The effects of grazing on daily caloric intake and dietary quality

Background The duration and frequency of eating occasions has been identified as a factor contributing to poor dietary quality among U.S. adults. The objective of this study is to examine whether grazing, defined as eating more than three times a day, affects total daily caloric intake and dietary quality measured by the 2015 Healthy Eating Index (HEI-2015). Methods We used a multivariate individual fixed-effects model to compare the caloric intake and dietary quality of individuals who grazed on 1 day but not another. This allowed us to control for differences in individual food intake and diet quality preferences among study participants. We use the National Health and Nutrition Examination Survey (NHANES), 2007-2018, and include data for adults aged 18 years or older who reported 2 days of dietary intake and were not pregnant or lactating (n = 27,775). Results Grazing increased total daily caloric intake by 205 cal and increased the daily HEI score by 0.59 points. Grazing increased HEI component scores for total fruit, whole fruit, and refined grains, and decreased HEI component scores for saturated fats. Morning grazing increased total daily caloric intake by 159 cal and increased the daily HEI score by 0.87 points — primarily by increasing component scores for total fruit, whole fruit, whole grains, total dairy, seafood and plant proteins, and sodium. Evening grazing increased daily caloric intake by 76 cal and decreased the daily HEI score by 0.41 points — primarily by decreasing the component scores for total fruit, whole grains, fatty acids, and saturated fats. Evening grazing increased HEI component scores for sodium and refined grains. Conclusions Grazing increases daily caloric intake and can decrease dietary quality (particularly when grazing in the evening).

The Effect of a Fat-Restricted Diet in Four Patients with Familial Chylomicronemia Syndrome: A Long-Term Follow-Up Study

(1) Background: Familial chylomicronemia syndrome (FCS) is a very rare autosomal recessive disorder characterized by severely elevated triglycerides and clinical symptoms in early childhood mainly presenting with abdominal pain, acute pancreatitis and hepatosplenomegaly. Primary treatment is a lifelong very strict low-fat diet, which might be challenging in pediatric patients. So far, data about children with FCS are rare. The aim of this study was to show the familial chylomicronemia syndrome traffic light table for pediatric patients and to assess the dietary fat intake and impact on triglycerides in children with FCS. (2) Methods: We performed a retrospective analysis in four children (50% male) affected by FCS from the Department of Pediatrics and Adolescent Medicine, Medical University of Vienna between January 2002 and September 2020. (3) Results: The four patients presented with classical FCS symptoms and showed baseline triglycerides (TG) exceeding 30,000 mg/dL in two patients, 10,000 mg/dL and 2400 mg/dL in one patient each. After diagnosis, fat percentage of total daily caloric intake was decreased and resulted immediately in triglyceride reduction. In all patients, FCS was genetically confirmed by mutations in genes encoding lipoprotein lipase. Acute pancreatitis and hepatosplenomegaly disappeared under the fat-restricted diet. A FCS traffic light table was developed as a dietary tool for affected families. (4) Conclusions: A restriction of dietary fat between 10% to 26% of the total daily caloric intake was feasible and effective in the long-term treatment of genetically confirmed FCS in children and could reduce the risk for acute pancreatitis. The dietary tool, the pediatric FCS traffic light table and the age-appropriate portion sizes for patients between 1 to 18 years, supports children and their parents to achieve and adhere to the lifelong strict low-fat diet.

The Contributions of Food Groups to the Daily Caloric Intake in Mongolian Population: A Mon-Timeline Study

(1) Background: The “Ger Recommendations” have been advised to promote a healthy diet in Mongolia. These recommendations emphasize the ratio of six macro-food components to ensure proper nutrition. In this study, the ratio of these six groups to the total daily caloric intake was determined. (2) Methods: This study was conducted as part of a study at the Clinical Cohort (“Mon-Timeline”) of the Mongolian National University of Medical Science. A macro-community ratio was calculated using a 24-h dietary recall diary of a total of 498 people. (3) Results: The mean age of the study participants was 43.9 ± 12.9 years. Among them, 21.8% (n = 110) were male. Of the total calories, 44.7% were grains, 29.2% were meat and protein products, 9.3% were fats, 7.1% were dairy products, 6.6% were vegetables, and 3.1% were fruits. According to the ratio of the six groups in the Ger Recommendations, meat and grains exceeded the recommended amount, while fruits, milk, and vegetables were consumed less. It has been observed that the older a person ages, the closer they are to following these recommendations. In terms of gender, women consumed more fruit and milk than men. (4) Conclusions: The ratio of macronutrients in the daily caloric intake of Mongolians is inadequate. Therefore, knowledge about the “Ger Recommendations” needs to be studied in relation to people’s healthy eating knowledge and attitudes. If necessary, the appropriate awareness needs to be increased to educate the public on proper eating habits.

Abstract P135: Dietary Sources Of Linoleic Acid (LA) Differ By Race/ethnicity In Adults Participating In The National Health And Nutrition Examination Survey (NHANES) Between 2015-2016

Background: Linoleic acid (LA), a primary polyunsaturated fatty acid, is a nutritional quandary as has been associated with diabetes and cardiovascular disease (CVD) protection but may have negative effects in inflammation and cancer. Objective: To determine whether the relative contributions of nine food sources (dairy, eggs, select fats and oils, fish, fruit, grains, meat, nuts, and desserts) to overall LA intake differ by race / ethnicity in the adult US population. Methods: We included all non-pregnant, non-lactating adults (< 20 years, ~50% female) with plausible dietary data (average daily caloric intake ≥600 kcals/day and ≤6000 kcals/day; N=3,884). The percentage of LA calories attributable from each of the nine food groups was calculated. Linear regression models, incorporating survey weights, examined differences by race/ethnicity and included age, gender, income level, highest level of education and daily caloric intake as covariates, with a post-hoc Tukey test applied to group comparison. Significance was set at Bonferroni corrected P≤.006. Results: Across the population as a whole, 7.14% of the overall caloric intake was attributable to LA. Grains contributed to the highest percentage of LA intake (29%) followed by meat (18%), with fish contributing the least (4%). Significant differences in the relative contribution of almost all food sources to overall LA were found across race/ethnic groups (all except dairy; Table 1). Fruits and Grains showed the greatest number of differences by race/ethnicity, with NHBs reporting the greatest intake contribution of fruit to LA intake (14.8%) and MAs the lowest (9.6%; P<.001 for the difference; Table 1). This pattern was reversed when looking at the contribution of grains to overall LA intake (25.9% vs 41.2% respective; P<.001; Table 1). Conclusions: Our findings suggest that the foods contributing to overall LA intake differ across race/ethnic groups. Interventions designed to alter LA intake may benefit from tailoring to a population’s ethnic/race distribution.

DESIGNING A HEALTHY MENU PROJECT FOR INDONESIAN JUNIOR HIGH SCHOOL STUDENTS

Project-based learning (PjBL) is an appropriate learning model that can shape students’ scientific, social and higher-order thinking. Implementing PjBL in education gives students the freedom to plan their own learning activities, conduct projects collaboratively and produce products. In a healthy menu project, PjBL can help students calculate their excess weight. The purpose of this study was thus to design a healthy menu that assists Indonesian junior high school students solve numeracy problems using obesity context. The method followed a design research type validation studies using observation and document reviews as data collection techniques. This study produced a learning trajectory that can help grade VII students solve arithmetic operations using obesity context through two activities. In the first, the students were asked to record their respective heights and weights, then use them to determine their body mass index (BMI) and body mass ratio (BMR). Then, the students confirmed their necessary daily caloric intake, and categorized their BMI and BMR results as underweight, normal, overweight or obese. In the second activity, the students developed healthy menus per their respective tastes based on their weight categories from the first activity. The study concluded with the students successfully producing healthy menus that they designed according to their calculated required daily caloric intake.

Understanding food westernisation and other contemporary drivers of adult, adolescent and child nutrition quality in urban Vietnam

Objective:To examine the association between consumption of western foods purchased and consumed away from home and measures of nutrition quality: average daily caloric intake and macronutrient (carbohydrates, fat and protein) shares, for urban consumers in Vietnam, a country undergoing economic transition.Design:Cross-sectional observational data were collected using household surveys and 24-h food diaries. Outcome variables were individual average daily caloric intake and shares of calories from macronutrients: carbohydrates, fat and protein. The key explanatory variable was individual daily share of calories from western food purchased and consumed away from home. Ordinary least squares and multivariate regression analyses were used to examine the association between the outcome variables: caloric intake and macronutrient shares and the share of calories from western food consumed away from home.Setting:Hanoi and Ho Chi Minh City in Vietnam.Participants:In total, 1685 households and 4997 individuals, including adults (aged $$ \ge $$ 18 years), adolescents (aged 10–17 years) and children (aged 0–9 years).Results:The share of calories from western food away from home was significantly associated with higher caloric intake among male and female adults (P < 0·01), adolescents (P < 0·01) and male children (P < 0·10) and was associated with higher shares of fat for male and female adults (P < 0·01), adolescents (P < 0·01) and male children (P < 0·01).Conclusions:Policymakers must be conscious of the numerous factors associated with poor nutrition quality, especially in younger Vietnamese individuals. Relevant interventions targeting at risk groups are required if nutrition improvement is a long-term goal.

Association between fast-food outlet exposure and Body Mass Index in 124,286 Lifelines participants

Background Elevated Body Mass Index (BMI) is a key risk factor for numerous non-communicable diseases, such as cardiovascular diseases, cancer, diabetes type II and dementia. Previous studies showed associations between fast-food outlet exposure and BMI, but contained methodological shortcomings. Particularly within the Netherlands, evidence is scarce. We aimed to examine the association between fast-food outlet exposure and BMI among the Dutch adult general population, and whether this association was mediated by daily caloric intake. Methods Cross-sectionally linking baseline adult data (N = 124,286) from the Lifelines cohort to fast-food outlet location (LISA: employer register) data, we regressed fast-food outlet density (within distances of 500 metre(m), and 1, 3, and 5 kilometre (km)) and fast-food outlet proximity around participants’ residential address on BMI. We used multilevel regression and multilevel mediation models, adjusting for age, sex, partner status, education, employment, neighbourhood deprivation and neighbourhood address density. We stratified analyses for urban and rural areas, as these involve different living environments and study populations. Results More than half (56%) of participants was overweight (BMI ≥ 25.0). The average BMI in urban and rural areas was 25.9 (SD 4.4) and 26.3 (SD 4.3), respectively. In rural areas, having at least three fast-food outlets within 500 m was associated with higher BMI (B = 0.17, 95% confidence interval (CI): 0.06, 0.28). In urban areas, having at least five fast-food outlets within 1 km was associated with higher BMI (B = 0.42, 95% CI: 0.20, 0.63). Having the nearest fast-food outlet within 100m was associated with higher BMI (B = 0.43, 95% CI: 0.19, 0.67). The associations were partly explained by daily caloric intake. Conclusions Fast-food outlet exposure may be an important environmental determinant of BMI. Policy-makers should consider intervening upon the fast-food environment. Key messages Fast-food outlets within 500 metres in rural areas and 1 kilometre in urban areas may play a fundamental role in the rise of BMI. Targeting fast-food outlets may be key to reduce BMI on a population level.

Six Weeks of Calorie Restriction Improves Body Composition and Lipid Profile in Obese and Overweight Former Athletes

Objective: The aim of the study was to compare the impact of 6 weeks of reducing daily caloric intake by 20% of total daily energy expenditure (TDEE)-CRI vs. reducing daily caloric intake by 30% of TDEE-CRII on body mass reduction and insulin metabolism in former athletes. Methods: 94 males aged 35.7 ± 5.3 years, height 180.5 ± 4.1 cm, and body mass 96.82 ± 6.2 kg were randomly assigned to the CRI (n = 49) or CRII (n = 45) group. Thirty-one participants (18 subjects from CRI and 13 from CRII) resigned from the study. The effects of both diets on the body composition variables (body mass—BM; body fat—BF; fat free mass—FFM; muscle mass—MM; total body water—TBW), lipid profile (total lipids—TL; total cholesterol—TCh; HDL cholesterol—HDL; LDL cholesterol—LDL; triglycerides—TG), and glucose control variables (glucose—GL, insulin—I, HOMA-IR, insulin-like growth factor-1—IGF-1, leptin and adiponectin) were measured. Results: After adhering to the CR I diet, significant differences were observed in FFM, MM and TG. After adhering to the CR II diet, significant differences were registered in tCh, TL and LDL. Both diets had a significant influence on leptin and adiponectin concentrations. Significant differences in FFM, MM, and tCh were observed between the CR I and CR II groups. At the end of the dietary intervention, significant differences in BF, FFM, MM and TBW were observed between the CR I and CR II groups. Conclusion: The 6 weeks of CR II diet appeared to be more effective in reducing BF and lipid profile and proved to be especially suitable for subjects with high body fat content and an elevated level of lipoproteins and cholesterol. Both reductive diets were effective in improving the levels of leptin and adiponectin in obese former athletes.