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.

The anabolic role of plant-based proteins in response to chronic resistance exercise

Proper maintenance of skeletal muscle mass is essential to prevent sarcopenia and ensure health and quality of life as aging progress. The two determinants of muscle protein synthesis are the increased load on skeletal muscle through resistance exercise and protein intake. For an effective result of maintaining or increasing muscle mass, it is relevant to consider the quantitative and adequate intake of protein, and the dietary source of protein since the plant-based protein has differences in comparison to animals that limit its anabolic capacity. Given the increase in vegetarianism and the elderly population, which consumes fewer food sources of animal protein, the importance of understanding how protein of plant-based protein can sustain muscle protein synthesis in the long term when associated with resistance exercise is justified, as well as the possibilities of dietary adequacy in the face of this demand.

Beetroot Juice and Red Spinach Juice to Increase Hemoglobin Levels in Anemic Adolescent Girls

BACKGROUND: The problem of iron (Fe) deficiency anemia in adolescents often occurs due to incorrect food habits caused an imbalance in nutritional intake and the recommended dietary adequacy. Spinach and beetroot are alternative plants to meet the Fe needs of anemic adolescents. The content of Vitamin C or ascorbic acid in beets and spinach can help absorb Fe in the body. Beetroot also contains relatively sufficient Fe beneficial in overcoming anemia caused by Fe deficiency. AIM: This study aimed to determine the effect of beetroot juice and red spinach juice on increasing hemoglobin (Hb) levels in anemic adolescents. METHODS: It was a Quasi Experiment with a pretest-posttest, non-equivalent control group design. The research subjects were twenty people per group of anemic adolescent girls. RESULTS: In this study, after 2 weeks of beetroot juice intervention to anemic adolescent girls, there was an increase in Hb levels from 11.47 g/dl to 12.02 g/dl. The increase in Hb levels was statistically different (Paired t-test) (p < 0.05). However, the 2 weeks of red spinach juice intervention also experienced an increase in Hb levels, from 11.4 g/dl to 12.08 g/dl. The increase in Hb levels was statistically significant (p < 0.05). CONCLUSION: An effect of beetroot juice and red spinach juice consumption on Hb levels of anemic adolescent girls.

The Consequences of Nutrition Hazards: A Literature Review

A better understanding of the factors that mitigate the consequences of nutrition-related hazards and encourage resilience is required to prevent against or improve poor development outcomes. This study included a review of the literature. Dietary adequacy is essential for growth and development, but current data suggests that nutrition supplements alone is insufficient to generate resilience to defend against, alleviate, and recover from nutritional stressors, as well as to promote healthy development. It is vital to combine nutrition therapy with stimulation and responsive care. Combined nutrition and psychosocial stimulation treatments may be successful in promoting protective factors and mitigating risks for impaired cognitive, motor, social, and affective functioning, hence assisting children in adapting to adversity.

The Diet Quality and Nutrition Inadequacy of Pre-Frail Older Adults in New Zealand

This study aimed to describe the diet quality of pre-frail community-dwelling older adults to extend the evidence of nutrition in frailty prevention. Pre-frailty, the transition state between a robust state and frailty, was ascertained using the FRAIL scale. Socio-demographic, health status, and 24-h dietary recalls were collected from 465 community-dwelling adults aged 75+ (60 years for Māori and Pacific people) across New Zealand. Diet quality was ascertained with the Diet Quality Index-International (DQI-I). Participants (median (IQR) age 80 (77–84), 59% female) had a moderately healthful diet, DQI-I score: 60.3 (54.0–64.7). Women scored slightly higher than men (p = 0.042). DQI-I components identified better dietary variety in men (p = 0.044), and dietary moderation in women (p = 0.002); both sexes performed equally well in dietary adequacy and poorly in dietary balance scores (73% and 47% of maximum scores, respectively). Low energy 20.3 (15.4–25.3) kcal/kg body weight (BW) and protein intakes 0.8 (0.6–1.0) g/kg BW were coupled with a high prevalence of mineral inadequacies: calcium (86%), magnesium (68%), selenium (79%), and zinc (men 82%). In conclusion, the diet quality of pre-frail older adults was moderately high in variety and adequacy but poor in moderation and balance. Our findings support targeted dietary interventions to ameliorate frailty.

Simulated Impact of Vitamin A Fortified Sugar on Dietary Adequacy and Association of Usual Sugar Intake With Plasma and Breast Milk Retinol Among Lactating Women in Rural Zambia

Objectives Zambia introduced mandatory sugar fortification with vitamin A (VA) in 1998; however, regulatory monitoring and evaluation have been limited. We studied the contribution of VA-fortified sugar intake to dietary adequacy, and examined associations between usual sugar and VA intakes with plasma and breast milk retinol concentrations in lactating women in rural Zambia. Methods We conducted three 24-h dietary recalls among each of 255 lactating women enrolled in a randomized trial, at the time of baseline venous blood and breast milk collection. We measured retinol in biospecimens using high-performance liquid chromatography. We simulated VA intake under various sugar fortification scenarios: 3.1 and 8.8 mg/kg (measured median fortification levels of VA in sugar from previous studies), 10 mg/kg (minimum legal requirement) and 15 mg/kg (minimum legal requirement at factory level). Usual intake distributions, prevalence of inadequate VA intake (&lt; Estimated Average Requirement of 900 μg RAE/d) and prevalence of retinol intake above the tolerable upper intake level (UL, &gt;3000 μg/d) for each scenario were estimated using the National Cancer Institute (NCI) method. We applied the NCI's “bivariate model” as a regression calibration tool to examine associations of usual intake of sugar and dietary VA with plasma and breast milk retinol concentrations. Results In the absence of sugar fortification, the prevalence of VA inadequacy was predicted to be 83% (SE: 6). Fortification of sugar with VA at 3.1 mg/kg, 8.8 mg/kg, 10 mg/kg and 15 mg/kg would reduce the prevalence of VA inadequacy by 7 (SE:6), 24 (SE:14), 30 (SE:15) and 47 (SE:18) percentage points, respectively, without increasing the risk of retinol intake above the UL. Usual sugar intake and usual VA intake were not associated with plasma retinol or breastmilk retinol concentrations. Conclusions The sugar fortification program has the potential to reduce dietary VA inadequacy, but the impact is likely to be limited if actual fortification levels are lower than mandated levels. Even if target fortification levels are achieved (10 mg/kg), sugar fortification alone is unlikely to eliminate dietary VA inadequacy among lactating women in rural Zambia. Funding Sources HarvestPlus and the Sight and Life Global Nutrition Research Institute at Johns Hopkins University.