Exploring the effects of increasing underutilized crops on consumers’ diets: the case of millet in Uganda

Known in the literature as underutilized, neglected or orphan crops, these crops have been cited as having the potential to improve food and nutritional security. The literature also highlights however that consumers in developing countries are increasingly abandoning their traditional diets that these crops are part of, and are replacing them by western diets. In this context, the purpose of this paper is to investigate the consumption and nutritional implications of expanding the participation of underutilized crops in current diets. This was done using a modified version of the microeconomic consumer problem. This was augmented with a linear constraint using generalized rationing theory that can be found in the economics literature. The method was applied to the case study of the consumption of millet (finger millet, botanical name: Eleusine coracana) by rural, urban-poor and urban-affluent Ugandan socioeconomic groups. The results indicated that millet could contribute to improving the intake of macronutrients and of some micronutrients, though the overall picture is complex. However, under current preferences and given its demand inelasticity, to achieve a substantial increase in the quantity of millet in the diet will require a significant reduction of its price. Otherwise, the net impact on nutrition as measured by the mean adequacy ratio will be only slightly positive for rural and urban-poor households. Our findings indicate that supply-side initiatives aimed at increasing the productivity of underutilized crops (reducing crop price) are likely to produce disappointing results in restoring their importance unless accompanied by specific interventions to expand demand.

Energy and nutritional inadequacies in a group of recreational adult Spanish climbers

Introduction: Although nutrition is determinant in the performance of athletes, few publications on this topic are available for climbers. Objectives: To measure body composition and dietary intake in a group of recreational Spanish climbers. Material and method: For body composition data we performed the measurements included in the ISAK anthropometric restricted- profile. Daily dietary intake was self-recorded on 3 days of the week: a non-climbing day, a climbing-gym training day and a rock- climbing day. Results were compared to Spanish nutritional recommendations. Results: 61 climbers (44 men, 17 women), aged 34 ± 8 years, volunteered. Body fat % was 8.1 ± 1.5% in men and 15.7 ± 3.0% in women. A negative correlation was found between body fat % and climbing ability (P<0.0005). Intake of energy and carbohydrates was 40% below estimated targets and that of proteins was 20-25% below. Moreover, macronutrient contribution to energy was unbalanced (protein: fat: CHO: alcohol was 17: 38: 42: 3%). We observed an elevated intake of SFA and sugars and low consumption of MUFA and fiber. Micronutrient intakes were acceptable except for iodine, zinc and vitamin D in both genders and iron and folate in women. Mean Adequacy Ratio of diet was higher in advanced/elite climbers compared with those in the intermediate level showing a possible relationship between climbing ability and diet quality. Conclusions: This study evidences there is a need of nutritional recommendations targeted to climbers. Our findings can contribute to the design of evidence-based food guides to help climbers optimise health and performance outcomes.

Association between Dietary Diversity Score and Nutrient Adequacy in Patients with Calcium Oxalate Kidney Stone

Background: Nephrolithiasis is a global health problem that is growing exponentially in the developed and developing countries. This study aimed to determine the dietary diversity score (DDS) and its association with nutrient adequacy in patients with calcium oxalate kidney stone. Methods: The present cross-sectional study was conducted on 276 male patients with calcium oxalate kidney stone. The validity and reliability of dietary intake was assessed by the 147-item food frequency questionnaire. Based on the USDA Food Guide Pyramid, the five food groups (grains, vegetables, fruits, meats, and dairy products) were used to determine the DDS. The nutrient adequacy ratio and the mean adequacy ratio were calculated using the Recommended International Standards. Results: The mean of the body mass index of the participants was 27.49 ± 4.01 kg/m2. Mean of the total DDS was also 5.62 ± 1.29. Participants in the highest DDS tertile had higher energy and fat intake than those in the lowest tertile (P-trend < 0.05). The highest and lowest DDS were observed in the fruit and vegetable groups: 1.58 ± 0.53 and 0.91 ± 0.29, respectively. The total DDS had a positive correlation with the adequacy of energy intake and macronutrients including protein and fats (P < 0.05). Furthermore, a significant positive correlation was found between the total DDS and the mean adequacy ratio (P < 0.01, r = 0.2). Conclusion: The findings showed that patients with calcium oxalate kidney stone did not have an appropriate level of total DDS (DDS < 6), indicating that they did not receive diverse nutrients.

The Relationship of Lifestyle Risk Factors and Depression in Korean Adults: A Moderating Effect of Overall Nutritional Adequacy

Background: Little is known regarding the role of nutrition in determining the associations between lifestyle risk factors and depression. Objectives: This study examined whether or not nutritional adequacy modulates the relationship between depression and lifestyle risk factors in Korean adults aged 18-65 years (n = 7446). Methods: Data were obtained from the 2016 and 2018 Korea National Health and Examination Survey. Depression, smoking, at-risk alcohol consumption, physical inactivity, sleep deprivation, and mean adequacy ratio (MAR) were assessed. Results: Individuals with two (OR = 1.960, p < 0.001), three (OR = 4.237, p < 0.001), or four (OR = 5.312, p < 0.001) risk factors had a significantly higher risk of depression compared to individuals with one or zero risk factor. In contrast, individuals with moderate MAR (OR = 0.607, p < 0.001) and high (OR = 0.698, p < 0.001) MAR had a lower depression risk compared to individuals with low MAR. Moderation analysis showed a moderating effect of MAR (coefficient = −0.220, p = 0.007) on the relationship between risk factors and depression. Conclusions: The current findings suggest that overall nutritional adequacy plays a modulating role in determining the relationship between depression and lifestyle risk factors in Korean adults.

Validation of the Nutrient-Rich Foods Index Estimated by 24-hour Dietary Recall Method in Chinese Mid-Eastern Adults

ObjectivesThe Nutrient-Rich Foods (NRF) Index is an important nutrient profiling model. Nutrition quality indices need to be tested and validated against the quality of the total diet and against health outcomes. A family of NRF indices was validated against the mean adequacy ratio (MAR), an overall measure of the nutrient adequacy. Besides, we examined the associations between the NRF index and obesity indicators. MethodsA total of 656 persons aged 18-75 years from Henan province of China since 2020 were studied. All foods consumed by participants were scored using NRFn.2 (where n= 6–11) indices based on unweighted sums, means, and ratios of percent Chinese Dietary Reference Intakes (DRIs) for beneficial nutrients (n) and nutrients to limit (2). NRF index scores in this study were calculated on 100 g, 100 kcal basis. The measure of index performance was the percentage of adjusted variation in MAR (R2). Multi-factor logistic regression models were used to examine the association between the NRF index scores and obesity indicators.ResultsThe NRF9.2 index, based on 9 beneficial nutrients and 2 nutrients to limit, using the algorithm based on sums and 100 kcal, was the best predicted model, with an adjusted R2 of 0.23 by multiple adjustments. The odds ratio (OR) for overweight (defined by BMI) in the 4th quartile (Q4) versus the 1st quartile (Q1) of the NRF9.2 index was 0.61 (95% CI=0.37, 0.98) after multiple adjustments. However, the NRF9.2 index score was not related to central obesity.ConclusionNRF9.2 index, using the algorithm based on sums and 100 kcal, was the best predicted model. NRF9.2 index scores were associated with BMI. These results revealed that the NRF9.2 index can be used as a validated tool to assess the overall diet quality among mid-eastern Chinese adults.

Analysis of dietary patterns and nutritional adequacy in lactating women: a multicentre European cohort (ATLAS study)

Eating habits of lactating women can influence the nutrient composition of human milk, which in turn influences nutrient intake of breastfed infants. The aim of the present study was to identify food patterns and nutritional adequacy among lactating women in Europe. Data from a multicentre European longitudinal cohort (ATLAS study) were analysed to identify dietary patterns using cluster analysis. Dietary information from 180 lactating women was obtained using 3-d food diaries over the first 4 months of lactation. Four dietary patterns were identified: ‘vege-oils’, ‘fish-poultry’, ‘confectionery-salads’ and ‘mixed dishes’. Nutrition adequacy was not significantly different between clusters, but the ‘vege-oils’ cluster tended to yield the highest nutrition adequacy measured by Mean Adequacy Ratio. Compared with European dietary reference values (DRVs) for lactating women, women in all clusters had inadequate intakes of energy, pantothenic acid, folate, vitamin C, vitamin A, vitamin D, zinc, iodine, potassium and linoleic acid. Adequate intake for fibre and α-linolenic acid was only achieved in the ‘vege-oils’ cluster. Overall, fat intake was above DRVs. The present study showed that various dietary patterns do not adequately supply all nutrients, indicating a need to promote overall healthy dietary habits for European lactating women.

Dietary Diversity and Micronutrients Adequacy in Women of Childbearing Age: Results from ELANS Study

Dietary diversity, an important component of diet quality, is associated with an increased probability of adequate micronutrient intake. Women of childbearing age (WCA) are particularly vulnerable to micronutrient inadequacy. The Minimum Dietary Diversity for Women (MDD-W) has been used widely as a proxy measurement of micronutrient adequacy. This study aimed to assess the association between MDD-W and nutrients adequacy among WCA of eight Latin American countries. Nutrient intakes from 3704 WCA were analyzed with two 24-hour dietary recalls. Dietary diversity was calculated based on ten food groups with a cut-off point of intake ≥5 groups. The mean dietary diversity score was 4.72 points, and 57.7% of WCA achieved MDD-W. Vitamin D and E showed a mean Nutrient Adequacy Ratio (NAR) of 0.03 and 0.38, respectively. WCA with a diverse diet (MDD-W > 5) reported a significantly higher intake of most micronutrients and healthy food groups with less consumption of red and processed meats and sugar-sweetened beverages. MDD-W was significantly associated with the mean adequacy ratio (MAR) of 18 micronutrients evaluated. Nevertheless, even those women with a diverse diet fell short of meeting the Estimated Average Requirements (EAR) for vitamins D and E. MDD-W is an appropriate tool to evaluate micronutrients adequacy in WCA from Latin America, showing that women who achieved the MDD-W reported higher adequacy ratios for most micronutrients and an overall healthier diet.

A Longitudinal Assessment of Diet Quality and Risks Associated with Malnutrition in Socioeconomic and Racially Diverse Adults

Little is known about the effects of diet quality through adulthood and its association with malnutrition later in life. The first research objective was to evaluate diet quality assessed by Mean Adequacy Ratio (MAR) of United States African American and White adults (n = 2066), examined at baseline and two follow-up waves in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. The sample was split into cohorts by age at study baseline: Younger, <50, and older, ≥50 years. The second objective was to assess the association of MAR and risk for malnutrition in adults who were ≥60 years at wave 4 (n = 746). The Mini Nutritional Assessment was used to determine risk for malnutrition. At each of the three study waves, 17 micronutrients from two 24 h dietary recalls were used to calculate MAR. Over 13 years MAR changed minimally in the younger cohort as they aged from early to middle adulthood. In contrast, a statistically significant decline in MAR was observed for the older cohort between baseline (2004–2009) and wave 4 (2013–2017), with a greater degree of worsening at low energy levels. The risk for malnutrition was significantly associated with consuming a diet low in energy, lower protein as a percent of energy at baseline, as well as being food insecure, a current smoker, and having income <125% poverty. The risk for malnutrition was not associated with a change in protein intake in years prior to age 60, change in MAR scores across waves, MAR at wave 4, age, sex, race, or having hypertension or diabetes. These longitudinal study findings revealed that diet quality was not predictive of risk for malnutrition.

Local traditional foods contribute to diversity and species richness of rural women’s diet in Ecuador

Objective:To evaluate the dietary diversity and the nutrient contribution of traditional foods (locally cultivated and wild) by conducting a food intake study in rural Ecuador.Design:Repeated 24 h recalls over a 14 d interval and frequency of consumption served to simulate the usual diet by the Multiple Source Method. Data on missing visits (n 11) were imputed using multivariate imputation by chained equations. The intakes of three macro- and six micronutrients were reported. Nutrient Adequacy Ratios, Mean Adequacy Ratio (MAR), Dietary Species Richness (DSR) and Minimum Dietary Diversity for Women were used as measures of dietary quality. A linear quantile mixed model was used to investigate the association between DSR, local species, MAR, age, education and occupation.Setting:Guasaganda, Cotopaxi (Ecuador).Participants:Rural, indigenous adult women, non-pregnant and not breast-feeding.Results:The studied diet had MAR of 0·78. Consumption of traditional foods contributed 38·6 % of total energy intake. Daily requirements for protein, carbohydrates, Fe and vitamin C were reached. An extra level of consumption of local species was associated with an increase in median MAR for macronutrients of 0·033 (P < 0·001). On the other hand, an extra level of consumption of local species was associated with an increase in median MAR for micronutrients of 0·052 (P < 0·001).Conclusions:We found statistical evidence that traditional foods contribute to adequate intakes of macro- and micronutrients and dietary diversification in the studied population. Future public health interventions should promote the cultivation and consumption of traditional foods to increase the quality of the local diet.