Systematic review of metrics used to characterize dietary nutrient supply from household consumption and expenditure surveys

Objective: To review existing publications using Household Consumption & Expenditure Survey (HCES) data to estimate household dietary nutrient supply to (1) describe scope of available literature, (2) identify the metrics reported and parameters used to construct these metrics, (3) summarize comparisons between estimates derived from HCES and individual dietary assessment data, and (4) explore the demographic and socioeconomic sub-groups used to characterize risks of nutrient inadequacy. Design: This study is a systematic review of publications identified from online databases published between 2000 to 2019 that used HCES food consumption data to estimate household dietary nutrient supply. Further publications were identified by “snowballing” the references of included database-identified publications. Setting: Publications using data from low- and lower middle income countries Results: In total, 58 publications were included. Three metrics were reported that characterized household dietary nutrient supply: apparent nutrient intake per adult-male equivalent per day (n=35), apparent nutrient intake per capita per day (n=24), and nutrient density (n=5). Nutrient intakes were generally overestimated using HCES food consumption data, with several studies finding sizeable discrepancies compared to intake estimates based on individual dietary assessment methods. Sub-group analyses predominantly focused on measuring variation in household dietary nutrient supply according to socioeconomic position and geography. Conclusion: HCES data are increasingly being used to assess diets across populations. More research is needed to inform the development of a framework to guide the use of and qualified interpretation of dietary assessments based on these data.

The Impact of High Carbohydrate Intake on Physical Frailty in Older Korean Adults: a Cohort-based Cross-sectional Study

Background: The relationship between macronutrients and frailty is unclear. Previous studies have confirmed the relationships between energy and protein intake and physical frailty, while few studies have examined the role of carbohydrate or fat intake in the prevalence of frailty. The aim of this study is to investigate the relationship of energy and macronutrients with physical frailty in the Korean elderly population who had a high proportion of energy intake from carbohydrates.Methods: This study included 954 adults aged 70 to 84 years who have completed the assessment of frailty and 24-h recall upon enrolment in the Korean Frailty and Aging Cohort Study and have no extreme intake under 400 kcal (n = 2). The relationship between energy or macronutrients and frailty was evaluated using multivariate logistic regression models and multivariate nutrient density models.Results: In the subjects with low energy intake (odds ratio [OR] = 2.94, 95% confidence interval [CI] = 1.34–6.45) and total subjects (OR = 2.01, 95% CI = 1.03–3.93), consuming carbohydrates above the acceptable macronutrient distribution range (65% of energy) was related to a higher risk of frailty. Substituting the energy from fat with carbohydrates was related to a higher risk of frailty (1%, OR = 1.05, 95% CI = 1.00–1.09; 5%, OR = 1.26, 95% CI = 1.02–1.56; 10%, OR = 1.59, 95% CI = 1.03–2.43).Conclusions: This study showed that the proportion of energy intake from carbohydrates and fats may be an important nutritional intervention factor for reducing the risk of frailty.

Genome-Wide Association Analysis To Delineate High-Quality Snps For Seed Micronutrient Density In Chickpea (Cicer Arietinum L.)

Chickpea is the most important nutrient rich grain legume crop in the world. A diverse core set of 147 chickpea genotypes was genotyped with 50K Cicer SNP array and trait phenotyped in two different environments for four seed micro-nutrients (Cu, Fe, Mn, and Zn). The trait data and high-throughput 50K SNP genotypic data was used for genome-wide association study (GWAS) that led the discovery of gene/QTLs for seed Cu, Fe, Mn, and Zn concentrations in chickpea. The analysis of seed micronutrient data revealed significant differences for all the four micronutrient concentrations (P ≤ 0.05). The mean concentration of seed Fe, Zn, Cu, and Mn pooled over two-year data was 146.1 ppm, 45.9 ppm, 63.8 ppm and 27.0 ppm respectively. The analysis of results led to the identification of 35 SNPs significantly associated with seed Zn, Cu, Fe and Mn concentrations. Among these 35 MTAs, 5 were stable (consistently identified in different environments), 6 were major (explain more than 15% phenotypic variation for an individual trait) and 3 were both major and stable MTAs. The stable and major MTAs identified during the present study shall prove useful in molecular breeding programs aimed at enhancing seed nutrient density of chickpea.

A Progressive Nutrient Profiling System to Guide Improvements in Nutrient Density of Foods and Beverages

Improving the nutrient density of processed foods is one way to bring the global food supply closer to the WHO Sustainable Development Goals. Nutrient profiling (NP) has emerged as the preferred method of monitoring the progress toward product innovation and reformulation. This paper presents PepsiCo Nutrition Criteria (PNC), a new internal NP model that was designed to guide and monitor improvements in nutrient density and overall nutritional quality of foods and beverages. The new PNC NP model assigns food products into four classes of increasing nutritional value, based on the content of nutrients to limit, along with nutrients and ingredients to encourage. The nutrient standards used for category assignment followed those developed by global dietary authorities. Standards are proposed for calories, sodium, added sugars, saturated, and industrially produced trans fats. Also included are minimum values for food groups to encourage, low-fat dairy, and for country-specific gap nutrients. Internal use of the NP model has spurred product changes that are consistent with WHO goals for industry transparency. An audited review of company products showed that 48% met added sugar, 65% met sodium, and 71% met saturated fat goals. By the end of 2020, in the top 26 regions in which products are sold, 48% of the total sales volume of global beverages had 100 kcal or less from added sugars per 355 ml serving representing 80% of beverage volume and over 90% of food volume sold globally. The PNC NP model is not consumer-facing but is specifically intended for internal use to motivate stepwise and incremental product innovation and reformulation. Transparent and published NP models further WHO goals of engaging industry stakeholders in the (re)formulation of processed foods and beverages consistent with public health goals.

Proximate Composition, Essential Heavy Metal Concentrations and Nutrient Density of the Mycelium and Fruiting Bodies of Organically Cultivated Pleurotus ostreatus

Proximate composition, essential heavy metal concentration of fruiting bodies (POFB) and mycelium (POMY) of Pleurotus ostreatus were conducted using standard methods. Moisture content was higher (9.79%) in POFB than in POMY (8.76%) on dry weight basis. Ash was higher in POFB(6.25%) than in POMY(3.25%).POFB presented higher crude protein value (24.66%) than POMY (21.17%). Crude fat values were low in both samples(POFB:0.28%; POMY:0.46) respectively. Fiber was higher in the mycelium (14.72%) than in the fruiting bodies (12.90%). The carbohydrate content of the mycelium was 51.93% while the value of carbohydrate in the fruiting bodies was 46.10%. POFB indicated energy value of 285.60Kcal/100g and the value in POMY was 296.57Kcal/100g. Iron, copper, manganese and chromium presented higher values in POFB than in POMY but zinc indicated higher level in POMY than in POFB. The %DV highlighted in the study showed that the fruiting bodies and mycelium of organically cultivated P. ostreatus are rich in protein, fiber, carbohydrate, copper and iron. The nutrient density (ND) results revealed that POFB and POMY samples are nutritionally dense in fiber, copper and iron based on the World Health Food Rating System. The results showed that POFB and POMY obtained by organic cultivation possess high nutritional profile, suggesting that people may use them in food and medicinal formulations.

Drought-tolerant Bambara groundnuts as future food: a comprehensive review of its properties and applications in food

PurposeThis review provides an overview of the applications of Bambara groundnuts in various food products. The genetic diversity, physical properties and chemical compositions of the crop are also elucidated.Design/methodology/approachThis paper critically reviewed the physicochemical properties and applications of Bambara groundnuts from recent literature.FindingsBambara groundnut (Vigna subterranea) is a drought-tolerant crop from West Africa that contains not only carbohydrates and fats but is also high in protein. The cultivars of Bambara groundnut can be distinguished by the colours of seeds, which range from red, blue-eye, brown and black-eye. Bambara groundnuts contain carbohydrate (57–67%), protein (15–25%), fat (4–8%), fibre (1.4–1.5%) and ash (2.9–4%). As a percentage of protein, the essential amino acids, lysine, methionine and cysteine are relatively high in Bambara groundnuts. Meanwhile, linoleic, palmitic and linolenic acids are the fatty acids present in this crop.Practical implicationsSeveral studies have shown that Bambara groundnuts can be used as fat substitutes, emulsifiers, water binders, bulking agents and thickeners due to its water and oil absorption properties, gelling, pasting, emulsifying and foaming abilities. Bambara groundnuts are used in the development of many intermediate or final products like flour blend, cookies, bread and fermented milk. It has a positive impact on the overall proximate, functional, mineral and amino acid profiles of the food products.Originality/valueDespite its high nutrient density, Bambara groundnuts are an underutilised legume due to unavailability and lack of knowledge among consumers on its benefits. There is a need to promote the use of Bambara groundnuts as a future food.

‘Old Is Gold’: How Traditional Indian Dietary Practices Can Support Pediatric Diabetes Management

Nutrition is crucial for maintaining normal growth, development, and glycemic control in young people with diabetes (PwD). Undue restrictions cause nutrient deficiencies as well as poor adherence to meal plans. Widespread availability of low-cost, ultra-processed, and hyperpalatable food is further damaging. Most families struggle to find ways to provide nutritious, yet attractive, food with a low glycemic index (GI). India is one of the oldest continuous civilizations with a rich and diverse cultural and culinary heritage. Traditional dietary practices, including the centuries-old ‘Thali’ (meaning plate) concept, emphasize combinations (grains, lentils, vegetables, dairy, spices, prebiotics and probiotics, and fats) of local, seasonal, and predominantly plant-based ingredients. These practices ensure that all of the necessary food groups are provided and fit well with current evidence-based recommendations, including the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 Guidelines. Techniques for the preparation, cooking, and preservation of food further impact the GI and nutrient availability. These practices benefit nutrient density, diet diversity, and palatability and thus improve adherence to meal plans and glycemic control. This narrative review describes the ancient wisdom, food composition, and culinary practices from across India which are still valuable today. These may be of benefit worldwide to improve glycemic control as well as quality of life, especially in PwD.

Glycaemic and Appetite Suppression Effect of a Vegetable-Enriched Bread

Bread, a frequently consumed food, is an ideal vehicle for addition of ingredients that increase nutrient density and add health benefits. This experimental cross-over study sought to test the effect of a vegetable-enriched bread (VB) in comparison to commercial white bread (WB) and wheatmeal bread (WMB) on serum glucose, insulin response and subjective appetite suppression. On three separate occasions, 10 participants (23 ± 7 years) visited the laboratory and consumed after an overnight fast, in random order, a 75 g serve of WB, WMB or VB. Venous blood samples drawn twice before (0 min) and at 15, 30, 45, 60, 90 and 120 min after consumption of the bread were analysed for glucose and insulin. Participants rated their subjective feelings of hunger, fullness, satisfaction and desire to eat on a 150 mm Likert scale. The mean glucose iAUC over 120 min was not different among the breads. The mean insulin iAUC for the VB was significantly lower than the WB and WMB; difference VB and WB 12,415 pmol/L*minutes (95% CI 1918, 22,912 pmol/L*minutes, p = 0.025) and difference VB and WMB 13,800 pmol/L*minutes (95% CI 1623, 25,976 pmol/L*minutes p = 0.031). The VB was associated with a higher fullness feeling in the participants over the 120-min period. The consumption of VB was associated with less insulin release and higher satiety over 120 min which may be related to the higher fibre content and texture of VB. The role of vegetable and fruit fibres such as pectin in bread and insulin response should also be further explored.

Processing Human Milk to Increase Nutrient Density for Preterm Infants

Background: Human milk is the optimal food for newborns. Choices to feed preterm infants in neonatal intensive care units are mother’s milk, donor milk, or formula. Preterm infants have better tolerance for human milk, but the lower caloric density of donor milk might not meet preterm infant growth needs. Preterm infants have higher protein and energy requirements with a limited stomach capacity. Therefore, there is a need for human milk with increased nutrient density. Research Aim: To concentrate donor milk to have a higher caloric and protein density while avoiding side effects of high osmolality by precipitating lactose at low temperatures. Methods: We investigated the results of volume reduction and lactose removal processes on the lactose, protein, osmolality, and viscosity of human milk. Donor milk was obtained from WakeMed Mothers’ Milk Bank. Homogenization and evaporative condensation were applied to samples ( N = 36) before they were stored frozen overnight, followed by refrigerated centrifugation for lactose removal at 0 °C. Supernatants were separated and compared to the composition of controls. Results: A significant reduction of lactose ( SW = -262, p < .0001) and osmolality ( SW = -211.5 p < .01) was achieved in the concentrated milk without a significant protein loss from centrifugation ( SW = -44.5, p = .49). A 30%–40% volume reduction is within the American Academy of Pediatrics recommended osmolality for infant feeding. Conclusion: Concentrating human milk in a milk bank setting for feeding preterm infants might be a simple and low-cost process to achieve a product with higher nutrient density and no non-human components.

Nutrient Density as a Dimension of Dietary Quality: Findings of the Nutrient Density Approach in a Multi-Center Evaluation

The nutrient adequacy of a diet is typically assessed by comparing estimated nutrient intakes with established average nutrient requirements; this approach does not consider total energy consumed. In this multinational survey investigation in Indonesia, Mexico, and South Africa, we explore the applications of the “critical nutrient-density approach”—which brings energy requirements into the equation—in the context of public health epidemiology. We conducted 24 h dietary recalls in convenience samples of normal-weight (BMI 18.5–25 kg/m2) or obese (BMI > 30 kg/m2), low-income women in three settings (n = 290). Dietary adequacy was assessed both in absolute terms and using the nutrient density approach. No significant differences in energy and nutrient intakes were observed between normal-weight and obese women within any of the three samples (p > 0.05). Both the cut-point method (% of EAR) and critical nutrient density approach revealed a high probability of inadequate intakes for several micronutrients but with poor concordance between the two methods. We conclude that it may often require some approximate estimate of the habitual energy intake from an empirical source to apply a true critical nutrient density reference for a population or subgroup. This will logically signify that there would be more “problem nutrients” in the diets examined with this nutrient density approach, and efforts toward improved food selection or food- or biofortification will frequently be indicated.