Risk Of Diet-related Chronic Diseases Research Articles

Oral health and multimorbidity: Is diet the chicken or the egg?

Oral health is a critical component of overall health and well-being, not just the absence of disease. The objective of this review paper is to describe relationships among diet, nutrition, oral, and systemic diseases that contribute to multi-morbidity. Diet and nutrient-related risk factors for oral diseases include high intakes of free sugars, low intakes of fruits and vegetables, and nutrient poor diets which are similar to diet and nutrient-related risk factors for systemic diseases. Oral diseases are chronic diseases. Once the disease process is initiated, it persists throughout the lifespan. Pain and tissue loss from oral disease leads to oral dysfunction which contributes to impaired biting, chewing, oral motility, and swallowing. Oral dysfunction makes it difficult to eat nutrient dense whole grains, fruits, and vegetables associated with a healthy diet. Early childhood caries (ECC) associated with frequent intake of free sugars is one of the first manifestations of oral disease. The presence of ECC is our 'canary in the coal mine' for diet-related chronic diseases. The dietary sugars causing ECC are not complementary to an Eatwell Guide compliant diet, but rather consistent with a diet high in energy dense, nutrient poor foods - typically ultra-processed in nature. This diet generally deteriorates throughout childhood, adolescence, and adulthood increasing the risk of diet-related chronic diseases. Recognition of ECC is an opportunity to intervene and disrupt the pathway to multi-morbidities. Disruption of this pathway will reduce risk of multi-morbidities and enable individuals to fully engage in society throughout the lifespan.

Characteristics of dietary intakes including NOVA foods among pre-adolescents living in urban Kuala Lumpur – Findings from the PREBONE-Kids study

Introduction: Evidence showed considerable variability of health risk factors within different socioeconomic groups. This study aimed to characterise dietary intakes by total household income among a sample of Malaysian pre-adolescents in urban Kuala Lumpur. Methods: Baseline data of 243 healthy, pre-adolescent children between 9 and 11 years old including socio-demographic background (gender, ethnicity, and total household monthly income), anthropometry (body weight and height), and 7-day diet histories were collected. Secondary analysis was performed on dietary intakes to quantify food groups based on the Malaysian Dietary Guidelines and NOVA classification systems besides nutrients. Differences and associations between total monthly household income categories with anthropometry and dietary intakes were tested using independent t-test/Mann-Whitney U (depending on normality) and chi-square tests, respectively. Results: Most children in this study population had dietary intakes below the recommended serving sizes for five food groups, except meat/poultry (195.2±107.2%) and fish (110.1±106.3%) and consumed about 32% of energy from ultra-processed foods (NOVA food group 4). While there was no difference in dietary intake between the bottom 40% with the middle 40% and high 20% household income groups, the percentage of energy contributed by NOVA food group 4 (processed fats/oils, condiments, and sauces) was higher in the bottom 40% households (p=0.024). Conclusion: Most pre-adolescent children in this study, regardless of household income, did not meet dietary recommendations and ate diets comprised of less nutritious foods. Comprehensive approaches that aim to improve dietary patterns and reduce the risk of diet-related chronic diseases are warranted.

Moving towards more sustainable diets: Is there potential for a personalised approach in practice?

Discourse on the relationship between food production, healthy eating and sustainability has become increasingly prominent and controversial in recent years. Research groups often take one perspective when reporting on sustainable diets, and several often neglect considerations for the multiple aspects that make a diet truly sustainable, such as cultural acceptability, differences in nutritional requirements amongst the population and the efficiency of long-term dietary change. Plant-based diets are associated with lower greenhouse gas emissions (GHGEs) and have been linked with better health outcomes, including lower risk of diet-related chronic disease. However, foods associated with higher GHGE, such as lean red meat, fish and dairy, have beneficial nutritional profiles and contribute significantly to micronutrient intakes. Some research has shown that diets associated with lower GHGE can be less nutritionally adequate. Several countries now include sustainability recommendations in dietary guidelines but use vague language such as "increase" or "consume regularly" when referring to plant-based foods. General population-based nutrition advice has poor adherence and does not consider differences in nutritional needs. Although modelling studies show potential to significantly reduce environmental impact with dietary changes, personalising such dietary recommendations has not been studied. Adapting recommendations to the individual through reproducible methods of personalised nutrition has been shown to lead to more favourable and longer-lasting dietary changes compared to population-based nutrition advice. When considering sustainable healthy dietary guidelines, personalised feedback may increase the acceptability, effectiveness and nutritional adequacy of the diet. A personalised approach has the potential for delivering a new structure of more sustainable healthy food-based dietary guidelines. This review evaluates the potential to develop personalised sustainable healthy food-based dietary guidelines and discusses potential implications for policy and practice.

Associations Between Household Frequency of Cooking Dinner and Ultraprocessed Food Consumption and Dietary Quality Among US Children and Adolescents.

Introduction: Dietary quality is poor and intake of ultraprocessed foods (UPFs) is high among children and adolescents in the United States. Low dietary quality and high UPF intake are associated with obesity and higher risk of diet-related chronic diseases. It is unknown whether household cooking behavior is related to improved dietary quality and lower consumption of UPFs among US children and adolescents. Methods: Nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey (n = 6032 children and adolescents ≤19 years of age) were used to examine the relationships between household cooking frequency of evening meals and children's dietary quality and UPF intake using multivariate linear regression models adjusted for sociodemographics. Two 24-hour diet recalls were used to assess UPF intake and dietary quality [Healthy Eating Index-2015 (HEI-2015)]. Food items were categorized according to Nova classification to obtain the UPF percent of total energy intake. Results: A higher household frequency of cooking dinner was associated with lower UPF intake and higher overall dietary quality. Compared to children in households cooking dinner 0-2 times per week, children in households cooking dinner 7 times/week had lower intake of UPFs [β = -6.30, 95% confidence interval (CI) -8.81 to -3.78, p < 0.001] and marginally higher HEI-2015 scores (β = 1.92, 95% CI -0.04 to 3.87, p = 0.054). The trends toward lower UPF intake (p-trend <0.001) and higher HEI-2015 scores (p-trend = 0.001) with increasing cooking frequency were significant. Conclusions: In this nationally representative sample of children and adolescents, more frequent cooking at home was associated with lower intake of UPFs and higher HEI-2015 scores.

Associations of Biomarker-Calibrated Healthy Eating Index-2010 Scores with Chronic Disease Risk and Their Dependency on Energy Intake and Body Mass Index in Postmenopausal Women

Prior studies examined associations between the Healthy Eating Index (HEI) and chronic disease risk based on self-reported diet without measurement error correction. Our objective was to test associations between biomarker calibration of the food-frequency questionnaire (FFQ)-derived HEI-2010 with incident cardiovascular disease (CVD), cancer, and type 2 diabetes (T2D) among Women's Health Initiative (WHI) participants. Data were derived from WHI postmenopausal women (n = 100,374) aged 50-79 y at enrollment (1993-1998) at 40 US clinical centers, linked to nutritional biomarker substudies and outcomes over subsequent decades of follow-up. Baseline or year 1 FFQ-derived HEI-2010 scores were calibrated with nutritional biomarkers and participant characteristics (e.g., BMI) for systematic measurement error correction. Calibrated data were then used in HR models examining associations with incidence of CVD (total, subtypes, mortality), cancer (total, subtypes, mortality), and T2D in WHI participants with approximately 2 decades of follow-up. Models were multivariable-adjusted with further adjustment for BMI and doubly labeled water (DLW)-calibrated energy. Multivariable-adjusted HRs modeled a 20% increment in HEI-2010 score in relation to outcomes. HRs were modest using uncalibrated HEI-2010 scores (HRs = 0.91-1.09). Using biomarker-calibrated HEI-2010, 20% increments in scores yielded multivariable-adjusted HRs (95% CIs) of 0.75 (0.60, 0.93) for coronary heart disease; 0.75 (0.61, 0.91) for myocardial infarction; 0.96 (0.92, 1.01) for stroke; 0.88 (0.75, 1.02) for CVD mortality; 0.81 (0.70, 0.94) for colorectal cancer; 0.81 (0.74, 0.88) for breast cancer; 0.79 (0.73, 0.87) for cancer mortality; and 0.45 (0.36-0.55) for T2D. Except for cancer mortality and T2D incidence, results became null when adjusted for DLW-calibrated energy intake and BMI. Biomarker calibration of FFQ-derived HEI-2010 was associated with lower CVD and cancer incidence and mortality and lower T2D incidence in postmenopausal women. Attenuation after adjustment with BMI and DLW-calibrated energy suggests that energy intake and/or obesity are strong drivers of diet-related chronic disease risk in postmenopausal women. The Women's Health Initiative is registered at clinicaltrials.gov at NCT00000611.

Increasing the level of resistant starch in 'Presidio' rice through multiplex CRISPR-Cas9 gene editing of starch branching enzyme genes.

Rice (Oryza sativa L.) is an excellent source of starch, which is composed of amylopectin and amylose. Resistant starch (RS) is a starch product that is not easily digestible and absorbed in the stomach or small intestine and instead is passed on directly to the large intestine. Cereals high in RS may be beneficial to improve human health and reduce the risk of diet-related chronic diseases. It has been reported through chemical mutagenesis and RNA interference studies that starch branching enzymes (SBEs) play a major role in contributing to higher levels of RS in cereal crops. In this study, we used multiplex clustered regularly interspaced short palindromic repeat (CRISPR)-CRISPR associated protein 9 (Cas9) genome editing to simultaneously target all four SBE genes in rice using the endogenous transfer RNA (tRNA)-processing system for expressing the single-guide RNAs (sgRNAs) targeting these genes. The CRISPR-Cas9 vector construct with four SBE gene sgRNAs was transformed into the U.S. rice cultivar Presidio using Agrobacterium-mediated transformation. Knockout mutations were identified at all four SBE genes across eight transgene-positive T0 plants. Transgene-free T1 lines with different combinations of disrupted SBE genes were identified, with several SBE-edited lines showing significantly increased RS content up to 15% higher than the wild-type (WT) cultivar Presidio. Although further efforts are needed to fix all of the mutant alleles as homozygous, our study demonstrated the potential of multiplex genome editing to develop high-RS lines.

Knowledge, Attitudes, and Behaviors Related to Use of Herbs and Spices Among Food Pantry Clients in Alaska

ObjectivesTo assess the knowledge, attitudes, and behaviors (KAB) related to use of herbs and spices to flavor foods rather than sugar, fat, and salt among food pantry clients in Alaska. MethodsAn electronic survey was administered to clients recruited via flyers from a food pantry in Anchorage, Alaska. The survey consisted of three sections: 1) eight knowledge questions related to herbs and spices; 2) nine attitudes questions related to the use of herbs and spices as a way to flavor foods and improve health; and 3) ten behaviors questions related to how often certain healthy and unhealthy cooking habits were performed. Correct answers to knowledge questions scored one point; incorrect answers scored zero points. Possible scores ranged from 0–7 points. Attitudes questions were asked on a five-point Likert-type scale to determine level of agreement with given statements. Responses ranged from strongly disagree to strongly agree, and were scored 1–5 points. Possible scores ranged from 0–17 points. Demographic information was collected. ResultsTwenty-five respondents completed the survey. Respondents (n = 25) scored an average of 5.27/7 points on knowledge, with lowest scores recorded on three questions related to when and how to use specific herbs and spices while cooking. Respondents (n = 15) scored an average of 8.8/17 points on attitudes, with most (40%) indicating that although herbs and spices are expensive, they somewhat or strongly agreed that they could enhance flavor (67%), make foods healthier (60%), and be good alternatives to salt (73%). For behaviors, respondents (n = 14), reported adding salt to foods during and after cooking (39%), using butter, shortening, coconut oil, or margarine during or after cooking (29%), and adding sugar to sweeten foods and beverages (36%) most or all of the time. ConclusionsFood pantry clients in Alaska have baseline knowledge of herbs and spices and generally believe that using herbs and spices to flavor foods can be beneficial and healthy. However, they also report negative behaviors related to the use of sugar, fat, and salt to flavor foods. Clients may benefit from nutrition education materials to improve KAB. This is especially important given the increased risk of diet-related chronic diseases among food insecure adults. Funding SourcesAcademy of Nutrition and Dietetics Foundation 2020 McCormick Science Institute Research Award.

Is fast-food consumption a problem among adolescents in Malaysia? An analysis of the National School-Based Nutrition Survey, 2012

BackgroundFast-food consumption is an unhealthy dietary behaviour because it increases the risk of diet-related chronic diseases. We aimed to investigate factors associated with fast-food consumption, namely sociodemographic characteristics, body mass index-for-age, meal away from home habit, and intake of various food groups among adolescents in Malaysia.MethodsWe analysed data from the National School-Based Nutrition Survey (NSNS). The NSNS was a nationwide, cross-sectional survey. Multiple-stage stratified cluster random sampling method was applied to obtain a representative sample of adolescents’ population. This study recruited adolescents aged 10–18 years who were attending schools. Pre-tested self-administered questionnaires in Malay language were used to obtain relevant information. Frequency of fast-food consumption per week was classified into three groups: “consumed fast-food four to seven days”, “consumed fast-food one to three days”, and “did not consume fast-food”. Intake of food groups was assessed by self-administered food frequency questionnaire. Descriptive and complex sample multinomial logistic regression analyses were performed in data analysis.ResultsA total of 26,383 from 40,012 selected adolescents completed all the relevant questions for this study. Of those surveyed, 13.5% of the respondents consumed fast-food 4 to 7 days, 69.3% of the respondents consumed fast food 1 to 3 days, and 17.2% of them did not consume fast-food in a typical week. Frequency of fast-food consumptions (4 to 7 days and 1 to 3 days per week) was significantly associated with age; sex; ethnicity; locality of schools; frequency of eating out; and not consuming recommended intake of cereals or grains, vegetables, and meat or poultry or eggs.ConclusionIn conclusion, age; sex; ethnicity; locality of schools; frequency of eating out per week; imbalanced intake of cereals or grains, meat, or poultry or eggs; and inadequate vegetable intake were significantly associated with fast-food consumption among adolescents in Malaysia. The findings of this study will be useful for policy makers in promoting healthy food choices among adolescents in Malaysia.

P15 Overeating: What Does It Mean To African American Female Caretakers?

<h3>Background</h3> African American women are disproportionately burdened with cardiovascular disease and co-morbid risk factors. Overeating has been established as a cardiovascular disease risk factor though there is limited evidence of its impact on cardiovascular disease risk in African American female caretakers. It is important to understand diet-related cardiovascular disease risk as it relates to overeating in this population given the potential impact of maternal dietary behaviors on children's dietary behaviors. <h3>Objective</h3> To explore how African American female caretakers describe overeating. <h3>Study Design, Settings and Participants</h3> This phenomenological study collected qualitative data on participants' views on overeating through individual online interviews using an interview guide. Participants were recruited from a local university's electronic listserv which included self-identified African American students and staff members <h3>Measurable Outcome/Analysis</h3> Data were content analyzed to identify themes related to general eating behaviors and overeating. <h3>Results</h3> Participants (n = 8) were university staff members and students identified as African American female caretakers with an average age of 33 years. Overeating was described using a variety of concepts ranging from high weight status to unawareness of satiety signals and with terms such as ‘stuffed' and ‘disordered eating.' The phrase ‘physically uncomfortable' was used to describe overeating in 50% of the interviews. When overeating, participants reported having a distinct taste preference for high-energy, carbohydrate-rich foods, such as cakes and cookies. Overeating occurred in social settings, including family and cultural events, over 50% of the time and as a result of daily stressors. <h3>Conclusion</h3> Culture, emotion and family play an integral role in how and when overeating occurs among this group. Consumption of energy dense foods because of overeating is particularly relevant because of the contribution to diet related chronic disease risk. Given the high rates of chronic disease among African American women, an understanding of how overeating is defined for this population will aid nutrition professionals in tailoring messages.

Percentage of Adolescents Meeting Federal Fruit and Vegetable Intake Recommendations - Youth Risk Behavior Surveillance System, United States, 2017.

According to the 2020-2025 Dietary Guidelines for Americans, persons should consume fruits and vegetables as part of a healthy eating pattern to reduce their risk for diet-related chronic diseases, such as cardiovascular disease, type 2 diabetes, some cancers, and obesity.* A healthy diet is important for healthy growth in adolescence, especially because adolescent health behaviors might continue into adulthood (1). The U.S. Department of Agriculture (USDA) recommends minimum daily intake of 1.5 cups of fruit and 2.5 cups of vegetables for females aged 14-18 years and 2 cups of fruit and 3 cups of vegetables for males aged 14-18 years.† Despite the benefits of fruit and vegetable consumption, few adolescents consume these recommended amounts (2-4). In 2013, only 8.5% of high school students met the recommendation for fruit consumption, and only 2.1% met the recommendation for vegetable consumption (2). To update the 2013 data, CDC analyzed data from the 2017 national and state Youth Risk Behavior Surveys (YRBSs) to describe the percentage of students who met intake recommendations, overall and by sex, school grade, and race/ethnicity. The median frequencies of fruit and vegetable consumption nationally were 0.9 and 1.1 times per day, respectively. Nationally, 7.1% of students met USDA intake recommendations for fruits (95% confidence interval [CI]=4.0-10.3) and 2.0% for vegetables (upper 95% confidence limit=7.9) using previously established scoring algorithms. State-specific estimates of the percentage of students meeting fruit intake recommendations ranged from 4.0% (Connecticut) to 9.3% (Louisiana), and the percentage meeting vegetable intake recommendations ranged from 0.6% (Kansas) to 3.7% (New Mexico). Additional efforts to expand the reach of existing school and community programs or to identify new effective strategies, such as social media approaches, might help address barriers and improve adolescent fruit and vegetable consumption.

Consumption of ultra-processed foods in Canada.

A larger share of ultra-processed foods and drinks (UPF) in the diet is increasingly linked with poor diet quality, weight gain and elevated risk of diet-related chronic disease. This study used 2015 national-level data, the most recent available, to characterize the intake of UPF among Canadians and to examine changes since 2004. The 2004 and 2015 Canadian Community Health Surveys provided 24-hour dietary recall data for Canadians aged 2 or older. All food and drink items were classified according to type of food processing using the NOVA classification. The mean energy contribution of UPF (as a percentage of total daily energy intake) was compared across survey years for the overall population and for eight age-sex groups. The National Cancer Institute's methodology was used to assess the distribution of usual energy contributed by UPF. On average, UPF contributed 47.8% (95% CI: 47.3% to 48.3%) of total daily energy in 2004 and 45.7% (95% CI: 45.0% to 46.4%) in 2015 among the overall population, and more than half of total daily energy among children and adolescents. Both the mean energy contribution of UPF and their usual energy distribution shifted downward since 2004 for all age-sex groups, except among adults aged 55 or older. The energy contributions of soft drinks, fruit juices and fruit drinks declined, particularly among children and adolescents. Ultra-processed breads contributed more energy in 2015 for nearly all age-sex groups. As in 2004, the overall dietary share of UPF in Canada remained high in 2015, but intakes of some UPF, particularly beverages, declined. The energy contribution of UPF remained highest among children and adolescents, and increased among adults aged 55 or older.

Food Outlets Dietary Risk (FODR) assessment tool: study protocol for assessing the public health nutrition risks of community food environments

BackgroundAvailability and accessibility of nutritious foods can vary according to the food outlets present within a neighbourhood or community. There is increasing evidence that community food environments influence food choice, diet and the risk of diet-related chronic disease, however contemporary community food environments assessments (e.g. unhealthy fast food outlets versus healthy supermarkets or fruit and vegetable shops) may be too simplistic to accurately summarise the complexities of their impacts on food choice. This study protocol describes the development of the Food Outlets Dietary Risk (FODR) assessment tool for use by local government in Perth, Western Australia.MethodsSimilar to food safety risk assessment, the FODR assessment tool rates the potential harmful public health nutrition impact of food outlets by identifying and characterising the issues, and assessing the risk of exposure. Scores are attributed to six public health nutrition attributes: 1) availability of nutrient-poor foods; 2) availability of nutritious foods; 3) acceptability and appeal; 4) accessibility; 5) type of business operation; and 6) complex food outlet considerations. Food retail outlets are then classified as having a low, medium, high or very high dietary risk based on their total score.DiscussionA local government administered tool to rate the public health nutrition risk of food outlets requires data which can be collected during routine assessments or sourced from the internet. The ongoing categorical classification of foods available within food outlets as either unhealthy or nutritious will require nutrition scientists’ input. An objective risk assessment of the dietary impact of food retail outlets can guide local government planning, policies and interventions to create supportive community food environments. It is intended that locally relevant data can be sourced throughout Australia and in other countries to apply the local context to the FODR assessment tool. Utility and acceptability of the tool will be tested, and consultation with environmental health officers and public health practitioners will inform future iterations.

Precision Nutrition Impact on Health-Related Behavior Change in Service Members

Abstract Objectives 1) Examine the effectiveness of gene-based nutrition counseling on health-related behaviors in service members as measured by body weight, body mass index, blood glucose, lipids, 25-hydroxyvitamin D, % body fat, waist circumference, and blood pressure; 2) Evaluate the feasibility of a digital application to accurately capture diet, activity, and sleep behaviors; 3) Describe military-unique characteristics in demographics, diet, and lifestyle for Northwest Army and Southwest Air Force cohorts Methods In this prospective RCT, a baseline genomic profile built from 70 genes/80 variants following amplicon sequencing on a MiSeq platform is augmented by serum biomarkers specific to diet-related chronic disease risk (metabolic syndrome and vitamin D deficiency) for each subject. Treatment group receives gene-based nutrition counseling; control group receives evidence-based nutrition pamphlets. A digital app is used for real-time health data capture, validated by in-person RD interviews. After the initial 6 weeks, both groups use study resources independently and return for final body composition, BP, and serum biomarkers at 12 weeks. Results Preliminary findings: Northwest cohort has enrolled 26 of 75 active duty soldiers. Sample has slightly more males (54%), mean age 29.6 years, 64% married, 77% Caucasian, non-Hispanic, and 60% report some college. About 50% lost an average of 15 lbs to join the Army. Mean anthropometrics for females: BMI 27.4, 30.3% body fat, waist circ 32.2 in; for males: BMI 30.7, 28% body fat, waist circ 40 in. High variant presence noted for obesity and hypertension. Signals of abnormal biomarkers are insignificant although 60% of sample has baseline serum vitamin D less than 30 ng/mL. Conclusions This initiative has begun to advance the precision nutrition agenda in the military setting where advanced practice RNs and RDs will soon use genomic risk data to guide diet and lifestyle counseling to support personal and military readiness and optimize mission performance. Funding Sources TriService Nursing Research Program.

Abstract P284: Higher Bitter Taste Perception is Associated With Lower Diabetes Risk Among Older Adults With Metabolic Syndrome - The PREDIMED-PLUS Trial

Background: Beyond taste perception, taste receptors in the mouth and gastrointestinal tract have been linked to the regulation of energy balance, endocrine function and glucose homeostasis. Despite this, little is known about the relationship between perception for the 5 tastes (sweet, salt, sour, bitter and umami) and diet-related chronic disease risk. Objective: To investigate the association between perception for the 5 tastes and diabetes status. Methods: A cross-sectional baseline analysis was performed on older (55-75 years), overweight (BMI, ≥27-&lt;40) adults diagnosed with metabolic syndrome who were participating in the PREDIMED-PLUS Valencia trial (N=367). Taste perception was measured by challenging participants with standard solutions representing sweet, salt, sour, bitter and umami (400 mM sucrose, 200 mM NaCl, 34 mM citric acid, 5.6 mM phenylthiocarbamide [PTC], 200 mM monopotassium glutamate, respectively) and was evaluated on a 0-5 unit scale. Diabetes status was determined by self-reported clinical diagnosis. Multivariable logistic regression models that included all 5 tastes were used to test the association between taste perception and diabetes status. Results: The prevalence of diabetes in this cohort was 38%. Compared to individuals without diabetes, individuals with diabetes had significantly lower bitter taste perception (unadjusted means: 1.6 versus 1.1 units, respectively) (t-test p&lt;0.001). After adjusting for age, sex, smoking status, physical activity, BMI and medication use, a 1 unit increase in bitter taste perception was associated with a 42% lower odds of being diagnosed with diabetes (adjusted odds ratio [aOR] = 0.58; 95% CI = [0.38, 0.84], p&lt;0.001). Although mean perceptions for sweet, salt, sour and umami were also lower in individuals with diabetes, the associations did not reach statistical significance. Conclusions: Among older adults with metabolic syndrome, higher bitter taste perception was associated with lower odds of being diagnosed with diabetes. Further investigations are warranted to confirm these observations and to determine whether bitter taste receptors may provide a possible therapeutic target for diabetes prevention and treatment.

In search of alternative proteins: unlocking the potential of underutilized tropical legumes

Protein is one of the essential nutrients required for almost every task of a human’s cellular life. Severe protein malnutrition, which can cause a fatal outcome, is the leading cause of death for infants and children in many African and Asian countries that have little to no access to complete proteins. Complete proteins, which contain all nine amino acids essential for human health, are usually found in animal-based foods such as meat and dairy products. The overconsumption of animal-based proteins, however, can potentially increase the risk of diet-related chronic diseases. Recent years have witnessed enhanced awareness about the health benefits of substituting animal-based proteins with plant-based proteins, especially in developed countries. Nitrogen-fixing grain legumes are considered important sources of protein in many developing countries because they are generally cheaper than meat or cereals. Extensive research has been conducted on several well-known legumes, notably soybean, which is the most economically important legume worldwide. Nevertheless, many lesser-known legumes with similar nutritional properties to soybean are still underdeveloped, including winged bean, lentil, lima bean, lablab, and bambara groundnut, which are commonly grown in the tropics. Only now are these species receiving more scientific attention. This review highlights the potential of these tropical legumes as future major sources of plant-based proteins, along with the critical research areas for their improvement. We provide insights into how these underutilized legumes could help resolve the global protein crisis and address food insecurity issues.

Milestones in DRI Development: What Does the Future Hold?

The state of nutritional health in the United States in the early part of the twentieth century was very different from today. Nutrient deficiencies and dental caries were prevalent health concerns for many Americans. In 1940, the US National Defense Advisory Commission asked the National Academy of Sciences for help in studying problems of nutrition in the United States. The outcome was issuance of the first RDAs. The goal of the RDAs was to recommend "…allowances sufficiently liberal to be suitable for maintenance of good nutritional status." In the subsequent decades, a very different nutritional health challenge began to emerge for an increasing proportion of the population, that of overweight and obesity and risk of diet-related chronic disease. In part, as a response to this challenge, the RDA process was revised and the Dietary Reference Intakes (DRIs) were developed. The DRIs are a set of reference values that, when adhered to, predict a low probability of nutrient inadequacy or excessive intake. Recently, new DRI guidelines were proposed to define reference points for nutrient and food component intakes that influence risk of chronic disease. Developing DRIs for chronic disease endpoints presents unique challenges, notably, chronic diseases are multifactorial in nature and not directly nutrient-specific; the body of evidence supporting nutrients and other food substances as modifiers of risk of chronic disease is generally limited; and there is a lack of consistency in findings across study types. In addition, the latency of dietary exposures and chronic disease outcomes makes it difficult to demonstrate causality. Adapting the DRI model to meet the needs of the general population in the current context suggests a need to redefine the boundaries that describe the health of the population and to re-examine how indicators of chronic disease can be integrated effectively into the DRI process.

Examining the correlates of meal skipping in Australian young adults

BackgroundMeal skipping is associated with diet-related chronic disease risk and is highly prevalent in young adults. Despite this, the correlates of meal skipping in this population group are unknown. Therefore, the aim of this study was to examine the prevalence and correlates of meal skipping in young adults.MethodsYoung adults aged 18–30 years (n = 578) (24% male, 76% female) used ‘FoodNow’, a purpose designed real-time smartphone application to record food and beverage consumption over four non-consecutive days. The day following each reporting day, participants were asked about their previous day’s eating occasions; if any eating occasions were not reported or if any were skipped. These data were used to categorise participants into specific meal skippers (breakfast, lunch and/or dinner skipper). Participants also completed an online questionnaire, which contained measures of correlates from the social-ecological framework across the individual, social-environmental and physical-environment domains. Logistic regression analyses were used to examine associations between specific meal skipping behaviours and measured correlates.ResultsIndividual domain correlates (education status, smoking status and time scarcity) were associated with varying meal skipping behaviours, while no correlates from the social-environmental or physical-environmental domains of the social-ecological framework were associated with any meal skipping behaviours. Participants with a university education were less likely to be a meal skipper (any meal) (OR = 0.46; 95%CI: 0.22, 0.95; p = 0.035), while those who previously or currently smoked cigarettes were more likely to be breakfast skippers (OR = 1.10; 95%CI: 1.15, 3.86; p = 0.016) compared to those who had never smoked before. Those who are time scarce were more likely to be either breakfast (OR = 1.12; 95%CI: 1.00, 1.26; p = 0.036) or lunch skippers (OR = 1.11; 95% CI: 1.01, 1.23; p = 0.033). No variables were significantly associated with dinner skipping.ConclusionsThe findings suggest that the correlates of meal skipping vary according to the specific meal skipped. University education status needs to be considered when designing interventions aimed at the reduction of meal skipping among young adults, while correlates such as time management and smoking status may offer potential behaviour change targets within these interventions.

Food and Nutrient Intakes of Jamaican Immigrants in Florida

This study assessed dietary intakes, nutritional composition, and identified commonly eaten foods among Jamaicans in Florida. Dietary intake was assessed among 44 study participants to determine commonly eaten foods and nutrient composition. Weighed recipes were collected and analyzed to determine nutrient composition for traditional foods. Top foods that contributed to macronutrient and micronutrient intake were identified and adherence to dietary recommendations was evaluated. Mean daily energy intake was 2879 (SD 1179) kcal and 2242 (SD 1236) kcal for men and women respectively. Mean macronutrient intakes were above dietary recommendations for men and women. Top foods contributing to energy included rice and peas, sweetened juices, chicken, red peas soup, and hot chocolate drink. Results showed sodium intake was more than double the adequate intake estimate (1300–1500 mg). Findings highlight the need to include commonly eaten traditional foods in dietary questionnaires to accurately assess diet-related chronic disease risk. Findings have implications for risk factor intervention and prevention efforts among Jamaicans.

Sensory Aspects of Bitter and Sweet Tastes During Early Childhood

The flavor of food arises from multiple sensory inputs, including taste, smell, and oral touch. Human preference for food is driven by both biology and previous experience. Hedonic responses for taste and chemesthesis (chemically initiated touch sensations) are generally hardwired, whereas hedonic responses for smell are almost exclusively learned. With time, individuals can also learn to like the initially aversive oral sensations, such as the bitterness of beer or the burn of chili peppers, through a variety of mechanisms. Encouraging the development of healthy eating habits early in life is considered to be an optimal strategy to reduce the risk of diet-related chronic diseases. Over the past 2 decades, much has been written about how individual differences in taste sensation, especially bitterness, may either predispose or prevent a person from making healthy food choices. A related but separate body of work has systematically explored perceptual interactions between various taste stimuli. Unfortunately, these findings are infrequently integrated within the context of eating real foods to consider how they may influence food choice in humans. This article briefly highlights some key findings and attempts to integrate them to provide new insights on how to best encourage appropriate child-feeding behaviors.

Associations between food and beverage groups and major diet-related chronic diseases: an exhaustive review of pooled/meta-analyses and systematic reviews.

Associations between food and beverage groups and the risk of diet-related chronic disease (DRCD) have been the subject of intensive research in preventive nutrition. Pooled/meta-analyses and systematic reviews (PMASRs) aim to better characterize these associations. To date, however, there has been no attempt to synthesize all PMASRs that have assessed the relationship between food and beverage groups and DRCDs. The objectives of this review were to aggregate PMASRs to obtain an overview of the associations between food and beverage groups (n = 17) and DRCDs (n = 10) and to establish new directions for future research needs. The present review of 304 PMASRs published between 1950 and 2013 confirmed that plant food groups are more protective than animal food groups against DRCDs. Within plant food groups, grain products are more protective than fruits and vegetables. Among animal food groups, dairy/milk products have a neutral effect on the risk of DRCDs, while red/processed meats tend to increase the risk. Among beverages, tea was the most protective and soft drinks the least protective against DRCDs. For two of the DRCDs examined, sarcopenia and kidney disease, no PMASR was found. Overweight/obesity, type 2 diabetes, and various types of cardiovascular disease and cancer accounted for 289 of the PMASRs. There is a crucial need to further study the associations between food and beverage groups and mental health, skeletal health, digestive diseases, liver diseases, kidney diseases, obesity, and type 2 diabetes.