Total Caloric Intake Research Articles

Low-fat versus Low-carbohydrate Diet

Abstract The global obesity rate has risen significantly, prompting research into the optimal dietary strategies for weight loss, particularly in relation to macronutrient composition. Despite numerous studies, the most effective macronutrient balance for weight reduction remains under debate. The objective of this article is to compare the impacts of a low-carbohydrate diet and a low-fat diet on weight loss and cardiovascular health. A comprehensive literature review was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Studies included randomized controlled trials and systematic reviews to provide a broad analysis of the evidence on a low-carbohydrate versus a low-fat diet. Short-term weight loss was significantly higher with a low-carbohydrate diet compared to an unrestricted low-fat diet. However, when matched for calorie intake, no significant difference in weight was observed between the two diets, suggesting that total calorie intake may be more influential than macronutrient composition. Notably, a low-carbohydrate diet induced a greater decrease in triglyceride levels and an increase in both high-density lipoprotein and low-density lipoprotein cholesterol levels compared to a low-fat diet.

A Pilot Study of a Novel Dietary Intervention Targeting Ultra-Processed Food Intake.

Ultra-processed foods (UPFs) are harmful to health but ubiquitous in the modern food environment, comprising almost 60% of the average American diet. This study assessed the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention designed to reduce UPF intake. Fourteen adults participated in an 8-week pilot intervention, which consisted of weekly group sessions, individual meal planning sessions, and financial support. Dietary intake was assessed using three Automated Self-Administered 24-h Dietary Recalls (ASA24) at both baseline and post-treatment. The intervention was highly feasible and acceptable. Qualitative data demonstrated that participants were enthusiastic about the benefits of reducing UPF intake and found the intervention highly valuable. Participants reduced average daily calories from UPF by 48.9%, number of UPFs consumed by almost half, total daily calorie intake by 612 calories/day, sodium consumption by 37% and sugar consumption by 50%. There were no significant changes in fruit or vegetable intake. Participants lost an average of 3.5kg (SD=3.0kg). This pilot data suggests that behavioral interventions to reduce UPF intake will be well-received and are capable of success despite the barriers of the United States food environment. Future research should prioritize behavioral interventions targeting UPF consumption alongside policy changes.

How Different Are the Influences of Mediterranean and Japanese Diets on the Gut Microbiome?

The gut microbiome is a complex ecosystem, mainly composed of bacteria, that performs essential functions for the host. Its composition is determined by many factors; however, diet has emerged as a key regulator. Both the Mediterranean (MD) and Japanese (JD) diets have been associated with significant health benefits and are therefore considered healthy dietary patterns. Both are plant-based diets and although they have much in common, they also have important differences mainly related to total calorie intake and the consumption of specific foods and beverages. Thus, it has been hypothesized that they exert their beneficial properties through different nutrients and bioactive compounds that interact with gut microbes and induce specific changes on gut metabolic pathways. In this review, we present current data on the effects of the MD and JD on the gut microbiome. Furthermore, we aim to examine whether there are differences or shared effects on the gut microbiome of people who adhere to these dietary patterns.

Impact of daily fasting duration on body composition and cardiometabolic risk factors during a time-restricted eating protocol: a randomized controlled trial

BackgroundTime-restricted eating (TRE) is a dietary regimen that limits food intake for at least 12 h daily. Unlike other fasting protocols, TRE does not dictate what or how much to eat but rather focuses on the timing of meals. This approach has been previously demonstrated to improve body composition in individuals with obesity or metabolic impairments. However, its impact on body composition and cardiometabolic factors in healthy individuals remains unclear. Furthermore, the optimal fasting duration is still debated. Thus, we aimed to compare the effects of 8 weeks of different fasting durations on body composition and biochemical parameters in metabolically healthy, non-trained individuals using a parallel randomized controlled trial.MethodsForty-one volunteers were randomly assigned to one of the four experimental groups: TRE 16:8 (16 h of fasting,8 h of eating), TRE 14:10 (14 h of fasting,10 h of eating), TRE 12:12 (12 h of fasting,12 h of eating) or a normal diet group (ND; no dietary restriction). Participants underwent body composition measurements and blood tests for lipid profiles (i.e., total cholesterol, LDL, HDL, and triglycerides), fasting glucose, leptin, and anabolic hormones (i.e., insulin and testosterone) levels. Data were analyzed using both intention-to-treat (ITT) and per-protocol (PP) analysis to account for compliance. A two-way ANOVA for repeated measures was employed to assess interactions between time and group.ResultsIn the ITT analysis, TRE 16:8 reduced body mass (-2.46%, p = 0.003) and absolute fat mass (-8.65%, p = 0.001) with no changes in lean soft tissue and in calorie intake. These results were consistent with the PP analysis which included 8 participants in TRE 16:8, 5 in TRE 14:10, 9 in TRE 12:12, and the entire ND group. Participants in the TRE 16:8 group spontaneously reduced their total caloric intake, although this reduction was not statistically significant. None of the other measurements significantly changed after 8 weeks.ConclusionsOur results suggest that a 16-hour fasting window, even without caloric restriction, may be a viable strategy for improving body composition in healthy and non-trained individuals, whereas a shorter fasting period may be insufficient to produce significant changes in a healthy population.Trial registrationNCT, NCT04503005. Registered 4 August 2020, https://clinicaltrials.gov/study/NCT04503005.

Food consumption patterns and Framingham cardiovascular risk score among shift workers: A NOVA-based approach

ObjectiveTo evaluate the association between dietary quantity and variety, by extent and purpose of processing, and Framingham cardiovascular disease (CVD) risk score among rotating shift workers. MethodsThe cross-sectional study included male shift workers. Dietary intake was assessed using a 24-hour recall method conducted by trained interviewers. Food items were classified using two approaches: the first was based on the amount of food consumed in each food group. Fruits, vegetables, and legumes (FVL) intake, is classified as recommended at 400g per day by WHO guidelines. Ultraprocessed foods (UPFs) were analyzed based on tertiles of daily caloric contribution. The second approach, the NOVA dietary diversity score (DDS-NOVA) assessed the variety of consumed items within each food group, assigning points for each unique item consumed, irrespective of quantity or frequency. The CVD-risk score was evaluated using the Framingham coronary heart disease risk score, categorizing participants as low risk (<5%) or intermediate to high risk (>5%). Descriptive, univariate, and multivariate logistic regression were used, with adjustments made for age, skin color, schooling, duration of shift work, physical activity, BMI and total caloric intake. ResultsThe study involved 213 participants, with an average age of 38.67 years (±6.96), a minimum of 26 and a maximum of 60. The majority (62.4%) were between 30 and 40 years old; 49.3% identified themselves as brown; 56.8% had completed high school; and 79.3% were married. The Framingham CVD-risk score indicated that 56.2% were at low risk (<5%) and 43.7% at intermediate to high risk (≥5%). The average consumption of FVL was 272.32g (±350.43), with 70.4% meeting the recommendation of ≥400g/day. Participants consumed an average of 3.46 fresh food items, 3.74 minimally processed food items, 2.54 processed food items and 3.39 ultra-processed food items. In the multivariate model, consuming ≥400g/day of FVL reduced the likelihood of cardiovascular risk ≥5% by 2.12 times (OR: 0.47; 95%CI: 0.23-0.98). Each additional item of fresh food reduced the risk by 49% (OR: 0.67; 95%CI: 1.01-1.66), while each additional item of ultra-processed food increased the risk by 30% (OR: 1.30; 95%CI: 0.52-0.87). There was no significant association between the calorie intake of ultra-processed foods and cardiovascular risk. ConclusionBoth adequate consumption of FVL quantity and a greater variety of fresh-foods were associated with a lower chance of CVD-risk, while a higher variety of consumption of UPF items increased this chance.

Metabolic syndrome in association with novel dietary index, metabolic parameters, nesfatin-1 and omentin-1

BackgroundMetabolic syndrome is a prevalent and common health problem and numerous studies have revealed the role of diet and lifestyle change in prevention of metabolic syndrome. However, the novel dietary index, cardioprotective index (CPI) and its association with metabolic syndrome is not investigated yet. In the current study, we evaluated the association between metabolic syndrome and its components, CPI, Nesfatin-1 and Omentin-1in a cross-sectional study.MethodsThree hundred forty eight overweight and obese individuals with metabolic syndrome were recruited. Subjects underwent anthropometric and laboratory assays including metabolic markers, Nesfatin-1 and Omentin-1 with commercial kits.ResultsThose at the first tertile of CPI had lower high density lipoprotein concentrations (HDL) and higher low density lipoprotein concentrations (LDL), triglyceride (TG), systolic and diastolic blood pressures (SBP, DBP) levels compared with those at the highest tertiles (P < 0.05). After adjustment for the confounding effects of age, sex, body mass index, physical activity and total calorie intake, LDL lost its significance across CPI tertiles. Moreover, serum total cholesterol, insulin and insulin resistance were not significant across CPI tertiles neither in crude nor in adjusted models (P > 0.05). Additionally, being at the third tertile of CPI was accompanied with significantly higher Nesfatin-1 and Omentin-1 levels compared with lowest tertiels (P < 0.05) in crude and confounder – adjusted models. Conclusions: To our findings, CPI was in positive relationship with metabolic parameters, blood pressure, Nesfatin-1 and Omentin-1 levels in metabolic syndrome. Further future studies will help to elaborate the causality.Clinical trial numberNot applicable.

The Role of Diet in Tympanostomy Tube Otorrhea.

The objective of this study was to evaluate the role of diet quality in children with tympanostomy tube placement (TTP) complicated by tympanostomy tube otorrhea (TTO). Three-day 24-hour diet recall. Tertiary care medical center. Children between the ages of 2 to 6 years old with TTP performed 6 months to 2 years prior to enrollment were included. Children with a history of Down syndrome, cleft palate, craniofacial syndromes, known immunodeficiency, g-tube dependent, or a non-English speaking family were excluded. The primary outcome variable was TTO. The primary predictor was total caloric intake measured by percent estimated energy rate (%EER). A total of 120 families completed the 3-day diet recall. The median age was 27 months (interquartile range: 7.9-68.5), with 57% male sex. Most children reported dietary intake within the recommended range percent intake for carbohydrates and fat and less than recommended range for percent vitamin D. Within this cohort 63 (52.5%) participants had >1 TTO episode and 57 (47.5%) 1 TTO episode. Children with an EER% that was average or high were at higher odds of >1 TTO episodes compared to participants with a low EER% with ORs of 4.6 (95% confidence interval [CI]: 1.4, 15.6) and 5.7 (95% CI: 1.5, 22.1) respectively. Children with a typical or high total daily caloric intake are approximately 5 to 6 times more likely to have multiple TTO episodes compared to those with low intake.

The impact of distraction, masticatory performance and sex on food intake of school children from public and private schools: a randomized trial

Recent research highlights the influence of distraction on caloric intake in adults. This study investigated the impact of smartphone use and reading comic book on food intake of schoolchildren aged 10 to 12 years. One hundred and twenty students from public and private schools participated in experimental meal sessions. Individual parameters such as sex, age, body mass index (BMI), and eating preferences were assessed during the first session. In subsequent appointments, participants consumed standardized meals without distraction, while using a smartphone, or reading comic books in a random order. Child Three-Factor Eating Questionnaire (CTFEQr-21) was administered to assess eating behavior, and total caloric intake (kcal), total amount (g) and medium/high-energy-dense amount (g) were measured in each session. No significant difference was observed in food intake among the three experimental meals (without distractor, using smartphone and reading comic book). Masticatory performance, number of chewing cycles, and time until swallow were similar between sexes and school types (p>0.05). Regression models showed that meal duration was dependent on school type, number of teeth, time until swallow and absence of distractor, while total caloric intake was dependent on school type (public), sex (male), time until swallow, and number of cycles. Besides, total amount ingested, and medium/high-energy-dense amount were dependent on school type (public), sex (male), age, size of the particles and time until swallowing, uncontrolled eating and body mass index (p<0.05). In conclusion, the primary factors affecting food/caloric ingestion were sex, school type, and masticatory parameters, while the absence of distractor had an influence on meal duration.

Early Adequate Nutrition in ICU is Associated with Survival Gain : Retrospective Cohort Study in Patient with Traumatic Brain Injury.

Patients with traumatic brain injury (TBI) commonly exhibit a poor mental health status and can easily develop aspiration pneumonia. Thus, early proper nutrition through oral or tube feeding is difficult to achieve, leading to malnutrition. However, evidence regarding early nutritional support in the intensive care unit (ICU) is lacking. We aimed to assess the effect of early nutrition in patients with TBI admitted to the ICU. Data of adult patients with TBI admitted to the trauma ICU of a regional trauma center in Korea between 2022 and 2023 were retrospectively analyzed. Those with ICU stay <7 days, younger than 18 years, and with underlying diseases that could alter baseline metabolism, were excluded. Nutritional support on day 4 of ICU admission was measured. The patients were classified into mortality and survival groups, and risk factors for mortality were evaluated. Subgroup analyses were performed based on TBI severity. Overall, 864 patients were diagnosed with acute TBI, of whom 227 were included in this study. The mortality rate in the study population was 15% (n=34). Those in the survival group were younger, had longer hospital stays, had a higher initial Glasglow Coma Scale (GCS) score, and had a higher intake of calorie supplements than those in the mortality group. In a subgroup analysis of patients with non-severe TBI (GCS>8), total calorie intake (751.4 vs 434.2 kcal, p=0.029), total protein intake (37.5 vs. 22.1 g, p=0.045), and ratio of supplied to target calories (0.49 vs 0.30, p=0.047) were higher in the survival group than in the mortality group. Logistic regression analysis revealed that calorie intake (B=-0.002, p=0.040) and initial hemoglobin level (B=-0.394, p=0.005) were risk factors for mortality in patients with non-severe TBI. More calories were supplied to the survival group than the mortality group among patients with TBI. Additionally, logistic regression analysis showed that increased calorie supply was associated with reduced mortality in patients with non-severe TBI. The mortality group had low protein intake; however, this did not emerge as a risk factor for mortality. Early sufficient nutritional support improves the prognosis of patients with TBI.

Time-limited access to palatable food reveals differential effects of psychological stress on homeostatic vs. hedonic feeding behavior in male rats

Psychological stress has complex effects on eating behavior, appearing to reduce homeostatically regulated feeding, while increasing hedonically motivated feeding. The present work tests this idea using two feeding paradigms that offer a highly palatable food on a time-limited basis, together with continual access to a low palatability food. This approach provides a natural separation between periods of eating that are primarily homeostatic vs. hedonically regulated. First, the impact of acute stress exposure on feeding behavior was tested using an acute “meal-dessert” paradigm. When fasted adult male rats were given a recent stressor of moderate intensity (restraint), refeeding with a chow-meal was reduced, without affecting chocolate-dessert intake, thereby increasing the proportion of calories derived from chocolate. Next, the effect of chronic moderate stress was tested using a “binge” eating paradigm. Chow-fed rats were given unexpected (3d per week) vs. expected (7d per week) brief access to a highly palatable high-fat diet (HFD), and feeding behavior was compared to control groups that were maintained with continuous access to only chow or only HFD. Chronic stress reduced total caloric intake in all groups, including binge-like HFD intake. Binge-like HFD intake caused metabolic dysfunction (increased adiposity and impaired glucose homeostasis) to an extent beyond that predicted by total caloric intake or body weight gain. Finally, binge-like HFD intake shifted stress coping behavior from an active to a passive phenotype, particularly in rats receiving concurrent chronic stress, suggesting the possibility of increased risk for stress-related disorders, like depression, in individuals who binge eat during stress.

Predicting Obesity via Deep Learning: The Role of Chrononutrition

Abstract Background Obesity is a significant public health challenge, prompting the need for assessing effective tools for its monitoring and prevention. Chrononutrition investigates the role of timing, regularity and frequency of food intake on body metabolism and health. Here we aim to check if data on the distribution of calorie intake in the day may improve BMI prediction as compared to using only data on total day intake. Methods We apply deep learning on chrononutritional data on calorie intake over 6 daily timeslots from a nationally representative cross-sectional survey sample of the Italian population (INRAN-SCAI 2005/2006) comprising 2313 Italian adults 18-64 ys old with 3 day diet diaries. In particular, we implemented three deep neural network models, varying network configurations and feature selection. The 1st includes 18 (6 for each day diary) chrononutritional variables and the 3 day total intakes, beside age and sex; the 2nd includes age, sex and the 18 chrononutritional variables only; the 3rd uses age, sex and the 3 day totals only. We applied Early Stopping to limit overfitting. Optimization was conducted using the Adam algorithm, minimizing the mean squared error (RMSE), while mean absolute error (MAE) was the primary performance indicator. Results The results highlight that Model 3 outperformed the other models with MAE=2.514 and RMSE=3.476, indicating that for the purpose of predicting obesity, information on the time-of-day distribution of calorie intake is not increasing predictive ability of BMI on top of age, sex and total calorie intake in the day. Conclusions Additional use of day-time intake information worsened prediction of BMI via deep learning using this cross sectional Italian survey. However the error made is still sizeable and warrants the inclusion of other variables; our results don’t rule out the role of chrononutrition on metabolic health which may act through other biological mechanisms related to specific nutrients. Key messages • Chrononutrition data don’t improve BMI prediction over total calorie intake data in a cross-setional representative sample of the Italian population. • Deep learning approach to BMI prediction shows the importance of targeted selection of features in public health nutrition.

Self-Initiated Dietary Adjustments Alter Microbiota Abundances: Implications for Perceived Health

Background/Objectives: Personalized and self-initiated dietary adjustments have been shown to alleviate mental and somatic complaints. Here, we investigated the potential role of gut microbiome alterations underlying these effects. Methods: For this purpose, participants (n = 185) underwent a four-week self-initiated dietary intervention and filled out weekly questionnaires on their dietary intake, somatic and mental symptoms, and physical activity. Results: Overall, the participants lost weight, had alleviated mental and somatic complaints, reduced their total caloric and percentual carbohydrate intake, and ate less processed, party-type, and traditional Dutch food items, but ate more Pescatarian type food items, while keeping their fiber intake unaltered. Baseline and endpoint gut microbiota analyses using 16S rRNA gene sequencing revealed an overall increase in Gemmiger formicilis and reductions in Peptostreptococcaceae and Ruminococcus bromii over the four-week dietary intervention. While these bacterial alterations were considered to be beneficial for the host, they were not individually correlated with alterations in, or endpoint levels of, somatic and/or mental complaints. Instead, individual increases in Ruminococcus bicirculans (a well-known utilizer of plant cell wall polysaccharides) were strongly correlated with reductions in mental complaints, even though overall R. bicirculans remained unaltered over the course of the four-week self-initiated dierary intervention. Conclusions: Our results suggest that overall altered versus individually correlated microbiota abundances and their relations with host health characteristics over the course of a self-chosen dietary intervention may represent different levels of regulation, which remain to be further untangled.

Association of Nutritional Intake with Physical Activity and Handgrip Strength in Individuals with Airflow Limitation.

We investigated whether nutritional intake is associated with physical activity (PA) and handgrip strength (HGS) in individuals with airflow limitation. This study analyzed data from the 2014 to 2016 Korean National Health and Nutrition Examination Survey. We assessed total protein intake (g/day), caloric intake (kcal/day), and other nutritional intakes using a 24-hour dietary recall questionnaire. HGS was measured three times for each hand using a digital grip strength dynamometer, and PA was assessed as health-enhancing PA. Airflow limitation was defined as a forced expiratory volume/forced vital capacity ratio of 0.7 in individuals over 40 years of age. Participants were categorized into groups based on their PA levels and HGS measurements: active aerobic PA vs. non-active aerobic PA, and normal HGS vs. low HGS. Among the 622 individuals with airflow limitation, those involved in active aerobic PA and those with higher HGS had notably higher total food, calorie, water, protein, and lipid intake. The correlations between protein and caloric intake with HGS were strong (correlation coefficients = 0.344 and 0.346, respectively). The forest plots show that higher intakes of food, water, calories, protein, and lipids are positively associated with active aerobic PA, while higher intakes of these nutrients are inversely associated with low HGS. However, in the multivariate logistic regression analysis, no significant associations were observed between nutritional intake and active aerobic PA or HGS. Nutritional intake was not found to be an independent factor associated with PA and HGS. However, the observed correlations suggest potential indirect effects that warrant further investigation.

Food consumption and adherence to dietary guidelines among Jordanian children and adolescents

Background Early-life food consumption patterns may affect children’s health by increasing susceptibility to developing non-communicable chronic diseases (NCDs) in adulthood. Aims To evaluate Jordanian children and adolescents’ energy and macronutrient intake and how closely they adhere to dietary recommendations. Methods This cross-sectional study used data from Jordan’s Population-based Food Consumption Survey, a household population-based study conducted in Jordan between 2021 and 2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall methods (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, consuming vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms.

Is there any association between type of dietary fat and quality of life in hemodialysis patients? A cross-sectional study.

Hemodialysis (HD) patients have a low quality of life (QOL), and dietary intakes may impact both somatic and psychosocial aspects of QOL. Nevertheless, the relationship between QOL and different dietary fats has not yet been evaluated. The purpose of this study was to assess the association between QOL and the types/quantities of dietary fats intake in HD patients. In this multi-center cross-sectional study, 251 adult patients under dialysis for at least 3 months were included. Participants' dietary intakes were collected using a validated 168-item semi-quantitative FFQ during the past year. Moreover, to assess QOL, Kidney Disease Quality of Life Short Form (KDQOL-SF 1/3) was used. The linear regression between QOL and different types of dietary fats was conducted. p < 0.05 was statistically significant. Overall, 66 women and 185 men participated in our study. Regression analysis adjusted for total calorie intake showed that there was a negative association between QOL and total fat (95% CI: -0.187, -0.043), SFA (95% CI: -0.688, -0.143), MUFA (95% CI: -0.389, -0.065) and PUFA (95% CI: -0.401, -0.056) when types of dietary fats were individually included to the regression analysis. When all types of dietary fats were simultaneously entered into the analysis, the association between QOL and MUFA (95% CI: -0.243, 1.031) and PUFA (95% CI: -1.159, 0.084) were attenuated. The regression coefficient for SFA remained significant (95% CI: -0.968, -0.138). Also, there was a marginally significant association between SFA and the risk of low QOL was observed when all types of dietary fats were simultaneously entered into the analysis (OR = 1.051, 95% CI: 0.998-1.104). Our investigation found a negative association between SFA consumption and QOL among different types of dietary fats. Furthermore, SFA mediated the relationship between QOL, MUFA, PUFA, and total fat. So, modification of dietary fat intake could enhance QOL in HD patients.

The Effect of Lower Body Compression Tights on the Running-Based Anaerobic Sprint Test in Young Male Basketball Players

This study aims to assess the influence of lower body compression tights on performance in the Running-Based Anaerobic Sprint Test (RAST) in young male basketball players. Twenty male basketball players participated in the study (age = 16.5±0.5 years, height = 176.8±5.71 cm, weight = 68.5±8.98 kg, basketball experience = 2.35±0.49 years). Players performed the RAST, comprising 6 x 35 m sprints with 10-second intervals, wearing regular shorts or compression tights, with a one-week interval between conditions. Before each test, a 24-hour dietary record was used to calculate the total calorie intake and the percentage of calories from carbohydrates to account for dietary variations. The Hooper Index was used to assess fatigue levels before each test. The RAST, conducted using a Newtest Powertimer photocell (300 Series, Oulu, Finland), determined maximal power (Pmax), minimum power (Pmin), average power (AP), and fatigue index (FI). Perceived exertion after each RAST was assessed using the Borg Scale (20-point system). Paired-samples ttest results showed no statistically significant difference (p&gt;0.05) between the means from the two test sessions. The study suggests that lower body compression tights did not significantly impact RAST performance in young basketball players. Considering the study design, applying it to more experienced players after familiarization sessions with compression tights may yield different results.

The consumption of ultra-processed foods was associated with adiposity, but not with metabolic indicators in a prospective cohort study of Chilean preschool children

BackgroundIncreasing consumption of ultra-processed foods (UPF) has been identified as a risk factor for obesity and various diseases, primarily in adults. Nonetheless, research in children is limited, especially regarding longitudinal studies with metabolic outcomes. We aimed to evaluate the longitudinal association between consumption of UPF, adiposity, and metabolic indicators in Chilean preschool children.MethodsWe conducted a prospective analysis of 962 children enrolled in the Food and Environment Chilean Cohort (FECHIC). Dietary data were collected in 2016 at age 4 years with 24-h recalls. All reported foods and beverages were classified according to the NOVA food classification, and the usual consumption of UPF in calories and grams was estimated using the Multiple Source Method. Adiposity (z-score of body mass index [BMI z-score], waist circumference [WC], and fat mass [in kg and percentage]) and metabolic indicators (fasting glucose, insulin, HOMA-IR, triglycerides, total cholesterol, and cholesterol fractions) were measured in 2018, at the age of 6 years. Linear regression models ((0) crude, (1) adjusted for covariables, and (2) adjusted for covariables plus total caloric intake) were used to evaluate the association between UPF and outcomes. All models included inverse probability weights to account for the loss to the follow-up.ResultsAt 4 years, usual consumption of UPF represented 48% of the total calories and 39% of the total food and beverages grams. In models adjusted for covariables plus caloric intake, we found a positive association between UPF and BMI z-score (for 100 kcal and 100 g, respectively: b = 0.24 [95%CI 0.16–0.33]; b = 0.21 [95%CI 0.10–0.31]), WC in cm (b = 0.89 [95%CI 0.41–1.37]; b = 0.86 [95%CI 0.32–1.40]), log-fat mass in kg b = 0.06 [95%CI 0.03–0.09]; b = 0.04 [95%CI 0.01–0.07]), and log-percentage fat mass (b = 0.03 [95%CI 0.01–0.04]; b = 0.02 [95%CI 0.003–0.04]), but no association with metabolic indicators.ConclusionsIn this sample of Chilean preschoolers, we observed that higher consumption of UPF was associated with adiposity indicators 2 years later, but not with metabolic outcomes. Longer follow-up might help clarify the natural history of UPF consumption and metabolic risks in children.

Substituting Refined Sugars With Maple Syrup Decreases Key Cardiometabolic Risk Factors in Individuals With Mild Metabolic Alterations: A Randomized, Double-Blind, Controlled Crossover Trial

BackgroundMaple syrup, a minimally transformed sweetener rich in polyphenols, can exert a action and improve metabolic parameters in animal models. However, no randomized clinical trial has investigated this. ObjectivesThis study aims to determine whether replacing refined sugars with an equivalent quantity of maple syrup could decrease key cardiometabolic risk factors in individuals with mild metabolic alterations. MethodsIn a randomized, double-blind, controlled crossover trial with 42 overweight adults with mild cardiometabolic alterations, participants were instructed to substitute 5% of their total caloric intake from added sugars with either maple syrup or an artificially flavored sucrose syrup for 8 wk. The primary outcome included changes in glucose homeostasis, whereas secondary outcomes were changes in other cardiometabolic risk factors such as blood pressure, anthropometric indices, and blood lipid profiles. Exploratory outcomes involved analyzing changes in gut microbiota composition. ResultsReplacing refined sugars with maple syrup over 8 wk decreased the glucose area under the curve when compared with substituting refined sugars with sucrose syrup, as determined during the oral glucose tolerance test, leading to a significant difference between the intervention arms (−50.59 ± 201.92 compared with 29.93 ± 154.90; P < 0.047). Substituting refined sugar with maple syrup also significantly decreased android fat mass (−7.83 ± 175.05 g compared with 67.61 ± 206.71 g; P = 0.02) and systolic blood pressure (−2.72 ± 8.73 mm Hg compared with 0.87 ± 8.99 mm Hg; P = 0.03). No changes in the blood lipid profile were observed. As an exploratory outcome, we further observed that substituting refined sugars with maple syrup promoted selective taxonomic changes in the gut microbiota such as a significant reduction in the abundance of Klebsiella species and decreased microbial functions associated with bacterial-induced cytokine response, when compared with substitution with sucrose syrup. ConclusionsSubstituting refined sugars with maple syrup in individuals with mild metabolic alterations result in a significantly greater reduction of key cardiometabolic risk factors compared with substitution with sucrose syrup, in association with specific changes in gut microbiota. The role of the gut microbiota in these effects remains to be further explored.This trial was registered at clinicaltrials.gov as NCT04117802.

Relationship of dietary nutrients with early childhood caries and caries activity among children aged 3–5 years—a cross-sectional study

BackgroundEarly childhood caries (ECC) is a challenge for pediatric dentists all over the world, and dietary factor is an important factor affecting the occurrence of ECC. Currently, there is limited research on the impact of dietary nutrient intake from Chinese diets on ECC. The purpose of this study is to explore the correlation of dietary nutrients intake with ECC and caries activity (CA) among children aged 3–5 years, and to provide dietary guidance to slow down the occurrence and development of ECC.MethodsA cross-sectional study was conducted in 2022. A total of 155 children were divided into three groups: caries-free group, ECC group and Severe early childhood caries (SECC) group according to the caries statues. And according to the caries activity test (CAT) value, they were also divided into three group: low CA group (L-CA), middle CA group (M-CA) and high CA group (H-CA). The 24-hour dietary intake information was collected by mobile phone application (APP). The intake of children’s daily dietary nutrients were calculated referring to “China Food Composition Tables”.ResultsIn this study, 17, 39,and 99 children were diagnosed with caries-free, ECC, and SECC. There were 33, 36, and 86 children diagnosed with L-CA, M-CA, and H-CA. The risk of ECC was increased with the intake of cholesterol(OR = 1.005) and magnesium (OR = 1.026) and decreased with the intake of iron (OR = 0.770). The risk of SECC was increased with the intake of cholesterol (OR = 1.003). The risk of high CA was increased with the intake of cholesterol (OR = 1.002). The combined application of dietary total calories, carbohydrate, cholesterol, sodium, magnesium and selenium in the diagnosis of ECC had an area under ROC curve of 0.741.ConclusionsThe increased dietary cholesterol intake may be a common risk factor for ECC and high CA in children aged 3–5. The combined application of dietary intake of total calories, carbohydrate, cholesterol, sodium, magnesium and selenium has a higher predictive value for the occurrence of ECC.

Perception of Paediatricians and Families about Nutritional Supplements: Acceptance, Tolerability and Satisfaction in Malnourished Children (PerceptiONS Jr Study).

Malnutrition is a common situation in the Spanish paediatric population. Malnourished children may benefit from different strategies, including dietary modifications or nutritional supplements (NS). It is important to know the different factors that can influence treatment tolerance and adherence, and their impact on nutrition monitoring. To explore the perception of doctors who prescribe nutritional supplements (NS) in children and to investigate different factors involved in tolerance and adherence. A cross-sectional, descriptive observational study based on an ad hoc electronic survey designed to study doctors' perceptions of at least five of their children with NS and their families, subjected to outpatient follow up. Variables included were the socio-demographic variables of the doctors and children, nutritional status of the patients, amount and characteristics of NS (hyper-caloric oral with fibre (HOFF), oral peptide (OPF) and hyper-caloric infant (HIF)), route of administration, perceived benefits, satisfaction, palatability, adherence, and acceptance. 815 patients aged 0-16 years (mean 10.6 years; SD 7.8) were included. A proportion of 64% received HOFF, 16% FOP, and 20% HIF. A proportion of 84% received exclusive oral NS. Total daily calorie intake prescribed with NS ranged from 30-75% in 48.2% of cases, though it was significantly higher in children under 6 months of age. Improvement in overall condition, nutritional status and quality of life was observed in 82%, 79.5%, and 80% of subjects. Improvement in tolerance and digestive symptoms was reported in 83.5% and 72% of subjects. The degree of satisfaction and acceptance of NS was very good in 80% of cases, with taste being the most influential factor (82.3%). Adherence was adequate in more than 60%, and smell was the most significant feature in lack of adherence (55%). The flavour of the best-accepted supplement was chocolate (44%). A total of 97% of prescribing doctors would recommend the same formula again. In our study, prescribing doctors and families perceived an excellent benefit from the use of the prescribed formulas, improved quality of life, high satisfaction, acceptance, and adherence. The positive factors for adequate adherence were sufficient information about the formulations and their benefits, and continuity of care during follow-up. Prescribing doctors would recommend supplement use again given the perceived benefits and satisfaction.