnutrition is an independent risk factor for increased morbidity and mortality, regardless of the underlying pathologies (chronic organ failure, cognitive impairment, cancer, cardiovascular disease, type 2 diabetes etc.) including overweight or obese subjects.The prevalence of malnutrition varies from 4% to 10% in the elderly population from the community, from 15% to 38% for institutionalized elderly people and from 30% to 70% for hospitalized ones. The purpose of this study was to assess the nutritional status of institutionalized elderly people and establish correlations between the determinants of malnutrition and fragility syndrome.Th e epidemiological study is part of the project 20.80009.8007.25 “Fragility: diagnosis and prophylaxis in relation to medicopsychosocial problems of the vulnerable elderly”, included 50 patients institutionalized in the Republican Asylum for the Disabled and Retired in Chisinau.All persons were examined by the complex geriatric evaluation, approved by the order of the Ministry of Health no. 619 of 07.09.2010. According to the results, both malnutrition and the risk of malnutrition were high in institutionalized elderly people.Among the determinants of malnutrition, the highest association had the number of concomitant diseases, decreased functionality of the elderly, the presence of depression syndrome and cognitive disorders. At the same time, the malnutrition syndrome correlated with the fragility criteria but also with the degree of severity of frailty of the institutionalized elderly people.

Combined Action of Shiga Toxin Type 2 and Subtilase Cytotoxin in the Pathogenesis of Hemolytic Uremic Syndrome.

Shiga toxin-producing E. coli (STEC) produces Stx1 and/or Stx2, and Subtilase cytotoxin (SubAB). Since these toxins may be present simultaneously during STEC infections, the purpose of this work was to study the co-action of Stx2 and SubAB. Stx2 + SubAB was assayed in vitro on monocultures and cocultures of human glomerular endothelial cells (HGEC) with a human proximal tubular epithelial cell line (HK-2) and in vivo in mice after weaning. The effects in vitro of both toxins, co-incubated and individually, were similar, showing that Stx2 and SubAB contribute similarly to renal cell damage. However, in vivo, co-injection of toxins lethal doses reduced the survival time of mice by 24 h and mice also suffered a strong decrease in the body weight associated with a lowered food intake. Co-injected mice also exhibited more severe histological renal alterations and a worsening in renal function that was not as evident in mice treated with each toxin separately. Furthermore, co-treatment induced numerous erythrocyte morphological alterations and an increase of free hemoglobin. This work shows, for the first time, the in vivo effects of Stx2 and SubAB acting together and provides valuable information about their contribution to the damage caused in STEC infections.

Neuroendocrine Mechanisms Underlying Non-breeding Aggression: Common Strategies Between Birds and Fish.

Aggression is an adaptive behavior that plays an important role in gaining access to limited resources. Aggression may occur uncoupled from reproduction, thus offering a valuable context to further understand its neural and hormonal regulation. This review focuses on the contributions from song sparrows (Melospiza melodia) and the weakly electric banded knifefish (Gymnotus omarorum). Together, these models offer clues about the underlying mechanisms of non-breeding aggression, especially the potential roles of neuropeptide Y (NPY) and brain-derived estrogens. The orexigenic NPY is well-conserved between birds and teleost fish, increases in response to low food intake, and influences sex steroid synthesis. In non-breeding M. melodia, NPY increases in the social behavior network, and NPY-Y1 receptor expression is upregulated in response to a territorial challenge. In G. omarorum, NPY is upregulated in the preoptic area of dominant, but not subordinate, individuals. We hypothesize that NPY may signal a seasonal decrease in food availability and promote non-breeding aggression. In both animal models, non-breeding aggression is estrogen-dependent but gonad-independent. In non-breeding M. melodia, neurosteroid synthesis rapidly increases in response to a territorial challenge. In G. omarorum, brain aromatase is upregulated in dominant but not subordinate fish. In both species, the dramatic decrease in food availability in the non-breeding season may promote non-breeding aggression, via changes in NPY and/or neurosteroid signaling.

Inflammation as a diagnostic criterion in the GLIM definition of malnutrition\u2014what CRP-threshold relates to reduced food intake in older patients with acute disease?

Background/objectivesIn the recently introduced GLIM diagnosis of malnutrition (Global Leadership Initiative on Malnutrition), details of how to classify inflammation as an etiologic criterion are lacking. This study aimed to determine at what level of serum C-reactive protein (CRP) the risk of low food intake increases in acutely ill older hospitalized patients.Subjects/methodsA total of 377 patients, who were consecutively admitted to a geriatric acute care ward, were analyzed. Nutritional intake was determined using the food intake item of Nutritional Risk Screening and the plate diagram method and patients were grouped into three categories as >75%, 50–75% and ≤50% of requirements. CRP was analyzed according to standard procedures and patients were classified into different CRP groups as follows: 0.0–0.99 mg/dl, 1.0–1.99 mg/dl, 2.0–2.99 mg/dl, 3.0–4.99 mg/dl, 5.0–9.99 mg/dl and ≥10.0 mg/dl.ResultsOf the total population (mean age of 82.2 ± 6.6 years; 241 females), 82 (22%) had intake <50% of requirements and 126 (33%) demonstrated moderate to severe inflammation. Patients with food intake <50% of requirements had a significantly higher median CRP level compared to patients with food intake >75% of requirements (P < 0.001). The group with serum-CRP levels above 3.0 mg/dl had a markedly higher proportion of patients with low food intake; i.e., <50% and <75% of the requirements.ConclusionA serum-CRP of 3.0 mg/dl appears to be a reasonable threshold of acute inflammation leading to reduced food intake to serve as an orientation with regard to the inflammation criterion of the GLIM diagnosis in acutely ill older patients.

Dietary habits among men and women in West Greenland: follow-up on the ACCEPT birth cohort

BackgroundIn the past decades, the diet in Greenland has been in transition resulting in a lower intake of traditional food and a higher intake of imported western food. This diet transition can affect public health negatively, and thus, continued monitoring of dietary habits is important. The present study aimed to follow up on the dietary habits of pregnant women included in the Greenlandic ACCEPT birth cohort (2013–2015) and the children’s father.MethodsThe follow-up food intake was assessed in 2019–2020 using food frequency questionnaires for 101 mothers and 76 fathers aged 24–55 years living in Nuuk, Sisimiut, and Ilulissat. Non-parametric statistical methods were used (Mann-Whitney U test/Spearman correlation) to assess the dietary pattern and influencing factors.ResultsThe proportion of traditional and imported food was 14 and 86%, respectively. Intake frequency differed by gender (vegetables, fruits, fast food), the living town (terrestrial animals, vegetables, fruits), and age (fish, meat products, fruits, fast food). Socioeconomic and lifestyle factors significantly correlated with the intake frequency of several traditional and imported foods. Few changes in the mother’s dietary habits from inclusion (during pregnancy) to follow-up (3–5 years later) were found, showing less frequent intake of seabirds and fruits and more frequent meat intake.ConclusionWe identified several factors that could affect dietary habits, and the results may be used to target future food recommendation for relevant population groups.

A single nucleotide mutation in the dual-oxidase 2 (DUOX2) gene causes some of the panda's unique metabolic phenotypes.

The giant panda (Ailuropoda melanoleuca) is an iconic bear native to China, famous for eating almost exclusively bamboo. This unusual dietary behavior for a carnivore is enabled by several key adaptations including low physical activity, reduced organ sizes and hypothyroidism leading to lowered energy expenditure. These adaptive phenotypes have been hypothesized to arise from a panda-unique single-nucleotide mutation in the dual-oxidase 2 (DUOX2) gene, involved in thyroid hormone synthesis. To test this hypothesis, we created genome-edited mice carrying the same point mutation as the panda and investigated its effect on metabolic phenotype. Homozygous mice were 27% smaller than heterozygous and wild-type ones, had 13% lower body mass-adjusted food intake, 55% decreased physical activity, lower mass of kidneys (11%) and brain (5%), lower serum thyroxine (T4: 36%), decreased absolute (12%) and mass-adjusted (5%) daily energy expenditure, and altered gut microbiota. Supplementation with T4 reversed the effects of the mutation. This work uses a state-of-the-art genome editing approach to demonstrate the link between a single-nucleotide mutation in a key endocrine-related gene and profound adaptive changes in the metabolic phenotype, with great importance in ecology and evolution.

Association between diet quality in adolescence and adulthood and knee symptoms in adulthood: a 25-year cohort study.

We aimed to describe associations between diet quality in adolescence and adulthood and knee symptoms in adulthood. Two hundred seventy-five participants had adolescent diet measurements, 399 had adult diet measurements and 240 had diet measurements in both time points. Diet quality was assessed by Dietary Guidelines Index (DGI), reflecting adherence to Australian Dietary Guidelines. Knee symptoms were collected using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analysed using zero-inflated negative binomial regressions. The overall adolescent DGI was not associated with adult knee symptoms, although lower intake of discretionary foods (e.g. cream, alcohol, bacon and cake) in adolescence was associated with lower pain (mean ratio (MR) 0·96) and dysfunction (MR 0·94). The overall adult DGI was not associated with knee symptoms; however, limiting saturated fat was associated with lower WOMAC (Pain: MR 0·93; stiffness: MR 0·93; dysfunction: MR 0·91), drinking water was associated with lower stiffness (MR 0·90) and fruit intake was associated with lower dysfunction (MR 0·90). Higher DGI for dairy products in adulthood was associated with higher WOMAC (Pain: MR 1·07; stiffness: MR 1·13; dysfunction: MR 1·11). Additionally, the score increases from adolescence to adulthood were not associated with adult knee symptoms, except for associations between score increase in limiting saturated fat and lower stiffness (MR 0·89) and between score increase in fruit intake and lower dysfunction (MR 0·92). In conclusion, the overall diet quality in adolescence and adulthood was not associated with knee symptoms in adulthood. However, some diet components may affect later knee symptoms.

Less need for differentiation? Intestinal length of reptiles as compared to mammals.

Although relationships between intestinal morphology between trophic groups in reptiles are widely assumed and represent a cornerstone of ecomorphological narratives, few comparative approaches actually tested this hypothesis on a larger scale. We collected data on lengths of intestinal sections of 205 reptile species for which either body mass (BM), snout-vent-length (SVL) or carapax length (CL) was recorded, transforming SVL or CL into BM if the latter was not given, and analyzed scaling patterns with BM and SVL, accounting for phylogeny, comparing three trophic guilds (faunivores, omnivores, herbivores), and comparing with a mammal dataset. Length-BM relationships in reptiles were stronger for the small than the large intestine, suggesting that for the latter, additional factors might be relevant. Adding trophic level did not consistently improve model fit; only when controlling for phylogeny, models indicated a longer large intestine in herbivores, due to a corresponding pattern in lizards. Trophic level effects were highly susceptible to sample sizes, and not considered strong. Models that linked BM to intestine length had better support than models using SVL, due to the deviating body shape of snakes. At comparable BM, reptiles had shorter intestines than mammals. While the latter finding corresponds to findings of lower tissue masses for the digestive tract and other organs in reptiles as well as our understanding of differences in energetic requirements between the classes, they raise the hitherto unanswered question what it is that reptiles of similar BM have more than mammals. A lesser effect of trophic level on intestine lengths in reptiles compared to mammals may stem from lesser selective pressures on differentiation between trophic guilds, related to the generally lower food intake and different movement patterns of reptiles, which may not similarly escalate evolutionary arms races tuned to optimal agility as between mammalian predators and prey.

Toward the development of a vibrant, super-aged society: The future of medicine and society in Japan.

Toward the development of a vibrant, super-aged society: The future of medicine and society in Japan.

Machine Learning Analysis to Identify Digital Behavioral Phenotypes for Engagement and Health Outcome Efficacy of an mHealth Intervention for Obesity: Randomized Controlled Trial.

BackgroundThe digital health care community has been urged to enhance engagement and clinical outcomes by analyzing multidimensional digital phenotypes.ObjectiveThis study aims to use a machine learning approach to investigate the performance of multivariate phenotypes in predicting the engagement rate and health outcomes of digital cognitive behavioral therapy.MethodsWe leveraged both conventional phenotypes assessed by validated psychological questionnaires and multidimensional digital phenotypes within time-series data from a mobile app of 45 participants undergoing digital cognitive behavioral therapy for 8 weeks. We conducted a machine learning analysis to discriminate the important characteristics.ResultsA higher engagement rate was associated with higher weight loss at 8 weeks (r=−0.59; P<.001) and 24 weeks (r=−0.52; P=.001). Applying the machine learning approach, lower self-esteem on the conventional phenotype and higher in-app motivational measures on digital phenotypes commonly accounted for both engagement and health outcomes. In addition, 16 types of digital phenotypes (ie, lower intake of high-calorie food and evening snacks and higher interaction frequency with mentors) predicted engagement rates (mean R2 0.416, SD 0.006). The prediction of short-term weight change (mean R2 0.382, SD 0.015) was associated with 13 different digital phenotypes (ie, lower intake of high-calorie food and carbohydrate and higher intake of low-calorie food). Finally, 8 measures of digital phenotypes (ie, lower intake of carbohydrate and evening snacks and higher motivation) were associated with a long-term weight change (mean R2 0.590, SD 0.011).ConclusionsOur findings successfully demonstrated how multiple psychological constructs, such as emotional, cognitive, behavioral, and motivational phenotypes, elucidate the mechanisms and clinical efficacy of a digital intervention using the machine learning method. Accordingly, our study designed an interpretable digital phenotype model, including multiple aspects of motivation before and during the intervention, predicting both engagement and clinical efficacy. This line of research may shed light on the development of advanced prevention and personalized digital therapeutics.Trial RegistrationClinicalTrials.gov NCT03465306; https://clinicaltrials.gov/ct2/show/NCT03465306

Type 2 diabetes patients\u2019 views on prevention of hypoglycaemia \u2013 a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

BackgroundHypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients.MethodsIn this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past.ResultsSixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%.ConclusionPeople with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

Examining the associations between a posteriori dietary patterns and obesity indexes: Systematic review of observational studies.

Few reports on the association of population-derived dietary patterns with excess body weight, using the approach of a systematic review currently exist. The aim of the present systematic review was to identify dietary patterns associated with body mass index (BMI), body weight (BW)/BMI change, weight status and weight loss maintenance status. Using MEDLINE (via PubMed) and EBSCO Host databases, we systematically reviewed studies from 1980 to 2020, which included men and women, aged ≥18 years. Primary outcome was BMI or the longitudinal change of individuals' BW or BMI, or weight status (normal weight/overweight/obesity) or weight loss maintenance status. We included observational studies, with or without a prospective design. Studies which met the inclusion criteria were evaluated based on the Newcastle-Ottawa Scale; only a posteriori dietary patterns were evaluated. Twenty-six studies were eligible for inclusion in the current analysis. The results indicate a relationship between adherence to a lacto-vegetarian dietary pattern, characterized by high intake of fruits, vegetables, whole grains, unprocessed cereals, dairy and low intake of high-fat foods and sweets, and longitudinal change of individuals' BW or BMI, or the risk of overweight/obesity. Promotion of this healthy dietary pattern, as an alternative to focusing on specific nutrients or foods, may be a promising approach to be included in future long-term weight maintenance interventions.

Trajectories of Eating Behaviours During Adolescence Among Canadian Youth

ObjectivesThis study aimed to investigate the presence of sub-groups of boys and girls presenting different trajectories of multiple eating behaviours (i.e., consumption of vegetables and fruits, sugary beverages, breakfast and fast food) throughout adolescence. MethodsData from seven cycles of the MATCH study, which followed 744 participants from the age of 11 to 18 years old, were included. At each cycle, participants reported how often they ate breakfast and consumed vegetables and fruits, sugary beverages and fast foods on a weekly basis. Trajectories of eating behaviours over a 7-year period were identified using group-based multi-trajectory modeling. ResultsChanges in eating behaviours occurred at roughly 13–14 years of age for both genders. For girls, three different groups were identified, namely ‘stable food intake with decline in daily breakfast consumption’ (39.9%), ‘moderate food intake and declining of overall eating behaviours’ (38.0%), and ‘stable high food intake’ (22.1%). For boys, five different groups were identified, namely ‘low food intake with stable daily breakfast consumption’ (27.3%), ‘breakfast skippers and increasing fast food intake’ (27.1%), ‘low food intake with decline in daily breakfast consumption’ (23.9%), ‘high food intake with worsening of eating behaviours’ (13.3%), and ‘average food intake with consistently high breakfast consumption’ (8.4%). ConclusionsAmong boys and girls, eating behaviours evolve through various distinct trajectories during adolescence. No group of adolescents presented eating trajectories that could be described as healthy and most are characterised by a worsening of eating behaviours throughout adolescence. To promote healthier eating behaviours during adolescence, gender-specific approaches and interventions are needed in addition to general public health messages. Funding SourcesThe MATCH study is supported by the New Brunswick Health Research Foundation (20,130,729), the Social Sciences and Humanities Research Council (435-2016-0888), and Sport Canada through the joint Sport Participation Research Initiative (862-2010-0001 and 862-2014-0002).

Consumption of Ready-to-Eat Cereal and Its Associations With Food Group Intake and Diet Quality in the United States, NHANES 2017–2018

ObjectivesReady-to-eat cereal (RTEC) is a nutrient-dense food that has been associated with better nutrient intake. This study was conducted to examine the association between consumption of RTEC and food group intake and diet quality in the United States using the most recent nationally representative data. MethodsParticipants from National Health and Nutrition Examination Survey (NHANES) 2017–2018 were classified as RTEC eaters or non-eaters depending on whether RTEC was reported in their day-1 dietary recall. Food group intake was estimated from Food Patterns Equivalence Database 2017–2018. Diet quality was assessed by the Healthy Eating Index 2015 (HEI-2015). Differences in food group intake and diet quality by RTEC consumption status were compared by ANOVA for survey, and were analyzed separately in children (2–17 y, N = 2135), adults 18–64 y (N = 3675), and older adults (65 y or older, N = 1221). ResultsConsumption of RTEC was associated with significantly higher intake of whole grains and dairy products, in all age groups examined (all P < 0.01). Children who consumed RTEC had a significantly lower intake of total protein foods (3.7 cup eq. vs 4.6 cup eq., P < 0.001) and vegetables (0.7 cup eq. vs 0.9 cup eq., P < 0.001) than non-eaters, however, intake of these food groups was not significantly different in adults 18–64 y or older adults by RTEC consumption status. Consumption of RTEC was not significantly associated with intake of added sugar in all age groups examined (all P > 0.05). Diet quality, as measured by HEI-2015 total score, was significantly higher in RTEC eaters than non-eaters in children, adults 18–64y, and older adults (all P < 0.01). ConclusionsThe results demonstrated that consumption of RTEC was associated with higher intake of whole grains and dairy products, but not with added sugar in the US population. RTEC consumption was also associated with better diet quality. Funding SourcesThe study was supported by Bell Institute of Health and Nutrition, General Mills, Inc.

Infant Young Child Feeding Practices From 12 to 24 Months of Age of Offspring From the Women First Trial

ObjectivesEvaluate infant young child feeding (IYCF) trends from 12 to 24 mo in four low middle-income countries: Democratic Republic of Congo (DRC); Guatemala; India; and Pakistan. Methods2413 children (570 DRC, 614 Guatemala, 589 India, and 640 Pakistan) born to women from the Women First Trial enrolled. Trained research health workers visited households and assessed children’s feeding practices from 12 to 24 mo. Child feeding indicators including the prevalence and longitudinal trends of meeting minimum diet diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were analyzed using the 2018 IYCF definitions from 12 to 24 mo for all four sites individually and combined. ResultsMDD significantly increased from 16% at 12 mo to 29% at 24 mo for all sites combined (p < 0.001); by site: 3 to 10 for DRC (p < 0.001), 33 to 42 for Guatemala (p = 0.001), 28 to 63 for India (p < 0.001), and 1 to 2 for Pakistan (not significant). MMF significantly increased from 49% at 12 mo to 68% at 24 mo for all sites (p < 0.001); by site: 22 to 49 for DRC (p < 0.001), 89 to 92 for Guatemala (not significant), 66 to 73 for India (0.012), and 18 to 58 for Pakistan (p < 0.001). MAD significantly increased (p < 0.001) for all sites, and by site for DRC and India only. Food groups least consumed at 24 mo for all sites were nuts/pulses (prevalence 20%), meats/fish/insects (21%), and vitamin A rich fruits & vegetables (38%); compared to grains/roots/tubers which were consumed by 98% of participants. For all sites, milk & dairy and eggs consumption significantly increased from 50 to 60% (p < 0.001) and 26 to 50% (p < 0.001), respectively. Breastfeeding decreased from 94% at 12 mo to 49% at 24 mo for all sites with the lowest prevalence of breastfeeding in Pakistan (23%), whereas the other sites were ∼50%. ConclusionsFor all sites, the prevalence of participants meeting IYCF recommendations for feeding indicators increased from 12 to 24 mo, but prevalence at 24 mo remained well below recommendations in all sites. Children with low IYCF scores are at risk for low intakes of vital nutrients, protein and vitamin A rich foods, which may negatively impact periods of rapid growth and development in these resource limited populations. Funding SourcesBill & Melinda Gates Foundation and Eunice Kennedy Shriver NICHD.