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.

Increasing Seaweed Consumption in the Netherlands and Portugal and the Consequences for the Intake of Iodine, Sodium, and Exposure to Chemical Contaminants: A Risk-Benefit Study

Background: Seaweed has a high potential for nourishing the future planet. However, besides being beneficial, it also contains adverse components; this poses the question whether consumption of seaweed foods overall contributes beneficially or detrimentally to human health, and hence if their consumption should be promoted or restricted.Methods: This study evaluated the impact of substituting regular foods with seaweed foods in the diet, both in terms of nutritional quality (via iodine and sodium) and food safety (via arsenic, cadmium, lead, and mercury). Food consumption data from the Netherlands and Portugal (adults aged >18 years) were used, in which 10% of the amounts of pasta, bacon, and lettuce consumed were replaced by seaweed-derived products made from kelp (Saccharina latissima). Using Monte Carlo Risk Assessment software (MCRA), long-term nutrient intake and exposure to contaminants were assessed. The results obtained for the Netherlands and Portugal were compared with data from Japan, a country that has a high natural consumption of seaweed.Results: This low-tier risk-benefit study reveals that an increased seaweed consumption (as assessed by the 10% replacement with seaweed products) has no consequences in terms of intake of sodium and exposure to cadmium, lead, and mercury, and the associated (absence of) adverse health aspects. The alternative scenario almost doubled the mean iodine intake in the Netherlands (to 300 μg/day) and Portugal (to 208 μg/day) and increased the average exposure to arsenic levels in the Netherlands (to 1.02 μg/kg bw/day) and Portugal (to 1.67 μg/kg bw/day).Conclusion: The intake of iodine and exposure to arsenic in the Netherland and Portugal were certainly higher due to the modeled increase of seaweed foods. If seaweed consumption increases close to the 10% substitution, the public health consequences thereof may trigger further research.

Level of Anxiety-State as a factor in changing eating patterns in college students: NUTSAU Study

With the purpose of identifying eating patterns of university students at a federal university in the state of Rio de Janeiro, a cross-sectional analysis of food consumption data was stratified by anxiety symptom scores of 147 students enrolled in the second semester of several undergraduate courses in the second semester of 2015. The State-Trait Anxiety Inventory determined the anxiety symptoms scores. A food frequency questionnaire was applied to obtain food consumption data. Students were stratified into two groups, using the median state anxiety score as cutoff point. For each group, some dietary patterns were derived by the application of the principal component analysis. Statistical analysis was performed using the SPSS software. The university students presented a median state-anxiety score of 43 points, and it was significantly higher in women. Three dietary patterns were identified for each group according to their nutritional characteristics, among which “Mixed 1”, “Healthy” and “Rice and Beans” for the less anxious students and “Western”, “Mixed 2” and “Rice and Beans” for the most anxious students. The results showed that it was possible to identify consistent food patterns for both, using a factorial analysis method. Students with the highest anxiety-state scores had a pronounced Western eating pattern, and those least anxious students had higher consumption of healthier food groups and lower consumption of caffeinated beverages. Although this is a cross-sectional analysis, it can contribute to optimize nutritional intervention for this population.

Validity of FFQ Estimates of Total Sugars, Added Sugars, Sucrose and Fructose Compared to Repeated 24-h Recalls in Adventist Health Study-2 Participants

Sugar intake is a potentially important aspect of diet which has not previously been validated in the Adventist Health Study-2 (AHS-2). We sought to validate the food frequency questionnaire (FFQ) measurement of total sugars, added sugars, sucrose, and fructose against multiple 24-h dietary recalls (recalls) in AHS-2 participants. Food consumption data from a self-administered FFQ and six recalls from 904 participants were combined with nutrient profile data to estimate daily sugar intake. Validity was evaluated among all participants and by race. FFQ and recall means were compared and correlation coefficients (Spearman’s, energy-adjusted log-transformed Pearson’s, deattenuated Pearson’s) were calculated. Mean total energy, total sugars, and fructose intake were higher in the FFQ, whereas added sugars and sucrose were higher in recalls. The energy-adjusted (log-transformed) deattenuated correlations among all participants were: total sugars (r = 0.42, 95% CI 0.32–0.52), added sugars (r = 0.50, 95% CI 0.36–0.59), sucrose (r = 0.32, 95% CI 0.23–0.42), and fructose (r = 0.50, 95% CI 0.40–0.59). We observed moderate validity for added sugars and fructose and low-moderate validity for total sugars and sucrose measured by the AHS-2 FFQ in this population. Dietary sugar estimates from this FFQ may be useful in assessing possible associations of sugars intake with health outcomes.

Inadequate Intake of Dietary Fibre in Adolescents, Adults, and Elderlies: Results of Slovenian Representative SI. Menu Study

Dietary fibre has proven to promote healthy body mass and reduce the risk of non-communicable diseases. To date, in Slovenia, there were only a few outdated studies of dietary fibre intake; therefore, we explored the dietary fibre intake using food consumption data collected in the SI.Menu project. Following the EU Menu methodology, data were collected on representative samples of adolescents, adults, and elderlies using a general questionnaire, a food propensity questionnaire, and two 24 h recalls. The results indicate that the intake of dietary fibre in Slovenia is lower than recommended. The proportion of the population with inadequate fibre intakes (<30 g/day) was 90.6% in adolescents, 89.6% in adults, and 89.3% in elderlies, while mean daily fibre intakes were 19.5, 20.9, and 22.4 g, respectively. Significant determinants for inadequate dietary fibre intake were sex in adolescents and adults, and body mass index in adults. The main food groups contributing to dietary fibre intake were bread and other grain products, vegetables and fruits, with significant differences between population groups. Contribution of fruits and vegetables to mean daily dietary fibre intake was highest in elderlies (11.6 g), followed by adults (10.6 g) and adolescents (8.5 g). Public health strategies, such as food reformulation, promoting whole-meal alternatives, consuming whole foods of plant origin, and careful planning of school meals could beneficially contribute to the overall dietary fibre intake in the population.

Exposure to food insecurity increases energy storage and reduces somatic maintenance in European starlings ( Sturnus vulgaris )

Birds exposed to food insecurity—defined as temporally variable access to food—respond adaptively by storing more energy. To do this, they may reduce energy allocation to other functions such as somatic maintenance and repair. To investigate this trade-off, we exposed juvenile European starlings ( Sturnus vulgaris , n = 69) to 19 weeks of either uninterrupted food availability or a regime where food was unpredictably unavailable for a 5-h period on 5 days each week. Our measures of energy storage were mass and fat scores. Our measures of somatic maintenance were the growth rate of a plucked feather, and erythrocyte telomere length (TL), measured by analysis of the terminal restriction fragment. The insecure birds were heavier than the controls, by an amount that varied over time. They also had higher fat scores. We found no evidence that they consumed more food overall, though our food consumption data were incomplete. Plucked feathers regrew more slowly in the insecure birds. TL was reduced in the insecure birds, specifically, in the longer percentiles of the within-individual TL distribution. We conclude that increased energy storage in response to food insecurity is achieved at the expense of investment in somatic maintenance and repair.

Issues and Challenges in the Application of the IEUBK Model in the Health Risk Assessment of Lead: A Case Study from Blantyre Malawi

The risk assessment of lead (Pb) requires the use of biokinetic models to translate measured concentrations of Pb in food and environmental media into blood lead (BPb). The aim of this study was to assess the applicability of the Integrated Exposure Uptake Biokinetic (IEUBK) model in the health risk assessment of Pb among children in Blantyre. Children (152) aged 1–6 years were recruited into this cross-sectional study, and foods, house dust, playground soil, water, and venous blood (1 mL) were collected and analyzed for Pb. A seven-day food frequency questionnaire (FFQ) was used to collect food consumption data. The concentrations of Pb ranged from 0.01 to 3.3 mg/kg in food, 2.3 to 265 mg/kg and 1.5 to 482 mg/kg in house dust and playground soil, respectively, as well as 2.0 µg/dL to 50.4 µg/dL and 6.8 to 39.2 µg/dL for measured and predicted BPb, respectively. Various statistical tests indicated less than satisfactory agreement between measured and predicted BPb values. Despite the lack of reliable food consumption data and other limitations, both the predicted and measured BPb values indicate that children in Blantyre are exposed to high levels of Pb, largely through food and soil as a minor source.

Antioxidants Such as Flavonoids and Carotenoids in the Diet of Bogor, Indonesia Residents

Due to the strong antioxidant activity of flavonoids and carotenoids, daily consumption of these bioactive compounds has the potential for reducing the risk of many chronic and degenerative diseases caused by or contributed to by oxidative stress. Currently, the available research results related to the flavonoid and carotenoid intake in Asian countries are very limited, especially for Indonesian population. The present study was conducted in Bogor City and Bogor District, West Java, Indonesia. Food consumption data was obtained through the food frequency questionnaire (FFQ) method, involving 200 respondents aged 25–65 years old. Flavonoids and carotenoids contents of the consumed food items were determined by referring to the databases developed by the United States Department of Agriculture (USDA), scientific journals, and calculation based on the recipes recorded in the survey. The total flavonoid intake of Bogor adults was estimated as 149.5 mg/day, consisting of 49.4% isoflavones, 24.0% flavonols, 9.4% flavanones, 7.0% flavan-3-ols, 6.0% flavones, and 4.2% anthocyanidins, and was contributed to mainly by legumes (70.7%), vegetables (10.1%), and fruits (7.3%). At the same time, the estimated total carotenoid intake reached 7.6 mg/day, and was contributed to mainly by vegetables (53.9%), fruits (20.2%), and snacks (14.4%), with β-carotene consumed in the highest proportion (49.9%), followed by lycopene (19.9%), lutein and zeaxanthin (13.5%), α-carotene (6.9%), and β-cryptoxanthin (2.6%). The effects of different respondents’ characteristics, such as area of residence (city vs. district), gender (male vs. female), and age (25–40, 41–55, and 56–65 years old) on the flavonoid and carotenoid intake varied widely, due to the differences in the overall consumption patterns of the respective respondents’ groups.

An overview on the nutrition transition and its health implications: Tunisia case

Background: In the last decades, Tunisia has undergone major demographic, socio-economic and lifestyle (including diet) changes, with drastic increases in excess adiposity and nutrition related non-communicable diseases (NCDs). This review provides an update of the nutritional situation in Tunisia. Methods: Several Tunisian datasets or international databases were used to assess availability and consumption of foods and health outcomes. Results: Both from national aggregated availability data and individual food consumption data, there was a trend both of increasing food intake and modernization/westernization of the diet (especially in urban areas), towards more consumption of dairy and meat products, sugar, fat and salt. But consumption of fruits and vegetables was still above WHO recommendations. Except for iodine, micronutrients deficiency (iron, vitamin A and D) was markedly, but unevenly, present among specific groups (e.g., a third of adult women had anemia). Among infants, both exclusive and predominant breastfeeding were low, while the minimum diet diversification rate was 63%. Among children, stunting was residual but increase of overweight was a concern. In 2016 17.6% of men and 34.6 % of women over 15 y. were obese and 15.5% had diabetes, a twofold increase in the last decades. These prevalence were much higher in urban and more developed areas. Also, 86% of the mortality rate was attributable to NCDs. Conclusion: Addressing the double burden of malnutrition and NCDs is a priority and should be based on a sustainability framework, involve a diversity of stakeholders and emphasize double duty actions and reduction of nutrition and health inequalities. Keywords: Tunisia, diet, food insecurity, micronutrient deficiencies, nutritional status, obesity, non-communicable diseases.