Anthropometric Parameters and Mediterranean Diet Adherence in Preschool Children in Split-Dalmatia County, Croatia—Are They Related?

Obesity is a rapidly growing problem in European countries, Croatia being among them. According to the latest CroCOSI data, every third child in Croatia aged 8.0–8.9 years is overweight or obese. The Mediterranean diet (MeDi) and its impact on nutritional status and health has been the focus of recent research. Therefore, the aim of this cross-sectional, observational study was to determine the nutritional status and adherence to the MeDi of preschool children in Split, Croatia. We included 598 preschool children aged 3 to 7 years and, for each child, parents completed a lifestyle questionnaire and the Mediterranean Diet Quality Index (KIDMED) in order to assess adherence to the MeDi. The anthropometric assessment included the measurement of weight, height, mid-upper arm circumference (MUAC), waist circumference (WC) and the z-score was calculated. According to the z-score, 420 (70.2%) children had a healthy body weight with 54 (9%) underweight and 124 (20.8%) overweight or obese children. Almost half (49%) of the study participants had a low KIDMED index score, indicating a low MeDi adherence, 37% had an average score, while only 14% had high MeDi compliance. Statistically significant negative correlations between MUAC and WC and the consumption of a second daily serving of fruit (p = 0.04) as well as a daily serving of vegetables (p = 0.03) were found. In conclusion, low compliance to the MeDi principles in preschool children is concerning. Considering the beneficial effects of the MeDi on overall health, further education, and the adoption of healthy eating habits in preschool children in this Mediterranean region are required.

Feasibility, Acceptability, and Adherence of Nutritional Supplement Amongst Pregnant Women in Rural Ethiopia

Objectives Providing balanced protein energy (BEP) supplementation to pregnant women in low-and-middle income countries has been shown to improve pregnancy outcomes. The objective of this study was to assess the feasibility, acceptability, and adherence of a proposed BEP product among pregnant women in rural Ethiopia prior to initiation of a clinical effectiveness study. Methods This formative study was conducted from October-November 2018 among pregnant women in the rural Amhara region of Ethiopia, prior to the “Enhancing Nutrition and Antenatal Infection Treatment (ENAT)” study [ISRCTN15116516]. Questionnaires to assess acceptability of a micronutrient fortified corn soy blend (CSB) BEP supplement were administered using a 7-point Likert scale (0 = strongly disagree, to 7 = strongly agree) after 2 and 4 weeks of utilization. Acceptability domains included: color, taste, texture, odor, portion size, ease of use, and adult favorability. Women were also given weekly provisions of daily sachets of the supplement and monitored weekly for adherence over one month. Results 39 women participated in the study and 33 completed the study at 4 weeks. Quantitative results demonstrated high acceptability (mean Likert score >6 of 7) for the following domains: color, odor and perceived adult favorability at mid and end point. Scores on acceptability and perception of the product remained generally stable through the duration of use. The average number of sachets consumed was 6.4 in week 1, 6.6 in week 2, 7 in week 3, and 6.9 in week 4. 43% of women consumed the portion in one sitting, whereas 57% of women split up the portion to consume throughout the day. The majority (66%) of women reported consuming the full daily serving. 26% of respondents reported sharing the supplement with family members. Conclusions These findings show that most women in rural Amhara, Ethiopia, found the BEP supplement acceptable and had positive perceptions of the product. Sharing of the product and completion of the full daily serving were important considerations. Overall, the BEP supplement demonstrated good feasibility of implementation in our study population. Future studies should consider utilizing such strategies to understand factors that may affect uptake and adherence of nutritional supplements. Funding Sources Bill & Melinda Gates Foundation.

Desperate Times Call for Desperate Measures: Use of Continuous Subcutaneous 1-34 PTH Infusion for Postsurgical Hypoparathyroidism

Objective. This case highlights use of 1-34 PTH continuous infusion in a patient with postsurgical hypoparathyroidism. Method. Clinical presentation and biochemical profile were monitored before and after 1-34 PTH infusion, with notable reduction in pill burden in a patient with postsurgical hypoparathyroidism. Results. We present a case of postsurgical hypoparathyroidism following thyroidectomy for Graves disease. The patient was requiring a total of 34 pills daily and, despite medication compliance, her clinical and biochemical control was unsatisfactory. Following initiation of 1-34 PTH in the form of a subcutaneous pump, we were able to stop all calcium supplementation and reduce calcitriol to 0.5 mcg daily. Her current biochemical control as well as quality of life improved significantly on CSPI, calcitriol, and a daily serving of dietary calcium. Conclusion. This case highlights the use of 1-34 PTH either as twice-daily dosing or continuous subcutaneous infusion for adult patients with hypoparathyroidism.

The Role of Reduction. Smaller Portion Sizes to Fight Overweight

For decades, portion sizes in packaged and unpackaged foods have been growing steadily. This not only affects amount of calories consumed, but also shifts our perception of "normal" serving sizes. Reducing the size of the package can make a significant contribution to the reduction of energy consumption and, hence, in fight against excess weight. This is especially true for sugary soft drinks containing about 10% sugar, so a 500 ml serving contains about 50 g of sugar, which makes up 200% of the WHO recommended 25 g daily serving.

Ground Flaxseed – How Safe is it for Companion Animals and for Us?

EFSA released the 89-page Scientific Opinion “Evaluation of the health risks related to the presence of cyanogenic glycosides in foods other than raw apricot kernels”. This opinion, and the ensuring media coverage, has left uncertainty in the minds of consumers, feed and supplement manufacturers and flaxseed producers of how much ground flaxseed can safely be consumed without crossing the threshold of cyanide toxicity. This editorial updates the science and tries to bring clarity to the question “how much flaxseed can I safely feed my dog, cat, horse on a daily basis?” and “how much can I safely eat?” The great majority of ground flaxseed products have a cyanogenic glycoside content of less than 200 mg / kg seed. For people, consuming 30 grams of such flaxseed the average peak blood cyanide concentration will be about 5 µmole / L, much less than the toxic threshold value of 20 to 40 µmole / L favoured by EFSA. Thus, as much as 120 grams of crushed / ground flaxseed can be consumed by a 70 kg adult person before a toxic threshold of 40 µmole / L is reached (up to 1.7 grams ground flaxseed / kg body weight). The toxic threshold of cyanide for dogs is 2 to 4-fold greater than for humans, and unknown for cats and horses. The daily serving amounts for dogs and cats are about 0.23 grams / kg body mass per day, which will result in blood cyanide well below the toxic threshold. The highest recommended daily serving amount for horses is 454 grams per day, or 0.8 to 2 grams per kg / body mass depending on mass of the horse. This amount for horses should not be exceeded.

Assessment of Nutrient and Food Group Intakes across Sex, Physical Activity, and Body Mass Index in an Urban Brazilian Population

The burden of preventable diet-related diseases is significant and becoming worse. Thus, accurately assessing food intake is crucial to guide public health policies and actions. Using food dietary recalls, we evaluated usual dietary intake according to physical activity and nutritional status in an adult urban population from Brasília, Brazil. The usual nutrient and energy intakes distributions were estimated using the Iowa State University (ISU) method. Energy and nutrient intakes were stratified by gender, age group, body mass index (BMI), and physical activity (PA). The prevalence of inadequate intake was highest for vitamins E and D. Both men and women had excessive sodium intake. The percentage of intakes below daily serving recommendations for food groups were 96% for cereals, 74% for vegetables, and 87% for dairy products, whereas percentage of intakes above daily serving recommendations were 97% for meat, 93% for pulses, and 99% for fat/oils. Energy and nutrient intakes were highest in overweight and physically active individuals within the categories of BMI and physical activity, respectively. Our study found that high-income urban Brazilians consume large quantities of meat, beans, fat/oils, and exhibit a low prevalence of nutrient inadequacies but have excessive sodium intake. Energy and nutrient intakes are highest among men, as well as overweight and physically active individuals.

Consumption of a single serving of red raspberries per day reduces metabolic syndrome parameters in high-fat fed mice

Intake of one daily serving of raspberry ameliorates the symptoms of metabolic syndrome in a high fat diet fed C57BL/6J mouse model.

Sweetened beverage intake and risk of latent autoimmune diabetes in adults (LADA) and type 2 diabetes

Objective Sweetened beverage intake is associated with increased risk of type 2 diabetes, but its association with autoimmune diabetes is unclear. We aimed to investigate sweetened beverage intake and risk of latent autoimmune diabetes in adults (LADA); autoimmune diabetes with features of type 2 diabetes. Design/methods Data from a Swedish population-based study was used, including incident cases of LADA (n = 357) and type 2 diabetes (n = 1136) and randomly selected controls (n = 1371). Diabetes classification was based on onset age (≥35), glutamic acid decarboxylase autoantibodies (GADA) and C-peptide. Sweetened beverage intake information was derived from a validated food frequency questionnaire. ORs adjusted for age, sex, family history of diabetes, education, lifestyle, diet, energy intake and BMI were estimated using logistic regression. Results Daily intake of >2 servings of sweetened beverages (consumed by 6% of participants) was associated with increased risk of LADA (OR: 1.99, 95% CI: 1.11–3.56), and for each 200 mL daily serving, OR was 1.15 (95% CI: 1.02–1.29). Findings were similar for sugar-sweetened (OR: 1.18, 95% CI: 1.00–1.39) and artificially sweetened beverages (OR: 1.12, 95% CI: 0.95–1.32). Similarly, each daily serving increment in total sweetened beverage conferred 20% higher type 2 diabetes risk (95% CI: 1.07–1.34). In type 2 diabetes patients, high consumers displayed higher HOMA-IR levels (4.5 vs 3.5, P = 0.0002), but lower HOMA-B levels (55 vs 70, P = 0.0378) than non-consumers. Similar tendencies were seen in LADA. Conclusions High intake of sweetened beverages was associated with increased risk of LADA. The observed relationship resembled that with type 2 diabetes, suggesting common pathways possibly involving insulin resistance.