Mean Nutrient Intakes Research Articles

The proportion of differently processed foods in the diet of Croatian school-aged children and its impact on daily energy and nutrient intake

In countries around the world, a dietary shift is observed in which the consumption of highly processed foods increases over unprocessed or minimally processed foods. The objective of this study was to observe the proportion of processed foods in the diet of school-aged children and to assess how this relates to sex, weight status and school meal consumption. The aim was to assess the impact of processed foods on overall diet quality in terms of ultra-processed foods contribution to total daily energy intake. Dietary intake was observed from dietary records for three non-consecutive days of 168 children (50.6% boys) aged 8.3 ± 0.5 years. All foods and beverages were classified into four groups according to NOVA food classification system. The contribution of each NOVA food group to total daily energy intake was calculated and the mean nutrient intake of children divided into terciles according to total daily energy intake from ultra-processed foods was compared. Anthropometric measurements were performed according to standard protocols, while sex and age z-scores were obtained using AnthroPlus software. Results show that unprocessed or minimally processed foods (38.1% kcal) and ultra-processed foods (38.1% kcal) had the highest proportion of dietary intake. There was no difference in NOVA food groups intake by sex or weight status, while number of school meals may contribute to the intake of processed culinary ingredients. Children who had higher energy intake from ultra-processed foods had lower intake of animal proteins (p=0.009), polyunsaturated fatty acids (p=0.014), vitamin A (p=0.027) and most minerals, but higher intake of carbohydrates (p=0.014) and copper (p=0.014) compared to children with lower energy intake from ultra-processed foods. In conclusion, school-aged children had equal share of energy from unprocessed or minimally processed foods and from ultra-processed foods. Higher share of energy from ultra-process foods may contribute to poor overall nutrition.

Examining Nutrient Intakes of Canadian Adults With Diabetes Using the Diabetes Canada Clinical Practice Guidelines Nutrient Profile Model

ObjectivesThe Diabetes Canada Clinical Practice (DCCP) Guidelines provide dietary recommendations for Canadians at risk and with diabetes to help lower risk and for self-management of diabetes. The DCCP nutrient profile model was developed to classify foods based on their adherence to the DCCP Guidelines. The objective of the study was to examine the nutrient intakes of Canadian adults with diabetes using the DCCP nutrient profile model. MethodsUsing one-day 24-hour dietary recall from the 2015 Canadian Community Health Survey-Nutrition, nutrient intakes of Canadian adults with self-reported status of diabetes were examined. Foods were categorized by the DCCP nutrient profile model as “least”, “partially”, or “most” aligned with the DCCP Guidelines. Mean nutrient intakes were estimated and standard errors were calculated using balanced repeated replication with 500 bootstrap weighted replicates. Mean estimates were adjusted for age, sex, energy intake, and misreporting status using least squares regression. ResultsCanadian adults with diabetes (n = 1,249) consumed 14% (341 kcal/d [95% CI: 254,428]), 54% (1,291 kcal/d [1112,1470]), and 31% (682 kcal/d [613,751]) of total calories from foods that are “least”, “partially”, and “most” aligned with the DCCP Guidelines, respectively. The proportion of total fat, carbohydrate, and protein intakes from foods that are “least”, “partially”, and “most” aligned with the DCCP Guidelines were similar to their caloric contribution. However, 49% of added sugar intakes (24.1 g/d [20.8, 27.4]) were consumed from foods “least” aligned with the DCCP Guidelines. Over 60% sodium (1,746 mg/d [1,578, 1,915]) and saturated fat (18.7 g/d [16.1, 21.4]) intakes were consumed from foods “partially” aligned with the DCCP Guidelines. More than half of the fiber intakes (11.2 g/d [10.2, 12.2]) were consumed from foods “most” aligned with the DCCP Guidelines. ConclusionsDespite the low caloric contribution of foods “least” aligned with the DCCP Guidelines, these foods contributed to disproportionate intakes of added sugar and saturated fat among Canadian adults with diabetes. The use of the DCCP nutrient profile model can help Canadians with diabetes improve their nutrient intakes. Funding SourcesCIHR Project Grant; Sanofi-Pasteur International Collaboration; CIHR-Doctoral Award (JJL).

Impact of Dietary Assessment Methods on Reports of DS Product Use and Nutrient Intakes Among DS Users

ObjectivesReliable dietary assessment tools for assessing nutrient intake from foods/beverages and dietary supplements (DS) are critical for population-level monitoring; yet, different tools vary in their strengths and weaknesses for assessing intake from foods/beverages, and less is known about the performance of these tools in measuring intake from DS. The Interactive Diet and Activity Tracking in AARP (IDATA) cohort study was designed to evaluate the measurement error structure of 24-hr dietary recall (24 HR) and food-frequency questionnaire (FFQ) data, inclusive of DS information. The objective of the study was to compare DS data reported on 24 HRs and frequency-based questionnaires from the IDATA study among U.S. adults (aged 50–74 y; n = 795).MethodsDS information was collected over 12 months among adults who participated in IDATA and completed up to 6 Automated Self-Administered 24 HRs (ASA24s; 2011 version) and 2 FFQs (i.e., Diet History Questionnaire (DHQ) II), which queried information on DS usage, frequency, and amount of DS taken. Prevalence of use by product type and estimated nutrient intakes from DS for selected nutrients (i.e., calcium, magnesium, vitamins C and D) were compared between the 2nd DHQ II and the average of ≥2 ASA24s using the kappa coefficient to quantify agreement and paired t-tests to compare mean nutrient intakes.ResultsThe majority of U.S. adult DS users who participated in IDATA reported DS use on the DHQ (84%) and on ≥2 ASA24s (84%). Among the DS products reported on ≥2 ASA24s and the DHQ, agreement between the two methods ranged from κ = 0.06 (multivitamin) to κ = 0.70 (calcium and vitamin D), with substantial agreement present (κ ≥ 0.61) for iron, omega-3, fish oil, multivitamin-mineral, potassium, vitamin C, and vitamin E products. When evaluating differences in mean nutrient intake reported on ≥2 ASA24s and on the DHQ, no significant differences in calcium or vitamin C intake were observed; however, for vitamin D, large variation in intake was observed between the DHQ (8.3 μg/d) and ≥2 ASA24s (19.9 μg/d).ConclusionsCurrently, no consensus exists on the best method for measuring intake from DS. The comparability of 24 HRs and frequency-based dietary assessment methods in measuring the prevalence of use of and estimating nutrient intakes from DS varies by the nutrient of interest, and the type of DS product consumed.Funding SourcesN/A.

Intake of Foods That Could Be Fortified and of Nutrients That Could Potentially Contribute to Anemia Among Indian Women Before Fortification Implementation

Objectives1) To estimate intake of staple foods and condiments that could be fortified if 2018 fortification regulations released by the Food Safety and Standards Authority of India for oil, wheat flour, rice, salt, and milk were implemented effectively under social protection programs; and 2) To estimate intake of nutrients that could potentially contribute to anemia among women of reproductive age (WRA) (15–49 y) in India, prior to fortification implementation. MethodsWe estimated WRA’s mean food intake and intake of iron, vitamin A, vitamin C, riboflavin, thiamine, zinc, and folate by integrating single-day 24-h dietary recall from the National Nutrition Monitoring Bureau (NNMB) Rural Survey 2009–2012 (n = 11,625) and our food composition table (FCT). This FCT was created using the 1989 and 2017 Indian FCTs, FCT for Bangladesh, and USDA’s Food Data Central to estimate WRA’s intake of nutrients that were not included in the original NNMB: copper, vitamin B12, vitamin B6, and vitamin E. ResultsOn a daily basis prior to fortification, WRA consumed on average 10.5 (SD 11.6) g of oil, 78.9 (SD 133.8) g of wheat flour, 227.4 (SD 158.8) g of rice, 0.4 (SD 4.6) g of salt, and 55.4 (SD 79.7) g of milk. On a daily basis, 73.1%, 45.5%, 85.5%, 12.8%, and 59.5% of WRA consumed oil, wheat flour, rice, salt and milk, respectively. Prior to fortification, WRA consumed on average 12.3 (SD 7.4) mg of iron, 190.7 (SD 473.1) mcg of vitamin A, 37.8 (SD 36.8) mg of vitamin C, 0.7 (SD 0.3), mg of riboflavin, 1.1 (SD 0.5) mg of thiamine, 7.8 (SD 3.6) mg of zinc, 235.4 (SD 419.6) mcg of folate, 1.9 (SD 0.8) mg of copper, 1.3 (SD 3.3) mcg of vitamin B12, 1.1 (SD 0.5) mg of vitamin B6, and 3.3 (SD 3.5) mg of vitamin E. ConclusionsStaple food consumption suggests that wheat flour, rice, and milk are good fortification vehicles to reach WRA. The percentage of women consuming condiments suggests oil is a good fortification vehicle for WRA. However, WRA’s intake of nutrients that could potentially contribute to anemia is varied. Our food composition table provides a unique opportunity to analyze nutrients in addition to those included in the NNMB. The NNMB data can be used to model the potential nutrient contribution of fortified foods among WRA in India. Funding SourcesGlobal Affairs Canada.

Effects of sub-acute co-exposure to WIFI (2.45GHz) and Pistacia lentiscus oil treatment on wound healing by primary intention in male rabbits.

BackgroundThe bioeffects of WIFI on cutaneous wound healing remains unexplored. In addition, several medicinal plant products including lentisk oil have been shown to interfere with wound healing process. Since the use of this oil is increasing, the co‐exposure (WIFI‐Lentisk oil) assessment is of paramount importance.ObjectivesWe aimed in the present study to investigate the effects of WIFI exposure as well as the application of Pistacia lentiscus oil on sutured wounds (SW).MethodsNew Zealand male rabbits (n = 24) were used and randomly divided into four groups of six animals each: a control group (SW) and three experimental groups (i) a first group exposed to WIFI (2.45 GHz, 6 h/day) during 16 days (SWW); (ii) a second group exposed to WIFI (2.45 GHz, 6 h/day) during 16 days and treated with lentisk oil (SWWL) and (iii) a third group not exposed to WIFI but treated with lentisk oil (SWL). The wound healing was evaluated by monitoring clinical parameters (temperature, food intake, relative weight variation, and macroscopic aspect) and histology.ResultsThe mean food intake was higher in the SWWL group compared to the three other groups (p < 0.001) and higher in the SWL group compared to the SW group (p = 0.014). The exposition to WIFI (SWW group) or lentisk oil application (SWL group) can promote the collagen deposition and ameliorate the general aspect of wounds. By contrast, the co‐exposure to WIFI and lentisk oil (SWWL) results in antagonist effects and extends the inflammatory phase of wound healing.ConclusionsWounds treated topically with Pistacia lentiscus oil should not be exposed to WIFI.

Analysis of food sources and nutrient intakes of selected breastfeeding mothers in Metro Manila, Philippines

BackgroundThis study evaluated the food and nutrient intakes of selected breastfeeding mothers and identified the top food sources of nutrient intakes.MethodsThis is a cross-sectional, non-interventional study conducted in one of the private medical centers in Metro Manila, Philippines. Participants: The sample size included 70 mothers of healthy, term, exclusively breastfed infants aged 21–26 days at enrollment. Mothers were scheduled to visit the clinic at days 1, 22, 57, and day 90.Similarly, food diaries were obtained during these periods with a 3-day food record per clinic visit totaling to 12 records per mother at the end of 90 days. At every clinic visit, the records were validated face – to – face by the registered nutritionist – dietitians. An extension of the mother’s participation until day 155 was implemented for the collection of clinical outcomes used by Pediatricians. Mean food intakes were calculated. A PC-Software for Intake Distribution Estimation (PC-SIDE) program was used in the estimation of inadequate intakes. Socio-economic status was collected using standard questionnaires. Weight and height were measured using standard techniques to compute for BMI.ResultsAnthropometric results for the breastfeeding mothers reported a mean weight of 56.9 kg (SE = 1.3) and a mean height of 152.4 cm (SE = 0.6). In terms of body mass index (BMI), 8.6% were chronic energy deficient, and 34.3% were overweight while 12.9% were obese. Mean energy intake of breastfeeding mothers was 2516.7 kcal/day, which was 28.6% higher than the EER of 1957 kcal/day. Mean protein intake was 78.4 g/day, which was 37% inadequate while fat intake as percentage of total energy was excessive by 4%. Nutrient inadequacy is high for almost all nutrients: iron (99%), folate (96%), riboflavin (39%), vitamin B6 (63%), vitamin B12 (46%) and thiamine (22%). The top 5-food sources with highest percent contribution to energy are rice (43.1%), bread (8.1%), pork (7.7%), powdered milk (5.9%), and sweet bakery products (5%).ConclusionsThere is a high prevalence of protein and micronutrient inadequacies in the diet of breastfeeding mothers. The prevalence of overweight and obesity is high among breastfeeding mothers. These findings might be explained by the low variety and nutrient-poor foods consumed by the breastfeeding mothers. Understanding the major food sources of nutrient intake of breastfeeding mothers could be used to intensify if not craft interventions to address the nutrient gaps. Improving the maternal nutrition may contribute to having quality breastmilk to infants.

Comparison of nutritional status of HIV positive children with homecare and institutional care/ orphanage - An eye opener cross sectional study.

ABSTRACTBackground:Nutrition has an important bearing on the health of Human immunodeficiency virus (HIV) positive children. Ascertaining the nutritional demands correctly and provisioning the nutritional needs to HIV positive/ Acquired Immunodeficiency syndrome (AIDS) children will go a long way in maximizing the therapeutic benefits reaped through ever improving pharmaceutical initiatives, and thus, contribute to prolonging the longevity of these children who have a whole life ahead of them.Objectives:To study the nutritional status, including dietary assessment and anemia status of HIV-positive children, and compare the outcomes among children under homecare (staying with families) and orphanages/institutional care.Methodology:A cross sectional study was carried out among children between 2 and 15 years who were attending Pediatric Outpatient department (OPD) of a tertiary care hospital in western Maharashtra. Data were collected from 106 children by the interviewer himself using pretested validated questionnaire along with anthropometric measures and relevant blood tests. A 24-h recall method was used to collect the dietary intake. Institutional ethical clearance was taken, and data were collected through informed consent of the parent/guardian accompanying the children.Results:Out of the 106 subjects studied, 54 (50.9%) were living in orphanages and 52 (49.1) were living with the family. Out of the 52 subjects of children under caregivers, 48.1% of the caregivers were unskilled workers and more than half of the subjects had a monthly family income of less than Rs 3,000. About 46.1% of the subjects’ caregivers were illiterate. In the orphanage, 28 (51.8%) were males and 26 (48.2%) were females; 52 (49.1%) children were living with family of whom 30 (57.7%) were males and 22 (42.3%) were females. The prevalence of anemia (86.5%) and undernutrition (61.1%) was more among those living with family compared to the orphans living in orphanages and the same was statistically significant (P < 0.05). Among the children living in orphanages, the mean intake for most of the nutrients was more across all age groups. Within homecare, the mean nutrient intake of the females for all nutrients was more than the males across all age groups except 3–9 years, where it was more in males. Overall, all the children received less of water-soluble vitamins compared to recommended daily allowances (RDA), and the children of age group 5–15 years received less vitamin A and iron also.Conclusion:Adequate nutrition, which is best achieved through the consumption of a balanced healthy diet, is vital for health and survival for all HIV-infected children. Specific measures to be directed to children under homecare and measures directed to improve social factors need to be undertaken.

Why don’t college freshmen meet the US dietary guidelines for added sugar, refined grains, sodium, and saturated fat?

Objective The objective of the study was to evaluate how well college students meet U.S. dietary guidelines by examining the mean intakes of nutrients to limit (sodium, sugar, refined grains, and saturated fat), and what factors lead to exceeding the dietary recommendations. Participants Participants were first-year undergraduate students (N = 269). Methods Diet was assessed using a DHQ-III and estimated with food source composition tables. Multivariable logistic regression analysis was used to model variables associated with exceeding the recommendations. One-sample t-tests were performed to compare the cohort with national intakes. Results One-third met added sugar guidelines; only 4% met daily refined grains requirements, Fewer than half met saturated fat guidelines, and slightly over half met recommended sodium guidelines. Level of physical activity, race/ethnicity, and living on campus were the important predictors for exceeding recommended intakes. Conclusions Most students do not adhere to the U.S. dietary guidelines for nutrients to limit.

Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review.

Health authorities increasingly recommend a more plant-based diet, rich in fruits, vegetables, pulses, whole grains and nuts, low in red meat and moderate in dairy, eggs, poultry and fish which will be beneficial for both health and the environment. A systematic review of observational and intervention studies published between 2000 and January 2020 was conducted to assess nutrient intake and status in adult populations consuming plant-based diets (mainly vegetarian and vegan) with that of meat-eaters. Mean intake of nutrients were calculated and benchmarked to dietary reference values. For micronutrient status, mean concentrations of biomarkers were calculated and compared across diet groups. A total of 141 studies were included, mostly from Europe, South/East Asia, and North America. Protein intake was lower in people following plant-based diets compared to meat-eaters, but well within recommended intake levels. While fiber, polyunsaturated fatty acids (PUFA), folate, vitamin C, E and magnesium intake was higher, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake was lower in vegetarians and vegans as compared to meat-eaters. Intake and status of vitamin B12, vitamin D, iron, zinc, iodine, calcium and bone turnover markers were generally lower in plant-based dietary patterns compared to meat-eaters. Vegans had the lowest vitamin B12, calcium and iodine intake, and also lower iodine status and lower bone mineral density. Meat-eaters were at risk of inadequate intakes of fiber, PUFA, α-linolenic acid (ALA), folate, vitamin D, E, calcium and magnesium. There were nutrient inadequacies across all dietary patterns, including vegan, vegetarian and meat-based diets. As plant-based diets are generally better for health and the environment, public health strategies should facilitate the transition to a balanced diet with more diverse nutrient-dense plant foods through consumer education, food fortification and possibly supplementation.

Nutritional Profile of Adult Men (35-55 years), Energy Balance and Impact of Nutrition Education on their Nutritional Knowledge

Two hundred adult men between 36 and 55 years were selected for the assessment of their nutritional status. Information pertaining to socio economic status, anthropometric measurement, clinical profile and dietary pattern was collected using interview schedule. Energy costs of the activities were also collected. Information on the dietary nutrient intake was collected using 3-day dietary recall method. Anthropometric measurements namely height, weight, BMI and waist hip ratio were analyzed using standard procedures. Data was statistically analyzed. Results show that a greater percentage of the selected adult men were involved in moderate activity and belonged in middle income group. The educational qualification showed that 66% have completed school. The greater percentages of the selected subjects were from nuclear family. Most of the subjects were of normal height when compared with reference value. BMI revealed that forty nine percent were normal, 30% were overweight and 21% were obesity. Most of the selected subjects had WHR greater than 1. The food habits showed that majority of them were non vegetarians. Consumption of green leafy vegetables and fruits was less. On the contrary rice, wheat, red gram dhal were consumed daily. Most of the selected subjects mean nutrient intake was deficit when compared to RDA. The results of energy balance study showed that mean positive energy balance was 2098.2±90 kcal in the selected subjects. Nutrition education was given by power point, charts, pamphlets and a low energy snack was formulated and demonstrated used in the nutrition education programme. Results of paired t-test done shows that the nutrition education was effective (t = 3.84) and helped in improving the nutrition knowledge. The formulated product contains high amount of fibre. There is a need for educating these subjects on the right type and quantity of foods, higher intake of fibre rich foods, as well as the importance of regular physical activity to combat obesity.

Assessment and Updating of the Fortification Model from 2006

In 2006 the, the Panel on Nutrition, Dietetic Products, Novel Food and Allergy in the Norwegian Scientific Committee for Food Safety (VKM) adapted a Danish model for assessing applications concerning food fortification into Norwegian conditions. The fortification model is presently used by the Norwegian Food Safety Authorities as a tool in the management of applications on food fortification.&#x0D; &#x0D; The model from 2006 was based on intake calculations from dietary surveys from 1997-2000. Since then, new national dietary surveys have been published. These are the comprehensive nationwide Norwegian dietary surveys among adults (Norkost 3, 2010-2011), among young children (Småbarnskost, 2007) and infants (Spedkost, 2006-2007). The Norwegian Food Safety Authority has requested VKM to implement the new data into the fortification model from 2006.&#x0D; &#x0D; In the model from 2006 it is assumed that 25% of the energy in the diet can be derived from fortified foods and drinks. Information from the Norwegian Food Safety Authority, including about a pilot study for Norkost 3 suggested that the overall intake of fortified foods and drinks was marginal. From management of applications for fortified foods, the Norwegian Food Safety Authority also experienced that there are few fortified foods on the market in Norway. The Norwegian Food Safety Authority has therefore requested VKM to evaluate whether the assumption that 25 energy percent (E%) deriving from fortified foods can be reduced to 15 E%, and if such a reduction will have health implications. In addition, the Norwegian Food Safety Authority has asked VKM to perform an evaluation of the safety factors in the model.&#x0D; &#x0D; VKM argues that the model for fortification should be based on the dietary intake of vitamins and minerals at the 95th percentile level in various age groups. This is in accordance with risk assessments performed in European Food Safety Authority (EFSA), and will assure that the dietary intake in a majority of the population will be covered, still within a reasonable secure use of dietary exposure calculations. Mean intake of vitamins and minerals from food supplements (among users only) was chosen, in an attempt to reduce the impact of those with a high intake of supplements. The intake at 95th percentile from the diet plus the mean nutrient intake from supplements is deducted from the tolerable upper intake level (UL) for each nutrient in each age group, giving the maximum amount of nutrients that can be “allocated” for food fortification. The maximum amount of a nutrient that can be “allocated” is then distributed over the energy intake at the 95th percentile level. In this manner an estimate is made showing which age group is most likely to have an excessive intake of a certain nutrient. &#x0D; &#x0D; VKM does not have access to any other information about available fortified foods on the Norwegian market than the information given by the Norwegian Food Safety Authority. However, based on this information, VKM considers that it seems reasonable that the energy intake from fortified foods is reduced to 15 E%. In this revised fortification model the assumption from 2006 that 25 E% of the total energy intake will be derived from fortified foods, have therefore been reduced to 15 E%. This adjustment implies that the addition of e.g. vitamin D, vitamin E, thiamine, riboflavin, niacin, folic acid, vitamin B12, vitamin C and calcium per 100 kcal can be increased without risk of exceeding UL. No changes are made for e.g. vitamin A, beta-carotene, magnesium, iron, zinc or copper. A more summary is presented in Table 1 and Appendix 1.&#x0D; &#x0D; The Panel on nutrition, dietetic products, novel food and allergy considers that this model for management of fortification will reduce health risk that could be caused by unauthorised food fortification.

Impact of Short-Term Nutrient Supplementation Versus Nutrition Education/Counselling on Macro- and Micronutrient Intakes Among Persons on Maintenance Haemodialysis

Abstract Objectives We evaluated the of nutrient supplementation versus nutrition education/counselling on nutrient intakes among persons with end-stage renal disease (ESRD) on maintenance hemodialysis (MH). Methods Participants had anthropometry measured in addition to four consecutive 24-hour recall at baseline and during intervention both interventions. Persons in the intervention groups (IVG) received a supplement containing 550 kcal of energy, 23 grams of fat, 36 g of whey protein and specific amounts of micronutrients daily for 8 weeks. Following a 2 week washout period, the IVG received personalized nutrition education/counselling on weekly for over an 8-week period. Person in the NIVG did not receive nutrition supplements or personalized nutrition education/counselling. Both groups received the routine healthcare offered at their respective treatment centers. Participation in the study was voluntary following both written and oral consent. The study was approved by the university's Ethics Committee. Results All together 69 persons (IVG = 33; NIVG = 36) participated in the study. IVG and NIVG were similar in age sex distribution, weight and height. There were no significant differences in mean nutrient intake between persons in the IVG and NIVG. Supplementation resulted is significantly higher intakes of macro- and micro-nutrients and reduction in the prevalence of nutrient inadequacies when compared to personalized nutrition education/counselling per se. Conclusions Among participants, supplementation resulted in significantly higher intakes of the indexed nutrients compared to nutrition education/counselling. Our findings suggest that persons on MH attending designated treatment clinics may benefit from a program that that includes nutrition supplementation. Funding Sources The Campus Research and Publication Fund Committee.

Association Between Chemosensory Dysfunction and Diet Quality in United States Adults.

Evidence suggests chemosensory dysfunction (CSD) patients have altered diet, but population-level evidence assessing diet quality in CSD patients is lacking. We examined the association between CSD and diet quality in a representative sample of United States adults. This cross-sectional study included 2831 adults aged greater than 40 years from the 2013-2014 National Health and Nutrition Examination Survey who completed the taste/smell questionnaire and examination. Mean nutrient intake in subjects with self-reported olfactory/gustatory dysfunction (sOD/sGD) and measured olfactory/gustatory dysfunction (mOD/mGD) were compared to those without CSD using univariate Wilcoxon rank-sum tests. The Healthy Eating Index (HEI), a validated measure of diet quality, was calculated. The proportion of subjects with CSD with bottom-quartile HEI was compared to those without CSD using multivariate logistic regression, adjusting for demographic and socioeconomic covariates. The population-weighted prevalence of sOD, sGD, mOD, and mGD was 20.1%, 14.4%, 15.9% and 25.6%, respectively. Subjects with mOD had lower mean intake of total calories, total fat, protein, sodium, and potassium compared to normal subjects (1873.4 ± 49.6 vs 2010.2 ± 24.2 kcal, 72.3 ± 2.7 vs 78.6 ± 1.0 gm, 74.0 ± 2.5 vs 80.4 ± 0.6 gm, 3122 ± 97.2 vs 3353.2 ± 37.0 mg, 2509.8 ± 69.8 vs 2684.7 ± 26.1 mg, P < 0.05 respectively). When controlling for sociodemographic factors and comorbidities, subjects with sOD were more likely to have bottom-quartile HEI compared to normal subjects (OR 1.33, 95% CI 1.04-1.70). This population-level study suggests an association between poor diet quality and variation in dietary intake in patients with CSD, which warrants further investigation and suggests the possible need for nutritional counseling for CSD patients.

Trends in Nutrient Intakes of Indian Adults: Computerized Diet Analysis (CDiet) of Cross-sectional Surveys between 1998 and 2015

Background: Time trends in nutrient intakes have been reported from household food consumption using food table values. However, accurate estimates of trends over the past decade in nutrient intakes using computerised nutrient analysis of Indian diets are lacking. Objectives: To examine changes in nutrient intakes of Indian adults by re-analysis of dietary food intakes between 1998 and 2015 with computerized diet analysis software, CDiet. Methods: Diets of men and women (20-60 years) from Western India in 1998-2000 (n=559), in 2007-2009 (n=638), and in 2013-2015 (n=1073) were assessed mostly using semi-quantitative food frequency questionnaire by interview method. Daily nutrient intakes were calculated with laboratory- based food composition database using computerised diet analysis software (CDiet). Physical activity was assessed through a structured questionnaire and classified as; sedentary, light, and moderate activity level (PAL). Trends in mean nutrient intakes were evaluated using generalised linear regression model. Results: Over the past 17 years, trend estimates of energy intakes adjusted for age and PAL showed a decline of 11 to 19.7% for men, whereas an insignificant increase of 1 to 3% in women. Higher reduction (23 to 45%) was seen in intakes of iron, riboflavin, thiamine, and folate than in other micronutrients. Men with sedentary activity increased by 16.8%, whereas women having light/moderate activity increased by 7.2%. Conclusions: A decreasing trend in nutrient intakes over the last 17 years and an increase in sedentary behavior suggested the need for change in lifestyle and increased consumption of nutrient-- dense foods by Indian adults.

Development and Validation of a Food Frequency Questionnaire for Population of Adolescents in Croatia.

SUMMARYResearch backgroundFood frequency questionnaire (FFQ) is an important method for the estimation of dietary intake in epidemiologic studies. The aim of the study is to develop a FFQ and evaluate its relative validity for adolescents 12 to 18 years old.Experimental approachFFQ was developed from a previously validated youth/adolescent diet questionnaire (YAQ) by modifying it in order to include Croatian national foods. The final version of the FFQ (FFQ-m) comprised 87 food items. The reference method was a set of two 3-day food records (3DFR) administered twice during the 3 non-consecutive days, one month apart. The FFQ-m was administered approximately on the last day of the second applied dietary food record. Adolescents were recruited from randomly selected elementary and high schools in urban and rural areas of Croatia. FFQ-m was validated on a sample of 84 adolescents (70.2% female). Nutritional intake from FFQ-m and 3DFR were analysed for each participant. Spearman correlation coefficients (r) and Bland-Altman method were used to assess the validity of the FFQ-m compared to 3DFR. Anthropometric parameters were assessed in 78 adolescents.Results and conclusionsThe mean nutrient intake estimated by the FFQ-m was higher than that of the 3DFR. The average correlation coefficient for energy and nutrients in our validation study was 0.40. On average, 76.5% of adolescents were classified in the same or adjacent quartile of the nutrient intake. Bland-Altman analysis showed good agreement with all macronutrients and some micronutrients (sodium, phosphorus, potassium, calcium, magnesium and iron). A simple self-administered questionnaire completed by adolescents is a valid tool for measuring energy and nutrient intake among adolescent population.Novelty and scientific contributionThis is the first FFQ developed and validated for population of adolescents in Croatia. It will contribute to further research of nutritional intake in the population of adolescents, especially those from the region.

Serum fatty acid synthase levels and n-3 fatty acid intake in patients with breast cancer.

Fatty acid synthase (FASN) is a key enzyme in fatty acid biosynthesis that is usually over-expressed in patients with breast cancer, but its relationship with the patient's dietary habit is not clear. A higher intake of n-3 polyunsaturated fatty acids is related to reduced breast carcinogenesis invitro and invivo. The aim of this study was to clinically investigate the association between serum FASN levels and fatty acid intake in women newly diagnosed with breast cancer. In a case-control cross-sectional study, with 18 breast cancer patients and 29 controls, we evaluated nutritional status, dietary intake, and serum FASN levels. Statistical analyses were carried out with parametric and non-parametric tests, according to the sample's normality distribution. The mean age of breast cancer group (n=18) and control group (n=29) was 46.8±9.7y and 44.4.±8.6y, respectively. Mean serum concentration of FASN in breast cancer group was significantly higher (132.51±95.05ng/mL) than in control group (36.88±20.87ng/mL) (p<0.0001). Among breast cancer group, serum FASN levels of premenopausal women were significantly higher than those of postmenopausal women (p=0.026). There was no significant difference between the early and late disease stages in regard to serum FASN levels in breast cancer group. Mean nutrient intake was similar and n-3 docosahexaenoic acid intake was low in both groups. We observed no association regarding fatty acid intake and serum FASN levels. These data suggest that dietary n-3 fatty acid has no association with serum FASN levels among newly diagnosed breast cancer patients.

Effect of Manual Data Cleaning on Nutrient Intakes Using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24).

Automated dietary assessment tools such as ASA24® are useful for collecting 24-hour recall data in large-scale studies. Modifications made during manual data cleaning may affect nutrient intakes. We evaluated the effects of modifications made during manual data cleaning on nutrient intakes of interest: energy, carbohydrate, total fat, protein, and fiber. Differences in mean intake before and after data cleaning modifications for all recalls and average intakes per subject were analyzed by paired t-tests. The Chi-squared test was used to determine whether unsupervised recalls had more open-ended text responses that required modification than supervised recalls. We characterized food types of text response modifications. Correlations between predictive energy requirements, measured total energy expenditure (TEE), and mean energy intake from raw and modified data were examined. After excluding 11 recalls with invalidating technical errors, 1499 valid recalls completed by 393 subjects were included in this analysis. We found significant differences before and after modifications for energy, carbohydrate, total fat, and protein intakes for all recalls (P < 0.05). Limiting to modified recalls, there were significant differences for all nutrients of interest, including fiber (P< 0.02). There was not a significantly greater proportion of text responses requiring modification for home compared with supervised recalls (P=0.271). Predicted energy requirements correlated highly with TEE. There was no significant difference in correlation of mean energy intake with TEE for modified compared with raw data. Mean intake for individual subjects was significantly different for energy, protein, and fat intakes following cleaning modifications (P< 0.001). Manual modifications can change mean nutrient intakes for an entire cohort and individuals. However, modifications did not significantly affect the correlation of energy intake with predictive requirements and measured expenditure. Investigators can consider their research question and nutrients of interest when deciding to make cleaning modifications.

Subcutaneous tiletamine-zolazepam immobilization and effect of flumazenil reversal in African pygmy hedgehogs (Atelerix albiventris)

African pygmy hedgehogs ( Atelerix albiventris ) are popular zoological companion animals that routinely require chemical immobilization for veterinary care. The objective of this randomized, blinded, cross-over study was to evaluate the efficacy of low and high dosages of subcutaneous (SC) tiletamine-zolazepam for sedation and the efficacy of flumazenil for recovery in African pygmy hedgehogs. Twelve adult hedgehogs (7 males, 5 females) were administered tiletamine-zolazepam at 10 mg/kg (T10) or 30 mg/kg (T30) SC. Physiologic variables, reflexes and behaviors were monitored to evaluate quality of immobilization. Forty-five minutes after tiletamine-zolazepam injection, hedgehogs were administered flumazenil or an equivalent volume of saline SC. Baseline daily food intake was measured and then recorded daily for 6 days following sedation trials. Median (interquartile range [IQR]) time to onset of first effects for T10 and T30 was 2.9 minutes (2.5–5.3 minutes) and 2 minutes (1.4–2.9 minutes), respectively. Eighty-three percent of T10 and 100% of T30 hedgehogs lost righting reflex. The median (IQR) duration righting reflex was lost for T10 was 32.5 minutes (23.8–37.5 minutes) and it was lost for 47.5 minutes (36.25–63.75 minutes) for T30. Jaw tone was reduced in the majority of animals for both dosages but never lost. Heart and respiratory rate for both treatments remained within normal limits. Hedgehogs became rapidly hypothermic after induction. Flumazenil administration did not have a statistically significant effect on recovery time, but mean recovery times were 18 minutes faster for T10 hedgehogs administered flumazenil. There were no statistically significant differences in food intake within or between dosages of tiletamine-zolazepam at any time point for hedgehogs administered saline or flumazenil; however, mean food intake over the 6 days following T10 administration was 16 g/kg more for hedgehogs administered flumazenil. SC tiletamine-zolazepam at 10 and 30 mg/kg produces dose-dependent heavy sedation to light anesthesia in hedgehogs. Subjectively, while both dosages provided a sufficient depth of immobilization to permit a physical examination and noninvasive procedures like blood collection or diagnostic imaging, some jaw tone was maintained precluding endotracheal intubation. T30 provided a deeper level of immobilization than T10 but longer recovery times. Flumazenil administration did not have a statistically significant effect on recovery but recovery times were noticeably faster following SC flumazenil in hedgehogs sedated with T10. For hedgehogs immobilized with T10, mean food intake was greater when flumazenil was administered. Tiletamine-zolazepam provides an injectable option for immobilization of hedgehogs.

The Nutritional Impact of Milk Beverages in Reducing Nutrient Inadequacy among Children Aged One to Five Years in the Philippines: A Dietary Modelling Study.

Around half of Filipino children are not consuming any dairy products on a given day, which has shown to be associated with increased risk of inadequate nutrient intakes. The current study applies dietary modelling to assess the nutritional impact of meeting dairy recommendations in reducing nutrient inadequacy in children aged one to five years in the Philippines. Dietary intake data of Filipino children aged one to five years (n = 3864) were analyzed from the 8th National Nutrition Survey 2013. Children who did not meet national dairy recommendations were identified. Two scenarios were applied, based on two types of commonly consumed milk products by the survey participants. In scenario one, one serving of powdered milk was added to the diet of these children. In scenario two, one serving of a young children milk (YCM) or preschool children milk (PCM) was added to the diet of children aged one to two years and three to five years, respectively. Mean nutrient intakes and percentages of children with inadequate intakes were estimated before and after applying modelling scenarios. Scenario one demonstrated improvement in calcium, phosphorus, sodium, vitamin A and riboflavin intakes, while in scenario two, further improvement of intakes of a wider range of nutrients including iron, selenium, zinc, magnesium, potassium, vitamins C, D, E, thiamin, niacin, vitamins B6, and B12 was observed. In both scenarios, if all children would meet their dairy recommendations, theoretical reductions in population nutrient inadequacy would be observed for all micronutrients, for example, only 20% of children aged one to two years would be inadequate in vitamin A instead of the current 60%, iron inadequacy would see a 5% reduction, and approximately 10% reduction for calcium and 20% reduction for folate. The present study is the first to apply dietary modelling to assess the theoretical impact of meeting dairy recommendations on nutrient inadequacy in children in the Philippines. Dairy consumption should be encouraged as part of the strategy to reduce nutrient inadequacies. Calcium, iron, vitamins D, E, and folate are of concern in the Philippines as the level of inadequacies are extremely high in early years, YCM and PCM can help increase the intake of these nutrients.

Grain Products Are a Top Source of Energy and Nutrients among Nova Scotian Adults Following a Gluten-Free Diet.

To determine the food sources of energy and 13 core nutrients, 89 diet recalls were analyzed from an explanatory mixed-methods pilot study with adults following a gluten-free diet (GFD) for any reason. Nonconsecutive dietary recalls were collected through a web-based, Automated Self-Administered 24-Hour (ASA24®-Canada-2016) Tool. Mean nutrient intakes were compared with Dietary Reference Intakes. Food items (excluding supplements) were extracted and categorized according to the Bureau of Nutritional Sciences Food Group Codes. Percentages of total dietary intakes from food sources were ranked. Grain products were the highest ranked contributor of energy (21.4%), carbohydrate (30.3%), fibre (29.1%), and iron (35.3%). Breakfast cereals, hot cereals, yeast breads, and mixed grain dishes (mainly rice or pasta-based) were the most important nutrient contributors for grains, despite most (64.3%) commercial cereals and breads being unenriched. Legumes and seeds were not frequently consumed. Nutrient density in the GFD could be improved with more emphasis on gluten-free (GF) whole grains, legumes, seeds, and enriched breads and cereals. More research is needed on the nutrient composition of GF foods to identify food sources of folate, other B vitamins, zinc and magnesium-nutrients of concern for those requiring a GFD.