Precision Nutrition Model Predicts Glucose Control of Overweight Females following the Consumption of Potatoes High in Resistant Starch

Individual glycemic responses following dietary intake result from complex physiological processes, and can be influenced by physical properties of foods, such as increased resistant starch (RS) from starch retrogradation. Predictive equations are needed to provide personalized dietary recommendations to reduce chronic disease development. Therefore, a precision nutrition model predicting the postprandial glucose response (PPGR) in overweight women following the consumption of potatoes was formulated. Thirty overweight women participated in this randomized crossover trial. Participants consumed 250 g of hot (9.2 g RS) or cold (13.7 g RS) potatoes on two separate occasions. Baseline characteristics included demographics, 10-day dietary records, body composition, and the relative abundance (RA) and α-diversity of gut microbiota. Elastic net regression using 5-fold cross-validation predicted PPGR after potato intake. Most participants (70%) had a favorable PPGR to the cold potato. The model explained 32.2% of the variance in PPGR with the equation: 547.65 × (0 [if cold, high-RS potato], ×1, if hot, low-RS potato]) + (BMI [kg/m2] × 40.66)—(insoluble fiber [g] × 49.35) + (Bacteroides [RA] × 8.69)—(Faecalibacterium [RA] × 73.49)—(Parabacteroides [RA] × 42.08) + (α-diversity × 110.87) + 292.52. This model improves the understanding of baseline characteristics that explain interpersonal variation in PPGR following potato intake and offers a tool to optimize dietary recommendations for a commonly consumed food.

Number of Days Required to Estimate Habitual Vegetable Variety: A Cross-Sectional Analysis Using Dietary Records for 7 Consecutive Days

The aim of this cross-sectional study was to examine the number of days required to estimate habitual vegetable variety by conducting a multiday, dietary record. Sixty respondents from three groups in Japan (rural residents, general students, and nutrition students) participated in the study using a self-administered questionnaire in September 2018. To measure vegetable variety, the number of different vegetables consumed was extracted from the dietary records of seven consecutive days. Differences in the number of vegetables consumed and the capture proportion over seven consecutive days between groups were examined using repeated measures analysis of variance and one-way analysis of variance. The vegetable variety between each day was also compared using Pearson’s correlation coefficient. The vegetable variety based on dietary records for seven consecutive days confirmed the differences between groups by repeated measurements (p = 0.013). However, there was no significant difference among groups in the capture proportion per survey day based on seven consecutive days. Furthermore, there were significant correlations between the number of vegetables consumed over seven consecutive days and that consumed on two or more days (r > 0.50, p < 0.01) and especially three or more days in all groups (r > 0.70, p < 0.001). The present study suggested that a dietary survey over two or more days could provide an estimate of habitual vegetable variety.

Dietary Intake of the Italian PHIME Infant Cohort: How We Are Getting Diet Wrong from as Early as Infancy

Unhealthy dietary habits established in early infancy may lead to under or over nutrition later in life. This paper describes the energy, nutrients and food-type intake of 18-month-old infants belonging to the Italian PHIME cohort (n = 389) and evaluates adherence to the Italian dietary reference values (DRVs). Infant dietary data were collected using 7-day dietary records. Mean energy, macro and micronutrient intakes were estimated and compared with the DRVs. The percentage contribution of 19 selected food groups to total energy and macro- and micronutrient intake was determined with the aim of establishing the main food sources. Most infants’ diet shared common characteristics: poor variety, excessive intake of proteins (16.5 E% vs. 8–12 E% DRV) and saturated fatty acids (SFAs) (13.8 E% vs. <10 E% DRV), mainly derived from milk and dairy products, and low intake of total fats (33.2 E% vs. 35–40 E% DRV), polyunsaturated fatty acids (PUFAs) (3.1 E% vs. 5–10 E% DRV), vitamin D (1.1 vs. 15 µg/day DRV) and iron (4.5 vs. 8 mg/day DRV). The unbalanced distribution of macronutrients was reflected in energy intakes outside DRV ranges for more than half the infants. Public health interventions promoting healthy eating habits from early on, even from pregnancy, could yield significant short- and long-term health benefits.

Self-Care by Muslim Women during Ramadan Fasting to Protect Nutritional and Cardiovascular Health

The practice of Ramadan involves a series of changes in lifestyle, mainly in eating habits. The research aim of this study is to determine the prevalence of overweight-obesity, the degree of compliance with dietary recommendations and the effects of religious fasting on cardiovascular health among a population of Muslim women living in Melilla, a Spanish city in North Africa. A follow-up cohort study was conducted on 62 healthy adult women (33.6 ± 12.7 years). Anthropometric and body composition parameters were obtained using bioimpedance and dietary records. All of the participants were overweight or obese, especially due to the non-compliance with dietary recommendations; however, more than 60% considered their weight was appropriate or even low. By the end of Ramadan, the women’s body mass index and fat component values had fallen significantly (p < 0.001), but this loss was later recovered. Dietary records revealed an excessive consumption of lipids and sodium, and the presence of a high waist-to-hip ratio. All of these factors are related to cardiovascular risk. In conclusion, promoting nutritional health and encouraging year-round self-care among adult Muslim women is necessary in order to ensure healthy fasting during Ramadan.

Faecalibacterium predicts postprandial glucose control following potatoes in overweight females

Background: Individual glycemic responses following dietary intake result from complex physiological processes and can be influenced by physical properties of foods, such as increased resistant starch (RS) from retrogradation of starch upon cooling after cooking. Predictive equations are needed to provide personalized recommendations for those individuals most at risk for poor metabolic outcomes. Methods: Thirty overweight women with no comorbid conditions participated in this randomized crossover trial, in which the women consumed 250g of hot (9.2 g RS) or cold (13.7 g RS) potatoes. Baseline characteristics included demographics, 10-day dietary records, body composition, and the relative abundance (RA) and α-diversity of gut microbiota. Elastic net regression using 5-fold cross-validation predicted postprandial glucose response (PPGR; incremental AUC0-120min) following the potatoes. Results: Thirty participants (29.6 ± 6.0 yrs; BMI 32.8 ± 3.7 kg/m2) participated in this trial. Most women (70%) showed a favorable PPGR to the cold potato. The model explained 32.2% of the variance in iAUC0-120min glucose with the equation: 547.65 x (0 [if cold potato], x 1 [if hot potato]) + (BMI[kg/m2] x 40.66) - (insoluble fiber[g] x 49.35) + (Bacteroides[RA] x 8.69) - (Faecalibacterium[RA] x 73.49) - (Parabacteroides[RA] x 42.08) + (α-diversity x 110.87) + 292.52.Conclusion: This model improves understanding of baseline characteristics that explain interpersonal variation in PPGR following potato intake and offers a tool to optimize dietary recommendations for a commonly consumed food. Larger studies are warranted to expand generalizability and application of the equation. Trial Registration: The National Clinical Trials number is NCT03310476, and this study was registered with clinicaltrials.gov on Oct 16, 2017.

Integrative analysis of dietary water footprint and dietary quality – Towards the practical application of sustainable nutrition

The contribution of food production to the environmental burden is considerable, therefore, numerous countries have been trying to create a sustainable food supply chain to ensure food and nutrition security. The scope of this study was to analyse the association between water footprint and healthiness based on dietary records. Furthermore, it was aimed to create a classification of integrative dietary indicators of sustainable nutrition. With these methodological aims, the dietary records of 25 healthy adults were assessed. The dietary quality scores and dietary water footprint were calculated and Spearman's rank correlation was tested between them. The indicator nutrients were classified based on their advantageous or disadvantageous health impact and association with water footprint. There was a significant positive correlation between the meat consumption and water footprint, while significant negative correlations were found between the dietary quality score and water footprint and dietary quality score and meat consumption (P < 0.05). Protein, energy, sodium, and saturated fatty acids as integrated indicator nutrients could be identified for both dietary quality and water footprint. The improvement in dietary quality could simultaneously decrease the dietary water footprint. The integration of environmental impact into the analysis of diets could be the future direction in the counseling practice of nutritionists.

The first semi-quantitative toddler’s food frequency questionnaire (T-FFQ) in Iran

Background: Only few food frequency questionnaires (FFQs) have been specifically designed and validated for toddlers. There is no valid instrument to assess usual intakes of Iranian toddlers. The present study was designed to develop a FFQ, and to examine its validity and reliability among toddlers. Material and methods: This cross-sectional study was conducted in 2019 in Iran. Mothers of 100 toddlers completed a semi-quantitative FFQ with 99 items as well as three non-consecutive dietary records. Data on maternal age, education, toddler gender, birth order, birth weight, current weight and height, and the age of beginning complementary foods were collected. By comparing the results obtained from dietary records and the FFQ, we assessed the relative validity. Reliability was evaluated by intra-class correlation coefficients between results of two FFQs administered with four weeks intervals to the same participants (n=20), as well as weighted kappa. The Bland-Altman plots were used to assess the level of agreement between two FFQs. Results: Mean and standard deviation (SD) of age was 32.71 (4.76) years and 22.42 (3.52) months, for mothers and toddlers, respectively. The FFQ showed acceptable validity and reliability. The correlation coefficients for the first FFQ were 0.82 (energy), 0.81 (fats), 0.60 (carbohydrate), 0.96 (calcium), 0.39 (iron) and 0.24 (vitamin C), all P-values were <0.001, except for vitamin C (P: 0.02). Reliability coefficients were between 0.77 (vitamin C) and 0.99 (calcium, potassium, phosphorus, zinc, riboflavin, vitamin B12, vitamin E and D). The Cronbach’s Alpha was 0.91, showing high reliability. Conclusion: The present study provided a thorough assessment of both validity and reliability of T-FFQ, and indicated acceptable validity as compared with three-day dietary records and good reliability. Therefore, this FFQ could be a useful tool to evaluate usual dietary intake of toddlers.

Food group intake of children and adolescents (6-18 years) on a vegetarian, vegan, or omnivore diet: Results of the VeChi Youth Study

Plant-based, i.e., vegetarian (without meat and fish) or vegan (exclusively plant-based foods) diets are in trend also among children and adolescents, but data on food intake in this group are lacking. Here, we compare the consumption of food groups of vegetarian (n 145), vegan (n 110), and omnivore (n 135) children and adolescents (6-18 years) in Germany using data of the VeChi Youth Study. Each food item reported in 3day weighed dietary records was assigned to one of 18 food groups and individual mean intake per day (g/MJ) was calculated. Group differences were assessed using covariance analyses adjusted for age, sex and other covariates. For food groups with a high number of non-consumers, non-parametric Kruskal-Wallis-Tests were run. Pairwise comparison of vegetarian and vegan groups indicated significantly higher intakes of legumes, nuts, milk alternatives (all P = 0.0003), and meat alternatives (P = 0.0065) among vegan subjects. Intake of these food groups of omnivore participants was low (Q3: 0.0 g/MJ for legumes, milk alternatives, and meat alternatives, 0.5 g/MJ for nuts). Dairy intake of vegetarians (11.6 g/MJ) was significantly lower than of omnivore subjects (24.7 g/MJ) (P = 0.0003). Intake of fats/oils and sweet foods was lowest in vegan compared to vegetarian and omnivore participants (p <0.05). Whole grain intake was higher in vegan participants (14.5 g/MJ) than of vegetarian (9.1 g/MJ) and omnivore (6.5 g/MJ) participants (P = 0.0003). Longitudinal studies are necessary to evaluate the long-term health consequences of vegetarian, vegan, and omnivore food patterns, especially in childhood and adolescence.

Low Comparability of Nutrition-Related Mobile Apps against the Polish Reference Method—A Validity Study

Nutrition-related mobile applications (apps) are commonly used to provide information about the user’s dietary intake, however, limited research has been carried out to assess to what extent their results agree with those from the reference method (RM). The main aim of this study was to evaluate the agreement of popular nutrition-related apps with the Polish RM (Dieta 6.0). The dietary data from two days of dietary records previously obtained from adults (60 males and 60 females) were compared with values calculated in five selected apps (FatSecret, YAZIO, Fitatu, MyFitnessPal, and Dine4Fit). The selection of apps was performed between January and February 2021 and based on developed criteria (e.g., availability in the Polish language, access to the food composition database, and the number of downloads). The data was entered by experienced clinical dietitians and checked by one more researcher. The mean age of study participants was 41.7 ± 14.8. We observed that all the apps tended to overestimate the energy intake, however, when considering the macronutrient intake, over- and underestimation were observed. According to our assumed criterion (± 5% as perfect agreement, ± 10% as sufficient agreement), none of the apps can be recommended as a replacement for the reference method both for scientific as well as clinical use. According to the Bland-Altman analysis, the smallest bias was observed in Dine4Fit in relation to energy, protein, and fat intake (respectively: −23 kcal; −0.7 g, 3 g), however, a wide range between the upper and lower limits of agreement were reported. According to the carbohydrate intake, the lowest bias was observed when FatSecret and Fitatu were used. These results indicate that the leading nutrition-related apps present a critical issue in the assessment of energy and macronutrient intake. Therefore, the implementation of validation studies for quality assessment is crucial to develop apps with satisfying quality.

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

Background: Special needs schools (SNS) educate children and young people with major neurological disabilities who are at high risk of oropharyngeal dysphagia (OD) and malnutrition (MN). We aimed to assess the prevalence of OD, MN, dehydration (DH), and oral health (OH) in students at an SNS. Methods: A cross-sectional observational study was conducted at SNS L’Arboç, Catalonia, Spain. We assessed (a) demographics, health status, comorbidities, and gross motor function classification system (GMFCS), (b) swallowing function, oral-motor evaluation, masticatory capacity, and EDACS classification for eating and drinking abilities, (c) nutritional and DH status (anthropometry, bioimpedance and dietary records), and (d) OH (Oral Hygiene Index Simplified). Results: A total of 33 students (mean age 13.3 years; 39.4% level V of GMFCS) were included. Main diagnosis was cerebral palsy at 57.6%. All students presented OD, 90.6% had impaired safety, 68.7% were at levels II–III of EDACS, and 31.3% required PEG; furthermore, 89.3% had chronic MN, 21.4% had acute MN, 70% presented intracellular DH, and 83.9% presented impaired OH. Conclusion: MN, DH, OD, and poor OH are highly prevalent conditions in students with cerebral palsy and other neurological disabilities and must be specifically managed through nutritional and educational strategies. The multidisciplinary team at SNS should include healthcare professionals specifically trained in these conditions.