Nutritional Burden Research Articles

The timing of adrenarche in Maya girls, Merida, Mexico.

BackgroundAdrenarche involves maturation of the hypothalamic‐pituitary‐adrenal axis and increased production of dehydroepiandrosterone and its sulfate ester, dehydroepiandrosterone‐sulfate (DHEA‐S). It occurs at ages 6 to 8 in industrialized populations, marking the transition from childhood to juvenility and cognitive development at middle childhood. Studies in subsistence level populations indicate a later age (8‐9) for adrenarche, but only two such studies currently exist for comparison.AimsTo investigate adrenarcheal age among Maya girls and its association with body composition and dietary variables. We hypothesized adrenarche would occur earlier given the current dual burden of nutrition in Mexico.Materials and Methods25 Maya girls aged 7 to 9 from Merida, Mexico using ELISAs to measure salivary DHEA‐S, standard anthropometry for height, weight, and skinfolds, bioelectrical impedance for body composition variables, as well as a food frequency questionnaire for dietary information.ResultsOur hypothesis was rejected—adrenarche occurred close to 9 years. While no measures of body composition were significantly associated with adrenarcheal status, girls eating meat and dairy products more frequently had significantly higher DHEA‐S levels.DiscussionLike other populations living in ecologically challenging environments, adrenarche occurred relatively late among Maya girls. Adrenarche has been linked to measures of body composition, particularly, the adiposity or body mass index rebound, but no relevant anthropometric measures were associated, possibly because of the small sample.ConclusionFurther studies are required to illuminate how adrenarcheal variation relates to developmental plasticity, body composition, pubertal progression, and animal product consumption in other transitional populations.

Personalized Nutrition in Food Allergy: Tips for Clinical Practice.

Nowadays, food allergies are considered as a wide spectrum of disorders that need different approaches. The “one size fits all” approach is giving way to a “targeted approach,” based on the identification of the patient's phenotype. Thus, the approach of nutritional management of food allergy has moved on from simply being “yes or no” to “how much?”, “in which form?” and “for which patients?” Different factors should be considered in order to make a patient-tailored nutritional plan in clinical practice. Tailored nutritional plans may help to reduce the nutritional, social and economic burden of food allergy.

Nutrition transition, prevalence of double burden of malnutrition and cardiovascular risk factors in the adult population living in the island of Anjouan, Comoros

Introductionle surpoids et de l'obésité progressent de manière effrayante, notamment dans les pays en développement. Cette étude vise à déterminer la prévalence de l'insuffisance et de la surcharge pondérale et à évaluer la relation entre l'Indice de Masse Corporelle et les facteurs de risque cardiovasculaires associés chez les adultes de l'île d'Anjouan.Méthodesl'enquête est une étude transversale, où un échantillon de 902 individus âgés de 25 à 64 ans est sélectionné en utilisant la méthode de sondage empirique « des quotas ». Le statut nutritionnel est déterminé en calculant l'indice de masse corporelle (IMC), le périmètre abdominal et le rapport tour de taille/tour de hanche (RTH). La pression artérielle, le périmètre abdominal et le tour de hanche ont été mesurés pendant l'interview tandis que la glycémie capillaire à jeun a été mesurée le lendemain.Résultatsles résultats ressortis font état d'une moyenne d'âge de 39,5 ± 11,67 ans. La prévalence globale de l'insuffisance pondérale, du surpoids et de l'obésité est respectivement de 4,1%, 28,6% et 22,2%. Les facteurs de risque associés au surpoids/obésité sont l'âge avancé (P= 0,004), le genre (P=0,000), le poids (P=0,000), le diabète (P= 0,006), l'hypertension (P= 0,01), l'obésité abdominale (P= 0,000), le tour de hanche (P=0,000), le RTH (P=0,000), la durée inactive/jour (P=0,001) et le tabagisme (P< 0,05), contrairement à l'inactivité physique (P= 0,10).Conclusionles résultats confirment la présence du double fardeau nutritionnel. D'où l'urgence de mettre en place des stratégies de prévention des maladies non transmissibles.

The Mismatch between Anthropogenic CO2 Emissions and Their Consequences for Human Zinc and Protein Sufficiency Highlights Important Environmental Justice Issues

The impacts of climate change are not equally distributed globally. We examined the global distribution of CO2 emissions and the ensuing distribution of increases in the risk of zinc and protein deficiency resulting from elevated atmospheric CO2 concentrations. We estimated cumulative per capita (2011–2050) CO2 emissions for 146 countries using existing measurement data and by apportioning regional emissions projections. We tested the relationship between cumulative per capita CO2 emissions and the risk of additional zinc and protein deficiency at the population-level and country-level. At the population-level (i.e., population-weighted), we observed a significant inverse association between CO2 emissions and the percentage of the population placed at additional risk of zinc (p-value: &lt;0.001) and protein (p-value: &lt;0.01) deficiencies. Country-level (i.e., unweighted) analyses produced significant but less strong associations. Populations with lower per capita CO2 emissions between 2011 and 2050 will experience a disproportionately high nutritional burden, highlighting socioeconomic, geospatial, and intergenerational injustices.

Body Image and the Double Burden of Nutrition among South Africans from Diverse Sociodemographic Backgrounds: SANHANES-1.

This study investigated the associations between underweight, obesity and body image (BI) among 15+ year-old South Africans with diverse socio-demographic backgrounds. A cross-sectional survey and the analyses of data for 6411 15+ year-old participants in the first South African National Health and Nutrition Examination Survey was undertaken. Body image was compared to body mass index (BMI) and socio-demography. Data were analyzed using SPSS versions 25. Results are in percentages, means, 95% confidence intervals, p-values, and odds ratios. Overall, participants who were obese of which majority: were females, earned ZAR 9601+, completed grade 6, were non-Black men, were married and resided in urban formal areas, were more likely to underestimate their BMI and desire to be lighter. Participants who were underweight of which majority: were males, had no form of income or education, were black men, were not married, resided in less urban and farm areas, were younger than 25 years, were more likely to overestimate their BMI and desire to be heavier. While underweight and obesity were strong determinants of BI, BI was differentiated by socio-demography. These findings have a public health implication that requires special attention to curb the irrepressible underweight and obesity in South Africa.

Birth weight, birth order, and age at first solid food introduction influence child growth and body composition in 6- to 8-year-old Maya children: The importance of the first 1000 days of life.

To analyze the relationship of birth weight, birth order, breastfeeding duration, and age of introduction of solid foods with height, fat mass, and fat-free mass in a sample of Maya children when aged 6 to 8 years old. We collected data on anthropometry, body composition, children's birth weight, birth order, early feeding practices, and household socioeconomic characteristics in a sample of 260 Maya children aged 6 to 8 years living in Merida and Motul, two cities in Yucatan, Mexico. Multiple regression models were performed to identify variables associated with height-for-age (HAZ), fat mass index (FMI), and fat-free mass index (FFMI). The predictors included in the models were birth weight (kg), birth order, duration of breastfeeding (months), age at introduction of solid foods (months), maternal age (years), and height (cm). Models were adjusted for the influence of children's age and sex, maternal educational level, and household overcrowding. HAZ was positively associated with child birthweight and maternal height and age, but inversely associated with birth order and age of introduction of solid foods. FMI was positively associated with birth weight, maternal age, and height, and negatively associated with birth order. FFMI was positively associated with maternal age and birth weight. These results are evidence of the importance of the first 1000 days of life for the growth and body composition of Maya children and contributed to understand the development of nutritional dual burden in this population.

Health inequality in the tropics and its costs: a Sustainable Development Goals alert.

BackgroundIt is known that health impacts economic performance. This article aims to assess the current state of health inequality in the tropics, defined as the countries located between the Tropic of Cancer and the Tropic of Capricorn, and estimate the impact of this inequality on gross domestic product (GDP).MethodsWe constructed a series of concentration indices showing between-country inequalities in disability-adjusted life years (DALYs), taken from the Global Burden of Disease Study. We then utilized a non-linear least squares model to estimate the influence of health on GDP and counterfactual analysis to assess the GDP for each country had there been no between-country inequality.ResultsThe poorest 25% of the tropical population had 68% of the all-cause DALYs burden in 2015; 82% of the communicable, maternal, neonatal and nutritional DALYs burden; 55% of the non-communicable disease DALYs burden and 61% of the injury DALYs burden. An increase in the all-cause DALYs rate of 1/1000 resulted in a 0.05% decrease in GDP. If there were no inequality between countries in all-cause DALY rates, most high-income countries would see a modest increase in GDP, with low- and middle-income countries estimated to see larger increases.ConclusionsThere are large and growing inequalities in health in the tropics and this has significant economic cost for lower-income countries.

Dual Nutrition Burden in Urban Women from Low Middle Income Families

&lt;p&gt; Currently India is experiencing dual nutrition burden. Prevalence of both under and over nutrition is reported to be higher in women as compared to men. Over nutrition rates in Delhi are among the highest in India. A mixed longitudinal study was undertaken to assess nutritional status of urban women from low middle income families. Between January 2015 and December 2017, 4155 non-pregnant non-lactating women were enrolled for this observational study. These women belonged to food secure low middle income families. They were living in highly congested urban localities in one or two room tenements and had no access to public spaces where they could go for walk or discretionary physical activities. In all women, height was measured at enrolment. Efforts were made to measure weight, mid upper arm, waist and hip circumferences once in three months. Prevalence of under nutrition (BMI &amp;lt; 18.5) in the 18-29 years age group was 12.1%, but 33.9% had BMI of ≥25. There was a progressive increase in over-nutrition, high waist and hip circumferences with increasing age; 68.4% of women aged 50 years and above were over-nourished. None of the undernourished women had waist circumference ≥ 80 cm; among the normally nourished 8.5% and in the over-nourished women 3/4th had waist circumference above 80cm. Hip circumference showed a similar trend but prevalence of ≥ 102 cm was lower. Prevalence of over nutrition, truncal and abdominal adiposity was high in women from Delhi low middle income families.&lt;/p&gt;

Barriers to Optimal Maternal and Child Feeding Practices in Pastoralist Areas of Somali Region, Eastern Ethiopia: A Qualitative Study

Maternal and child nutrition is critical for child health and survival. Appropriate feeding practices are of fundamental importance for health, nutrition, survival and development of infants and children. In pastoral areas of Ethiopia, barriers related to culture, knowledge, social norms, beliefs, behaviors, decision making in the household and burden of other responsibilities contribute to nutritional status of women and children to deteriorate. Policies and strategies are recommending assessment of barriers for designing programs and interventions to improve maternal and child nutrition practices. This study is aimed to assess barriers of optimal maternal and child feeding practices in Pastoralist areas of Somali region, Eastern Ethiopia. A qualitative community based research method was used involving 17 focus group discussions and 20 in-depth interviews with mothers, grandmothers, health professionals and religious leaders from three districts. Data from FGDs and interviews were transcribed and coded. The agreed upon codes were synthesized and grouped into exhaustive categories. The categories were then merged into themes representing the most common barriers on maternal and child feeding practice that emerged from the FGDs and interviews. We found that traditional beliefs, myths, culture custodian influence, low accessibility and availability of nutritional foods, pattern and burden of other responsibilities, poor knowledge and health seeking behavior, perceived milk insufficiency as main barriers for optimal maternal and child feeding practices. Barriers on optimal maternal and child feeding are very common in the study areas. More work needs to be done to strengthen community-based nutrition with strong social behavioral change communication with emphasis on age-specific counselling on maternal and child nutrition at health facilities, during antenatal and early postnatal visits in the study areas through different media channels, particularly, Somali Region TV and FMs to promote optimal nutrition in the region.

Malezya'da Tüberkülozda Beslenme Yükü ve Sektörler Arası Beslenme Yönetimi: Malezya'da Bir Gözden Geçirme

Undernutrition and tuberculosis (TB) are a vital issue in most developing countries of the world. Both of these medical problems tend to have interacted with each other and bidirectional. The undernutrition creates a more significant problem in patients with active TB rather than among healthy individuals. Despite that, there is no protocol available on nutritional support in Malaysia to tackle on this issue. The objective of this review is to explore the nutrition burden of TB disease and the management available in Malaysia. The treatment for TB lasts for six months and above. Hence, it causes a financial burden not only for the healthcare provider but for the patient and the family members. If treatment is not successful and extends to a few months, it will increase the cost of the treatment. Malnutrition in TB patients will cause a problem in the outcome of TB treatment. It includes worsening of the disease, delayed sputum conversion, and increased risk of mortality. Other problems include malabsorption of Rifampicin, drug-induced hepatotoxicity, increased rate of relapse, and persistent of positive cultures in MDR-TB. Benefits of nutritional support for tuberculosis patients include improved body weight, increase in adherence/ compliance to the tuberculosis treatment and increase in the success of the treatment. Implementation of nutritional support protocol by the government and Non-profit organization (NGO) will be beneficial and improve the quality of life of tuberculosis patients.

Double Burden of Nutrition and some Eating Habits Characteristics of Preschool Children in Nam Hong Commune, Dong Anh district, Hanoi, 2018

Double Burden of Nutrition and some Eating Habits Characteristics of Preschool Children in Nam Hong Commune, Dong Anh district, Hanoi, 2018

Double burden of underweight and overweight among women of reproductive age in Bangladesh.

Bangladesh, like many emerging economies of South-East Asia, has started to experience a double burden of continuing high rates of undernutrition and increasing rates of overweight and obesity. A lack of assessment of the nutritional shift leaves a gap in current policies: the growing overweight and obesity is yet to be addressed. The present paper investigates the change in nutritional status, particularly the shift in BMI, of Bangladeshi women of reproductive age (15-49 years) and characterizes the vulnerable households for both underweight and overweight status during a period of 10 years (2004-2014). Generalized linear mixed-effect models were fitted for both urban and rural residents to assess underweight and overweight status. Bangladesh Demographic and Health Surveys. Women aged 15-49 years (n53 077). The proportion of overweight increased during 2004-2014 from 10·7 to 25·1 % and the proportion of underweight decreased from 32·6 to 18·2 %. Prevalence of underweight status remained high in rural areas and prevalence of overweight increased rapidly in both rural and urban areas, creating a double burden. The significant contributors to this double burden were the change in women's level of education, increased household wealth, divisional location and rapid urbanization. The findings indicate that specific cohort- or area-based intervention policy studies in line with the UN Decade of Action on Nutrition are required to address the nutritional double burden in Bangladesh.

Assessment of Nutritional Intakes in Individuals with Obesity under Medical Supervision. A Cross-Sectional Study.

People with obesity in Romania are often under medical supervision, which is aimed to decrease body weight and treat accompanying metabolic disorders and cardiovascular implications. However, there is limited information regarding the implementation of dietary recommendations in adults with obesity. We aimed to evaluate the prevalence of reaching the recommended intakes of macro- and micro-nutrients in adults with obesity under medical supervision. Individuals with obesity, recruited in the context of a study with a larger scope (NutriGen ClinicalTrials.gov NCT02837367), who were under medical supervision underwent four 24 h recalls in order to assess daily food intakes. Macro- and micro-nutrient intakes were computed, and the prevalence of reaching recommended dietary allowances (RDAs) for each nutrient was calculated. The majority of subjects did not meet the recommended intakes for most nutrients. Energy from fat exceeded the threshold of 35% recommended intake, even in the lowest quartile of energy intake. The micronutrients with less than 5% of individuals reaching the RDAs were vitamin D, vitamin E, fluoride, and omega-3 fatty acids for both males and females, and choline, magnesium, and potassium in females. The burden of inadequate nutrition in individuals with obesity should be acknowledged and properly addressed within efforts to reduce obesity rates and associated disorders.

Screening tools for targeted comprehensive geriatric assessment in HIV-infected patients 50 years and older.

Many people living with HIV (PLWH) are aging with geriatric syndromes, but few undergo comprehensive geriatric assessment (CGA) due to limited resources. Our study evaluates tools to identify aging PLWH who may forego CGA. We conducted a cross-sectional study on 357 PLWH ≥50 years old at the Red Cross, Thailand. Tools evaluated were the Veterans Aging Cohort Study Index (VACSI) and G-8, which is predictive among older cancer patients. CGA consists of eight tests: history of fall within 12 months, timed-up-and-go test (TUG), activities of daily living (ADL), instrumental ADL (IADL), Montreal cognitive assessment (MoCA), Thai depression scale (TDS), mini nutritional assessment (MNA), and HIV symptom index (HSI). We considered ≥2 impaired domains on CGA to be abnormal results. Forty-nine percent (n = 175) had ≥2 impaired domains on CGA. Few participants had experienced a fall (11%) or abnormal TUG/ADL/IADL (&lt;2%), and only MoCA/TDS/MNA/HSI were analyzed. A VACSI &lt; 17 produces 85% sensitivity (Se) and 30% specificity (Sp) (area under the ROC curve [AUC] = 63, 95%CI 58–69) and G-8 &gt; 15.5 produces 90%Se and 33%Sp (AUC = 74, 95%CI 69–79) in identifying patients with &lt;2 impaired domains. A G-8 &gt; 13.5 produces 91%Se and 77%Sp (AUC = 89, 95%CI 86–92) in ruling out abnormal nutrition. Patients with VACSI &lt; 17 and G-8 &gt; 15.5 may forego CGA due to low likelihood of abnormal cognition, mood, nutrition, or symptom burden.

The Forgotten Agriculture-Nutrition Link: Estimating the Energy Requirements of Different Farming Technologies in Rural Zambia With Time-Use Data

In the quest to reduce global under- and malnutrition, which is particularly high among smallholder farmers, agriculture-nutrition linkages have received a lot of attention in recent years. Researchers have analysed the link between the quantity of food that farmers produce and nutritional outcomes and the link between farm diversity and consumption diversity. A third agriculture-nutrition link has been largely neglected in recent years: the impact of how food is produced on human energy requirements, and, consequently, nutritional outcomes. This neglect persists despite the fact that the majority of smallholder farmers in Sub-Saharan Africa rely on hand tools for farming, which implies heavy physical work and, thus, high energy requirements. To address this research gap, the present study compares the energy requirements of farm households in rural Zambia that are characterized by three different levels of mechanization: hand tools, animal draught power and tractors. Detailed time-use as well as food and nutrition data was collected from male and female adults and from children during different seasons: land preparation, weeding and harvesting/processing. Subjects recorded time-use themselves using an innovative picture-based smartphone app called “Timetracker”. The time-use data served to calculate daily energy requirements using “Ainsworth’s Compendium of Physical Activities”. To analyse the link between mechanization and energy use as well as nutritional outcomes, linear mixed models and multiple linear regressions were used. The results show that during land preparation, individuals in non-mechanized households are, on the average, not able to meet their dietary energy requirements. In subsequent farming periods, results are more mixed. Gender differences are noteworthy throughout, with men mostly having higher physical activity levels and energy requirements compared to women The findings suggest that farm technologies affect nutritional outcomes substantially and that this neglected agriculture-nutrition linkage deserves more scientific and political attention in order to reduce the prevalence of both under- and malnutrition among smallholder farmers, while safeguarding against emerging double burden of nutrition.

Dietetic characteristics of a sample of Mayan dual burden households in Merida, Yucatan, Mexico.

The Maya are the most populous and shortest in stature Native American ethnic group. The Maya provide us a good opportunity to study the dietetic characteristics of a group who experience nutritional dual burden (the combination of under and ovenutrition) at the individual, mother-child dyad and population level. The aim of this study is to describe general dietetic patterns of a sample of Maya mothers and children who experienced nutritional dual burden and were living in the city of Merida, Yucatan, Mexico. From February to July 2010 we applied food frequency questionnaires (FFQ) to 58 dyads of Maya mothers and their children (7-9 years old). The FFQ was developed by staff of the Department of Human Ecology at Cinvestav and included 78 foods, grouped in: cereals and tubers, foods of animal origin, leguminous vegetables, fats, fruits, vegetables, sugars, and daily products. The frequencies of consumption were classified in four levels: 1) no consumption, 2) low (1-2 days/week), 3) medium (3-4 days/week), high (5-7 days/week). The observed pattern suggests a low consumption of fruits and vegetables, a medium consumption of pork, eggs, oil and lard, and a high consumption of soda and whole milk. From these frequencies we extrapolated that the dietetic pattern is characterized by a low intake of fibre and micronutrients and high intake of fat and sugars, findings supported by previous National and regional studies. Our observations suggest that the studied group have a dietetic pattern that has moved away from a traditional Maya diet.

Risk factors and socioeconomic inequalities in undernutrition among children 0-59 months of age in India

In the majority of low- and middle-income counties, child health-care dissimilarities are further aggravated by nutritional status (i.e., stunting, underweight, and wasting). In India, child malnutrition is the most important contributor to disease burden. The present study uses data from the 4th round of the National Family Health Survey (NFHS-4), conducted in 2015-2016. We considered anthropometric indicators of unit-level data of 2, 48, and 174 children aged 0-59 months. This study examines the socio-economic inequality in nutritional status and their determinants among under-5 year children. The factors considered in the analysis were categorized as child age in months, mother’s educational status, mother’s nutritional-status, type of caste, wealth index, birth order, and size of a child at birth. In this study, multivariate logistic regression and concentration index (CI) have been employed to explore the effect of various factors on the child’s nutritional status. The binary logistic analysis has demonstrated a significant association between child nutritional status and mother’s education, mother’s nutritional status, type of caste, wealth index, birth order, and size of a child at birth. The results show that the CI for stunting, underweight, and wasting were −0.14, −0.16, and −0.08. Therefore, these factors were significantly high in poorer households. Our study suggests that the nutrition-specific programs to encourage nutritional adequacy, diversity, reduces the nutritional burden, and growth of child’s in India.

EFEKTIVITAS PENDIDIKAN GIZI MENGGUNAKAN MEDIA EDUTAINMENT CARD TERHADAP PENINGKATAN PENGETAHUAN TENTANG PEDOMAN GIZI SEIMBANG PADA SISWA SEKOLAH DASAR

Background: Indonesia is still faced with a triple burden of nutrition, such as malnutrition, stunting and overnutrition. According to UNICEF, one of the cause nutrition problems is the lack of knowledge about nutrition. The prevention of health problem starts at the early stage, namely the understanding of balance nutrition guideline in school-age children. New method need to be made to make it easier for students to arrest nutrition message, namely in the form of edutainment cards.Objective: To determine the effectiveness of nutrition education by using the edutainment card method on knowledge about balance nutrition guideline in elementary school.Research Methods: The type of research is Experimental with pre and post-control group design design. Sampling using random sampling technique to get 30 treatment samples and 30 control samples. Research was in SDN Palebon 02, conducted in Februari 2019. The data collected are sample identity dataand knowledge of balance nutrition guideline. The data was analysed by independent t-test with 95% confidence level.Results: There was significant difference in knowledge about balance nutrition guideline in the treatment and control groups after intervention with edutainment card method (p value = 0.001).Conclusion: Edutainment card as a media for education is effective for increasing nutrition knowledge in children

Taste Disturbance Evaluation Is Feasible and Higher Melphalan Pharmacokinetics Are Associated with Poorer Nutrition and Symptom Burden after Autologous HCT for Multiple Myeloma

Introduction Dysgeusia commonly influences nutritional intake and quality of life after HCT, yet its pathobiology is poorly understood and methods to study it are not established. We report interim results of a prospective feasibility study of chemical gustometry (CG) to measure dysgeusia in pts with multiple myeloma (MM) undergoing high-dose melphalan and autologous HCT (mel-AHCT). We evaluated associations between dysgeusia and symptoms, nutrition, mel pharmacokinetics (PK), and oral microbiota composition. We hypothesized that mel penetration into saliva contributes to dysgeusia. Methods CG was performed by the Henkin method pre-AHCT and on days (d) -1, +7, +14, +30 testing 5 flavors (sweet, sour, salty, bitter, umami) to calculate a total taste score (max value 30). CG was considered feasible if > 60% of pts could complete > 60% of all evaluations. Caloric intake (kcal) was calculated with 24-hr recall using the USDA 5-Step Multiple-Pass Method, and pt-reported symptoms were assessed using the MD Anderson Symptom Inventory (MDASI) at the above times and on d +3 and +10. Salivary microbiome diversity was assessed longitudinally by 16S sequencing and the inverse Simpson index. 6-point serum mel concentrations were used to calculate an area under the curve (AUC) and peak salivary mel was obtained 75 min post-infusion. Spearman rank-sum correlation was used to assess associations. Results 22 mel-AHCT MM pts have follow-up through d +30. 18 pts (82%) completed > 60% of all assessments. Median age was 62 (range 41-75). 11 pts (50%) were male. Mel 200 mg/m2 and 140 mg/m2 was given in 19 (86%) and 3 (14%) pts, respectively. Median serum mel AUC was 12.6 mg*h/L (range 5.8-17.5); median salivary mel was 119 ng/ml (range 25-662). Higher serum mel AUC correlated with higher salivary mel levels, p=0.004, and associated with poorer caloric intake from pre-ASCT to d +30, p=0.04. Higher serum mel AUC associated with higher MDASI scores (worse symptom burden) from pre-AHCT to d +30, p=0.005, but not with taste scores. Higher salivary mel associated with poorer caloric intake from pre-AHCT to d +30, p=0.02. MDASI scores peaked d +10, coincident with nadirs in taste scores and caloric intake on d +7 and +10, respectively. Taste scores partially recovered by d +30, but often did not return to baseline (Fig 1A-C). Oral microbiota diversity was stable early after AHCT but increased by d+100. D+7 diversity did not correlate with serum mel AUC, p=0.4, or salivary mel, p=0.84 (Fig 2A-C). Conclusion CG is a feasible method to evaluate dysgeusia after AHCT. Dysgeusia peaked by d +7 and often persisted through d +30. Oral microbiota diversity was stable early after AHCT. Higher serum and salivary mel levels did not correlate with microbiota diversity but were associated with poorer caloric intake and higher MDASI scores suggesting that using targeted mel PK dosing may improve caloric intake and limit symptom burden after AHCT.

Nutritional dual burden in Indigenous young adults: The geographical differential.

Nutritional dual burden is defined as the coexistence of underweight and overweight in the same population. We report the rates of nutritional dual burden in Indigenous young men and women in the Northern Territory. Additionally, we examine the impact geographical area has on these rates. Cross-sectional data obtained from the longitudinal Aboriginal Birth Cohort Study. Participants residing in over 40 urban and remote communities across the Top End of the Northern Territory. Young adults aged 23-28 years; urban (n = 99) and remote (n = 316). Anthropometric data was directly collected using standardised methods. Underweight was defined as BMI ≤ 18.5 kg/m2 and overweight/obese as body mass index ≥ 25 kg/m2 . Remote residency was categorised by established shires/regions (Vic/Daly, Arnhem and Tiwi). Significantly higher levels of underweight were seen in remote participants, compared to urban participants, irrespective of sex. Further differences were seen by regions, with the highest rates seen in Vic/Daly, compared to Arnhem and Tiwi. Higher rates of overweight/obesity were found in urban participants, compared to remote. The levels of overweight/obesity varied, depending on region of residence. Underweight and overweight patterns coexist in Indigenous young adults, with variation across geographical regions. Health programs need to take this dual nutritional burden into consideration to avoid worsening the severity of underweight, whilst reducing levels of overweight.