Recommended Nutrient Intake Research Articles

A review of recent evidence of dietary protein intake and health.

The Korea National Health and Nutrition Examination Survey of 2013 to 2017 reported that the average protein consumption of the Korean population is above the current recommended nutrient intake of protein proposed by the Dietary Reference Intakes for Koreans. Some health professionals and the media often advise consuming diets high in protein for promoting metabolic regulation, weight control, and muscle synthesis. However, due to lack of scientific evidence, the validity and safety of high protein consumption are yet to be fully ascertained. The present review assesses recent evidence published in 2014–2020 from human studies, focusing on adequate protein intake and protein sources for the prevention of chronic diseases, particularly metabolic disorders and sarcopenia.

Vitamin C and scar strength: analysis of a historical trial and implications for collagen-related pathologies

A double-blind controlled trial initiated in 1944 has led to the common narrative that a 10-mg daily vitamin C intake is adequate to prevent and treat impaired wound healing, and by inference, other collagen-related diseases such as heart disease or stroke. The WHO relies on this narrative to set the recommended nutrient intake for vitamin C. This narrative, however, is based on what is known as the eyeball method of data assessment. The 1944 trial published individual participant data on scar strength providing an opportunity to statistically probe the validity of the 10-mg narrative, something which has not yet been done. The findings show that a vitamin C intake that averages to 10mg/d over a mean follow-up of 11.5 mo was associated with a 42% weakened scar strength when compared with 80mg vitamin C intake/d (P<0.001). The observed dose-response curve between scar strength and vitamin C intake suggests that the daily vitamin C intake needed to prevent collagen-related pathologies is in the range recommended by the National Academy of Medicine and the European Food Safety Authority (75 to 110mg/d), not the WHO recommendation (45mg/d). The findings also show that a vitamin C intake that averages to 65mg/d over a mean follow-up of 6.5 mo failed to restore the normal wound-healing capacity of vitamin C-depleted tissues; such tissues had a 49% weaker scar strength when compared with nondepleted tissues (P<0.05). Thus, average daily vitamin C intakes ∼50% higher than the WHO recommends may fail to treat existing collagen-related pathologies. It is concluded that the prior lack of statistical analyses of a landmark trial may have led to a misleading narrative on the vitamin C needs for the prevention and treatment of collagen-related pathologies.

SPATIAL DISTRIBUTION AND SOCIO-ECONOMIC STATUS OF TRIBAL SETTLEMENTS IN THE WESTERN GHATS

The Western Ghats, also known as Sahyadri is a mountain range that covers an area of 140,000 square km parallel to the Western coast of the Indian Peninsula .It traverses the states of Kerala , Tamilnadu , Karnataka ,Goa ,Maharashtra, and Gujarat. It is a UNESCO world heritage site and is one of the eight hottest hot spots of biological diversity in the world. It covers 5000 species of flowering plants ,139 mammals species ,508 birds species, and 179 amphibian species ,many discovered species live in the Western Ghats . At least 325 globally threatened species occur in this region. The region glitches many anthropogenic intervention like illegal mining, the establishment of human settlement and deforestation etc. From a Historical view, the Western Ghats is the home for tribes &gt; 50 types of tribes are living in the Western Ghats from the anecdotal period. The majority of the tribal are largely dependent on forests for their livelihood. After the implementation of the forest policy , the tribal livelihood status really worsened in the Western Ghats , they are unable to meet the daily requirement of recommended food intake &gt;2500 Kcl. After post-independence (73years ) of India many development programs are implemented in the tribal area for improvement of livelihood status , but as of calendar date they are facing many problems like economic instability , lack of literacy , lower level of quality of life and not politically empowered . In this context , in the interest of policy implication at the tribal area , the present study was undertaken to study the socioeconomic status and spatial distribution of tribal in the Western Ghats. This study practically helps the policymakers , planners of the policy, and researcher scholars to extrapolate the tribal settlement through the geo-spacing tag of tribal , socio-economic level, Knowledge and attitude of Conservation of Western Ghats at the population level .

Priority Micronutrient Density of Foods for Complementary Feeding of Young Children (6-23 Months) in South and Southeast Asia.

Background: Given their high nutrient requirements and limited gastric capacity, young children during the complementary feeding period (6–23 months) should be fed nutrient-dense foods. However, complementary feeding diets in low- and middle-income countries are often inadequate in one or more essential micronutrients. In South and Southeast Asia infants' and young children's diets are commonly lacking in iron, zinc, vitamin A, folate, vitamin B12, and calcium, hereafter referred to as priority micronutrients.Objective: This study aimed to identify the top food sources of priority micronutrients among minimally processed foods for complementary feeding of children (6–23 months) in South and Southeast Asia.Methods: An aggregated regional food composition database for South and Southeast Asia was built, and recommended nutrient intakes (RNIs) from complementary foods were calculated for children aged 6–23 months. An approach was developed to classify foods into one of four levels of priority micronutrient density based on the calories and grams required to provide one-third (for individual micronutrients) or an average of one-third (for the aggregate score) of RNIs from complementary foods.Results: We found that the top food sources of multiple priority micronutrients are organs, bivalves, crustaceans, fresh fish, goat, canned fish with bones, and eggs, closely followed by beef, lamb/mutton, dark green leafy vegetables, cow milk, yogurt, and cheese, and to a lesser extent, canned fish without bones.Conclusions: This analysis provided insights into which foods to prioritize to fill common micronutrient gaps and reduce undernutrition in children aged 6–23 months in South and Southeast Asia.

Potential contribution of captured fishes to the recommended nutrient intakes (RNIs): A case study of commercial fish species from Ikpoba reservoir, Edo State, Nigeria

Global concern for good health and well-being of human populations especially in underdeveloped and developing nations has necessitated the need for routine nutritional assessment of food sources. This study was undertaken to determine the nutrient composition of commonly consumed freshwater fish species in Ikpoba reservoir and to assess the potential contribution of selected key nutrients in the fishes to recommended nutrient intakes (RNIs). Proximate composition of Clarias gariepinus and Tilapia zillii showed moisture content of 61.09% and 63.39%; protein value of 15.15% and 15.71%; lipid value of 6.03% and 1.48%; and ash content of 4.58% and 5.09% respectively. Mineral content of fish species ranged from 3.32 to 5.64 mg/100 g (sodium); 8.14 to 12.64 mg/100 g (potassium); 2.56 to 4.42 mg/100 g (magnesium); 1.75 to 5.85 mg/100 g (calcium); 5.47 to 9.35 mg/100 g (iron) and 1.40 to 3.66 mg/100 g (zinc). Potential contribution to RNIs for preschool children and adults indicated that Clarias gariepinus and Tilapia zillii contributed ≥25% of RNIs for iron (38.71% and 44.57%) and zinc (38.33% and 25.67%) for preschool children. This study has increased the knowledge on the contribution of fishes to RNI in combating nutritional deficiencies in Nigeria.

Vitamin D Biofortification of Pork May Offer a Food-Based Strategy to Increase Vitamin D Intakes in the UK Population

Hypovitaminosis D is prevalent worldwide, with many populations failing to achieve the recommended nutrient intake (RNI) for vitamin D (10–20 μg/day). Owing to low vitamin D intakes, limited exposure to ultraviolet-B (UVB) induced dermal synthesis, lack of mandatory fortification and poor uptake in supplement advice, additional food-based strategies are warranted to enable the UK population to achieve optimal vitamin D intakes, thus reducing musculoskeletal risks or suboptimal immune functioning. The aims of the current study were to (1) determine any changes to vitamin D intake and status over a 9-year period, and (2) apply dietary modeling to predict the impact of vitamin D biofortification of pork and pork products on population intakes. Data from the UK National Diet and Nutrition Survey (Year 1–9; 2008/09–2016/17) were analyzed to explore nationally representative mean vitamin D intakes and 25-hydroxyvitamin D (25(OH)D) concentrations (n = 13,350). Four theoretical dietary scenarios of vitamin D pork biofortification were computed (vitamin D content +50/100/150/200% vs. standard). Vitamin D intake in the UK population has not changed significantly from 2008 to 2017 and in 2016/17, across all age groups, 13.2% were considered deficient [25(OH)D <25 nmol/L]. Theoretically, increasing vitamin D concentrations in biofortified pork by 50, 100, 150, and 200%, would increase vitamin population D intake by 4.9, 10.1, 15.0, and 19.8% respectively. When specifically considering the impact on gender and age, based on the last scenario, a greater relative change was observed in males (22.6%) vs. females (17.8%). The greatest relative change was observed amongst 11–18 year olds (25.2%). Vitamin D intakes have remained stable in the UK for almost a decade, confirming that strategies are urgently required to help the population achieve the RNI for vitamin D. Biofortification of pork meat provides a proof of concept, demonstrating that animal-based strategies may offer an important contribution to help to improve the vitamin D intakes of the UK population, particularly adolescents.

Changes in Dietary Intake of Breast Cancer Survivors: Early Findings of a Malaysian Breast Cancer Prospective Cohort Study

This study aimed to evaluate the changes in post-diagnosis dietary intake of breast cancer survivors. A total of 112 participants from the Malaysian Breast Cancer Survivorship Cohort study with dietary intake at one-year post-diagnosis (T1) and three-year post-diagnosis (T2) were included. A three-day food record was used to assess the dietary intake of breast cancer survivors. The participants’ anthropometrical measurements were measured at both time points (n = 95). Notably, we found that around half of the participants were obese at both time points. Body weight and body mass index increased significantly between the two time points (P < 0.01). Most of the participants did not meet the Malaysian recommended nutrient intake for dietary fat, fiber, and calcium at both time points. The energy intake significantly decreased (from 1,596 kcal/day to 1,524 kcal/day, P = 0.028) within the survivors. Significant decreases were observed in the overall intakes of carbohydrates, total sugar, protein, fiber, and calcium (P < 0.05). Overall, many Malaysian breast cancer survivors remained overweight or obese and had suboptimal dietary intake even at three years post-diagnosis. These require more proactive dietary intervention with continuous monitoring and evaluation among breast cancer survivors for their survivorship care.

Variations in greenhouse gas emissions of individual diets: Associations between the greenhouse gas emissions and nutrient intake in the United Kingdom.

BackgroundFood production accounts for 30% of global greenhouse gas (GHG) emissions. Less environmentally sustainable diets are also often more processed, energy-dense and nutrient-poor. To date, the environmental impact of diets have mostly been based on a limited number of broad food groups.ObjectivesWe link GHG emissions to over 3000 foods, assessing associations between individuals’ GHG emissions, their nutrient requirements and their demographic characteristics. We also identify additional information required in dietary assessment to generate more accurate environmental impact data for individual-level diets.MethodsGHG emissions of individual foods, including process stages prior to retail, were added to the UK Composition Of Foods Integrated Dataset (COFID) composition tables and linked to automated online dietary assessment for 212 adults over three 24-hour periods. Variations in GHG emissions were explored by dietary pattern, demographic characteristics and World Health Organization Recommended Nutrient Intakes (RNIs).ResultsGHG emissions estimates were linked to 98% (n = 3233) of food items. Meat explained 32% of diet-related GHG emissions; 15% from drinks; 14% from dairy; and 8% from cakes, biscuits and confectionery. Non-vegetarian diets had GHG emissions 59% (95% CI 18%, 115%) higher than vegetarian. Men had 41% (20%, 64%) higher GHG emissions than women. Individuals meeting RNIs for saturated fats, carbohydrates and sodium had lower GHG emissions compared to those exceeding the RNI.DiscussionPolicies encouraging sustainable diets should focus on plant-based diets. Substituting tea, coffee and alcohol with more sustainable alternatives, whilst reducing less nutritious sweet snacks, presents further opportunities. Healthier diets had lower GHG emissions, demonstrating consistency between planetary and personal health. Further detail could be gained from incorporating brand, production methods, post-retail emissions, country of origin, and additional environmental impact indicators.

Association between dietary vitamin A intake and gestational diabetes mellitus in the first trimester

Objective: To investigate the relationship between dietary vitamin A intake and its sources in the first trimester and gestational diabetes mellitus (GDM). Methods: A prospective study was conducted to select women at 6-14 weeks of gestation in an obstetric clinic of a maternal and child health care medical institution in Chengdu in 2017. The types and quantities of food during the first trimester were collected by 3-day 24-hour dietary recalls. Dietary vitamin A intake was calculated based on the Chinese Food Composition Table (2018), and it was divided into animal and plant vitamin A intakes according to its food sources. An oral glucose tolerance test was performed at 24-28 weeks of gestation to diagnose GDM according to the Chinese guidelines for diagnosis and treatment of gestational diabetes mellitus (2014). According to the estimated average requirement (EAR) and recommended nutrient intake (RNI), dietary vitamin A intake was divided into low-level group (<EAR), medium-level group (EAR-RNI) and high-level group (>RNI). Animal and plant vitamin A intakes were divided into four groups (Q1-Q4) according to the quartile method, respectively. The association between dietary vitamin A intake, its different sources of vitamin A intake and GDM in the first trimester was analyzed by log-binomial regression models. Results: A total of 1 298 valid samples were finally included. The average dietary vitamin A intake, animal and plant vitamin A intakes in the first trimester were 341.1 (227.8-501.0) μgRAE/d, 139.3 (69.6-195.3) μgRAE/d and 184.2 (99.4-301.1) μgRAE/d, respectively. After adjusting for confounding factors, log-binomial regression analysis showed that the risk of GDM in high-level group of dietary vitamin A intake was lower than that in low-level group [RR (95%CI):0.53 (0.36-0.80)]. Pregnant women in the highest quartile of animal vitamin A intake had a lower risk of GDM than those in the lowest quartile [RR (95%CI):0.66 (0.47-0.95)]. No relationship between plant vitamin A intake and GDM was found. Conclusion: Dietary vitamin A intake in the first trimester is associated with the occurrence of GDM, and higher intake than RNI may reduce the risk of GDM. Higher vitamin A intake from animal-derived food is associated with decreased risk of GDM.

Dietary Protein Intake Dynamics in Elderly Chinese from 1991 to 2018.

Unique rapid urbanization-related changes in China may affect the dietary protein intake of the aging population. We aimed to evaluate trends in dietary protein intake and major food sources of protein and estimate conformity to the dietary reference intakes (DRIs) in the elderly Chinese population. A sample of 10,854 elderly adults aged 60 years or older, drawn from 10 waves of the China Health and Nutrition Survey (CHNS) between 1991 and 2018, was included. Protein intake data were obtained on the basis of 3-day, 24 h dietary recalls. The dietary protein intake among elderly Chinese individuals declined from 63.3 g/day to 57.8 g/day over the 28-year period, with a −0.032 ± 0.0001 g/day change per year (p < 0.05). There was a significant increase in the proportion of subjects with a protein intake level below the estimated averaged requirement (EAR) and a reduction in the proportion of subjects consuming protein above the recommended nutrient intake (RNI) across all population subgroups. Cereals ranked as the major sources of dietary protein, although their contribution to dietary protein gradually decreased as time went on. The contribution from meat steadily rose from 18.2% in 1991 to 28.7% in 2018. The proportion of energy gained from fat increased notably, reaching 34.2% in 2018. The elderly Chinese population experienced a significant reduction in dietary protein intake. Although the transformation of dietary patterns had positive effects on improving protein quality due to increases in animal source food, some elderly Chinese individuals currently face the risk of inadequate dietary protein intake.

The use of linear programming to determine whether breastfed infants can achieve a nutritionally adequate complementary feeding diet: a case study of 6–11-month-old infants from KwaMashu, KwaZulu-Natal, South Africa

Objectives: The objectives of this study were to ascertain whether the nutrient requirements of 6–11-month-old infants can be met with a food-based approach, and to identify the nutrients of which it is difficult to achieve adequate intakes. Design, setting and subjects: A cross-sectional survey and interviews with mothers and caregivers from the KwaMashu Community Health Centre were conducted. One hundred and thirty-four interviews were completed. This information provided the food consumption input for the model using Optifood software. Results: The results revealed that with the current food pattern of infants from the study group in KwaMashu, iron, zinc and calcium are nutrients whose requirements are likely not to be met in the diet. The percentage RNI (recommended nutrient intake) for iron was 25.2%, zinc 51.3% and calcium 77%. Nutrient intakes for these nutrients of concern improved in the ‘No pattern’ diet but iron and zinc intakes remained below the RNI. According to the best diets modelled by Optifood, it appears that infants in KwaMashu would be able to achieve the recommended intakes of energy, protein, and 8 of the 11 micronutrients, as long as breastfeeding on demand continues during the complementary feeding phase. Conclusions: This study calls into question the continued food-based focus to ensure nutrient adequacy in infants. In conjunction with efforts to improve household food security and continued support and promotion of breastfeeding for the first 2 years of life, targeted micronutrient supplementation may be needed to ensure the optimal growth and development of infants in South Africa.

Association between dietary quality and growth of the aboriginal primary school children in Negeri Sembilan

PurposeThis study aims to determine the association between dietary quality and growth of the aboriginal primary school children in Negeri Sembilan, Malaysia.Design/methodology/approachThe cross-sectional study was carried out in Negeri Sembilan. A total of 194 school-aged aboriginal children participated in the study. The dietary intake and socioeconomic status data were collected from the parents using an interviewer-administrated structured questionnaire comprised of sociodemographic questions and three days of dietary recall. The Malaysian Healthy Eating Index was used to determine the diet quality of children. WHO Anthro Plus software was used to determine the z-score of weight-for-age (WAZ), height-for-age (HAZ) and body mass index (BMI)-for-age (BAZ).FindingsAmong all children, 15, 9 and 5% of them were stunted, underweight and thin, respectively. On the other hand, 16 and 12% of the children were overweight and obese, respectively. The aboriginal children were at risk of poor diet quality (37.19 ± 12.07) and had high dietary protein and fat intake than national recommended nutrient intake. The children achieved micronutrients intake, except for calcium. There was no significant association between total diet quality scores with growth indices among the aboriginal children. There is significant negative correlation between dietary vitamin A intake with HAZ (r = −0.168, p < 0.05) and WAZ (r = −0.219, p < 0.05) z-score of the aboriginal children.Originality/valueAlthough there was a reduction in under-nutrition among the aborigines, an increasing over-nutrition status among aborigines should be considered, especially in terms of poor dietary quality and intake.

Preliminary Finding: Survey on Eating Disorder and Nutritional Status among Young Athletes

Introduction: It is well documented that eating disorders will have a negative impact on health status and athletic performance. The risks of eating disorders among athletes are required to be detected early before it affects athlete’s health and exercise performance. To date, there is still scanty information on eating disorder and nutritional status among young athletes in Sabah. Objective: The objective of this study was to determine eating disorders and nutritional status among young athletes in Sabah. Methodology: A total of 55 young athletes who are active representatives of sports competitions were selected to participate in this study. Eating attitudes test questionnaires (EAT-26) was used to determine eating disorder risk. International physical activity questionnaire (IPAQ) and 3-days food diary were used to determine nutritional status and physical activity level. Statistical Package for the Social Sciences (SPSS) version 27.0 was used to analyse the collected data. Pair-t test was used to compare energy intake of subjects with the recommended nutrient intake for Malaysia (PAL2.0). The significant level is p&lt;0.05. Results: This study found that aesthetic and weight category sports were the highest risk for eating disorder. Energy intake (kcal/day) in the aesthetic, weight category, endurance and ball games did not significantly meet the daily energy intake recommendations. Conclusion: As a conclusion, majority of the subjects did not practicing balanced diet and meet the recommended nutrient intake (RNI) especially in the aesthetic and weight category sports. These current findings are useful to detect early eating disorder among young athletes before it become critical and affect athletes’ exercise performance and health status.

The New Standardized Malaysian Healthy Eating Index.

Healthy Eating Index (HEI) is a diet quality measure that assesses the population’s compliance towards dietary guidelines. In Malaysia, diet quality measure, though existing, has some limitations in terms of application and relevance. This study aims to develop a new standardized Malaysian Healthy Eating Index (S-MHEI) that can measure the diet quality of all Malaysians regardless of their energy requirement level. The Malaysian Dietary Guidelines (MDG) 2010 and MDG for Children and Adolescents (MDGCA) 2013 were used as main references in developing the index components. In addition, the latest Malaysian Adults Nutrition Survey (MANS) and Adolescent Nutrition Survey (ANS) were also referred to ensure the relevance of the components selected. For adequacy components, the least restrictive method was used in setting the standard for the scoring system. Meanwhile, the scoring system for moderation components was built based on the Recommended Nutrient Intake (RNI) 2017. The new S-MHEI comprises of 11 components with a maximum total score of 100. The least restrictive method allowed the index to be used across energy requirement levels. However, the index will not be sensitive towards adhering to the specific recommended amount of intake—which in effect, made the index focus on measuring diet quality rather than diet quantity.

Estimated contribution of most commonly consumed industrialized processed foods to salt intake and iodine intakes in Sri Lanka.

In Sri Lanka dietary patterns are shifting towards increased consumption of industrially processed foods (IPF). This study aimed to estimate the contribution of IPF to salt and iodine intake and assess the possible impact of salt reduction on iodized salt intake. The assessment was conducted using guidance published by the Iodine Global Network. National nutrition and household income expenditure surveys were used to estimate adult per capita consumption of household salt and commonly consumed salt-containing IPF. Industry and laboratory data were used to quantify salt content of IPF. Modelling estimated the potential and current iodine intake from consumption of household salt and using iodized salt in the identified IPF. Estimates were adjusted to investigate the likely impact on iodine intake of achieving 30% salt reduction. IPF included were bread, dried fish and biscuits, with daily per capita consumption of 32g, 10g and 7g respectively. Daily intake of household salt was estimated to be 8.5g. Potential average national daily iodine intake if all salt in these products was iodized was 166μg. Estimated current daily iodine intake, based on iodization of 78% of household salt and dried fish being made with non-iodized salt, was 111μg nationally, ranging from 90 to 145μg provincially. Estimated potential and current iodine intakes were above the estimated average requirement of 95μg iodine for adults, however, current intake was below the recommended nutrient intake of 150μg. If the 30% salt reduction target is achieved, estimated current iodine intake from household salt, bread and biscuits could decrease to 78μg. The assessment together with data for iodine status suggest that current iodine intake of adults in Sri Lanka is adequate. Recommendations to sustain with reduced salt intake are to strengthen monitoring of population iodine status and of food industry use of iodized salt, and to adjust the salt iodine levels if needed.

Calcium and iron intakes of adolescents in Malaysia and their relationships with body mass index (BMI): Findings from the Adolescent Nutrition Survey 2017

Introduction: Adolescent health is a priority considering they represent the future generation. Data from the Adolescent Nutrition Survey 2017 were analysed to determine the prevalence of micronutrient inadequacy, particularly calcium and iron, and the relationship with body mass index (BMI) among Malaysian secondary school students. Methods: This cross-sectional study included students aged 13 to 17 years old studying at public and private schools. Twenty-four hours dietary recall via face-to-face interview was conducted by trained nutritionists to obtain data on dietary intake. For nutritional status, BMI-for-age z-score (BAZ) was analysed using WHO Anthroplus software. Results: From 999 respondents, 449 were boys and 550 were girls. Overall findings indicated that both boys and girls had inadequate intakes of calcium and iron in their daily diet. Mean intakes of calcium (695.7±463.2 mg/day) and iron (23.4±21.0 mg/day) were higher among boys aged 16 to 17 years old. Mean intake of iron were higher among the older age groups. Majority of the respondents (boys: 94%; girls: 97%) did not meet the recommended nutrient intake (RNI) for calcium and more than half (boys: 50%; girl: 80%) did not achieve the RNI for iron. Current findings also found significant positive but weak correlations between calcium (r=0.112, p=0.001) and iron (r=0.084, p=0.008) intakes with BMI-for-age. Conclusion: BMI-for-age was related to calcium and iron intakes among secondary school students in Malaysia. Thus, intervention strategies should focus on early screening and nutrition education on food choices of high calcium and high iron contents, including iron supplementation programmes, if needed.

Inadequate Intake of Energy and Nutrients Is Common in Older Family Caregivers.

The aim of this study was to investigate the nutritional status, determinants of nutritional status, and adequacy of energy and nutrient intake of older family caregivers (FC). Nutritional status was measured using the Mini Nutritional Assessment (MNA), plasma albumin, plasma pre-albumin, and blood hemoglobin concentrations. Dietary intake was assessed with a three-day food record. Comorbidity (B −0.283, 95% CI: −0.492, −0.073), quality of life (B 0.045, 95% CI: 0.018, 0.072) and energy intake (B 0.001, 95% CI: 0.000, 0.002) were significantly associated with the MNA scores of the older FCs (n = 125). It was common for FCs to have lower than recommended intakes of energy and several nutrients, independent of the risk of malnutrition assessed by the MNA. Over half of the FCs had inadequate intake of protein, vitamin A, folate, and fiber, and 25–40% of the FCs had a low intake of vitamin D, vitamin E, thiamine, magnesium, iron, and selenium. It is important to follow both the nutritional status and dietary intake of older FCs regularly to find those with lower than recommended nutrient intake and to avoid poor nutritional status and its adverse effects hampering their ability to serve as FCs.

The longitudinal relationship between nutritional status and anaemia among Malaysian adolescents.

IntroductionThe triple burden of malnutrition characterised by stunting and wasting, overweight/obesity, and anaemia experienced by Malaysians causes severe and long-lasting damage during the period of development and rapid growth, particularly in adolescence. This study aimed to demonstrate the trend of anaemia prevalence and to determine its longitudinal association with nutritional status and lifestyle among Malaysian adolescents.MethodThe study involved secondary data analysis from the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. A closed cohort secondary data analysis was performed from the dynamic cohort of 528 adolescents (male = 151; female = 377) aged 13 years attending secondary school who were followed up at 15 and 17 years. Anaemia status was determined by haemoglobin level < 12g/dL based on FBC, and iron deficiency anaemia (IDA) was determined when the Mentzer Index < 13. A generalised estimating equation (GEE) was constructed to investigate the longitudinal relationship between nutritional status and lifestyle on anaemia status over five years.ResultsThe trend of anaemia prevalence increased significantly across the age group (7•9%; 95% CI: 2•3-11•1, 13•9%; 95% CI: 10•8-15•7 and 15•8%; 95% CI: 3•8-23•1) at 13, 15 and 17 years, respectively, especially among females. The trend of anaemia prevalence among females, also increased significantly across the age group (11.1%;95% CI:6.7-17.8, 15.7%;95% CI:11.4-21.3, 23.1%;95% CI:16.8-31.0). A similar trend was noted for the prevalence of IDA among those who were anaemic (66•5%; 95% CI: 40•4-85•3, 72•2%;95% CI: 54•8-85•4, 76•3%; 95% CI: 59•2-87•7). A longitudinal analysis using GEE revealed that adolescents who did not meet the Recommended Nutrient Intake (RNI) for total iron intake per day were significantly associated with anaemia (RR=1•517;95% CI: 1•012-2•275; p=0•044) and IDA (RR=1•776;95% CI: 1•225-2•57; p= 0•002).ConclusionThe overall trend of anaemia among adolescents is in increasing trend and anaemia is prevalent among female adolescents in this study. It is crucial to understand that the current fortification strategy may need to be revisited, and robust intervention programmes are necessary and should be sex specific.

Effect of using commercial pre-packaged baby foods on the Fe intake of 7-8 months old infants.

To examine the potential effect on Fe intake of 7-8 months old infants if pre-packaged baby foods (PBF) were used as the sole source of complementary foods. Based on the 7-d recommended feeding plan for 7-8 months old infants in Hong Kong (moderate Fe-fortified rice cereal with home-cooked meals), twenty-four modelling scenarios were created which comprised of two milk use modes (breastmilk v. infant formula), three modes of rice cereal use (no-rice cereal; non-Fe-fortified rice cereal and Fe-fortified rice cereal) and four baby foods usage modes (home-cooked meals; low-Fe PBF only; high-Fe PBF only and mixed PBF). The PBF were randomly selected in each of the models and substituted the original meals/snacks. The average daily Fe intakes of the modelled meal plans were compared with the Chinese estimated average requirement (EAR) and recommended nutrient intake (RNI) for Fe. Modelling study. Not applicable. In general, the infant-formula-based complementary feeding pattern (CFP) had higher average daily Fe intake when compared with breastmilk-based CFP. The Fe intakes of all scenarios under the breastmilk-based CFP were below the RNI and EAR, except for the fortified rice cereal meal plans with high-Fe or mixed PBF. For infant-formula-based CFP, the Fe intakes were close to or above the RNI regardless of types of PBF or rice cereal used. The inclusion of fortified rice cereal was important in maintaining adequate Fe intake for infants, especially for breast-fed infants. The replacement of home-cooked meals by low-Fe PBF could potentially put infants at risk of Fe deficiency.

Complementary Foods and Milk-Based Formulas Provide Excess Protein but Suboptimal Key Micronutrients and Essential Fatty Acids in the Intakes of Infants and Toddlers from Urban Settings in Malaysia.

This study determined the intakes of complementary foods (CFs) and milk-based formulas (MFs) by a total of 119 subjects aged 6–23.9 months from urban day care centers. Dietary intakes were assessed using two-day weighed food records. Intake adequacy of energy and nutrients was compared to the Recommended Nutrient Intakes (RNI) for Malaysia. The most commonly consumed CFs were cereals (rice, noodles, bread). The subjects derived approximately half of their energy requirements (kcals) from CFs (57 ± 35%) and MFs (56 ± 31%). Protein intake was in excess of their RNI requirements, from both CFs (145 ± 72%) and MFs (133 ± 88%). Main sources of protein included meat, dairy products, and western fast food. Intake of CFs provided less than the RNI requirements for vitamin A, thiamine, riboflavin, folate, vitamin C, calcium, iron, and zinc. Neither CF nor MF intake met the Adequate Intake (AI) requirements for essential fatty acids. These findings indicate imbalances in the dietary intake of the subjects that may have adverse health implications, including increased risk of rapid weight gain from excess protein intake, and linear growth faltering and intellectual impairment from multiple micronutrient deficiencies. Interventions are needed to improve child feeding knowledge and practices among parents and child care providers.