Lower Food Intake Research Articles

Diet and gastric cancer risk: an umbrella review of systematic reviews and meta-analyses of prospective cohort studies.

Several systematic reviews and meta-analyses evaluated the associations between dietary factors and the incidence of gastric cancer (GC). To evaluate the strength and validity of existing evidence, we conducted an umbrella review of published systematic reviews and meta-analyses that investigated the association between diets and GC incidence. We searched the PubMed, Embase, and Cochrane databases for systematic reviews and meta-analyses of prospective cohort studies investigating the association between dietary factors and GC risk. For each association, we recalculated the adjusted summary estimates with their 95% confidence interval (CI) and 95% prediction interval (PI) using a random-effects model. We used the I2 statistic and Egger's test to assess heterogeneity and small-study effects, respectively. We also assessed the methodological quality of each study and the quality of evidence. Finally, we identified 16 meta-analyses that described 57 associations in this umbrella review. Of the 57 associations, eight were statistically significant using random-effects, thirteen demonstrated substantial heterogeneity between studies (I2 > 50%), and three found small-study effects. The methodological quality of meta-analyses was classified as critically low for two (13%), low for thirteen (81%), and only one (6%) was rated as high confidence. Quality of evidence was rated high for a positive association for GC incidence with a higher intake of total alcohol (RR = 1.19, 95% CI 1.06-1.34) and moderate-quality evidence to support that increased processed meat consumption can increase GC incidence. Three associations (total fruit, vitamin E, and carotenoids) were determined to be supported by low-quality evidence, and two (pickled vegetables/foods and citrus fruit) were supported by very low-quality. Our findings support the dietary recommendations for preventative GC, emphasizing lower intake of alcohol and foods preserved by salting. New evidence suggests a possible role for total fruit, citrus fruit, carotenoids, and vitamin E. More research is needed on diets with lower quality evidence. CRD42021255115.

Lower Intakes of Key Nutrients Are Associated with More Workplace Absenteeism: NHANES 2003–2008

ObjectivesWhile the literature supports the importance of nutrition in physical health, the role of nutritional status, especially nutrient consumption, on work absenteeism in the United States population is largely unknown. The objective of this study was to determine whether dietary intake is associated with absenteeism in the workplace in US adults (19–64 years).MethodsData from NHANES 2003–08 cycles were used to estimate intakes of nutrients from food and food + supplements. Usual dietary intake was derived using the National Cancer Institute method with data from two valid 24-hr dietary recalls and a 30-day supplement use questionnaire. The mean of workplace absenteeism per year was estimated using negative binomial regression models with absenteeism data from the Medical Conditions Questionnaire.ResultsOut of 8,252 subjects, 3,919 reported missing workdays due to illness/injury (51%). The predicted mean of missed workdays was 4.79 days per year. Adults with absent days higher than 4.79 days had statistically significant lower intakes of nutrients including protein, vitamin E, thiamine, niacin, B6, folate, vitamin C, selenium, vitamin K, total choline, potassium, dietary fiber, alpha-Linolenic acid, alpha-carotene, and lycopene from food only. This association persisted for protein, selenium, vitamin K, total choline, potassium, dietary fiber, alpha-Linolenic acid, alpha-carotene, and lycopene when analyzed with usual intakes from both food and supplements.ConclusionsLower intakes of protein and several essential micronutrients are associated with higher workplace absenteeism due to illness/injury. This negative association may be corrected by increasing fortified foods and/or adding supplements. Future studies are needed to ascertain whether more nutrient intakes from food and supplements, particularly for nutrients not commonly found in the typical American diet or supplements, is an effective intervention to reduce workplace absenteeism to improve work productivity.Funding SourcesThis study was funded by Pharmavite LLC.

Navigating Globalized Food Environments: Market Access, Consumer Behavior, and Dietary Diversity in the Galapagos Islands of Ecuador

ObjectivesThis study has two objects: (1) determine whether different types of food environment measures shape diet outcomes; (2) determine whether consumer behavior modifies the association between geographic food environments and diet outcomes. MethodsHousehold sociodemographic data and individual data including diet recalls are from 429 participants in the Healthy Family Study conducted in San Cristóbal island Galápagos in 2018. Geocoded market inventory and price data were obtained at the same time using the Nutritional Measurement Survey for stores (NEMS-S). Geographic food environment measures were based on market access and market survey stores. Experience-based food environment measures were based on factor analyzed consumer behavior strategies for each household. Diet quality and diversity scores were based on Global Dietary Recommendations (GDR) scoring schema. Linear regressions tested the relationships between diet outcomes and food environment measures and included key sociodemographic covariates. Interactions terms between geographic and experience-based food environment measures were included. ResultsObjective 1: Increasing nearest market score was associated with lower healthy food intake (β = –0.14) and higher unhealthy food intake (β = 0.14). Increasing preferred market price index was associated with lower unhealthy food intake (β = –0.31). Higher prioritization of convenience when food shopping was associated with lower of healthy food intake (β = –0.47). Objective 2: the relationship between food environment measures and diet outcomes is strongly modified by consumer behavior. For households that prioritize convenience when food shopping, price and inventory at the nearest market was most associated with diet. For households that prioritize quality when food shopping, price and inventory at the preferred market was most associated with diet. ConclusionsMarket inventory can be healthful to some and deleterious to diets of others, depending how they navigate their food environments. “Objective” measures of quality and access that fail to consider consumer behavior may fail to capture realistic representations of food environment and diet relationships. Funding SourcesThis research is funded by an NIH/FIC R21 and the Carolina Population Center for training support and general support.

γ-Glutamyl Valine, Found in Dry Edible Beans, Is Anti-diabetic in db/db Mice

ObjectivesDietary γ-glutamyl peptides (γ-GPs) found in dry edible beans exhibit biological activities (antioxidant, anti-inflammatory) with potential benefits against chronic metabolic disorders. γ-GPs are responsible for the desirable Kokumi flavor through allosteric activation of the Calcium Sensing Receptor (CaSR) present in multiple mammalian tissues. In this study, we investigated the metabolic effects of γ-glutamyl valine (γ-EV) in diabetic obese mice. MethodsFour-weeks old male db/db mice (BKS.Cg-Dock7m +/+ Leprdb/J) were fed AIN-93G diet ad libitum and given water with or without γ-EV (500 mg/kg body weight) for 3 weeks. After 3 weeks of intervention, blood, intestine and liver were collected to determine blood glucose, blood plasma γ-EV concentrations (LC-MS/MS), alanine aminotransferase (ALT) activity, jejunum and liver transcriptomes (RNA-Seq), liver protein expression (Western blot), and liver glycogen content. ResultsMice given γ-EV had higher weight gain (45%, p < 0.001, n = 8), lower food intake (21%, p < 0.0001), and better food efficiency (79%, p < 0.0001) than their control counterparts. γ-EV blood concentrations reached 2.07 ± 0.56 μM. Blood glucose levels decreased (29%, p < 0.01) and urination was markedly improved. The hepatosomatic index increased (66%, p < 0.0001); however, blood ALT activity was not significantly changed. RNA-Seq analysis revealed 147 jejunal genes and 1308 liver genes were differentially expressed due to γ-EV intake, 26 of these genes were common to these tissues. The top 3 GO categories affected by γ-EV in jejunum were fatty acid metabolic process (17/193 genes), lipid metabolic process (22/545 genes), and peroxisome (11/136 genes); and in liver, the top 3 GO categories were oxidoreductase activity (104/686 genes), lipid metabolic process (79/545 genes), and iron ion binding (43/185 genes). Hepatic AMP-activated protein kinase (p-AMPKα, Thr172) abundance, a major cellular regulator of lipid and glucose metabolism, increased (86%, p < 0.05), and liver glycogen decreased (79%, p < 0.0001) in the treatment group suggesting γ-EV induced catabolism. Conclusionsγ-EV improved the diabetic condition of db/db mice via modulation of glucose and lipid metabolism. Funding SourcesFunding was provided by the University of Nebraska-Lincoln Collaboration Initiative and the Nebraska Dry Bean Commission.

154-OR: The Site Specific Role of GDF15 in Metformin Action

Metformin lowers glucose levels, appetite and body weight in rodents and humans, but the mechanisms on energy balance regulation have been rarely studied. Metformin increases plasma growth/differentiation factor 15 (GDF15) levels in humans and rodents, while elevating GDF15 via GDF15 infusion in rodents lowers food intake and body weight via its receptor GDNF family receptor α-like (GFRAL) , which is expressed in the hindbrain nucleus area postrema (AP) . However, whether the GDF15-GFRAL axis in the AP mediates metformin effect is unknown. In this study, metformin (200 mg/kg) was infused into the upper small intestine (USI) of rats, while fasting-refeeding study or intravenous glucose tolerance test was performed. USI metformin infusion elevated plasma GDF15 levels (met 138 ± 25 vs. veh 59 ± 7 pg/ml, n = 8, p &amp;lt; 0.01) in parallel to a lowering of food intake (met 30 ± 2 vs. veh 40 ± 2 kcal, n = 16, p &amp;lt; 0.01) and an increase in glucose tolerance (AUC met 5243 ± 75 vs. veh 5674 ± 153, n = 7, p &amp;lt; 0.05) . Further, metformin lowered not only food intake but also body weight gain by 12 h (met 14 ± 1 vs. veh 23 ± 3 g, n = 8, p &amp;lt; 0.01) . Importantly, a knockdown of GFRAL achieved via an injection of lentivirus expressing shRNA GFRAL vs. mismatch into the AP by ∼40% (p &amp;lt; 0.05) negated the ability of metformin to not only lower food intake and body weight, but also increase glucose tolerance independent of body weight. Finally, acute AP GDF15 infusion (2 pmol) decreased food intake (GDF15-25 ± 2 vs. veh-36 ± 3 kcal, n = 10, p &amp;lt; 0.01) and weight gain (as early at 6 h, GDF15 3.6 ± 1.2 vs. vehicle 8.7 ± 1.6 g, n = 10, p &amp;lt; 0.05) , and increased glucose tolerance independently from body weight (AUC, GDF15-5322 ± 94 vs. veh-5722 ± 169, n = 6, p &amp;lt; 0.05) , and these metabolic effects of AP GDF15 infusion were prevented by GFRAL knockdown in the AP. In summary, our findings indicate that the AP GDF15-GFRAL axis is sufficient and necessary for metformin to regulate energy and glucose homeostasis in rodents. Disclosure S.Zhang: None. R.Li: None. Z.Danaei: None. Y.Lim: None. T.K.Lam: None. Funding Canadian Institutes of Health Research (FDN-143204)

Dietary diversity and associated factors among pregnant women in urban Northern Ghana

Background: Though low dietary diversity during pregnancy results in low nutrient intake and adverse pregnancy outcomes, information on dietary diversity and its associated factors among pregnant women in Ghana particularly Northern Ghana is scanty. This study therefore assessed dietary diversity and associated socio-demographic characteristics among pregnant women in urban Northern Ghana. Methods: An analytical cross-sectional study design was used, involving 273 pregnant women randomly selected from 8 health facilities in Tamale Metropolis and Sagnarigu Municipality. Socio-demographic characteristics of participants were documented using a structured questionnaire. Dietary diversity of participants was assessed using a 24 hour dietary recall method and the dietary diversity score was calculated based on ten food groups. Chi-square test and binary logistic regression analysis were used to identify the factors associated with low dietary diversity. Results: The mean age of the participants was 26.44 ±5.75 years with minimum and maximum ages of 16 and 44 years respectively. About 48% of the women had low dietary diversity. The mean dietary diversity score was 4.87 ± 2.04. Having no education at all [Odds Ratio (OR) = 5.5; 95% CI (2.09 –14.31); p = 0.001] and having only primary education [OR = 3.8; 95% CI (1.21 –12.09); p &lt; 0.022] were significantly associated with low dietary diversity. Conclusion: The study revealed that the prevalence of low dietary diversity is high among pregnant women in urban Northern Ghana. Improving the educational level of women is recommended to improve their dietary diversity.

Prevalence of Anemia and Correlation with Knowledge, Nutritional Status, Dietary Habits among Adolescent Girls at Islamic Boarding School

Background: Anemia is a globally public health problem, including in Indonesia (22.2%) and it has negative health impacts. Adolescent girls have high risk of anemia. Previous studies reported that adolescent girls at islamic boarding school had low food intake and poor knowledge about nutrition in preventing anemia. Objectives: To assess the prevalence of anemia and to analyze association between knowledge, nutritional status, and dietary habits and anemia in adolescent girls. Materials and Methods: A cross-sectional study was conducted in November 2020 among adolescent girls at islamic boarding school in Semarang. A total of 162 respondents were selected by cluster sampling. Anemia was determined by measuring the hemoglobin level in the blood by Cyanmethemoglobin method. Knowledge and dietary habits were collected through questionnaires. Nutritional status was assessed by measuring weight and height, then classified by body mass index for age using WHO Anthro. Bivariate and multivariate logistic analysis were used to test hypothesis and it was significant if p&lt;0.05. Results: The prevalence of anemia was found to be 17.3%. In the bivariate analysis, overweight was more likely to have anemia (p=0.044). There was no association between father’s education, mother’s education, knowledge, frequency of staple food, breakfast habits, consumption of animal side dishes, consumption of vegetable side dishes, consumption of sweet tea and anemia. Mulitvariate model showed that overweight (OR=3.658; 95%CI=1.224-10.932; p=0.020) and good knowledge (OR=3.652; 95%CI=1.221-10.922; p=0.020) were significant associated with the anemia.Conclusion: Nutritional status and knowledge were significantly associated with anemia among adolescent girls.

Ultraprocessed Food Consumption, Diet Patterns, and Perception of Diet Quality and Body Weight in the US

ObjectivesUltraprocessed foods (UPF) have recently been examined as a risk factor for diet-related disease in adults. Studies have demonstrated changes in trends in consumption patterns of UPF over the past several decades, but few studies have evaluated the association between UPF and perception of diet along with measured dietary intake. The objective of this study was to examine the association between UPF consumption, dietary intake patterns, and self-perceived diet quality in a nationally representative sample of US children and adults. MethodsData from the 2017–2018 NHANES was used for this study. Dietary intake information was collected using 24-hour recall; recalled foods were classified using the NOVA classification system and NOVA Category 4 (ultraprocessed) were identified. All data were analyzed using SAS 9.4 survey procedures to account for the unequal sampling probability and complex survey design of the. ResultsConsumption of ultraprocessed foods is associated with poor diet in US children and adults. In adults, higher consumption of ultraprocessed foods was is associated with higher dietary energy density (p = 0.0001), lower vegetable consumption (p = 0.002), greater intake of added sugars (p < 0.0001), and lower intake of plant-based protein foods (p < 0.0001). In children, consumption of ultraprocessed foods was associated with higher dietary energy density (p < 0.0001), lower consumption of vegetables (p < 0.0001) even when including fewer servings of white potatoes (p = 0.04). Interestingly, perception of diet quality was also strongly associated with ultraprocessed food consumption. Individuals who self-reported a ‘poor’ diet consumed 84% of daily calories from ultraprocessed foods, compared to individuals who self-reported an ‘excellent’ diet reporting 52% of daily calories from ultraprocessed foods, p < 0.0001. Adults who perceived themselves to be overweight also reported higher consumption of processed foods than adults who perceived themselves to be about the right weight (60% vs. 56%, p = 0.004). There was no association with processed food consumption and parent perception of child weight. ConclusionsUltraprocessed food consumption is associated with lower diet quality in US children and adults. Additionally, UPF consumption is associated with perception of diet quality and body weight. Funding SourcesNone.

Low Fruit, Vegetables, and Carotenoids Intake Driving Low Healthy Eating Index in Young Children With Food Insecurity

ObjectivesThis pediatric primary care setting implementation program provides supplemental food delivery and intensive family support to decrease food insecurity and improve child nutrition and health. The objective of this preliminary sub-analysis is to use a variety of metrics to describe nutritional profiles of young children and their caregivers. Methods38 families with children ages 0–5 years who are patients in a Washington, DC pediatric primary care clinic and had food insecurity were consented and enrolled in a 12-month program. We utilized Automated Self-Administered 24-hour (ASA24) dietary recalls for adults and children. ASA data were used to score the Healthy Eating Index (HEI, rated to 100) and sub-scores for daily intakes including Total Fruits (TF), Total Vegetables (TV), and Total Carotenoids (TC). The Veggie Meter (VM) portable reflection spectrometer was used to measure skin carotenoids. Statistical analysis included means/medians, distributions, and point-biserial correlations. ResultsTo date, 26 parent-child dyads completed full baseline assessments; 96% of families were African American, and 100% were Medicaid eligible. Mean child age at enrollment was 3.2 years; 24% of children were overweight. Mean TF and TV (cups/day) were, respectively, 1.08 and 0.61 in children and 0.52 and 0.95 in adults. Mean children’s HEI was 52 (U.S. avg. 60.1) and parents’ HEI was 48 (U.S. avg. 58.3). Low intakes of fruits/vegetables, dairy, and healthy protein contributed more to low HEI scores than overconsumption of less healthy foods. Mean TC intakes (mg/day) were 4.09 in children and 6.04 in adults. VM scores were similarly low: 236 for children and 247 for adults. VM weakly correlated with TV and carotenoids, but not TF. In adults, TV was moderately correlated with TC but was negatively correlated with VM. ConclusionsYoung children and families experiencing food insecurity have poor nutritional quality characterized more by low intake of healthful foods rather than excessive processed, fatty, and high carbohydrate foods, supporting public health interventions that provide supplemental fruits, vegetables and nutritional education to families experiencing food insecurity. Funding SourcesA. James and Alice B. Clark Foundation, Share Our Strength’s No Kid Hungry, Power of 10, J. Willard and Alice S. Marriott Foundation.

237-LB: Weight-Independent Effects of Roux-en-Y Gastric Bypass Surgery on Remission of Nonalcoholic Fatty Liver Disease in Mice

Introduction: Obesity is the primary determinant of nonalcoholic fatty liver disease (NAFLD) . Interventions that decrease body weight, such as bariatric surgery and/or calorie restriction (CR) , may serve as effective therapies for NAFLD. The purpose of this study was to compare the effects of Roux-en-Y gastric bypass surgery (RYGB) to CR on hepatic function in mice with obesity and NAFLD. Methods: 6-week-old male C57BL/6J mice were fed a two-choice chow/high-fat diet (HFD) to promote diet-induced obesity. At 16 weeks of age, mice were randomized to (1) sham surgery (Sham) , (2) RYGB, or (3) sham + weight-matched calorie restriction to RYGB (WM) . Mice were euthanized at 36 weeks for determination of NAFLD/NASH and hepatic function. Body weight/composition and food intake were measured weekly during the treatment period. ANCOVA-adjusted energy expenditure (EE) was determined 3 and 17 weeks after treatment. Hepatic lipid content and NAFLD scores were determined from H&amp;E-stained tissue sections. Hepatic enzymes and glycogen content were determined by ELISA. Results: RYGB &amp; WM achieved a similar reduction in body weight relative to baseline. RYGB decreased adiposity to a greater extent than WM relative to baseline and Sham (-4.4±0.6 vs. -1.3±0.6 Δg, P&amp;lt;0.001) . Decreased body weight was attributable to lower food intake in WM compared to RYGB and Sham (P&amp;lt;0.0001) . WM decreased EE relative to RYGB and Sham (WM:8.6±0.4 vs. RYGB:10.4±0.4 vs. Sham:10.5±0.6 kcals/day, P&amp;lt;0.001) . RYGB decreased hepatic lipid content to a greater extent than WM (92.6 vs. 76.5 % reduction, P=0.02) . RYGB and WM similarly decreased AST and ALT activity relative to Sham. RYGB increased hepatic glycogen relative to both Sham and WM (P&amp;lt;0.001) . Conclusions: RYGB and WM improve hepatic function and decrease the severity of NAFLD through shared and discrete mechanisms of action. RYGB decreases hepatic lipid content to a greater extent than WM independent of food intake, indicating that evading the expected metabolic adaptation in EE after weight loss likely accounts for the additive hepatic benefit of RYGB. Disclosure C. L. Axelrod: None. I. M. Langohr: None. W. S. Dantas: None. R. Townsend: None. V. L. Albaugh: None. J. P. Kirwan: None. H. Berthoud: None. Funding National Institutes of Health (U54GM104940)

1400-P: Endothelial Cell Autophagy Contributes to HFD-Induced Obesity and Insulin Resistance in Mice

Autophagy is a catabolic process and plays crucial roles in cellular physiology, including energy homeostasis, cell survival, and inflammation. Autophagy-related gene 7 (ATG7) is an essential regulator of autophagosome formation. Although endothelial cell ATG7 (EC-ATG7) plays a critical role in atherosclerosis, thrombosis, and injuries from ischemia/reperfusion, the role of EC-ATG7 in obesity and insulin resistance is not known. Because endothelial function contributes to insulin resistance by regulating blood flow and delivery of nutrients and hormones to metabolic tissues, EC autophagy may affect metabolism and insulin resistance. Thus, we hypothesize that EC-ATG7 contributes to high-fat diet (HFD) -induced obesity and insulin resistance. To examine the role of EC-ATG7 in obesity and insulin resistance, we generated an EC-specific ATG7 knockout mouse (ATG7Δ EC) by breeding Cdh5-CRE mouse with ATG7flox/flox mouse. ATG7Δ EC mice were fed a normal chow diet (NCD) or HFD for twelve weeks. HFD-fed ATG7Δ EC mice gained less body weight compared with HFD-fed wild-type (WT) mice, while body weight was not different when the mice were fed NCD. HFD-fed ATG7Δ EC mice demonstrated lower food intake. Interestingly, intraperitoneal injection of low dose 2-arachidonoyl glycerol (2AG) , a cannabinoid receptor agonist, restored the food intake in ATG7Δ EC mice but not in WT mice. This indicates that the EC-ATG7 affects food intake by stimulating endogenous cannabinoid receptor (s) in the brain. Furthermore, HFD-fed ATG7Δ EC mice were more insulin sensitive than HFD-fed WT mice. In conclusion, our findings demonstrate a novel function of EC-ATG7 in regulating food intake and insulin resistance. Disclosure G.Ren: None. J.Kim: None. Funding National Institutes of Health (R01-HL128695, R03-AG058078, P30-DK079626)

Oral -Somatosensory Alterations in Head & Neck Cancer Patients and Food Intake

ObjectivesPrevalence of malnutrition in cancer ranges between 25–70% with increased risk in sites related to food ingestion, namely head and neck cancer (HNC). This is attributable to oral manifestations observed during treatments such as sensory alterations (SA). SA have been well documented and are associated with altered food perception and reduced food intake. In addition to taste and smell, food perception is also influenced by somatosensation comprising of tactile/texture, thermal, and trigeminal perception. The current review aims to investigate SA, specifically oral somatosensory alteration, among HNC patients and its potential consequences on food intake. MethodsA literature search was conducted using PubMed, Scopus, and Web of Science. Related works were also identified by snowballing. Keywords searched were, but not limited to: head and neck cancer; malnutrition; taste; smell; oral somatosensation; texture; oral tactile; trigeminal; thermal; chemotherapy; radiotherapy. ResultsMalnutrition in HNC patients ranged between 9–100% depending on tumor site, treatment, and time point (before, during, or after treatment). Between 56–100% of HNC patients experienced taste and/or smell alterations. Patients with these alterations showed altered food behavior including food aversion, modified food preference, reduced appetite, and lower food enjoyment. SA were also linked to lower food intake and higher weight loss. Regarding somatosensation, psychophysical studies (n = 7) showed reduced oral tactile function among HNC patients but its correlation with texture perception remains elusive. These studies (n = 2) also indicated reduced thermal sensitivity, whereas psychophysical studies investigating trigeminal perception have not been identified. Qualitative studies reported alterations such as altered sensitivity to spices, certain food textures, and temperature. ConclusionsSA are directly linked to food perception which contributes to changes in food behavior. However, evidence is still limited on oral somatosensory alteration and overall, results are inconclusive on the relationship between altered food behavior and intake. Such insights should support optimization of personalized meal for patients. Funding SourcesDanone Nutricia Research, French Industrial Training through Research Agreements, French League against Cancer.

Sustainability of Diets in Mexico: Diet Quality, Environmental Footprint, Diet Cost, and Sociodemographic Factors.

BackgroundLittle is known about the current intake of sustainable diets globally and specifically in middle-income countries, considering nutritional, environmental and economic factors.ObjectiveTo assess and characterize the sustainability of Mexican diets and their association with sociodemographic factors.DesignDietary data of 2,438 adults within the National Health and Nutrition Survey 2012 by integrating diet quality measured by the Healthy Eating Index (HEI-2015), diet cost, and four environmental indicators were analyzed: land use (LU), biodiversity loss (BDL), carbon footprint (CFP), and blue water footprint (BWFP). We defined healthier more sustainable diets (MSD) as those with HEI-2015 above the overall median, and diet cost and environmental indicators below the median. Logistic regression was used to evaluate the association of sociodemographic factors with MSD.ResultsMSD were consumed by 10.2% of adults (4% of urban and 22% of rural), who had lower intake of animal-source foods, unhealthy foods (refined grains, added sugar and fats, mixed processed dishes and sweetened beverages), fruits, and vegetables, and higher intake of whole grains than non-MSD subjects. Characteristics of MSD vs. non-MSD (urban; rural) were: HEI-2015 (62.6 vs. 51.9; 66.8 vs. 57.6), diet-cost (1.9 vs. 2.8; 1.9 vs. 2.5 USD), LU (3.3 vs. 6.6; 3.2 vs. 5.9 m2), BDL (105 vs. 780; 87 vs. 586 species × 10−10), BWFP (244 vs. 403; 244 vs. 391 L), and CFP (1.6 vs. 4.4; 1.6 vs. 3.7 kg CO2eq). Adults from rural vs. urban (OR 2.7; 95% CI: 1.7, 4.1), or from the South (OR 2.1; 95% CI: 1.1, 3.9), Center (OR 2.3; 95% CI: 1.3, 4.4) vs. the North were more likely to consume MSD, while adults with high vs. low socioeconomic status were less likely (OR 0.17; 95% CI: 0.09, 0.3).ConclusionsThe MSD is a realistic diet pattern mainly found in disadvantaged populations, but diet quality is still sub-optimal. Increased consumption of legumes, fruits, and vegetables, and a reduction in unhealthy foods, is required to improve nutritional quality of diets while ensuring their environmental sustainability.

Associations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth

BackgroundExcessive intake of ultra-processed foods, formulated from substances extracted from foods or derived from food constituents, may be a modifiable behavioral risk factor for adverse maternal and infant health outcomes. Prior work has predominately examined health correlates of maternal ultra-processed food intake in populations with substantially lower ultra-processed food intake compared to the US population. This longitudinal study investigated relations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth in a US cohort.MethodsMothers in the Pregnancy Eating Attributes Study were enrolled at ≤12 weeks gestation and completed multiple 24-Hour Dietary Recalls within six visit windows through one-year postpartum (458 mothers enrolled, 321 retained at one-year postpartum). The NOVA (not an acronym) system categorized food and underlying ingredient codes based on processing level. Maternal anthropometrics were measured throughout pregnancy and postpartum, and infant anthropometrics were measured at birth and ages 2 months, 6 months, and 1 year. Maternal cardiometabolic markers were analyzed from blood samples obtained during the second and third trimesters.ResultsHolding covariates and total energy intake constant, a 1-SD greater percent energy intake from ultra-processed foods during pregnancy was associated with 31% higher odds of excessive gestational weight gain (p = .045, 95% CI [1.01, 1.70]), 0.68±0.29 mg/L higher c-reactive protein during pregnancy (p = .021, 95% CI [0.10, 1.26]), 6.7±3.4% greater gestational weight gain retained (p = .049, 95% CI [0.03, 13.30]), and 1.09±0.36 kg greater postpartum weight retention (p = .003, 95% CI [0.38, 1.80]). No other significant associations emerged.ConclusionsUltra-processed food intake during pregnancy may be a modifiable behavioral risk factor for adverse maternal weight outcomes and inflammation. Randomized controlled trials are needed to test whether targeting ultra-processed food intake during pregnancy may support optimal maternal health.Trial registrationClinicaltrials.gov. Registration ID – NCT02217462. Date of registration – August 13, 2014.

Prevalencia de factores de riesgo de desnutrición en pacientes latinoamericanos hospitalizados: un análisis de nutritionDay 2016-2020

Hospital malnutrition is a complex international health issue described to be associated with worse patient outcomes and increased healthcare costs(1). A large proportion of patients is already found malnourished at the time of hospital admission, others develop malnutrition while in hospital, often as a complication associated with the disease. Malnutrition screening is crucial for identifying vulnerable patients who are nutritionally at risk already on admission, presenting well-known risk factors such as poor appetite, low food intake, history of unintentional weight loss or low body mass index (BMI).

Lower food intake due to domestic grazing reduces colony size and worsens the body condition of reproductive females of harvester ants

Lower food intake due to domestic grazing reduces colony size and worsens the body condition of reproductive females of harvester ants

Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data

BackgroundDiet is an important determinant of systemic pH and acid–base regulation. A frequent consumption of acid-inducing foods (including processed meats and cheese) combined with a low intake of base-inducing foods (such as fruits, legumes and vegetables) increases Dietary Acid Load (DAL), which has been associated with an increased risk for certain cancers. DAL also appears to be of paramount importance in cancer survivors, in whom it was associated with increased mortality and poor overall physical health. Literature on DAL in cancer survivors, however, is scarce and limited to a few studies.MethodsUsing cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES), we sought to quantify DAL in U.S. cancer survivors and contrasted the results to the general population. DAL was estimated using established formulas (Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP)).ResultsOur study comprised 19,413 participants, of which 1444 were self-reported cancer survivors. Almost 63% of cancer survivors were female (weighted proportion) with a mean age of 61.75 (0.51) years. DAL scores were consistently higher in cancer survivors (as compared to the general population) after adjustment for confounders in multivariate regression models. These differences, however, were not statistically significant (p = 0.506 for NEAPF, 0.768 for PRALR and 0.468 for NEAPR, respectively). Notably, DAL scores were positive throughout (> 0 mEq/d) in cancer survivors, suggesting an acidifying diet. Specific examples include mean PRALR scores > 11 mEq/d in cancer survivors aged 55 years and mean NEAPF scores > 50 mEq/d in cancer survivors aged 40–60 years).ConclusionsThe acidifying diet in this sample of cancer survivors warrants caution and requires further investigation. Comparably high DAL scores have been associated with adverse health outcomes and an increased mortality in previous studies in breast cancer survivors. Thus, increased awareness as well as additional clinical trials in this field are urgently warranted.

Brazilian Green Propolis Modulates Cholesterol Homeostasis in a Preclinical Guinea Pig Model

This study investigates the effect of the hydroalcoholic extract of Brazilian green propolis on lipid metabolism in hypercholesterolemic guinea pigs. This product has been considered an important source of bioactive compounds with potential health benefits. Thirty‐six guinea pigs, Cavia porcellus (male), 90 days old, weight of 400 g, were divided into six groups of six animals each and fed a standard AIN‐93 M diet (C), hypercholesterolemic diet (H), hypercholesterolemic diet + hydroalcoholic extract (75 mg/kg body weight [HEtOH1]; 150 mg/kg body weight [HEtOH2], and 300 mg/kg body weight [HEtOH3]), or hypercholesterolemic diet + simvastatin (1.5 mg/kg body weight) (HS) for 10 weeks. The group‐specific diet and water were provided ad libitum throughout the experimental period. Blood and liver tissue samples were collected for biochemical analysis and histopathology. Statistical analysis was performed using GraphPad Prism software version 5.0. The experimental protocol for the use of animals was approved by the Ethics Committee on Animal Use of the University of São Paulo (N°18.1.999.60.0). Animals in the H groups had a lower food intake than in the C group. Fecal excretion was regulated by the administration of extracts, being higher in these groups when compared to H and HS groups. Liver weights were influenced by the diet and administration of the hydroalcoholic extract of green propolis. Hypercholesterolemic diets determined an increase of about 2 times in the relative weight of this organ when compared to the C group, being more expressive in the groups of animals that received the hydroalcoholic extract. A significant increase in serum levels of total and non‐HDL cholesterol was observed in H group, concomitant with a reduction in the concentration of cholesterol‐HDL when compared to group C. However, these high levels of total cholesterol were reduced when simvastatin and extracts were administered with the hypercholesterolemic diet. The same was observed for the non‐HDL cholesterol fraction, where administration with simvastatin and extracts significantly reduced the concentration of these fractions, especially in HS and HEtOH3 groups when compared to group H. Analysis of the HDL fraction demonstrates that the animals submitted to the hypercholesterolemic diet had the lowest levels for this parameter when compared to the groups that received the control diet and/or extracts and simvastatin. There was a significant reduction in serum triacylglycerol levels in the HEtOH2 and HEtOH3 groups. However, a change in liver metabolism was observed, favoring the deposition of lipids in the liver, a different profile from what was observed when administering simvastatin. C group presented a histological aspect compatible with the normality of the organ. The H and HS groups presented moderate to severe fat degeneration, with a slight degeneration in the HS group when compared to the H group. A profile similar to that of the HS group was observed in the HEtOH2 group. Our results suggest that the Brazilian green propolis extract induces positive effects on dyslipidemia.

Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition.

The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.

Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition

The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.