Validating dietary assessment tools with energy expenditure measurement methods: Is this accurate?

Having an accurate dietary assessment tool is a necessity for most nutritional studies. As a result, many validation studies have been carried out to assess the validity of commonly used dietary assessment tools. Since based on the energy balance equation, among individuals with a stable weight, Energy Intake (EI) is equal to Energy Expenditure (EE) and there are precise methods for measurement of EE (e.g. doubly labeled water method), numerous studies have used this technique for validating dietary assessment tools. If there was a discrepancy between measured EI and EE, the researchers have concluded that self-reported dietary assessment tools are not valid or participants misreport their dietary intakes. However, the calculation of EI with common dietary assessment tools such as food frequency questionnaires (FFQs), 24-hour dietary recalls, or weighed food records, is based on fixed factors that were introduced by Atwater and the accuracy of these factors are under question. Moreover, the amount of energy absorption, and utilization from a diet, depends on various factors and there are considerable interindividual differences in this regard, for example in gut microbiota composition. As a result, the EI which is calculated using dietary assessment tools is likely not representative of real metabolizable energy which is equal to EE in individuals with stable weight, thus validating dietary assessment tools with EE measurement methods may not be accurate. We aim to address this issue briefly and propose a feasible elucidation, albeit not a complete solution.

obesity paradox and mortality after pathological hip fractures: a Swedish registry study

Background and purpose — Obesity as measured by BMI has been associated with increased survival in various diseases, a phenomenon known as the “obesity paradox.” It is unknown whether obesity is associated with survival after pathological fractures. We investigated the association between BMI and survival after surgery for pathological hip fracture, to improve survival prognostication, and lay grounds for further interventional nutritional studies. Patients and methods — We analyzed prospectively collected data from Swedish nationwide registry “RIKSHÖFT.” The study cohort included 1,000 patients operated for a pathological hip fracture between 2014 and 2019. BMI registered on admission was available in 449 patients. Overall patient survival was measured according to the Kaplan–Meier method. Multivariable regression was used to evaluate association with other potential factors that influence patient survival. Results — Overweight and obesity were associated with an increased postoperative survival in male patients with surgically treated pathological hip fractures. Multivariable analysis considering potential confounders confirmed this finding. The association was not that strong in women and did not reach statistical significance. Interpretation — BMI, a commonly available clinical parameter, is a good predictor of overall survival for patients operated on for pathological hip fracture. Incorporation of BMI in existent survival prognostication algorithms should be considered. Treatment of malnutrition in this frail group of patients is worth studying.

Measuring Livestock CH4 Emissions with the Laser Methane Detector: A Review

The handheld, portable laser methane detector (LMD) was developed to detect gas leaks in industry from a safe distance. Since 2009, it has also been used to measure the methane (CH4) concentration in the breath of cattle, sheep, and goats to quantify their CH4 emissions. As there is no consensus on a uniform measurement and data-analysis protocol with the LMD, this article discusses important aspects of the measurement, the data analysis, and the applications of the LMD based on the literature. These aspects, such as the distance to the animal or the activity of the animals, should be fixed for all measurements of an experiment, and if this is not possible, they should at least be documented and considered as fixed effects in the statistical analysis. Important steps in data processing are thorough quality control and reduction in records to a single point measurement or “phenotype” for later analysis. The LMD can be used to rank animals according to their CH4 breath concentration and to compare average CH4 production at the group level. This makes it suitable for genetic and nutritional studies and for characterising different breeds and husbandry systems. The limitations are the lower accuracy compared to other methods, as only CH4 concentration and not flux can be measured, and the high amount of work required for the measurement. However, due to its flexibility and non-invasiveness, the LMD can be an alternative in environments where other methods are not suitable or a complement to other methods. It would improve the applicability of the LMD method if there were a common protocol for measurement and data analysis developed jointly by a group of researchers.

Cosmetic, Culinary and Therapeutic Uses of Cucumber (Cucumis sativus L.)

Cucumber (Cucumis sativus L.) is cultivated throughout the world as an important vegetable. This review offers an insight on the versatile use of cucumbers for cosmetic, culinary and therapeutic purposes. Epidemiological and nutritional studies have shown various benefits associated with the use of cucumber. As cosmetic, cucumber is popularly used for natural beautification and for skin treatments. As a vegetable, cucumber is the quintessential materials and indispensable for salads, soups and smoothie with diverse health benefits including weight loss, remedy for chronic constipation, anti-inflammatory, cardiovascular and cancerous diseases among others. The use including weight loss, cosmetic, culinary and therapeutic purposes.

Association between diet quality index, food and nutrient intake, and metabolic parameters in adolescents from Recife, northeastern Brazil

Nutritional studies shifted the focus of attention to the analysis of food quality, addressing general diet considering the foods, food groups, and nutrients included. This study evaluates the association between diet quality index, food and nutrient intake, and metabolic parameters of adolescents from Recife, northeastern Brazil. It is a cross-sectional study involving adolescents aged 12 to 19 years. Food intake was assessed using the Food Frequency Questionnaire to estimate the adapted Diet Quality Index for Adolescents for Brazilians (DQIA-BR-A). The analysis included metabolic parameters (glucose, lipid profile, apolipoprotein A1 and B, 𝛼-1-acid glycoprotein, retinol, 𝛽-carotene, 𝛼-tocopherol, 25(OH)D, and parathormone). Multiple linear regression analysis between the DQIA-BR-A and daily nutrient intake showed a positive correlation (R2adjusted = 0.29) for linoleic fatty acid, calcium, and folate, and a negative correlation for oleic fatty acid, carbohydrates, and vitamin B2 and C, in addition to a low correlation (R2adjusted < 0.07) with all metabolic parameters. However, the DQIA-BR-A correlated significantly (R2adjusted = 0.62; p < 0.001) with food intake. In this way, the DQIA-BR-A can be considered as an accurate and useful instrument for assessing the overall quality of adolescent diets. The diet of the adolescents was considered to be of moderate quality. Changes are required to ensure a balanced diet, considering the high sugar intake and consumption of sweets as well as the low consumption of vegetables, milk and dairy products, oils, fats, and seeds. Such changes should prioritize the consumption of foods rich in essential fatty acids and poor in saturated fat.

Evaluation of Dietary Assessment Tools Used in Bariatric Population

Severe obesity is associated with major health issues and bariatric surgery is still the only treatment to offer significant and durable weight loss. Assessment of dietary intakes is an important component of the bariatric surgery process. Objective: To document the dietary assessment tools that have been used with patients targeted for bariatric surgery and patients who had bariatric surgery and explore the extent to which these tools have been validated. Methods: A literature search was conducted to identify studies that used a dietary assessment tool with patients targeted for bariatric surgery or who had bariatric surgery. Results: 108 studies were included. Among all studies included, 27 used a dietary assessment tool that had been validated either as part of the study per se (n = 11) or in a previous study (n = 16). Every tool validated per se in the cited studies was validated among a bariatric population, while none of the tools validated in previous studies were validated in this population. Conclusion: Few studies in bariatric populations used a dietary assessment tool that had been validated in this population. Additional studies are needed to develop valid and robust dietary assessment tools to improve the quality of nutritional studies among bariatric patients.

Peripheral Oxidation Markers in Down Syndrome Patients: The Better and the Worse

Oxidative stress plays an important role in Down syndrome (DS) pathology since the gene dose effect leads to abnormal levels of certain enzymes and metabolites. In this review, we focused on relatively easy-to-obtain, peripheral markers of oxidative stress and inflammation, in order to compare the levels of these markers in DS patients and chromosomally healthy persons. Studies taking into account age- and sex-matched control groups were of particular interest in this context. We analyzed the factors that influence the levels of said markers in both groups (i.e., the usefulness of the markers), including the age of DS patients, occurrence of regular trisomy 21 or mosaicism, physical activity of patients, and the onset of Alzheimer’s disease in DS. This paper was conceived as a handbook—to help for selecting suitable, easy-to-obtain markers for monitoring of the health status of DS patients (e.g., in nutritional studies and during dietary supplementation).

Effects of Eggshell Membrane on Keratinocyte Differentiation and Skin Aging In Vitro and In Vivo

Skin aging is one of the hallmarks of the aging process that causes physiological and morphological changes. Recently, several nutritional studies were conducted to delay or suppress the aging process. This study investigated whether nutritional supplementation of the eggshell membrane (ESM) has a beneficial effect on maintaining skin health and improving the skin aging process in vitro using neonatal normal human epidermal keratinocytes (NHEK-Neo) and in vivo using interleukin-10 knockout (IL-10 KO) mice. In NHEK-Neo cells, 1 mg/mL of enzymatically hydrolyzed ESM (eESM) upregulated the expression of keratinocyte differentiation markers, including keratin 1, filaggrin and involucrin, and changed the keratinocyte morphology. In IL-10 KO mice, oral supplementation of 8% powdered-ESM (pESM) upregulated the expression of growth factors, including transforming growth factor β1, platelet-derived growth factor-β and connective tissue growth factor, and suppressed skin thinning. Furthermore, voltage-gated calcium channel, transient receptor potential cation channel subfamily V members were upregulated by eESM treatment in NHEK-Neo cells and pESM supplementation in IL-10 KO mice. Collectively, these data suggest that ESM has an important role in improving skin health and aging, possibly via upregulating calcium signaling.

Beyond the Paradigm of Weight Loss in Non-Alcoholic Fatty Liver Disease: From Pathophysiology to Novel Dietary Approaches

Current treatment recommendations for non-alcoholic fatty liver disease (NAFLD) rely heavily on lifestyle interventions. The Mediterranean diet and physical activity, aiming at weight loss, have shown good results in achieving an improvement of this liver disease. However, concerns related to compliance and food accessibility limit the feasibility of this approach, and data on the long-term effects on liver-related outcomes are lacking. Insulin resistance is a central aspect in the pathophysiology of NAFLD; therefore, interventions aiming at the improvement of insulin sensitivity may be preferable. In this literature review, we provide a comprehensive summary of the available evidence on nutritional approaches in the management of NAFLD, involving low-calorie diets, isocaloric diets, and the novel schemes of intermittent fasting. In addition, we explore the harmful role of single nutrients on liver-specific key metabolic pathways, the role of gene susceptibility and microbiota, and behavioral aspects that may impact liver disease and are often underreported in clinical setting. At present, the high variability in terms of study populations and liver-specific outcomes within nutritional studies limits the generalizability of the results and highlights the urgent need of a tailored and standardized approach, as seen in regulatory trials in Non-Alcoholic Steatohepatitis (NASH).

Long-Term Iron and Vitamin B12 Deficiency Are Present after Bariatric Surgery, Despite the Widespread Use of Supplements

There are few long-term nutritional studies in subjects undergoing bariatric surgery that have assessed weight regain and nutritional deficiencies. In this study, we report data 8 years after surgery on weight loss, use of dietary supplements and deficit of micronutrients in a cohort of patients from five centres in central and northern Italy. The study group consisted of 52 subjects (age: 38.1 ± 10.6 y, 42 females): 16 patients had Roux-en-Y gastric bypass (RYGB), 25 patients had sleeve gastrectomy (SG) and 11 subjects had adjustable gastric banding (AGB). All three bariatric procedures led to sustained weight loss: the average percentage excess weight loss, defined as weight loss divided by excess weight based on ideal body weight, was 60.6% ± 32.3. Despite good adherence to prescribed supplements, 80.7% of subjects (72.7%, AGB; 76.7%, SG; 93.8 %, RYGB) reported at least one nutritional deficiency: iron (F 64.3% vs. M 30%), vitamin B12 (F 16.6% vs. M 10%), calcium (F 33.3% vs. M 0%) and vitamin D (F 38.1% vs. M 60%). Long-term nutritional deficiencies were greater than the general population among men for iron and among women for vitamin B12.