Certain dietary patterns are associated with GLIM criteria among Chinese community-dwelling older adults: a cross-sectional analysis

Disease-related malnutrition is prevalent among older adults; therefore, identifying the modifiable risk factors in the diet is essential for the prevention and management of disease-related malnutrition. The present study examined the cross-sectional association between dietary patterns and malnutrition in Chinese community-dwelling older adults aged ≥65 years in Hong Kong. Dietary patterns, including Diet Quality Index International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score, ‘vegetable–fruit’ pattern, ‘snack–drink–milk product’ pattern and ‘meat–fish’ pattern, were estimated and generated from a validated food frequency questionnaire. Malnutrition was classified according to the modified Global Leadership Initiative on Malnutrition (GLIM) criteria based on two phenotypic components (low body mass index and reduced muscle mass) and one aetiologic component (inflammation/disease burden). The association between the tertile or level of adherence of each dietary pattern and modified GLIM criteria was analysed using adjusted binary logistic regression models. Data of 3694 participants were available (49 % men). Malnutrition was present in 397 participants (10⋅7 %). In men, a higher DQI-I score, a higher ‘vegetable–fruit’ pattern score and a lower ‘meat–fish’ pattern score were associated with a lower risk of malnutrition. In women, higher adherence to the DASH diet was associated with a lower risk of malnutrition. After the Bonferroni correction, the association remained statistically significant only in men for the DQI-I score. To conclude, a higher DQI-I score was associated with a lower risk of malnutrition in Chinese older men. Nutritional strategies for the prevention and management of malnutrition could potentially be targeted on dietary quality.

Salt intake per dish in the Japanese diet: a clue to help establish dietary goals at home

The salt intake of Japanese at home remains high. To aid in salt reduction and encourage a balanced diet, we conducted a cross-sectional study using data from a previous clinical trial in community-dwelling individuals to evaluate major salt sources and relationships among the intake of different dishes in the Japanese diet at home. Dietary records and urinary salt excretion measurements were performed daily for 1 month in seventy-nine participants. The records were classified into six grain dish categories as staple dishes, seven side dish categories and a snack category. Regression analyses were used to estimate (1) salt intake per meal for each category of grain dish, (2) salt intake per dish from each dish category and its contribution to the total salt intake and (3) the influence of grain dish selection on the frequencies of other dishes. Salt intake per meal was approximately 3 g, regardless of grain dish selection. Fish and meat dishes showed the largest contribution to the total salt intake (35 %), followed by vegetable dishes (19 %). The intake of fish or meat and vegetables was promoted by plain rice and reduced by ramen noodles. The intake of dairy products was only promoted by bread, while that of fruits was not influenced by any grain dish category. These results suggest simple strategies to reduce salt intake while maintaining dietary balance, such as eating plain rice more often and using less salt to cook meat/fish and vegetable dishes.

Association of adherence to the Australian Dietary Guidelines with cognitive performance and cognitive decline in the Sydney Memory and Ageing Study: a longitudinal analysis

This study investigated associations of adherence to the Australian Dietary Guidelines (ADG) with cognitive performance and cognitive decline over 6 years. We used longitudinal data from the Sydney Memory and Aging Study comprising 1037 community-dwelling non-demented participants aged 70–90 years. Dietary intake was assessed at baseline using the Dietary Questionnaire for Epidemiological Studies Version 2. Adherence to the ADG was scored using the Dietary Guideline Index 2013 (DGI-2013). Cognition was assessed using neuropsychological tests in six cognitive domains and global cognition at baseline and 2, 4 and 6 years later. Linear mixed models analysed the association between adherence to the ADG and cognitive function and cognitive decline over 6 years. Results indicated that overall adherence to the ADG was suboptimal (DGI-2013 mean score 43⋅8 with a standard deviation of 10⋅1; median score 44, range 12–73 with an interquartile range of 7). The percent of participants attaining recommended serves for the five food groups were 30⋅2 % for fruits, 11⋅2 % for vegetables, 54⋅6 % for cereals, 28⋅9 % for meat and alternatives and 2⋅1 % for dairy consumption. Adherence to the ADG was not associated with overall global cognition over 6 years (β = 0⋅000; 95 % CI: −0⋅007, 0⋅007; P = 0⋅95). Neither were DGI-2013 scores associated with change in global cognitive performance over 6 years (β = 0⋅002; 95 % CI: −0⋅002, 0⋅005; P = 0⋅41) nor in any individual cognitive domains. In conclusion, adherence to the ADG was not associated with cognitive health over time in this longitudinal analysis of older Australians. Future research is needed to provide evidence to support specific dietary guidelines for neurocognitive health among Australian older adults.

Camel milk consumption is associated with less childhood stunting and underweight than bovine milk in rural pastoral districts of Somali, Ethiopia: a cross-sectional study

Undernutrition is a major global health problem. Various types of animal milk are used for feeding children at early ages; however, associations of camel milk (CaM) and bovine milk (BM) with the nutritional status of children have not been explored. A comparative community-based cross-sectional study was conducted among pre-schoolers in rural pastoral districts of Somali, Ethiopia. Children were selected from households with lactating camels or cows. Anthropometric measurements followed standard procedures for height-for-age, weight-for-age and weight-for-height scores. Independent sample t-tests identified significant differences in anthropometric indices based on the type of milk consumed. Multivariable logistic regression was used to examine associations between milk consumption and other predictors of growth failures. The prevalence of stunting was 24⋅1 % [95 % confidence interval (CI) 20⋅5, 28⋅3] of pre-schoolers, 34⋅8 % (95 % CI 29⋅9, 39⋅6) were wasted and 34⋅7 % (95 % CI 30⋅1, 39⋅9) were underweight. Higher proportions of BM-fed children were severely stunted, wasted and underweight compared with CaM consumers. Using logistic regression models, children who consumed BM [adjusted odds ratio (AOR): 2⋅10; 95 % CI 1⋅22, 3⋅61] and who were anaemic (AOR: 4⋅22; 95 % CI 2⋅23, 7⋅98) were more likely to be stunted than their counterparts, while girls were less likely to be stunted than boys (AOR: 0⋅57; 95 % CI 0⋅34, 0⋅94). Similarly, children who consumed BM (AOR: 1⋅97; 95 % CI 1⋅20, 3⋅24), who were anaemic (AOR: 2⋅27; 95 % CI 1⋅38, 3⋅72) and who drank unsafe water (AOR: 1⋅91; 95 % CI 1⋅19, 3⋅07) were more likely to be underweight than their counterparts. In conclusion, CaM consumption was associated with lower prevalence of stunting and underweight than BM. Promoting CaM in pastoralist areas may help to curb the high level of undernutrition.

Categorising ultra-processed foods in large-scale cohort studies: evidence from the Nurses’ Health Studies, the Health Professionals Follow-up Study, and the Growing Up Today Study

This manuscript details the strategy employed for categorising food items based on their processing levels into the four NOVA groups. Semi-quantitative food frequency questionnaires (FFQs) from the Nurses’ Health Studies (NHS) I and II, the Health Professionals Follow-up Study (HPFS) and the Growing Up Today Studies (GUTS) I and II cohorts were used. The four-stage approach included: (i) the creation of a complete food list from the FFQs; (ii) assignment of food items to a NOVA group by three researchers; (iii) checking for consensus in categorisation and shortlisting discordant food items; (iv) discussions with experts and use of additional resources (research dieticians, cohort-specific documents, online grocery store scans) to guide the final categorisation of the short-listed items. At stage 1, 205 and 315 food items were compiled from the NHS and HPFS, and the GUTS FFQs, respectively. Over 70 % of food items from all cohorts were assigned to a NOVA group after stage 2. The remainder were shortlisted for further discussion (stage 3). After two rounds of reviews at stage 4, 95⋅6 % of food items (NHS + HPFS) and 90⋅7 % items (GUTS) were categorised. The remaining products were assigned to a non-ultra-processed food group (primary categorisation) and flagged for sensitivity analyses at which point they would be categorised as ultra-processed. Of all items in the food lists, 36⋅1 % in the NHS and HPFS cohorts and 43⋅5 % in the GUTS cohorts were identified as ultra-processed. Future work is needed to validate this approach. Documentation and discussions of alternative approaches for categorisation are encouraged.

Nutrient intake and gender differences among Saudi children

Dietary surveillance is necessary to determine community needs for nutrition interventions. Yet, the nutrient intake of Saudi children has not been previously investigated. The objective of the present study is to evaluate dietary data of Saudi children and investigate gender differences in nutrient intake. In this cross-sectional study, dietary data of 424 Saudi children (6–12 years of age) were collected using telephone-administered single 24-h dietary recall. Three 24-h dietary recalls were collected from a subsample of 168 children (39⋅6 %) and compared with the Dietary Recommended Intakes (DRIs). Nutrient intakes and proportions of children meeting the DRI requirements were similar and did not vary by children's gender. Over two-thirds of the children had an adequate usual intake of vitamin B12, and over half had adequate intakes (AIs) of vitamin C and phosphorus. On the other hand, our data indicated that low proportions of children consumed adequate usual intakes of magnesium and vitamin E. Over half of the children in our sample met the AI for sodium and vitamin D. Only small proportions of children met the AI for calcium, potassium and fibre. Cholesterol and saturated fat intake exceeded the limits of 300 mg and 10 % of total energy intake by 13⋅7 % (n 23) and 80⋅4 % (n 135) of the sample, respectively. Suboptimal intake of several micronutrients was observed among children, suggesting an urgent need to identify barriers to high-quality diet and to develop evidence-based interventions to promote optimal dietary efficacy for children in Saudi Arabia.

Time out: should vitamin D dosing be based on patient's body mass index (BMI): a prospective controlled study

The recommended daily dose of vitamin D is 2000 IU was found to be insufficient in many patients. The objective of the present study is to find whether the daily dose of vitamin D should be based on BMI. Two hundred and thirty patients with an established vitamin D deficiency (serum level of 25 Hydroxy vitamin D3 (25OHD3) of ≤20 ng/ml) and patients with BMI ≥30 kg/m2 were included in the study. Demographic data, comorbidities and BMI were recorded. Pre-treatment and post-treatment serum 25OHD3, calcium, phosphorus and parathyroid hormone (PTH) were tested at 0-, 3- and 6-month periods. Patients were treated with a standard dose of 50 000 IU of vitamin D weekly and 600/1200 mg of calcium a day. Once their level of 25OHD3 reached ≥30 ng/ml, patients were randomised into two groups. Group A received a standard recommended maintenance dose of 2000 IU daily and Group B patients received 125 IU/kg/m2 of vitamin D3. The data were entered in the database and analysed. The mean age of Group A was 50⋅74 ± 7⋅64 years compared to 52⋅32 ± 7⋅21 years in Group B. In both groups, pre-treatment vitamin D level was ≤15 ng/ml and increased to 34⋅6 ± 2⋅6 and 33⋅7 ± 2⋅4 ng/ml at the end of 3 months treatment with a dose 50 000 IU of vitamin D3 and calcium 600/1200 mg once a day for group A and group B, respectively. At 6 months, patients in Group A 25OHD3 level was 22⋅8 ± 3⋅80 and in Group B was 34⋅0 ± 1⋅85 ng/ml (P < 0⋅001). This preliminary study suggests that obese patients need higher dosage of vitamin D than the recommended dose. It is prudent that the dosage should be based on the BMI to maintain normal levels for a healthy musculoskeletal system.

Interrelationship between micronutrients and cardiovascular structure and function in type 2 diabetes

Micronutrients are important for normal cardiovascular function. They may play a role in the increased risk of cardiovascular disease observed in people with type 2 diabetes (T2D) and T2D-related heart failure. The aims of this study were to (1) examine micronutrient status in people with T2D v. healthy controls; (2) assess any changes following a nutritionally complete meal replacement plan (MRP) compared with routine care; (3) determine if any changes were associated with changes in cardiovascular structure/function. This was a secondary analysis of data from a prospective, randomised, open-label, blinded end-point trial of people with T2D, with a nested case–control [NCT02590822]. Anthropometrics, cardiac resonance imaging and fasting blood samples (to quantify vitamins B1, B6, B12, D and C; and iron and ferritin) were collected at baseline and 12 weeks following the MRP or routine care. Comparative data in healthy controls were collected at baseline. A total of eighty-three people with T2D and thirty-six healthy controls were compared at baseline; all had micronutrient status within reference ranges. Vitamin B1 was higher (148⋅9 v. 131⋅7; P 0⋅01) and B6 lower (37⋅3 v. 52⋅9; P 0⋅01) in T2D v. controls. All thirty participants randomised to routine care and twenty-four to the MRP completed the study. There was an increase in vitamins B1, B6, D and C following the MRP, which were not associated with changes in cardiovascular structure/function. In conclusion, changes in micronutrient status following the MRP were not independently associated with improvements in cardiovascular structure/function in people with T2D.

Effect of fish paste products, fish balls ‘tsumire’, intake in Sprague–Dawley rats

The fish paste product, fish balls ‘tsumire’, is a traditional type of Japanese food made from minced fish as well as imitation crab, kamaboko and hanpen. Although tsumire is known as a high-protein and low-fat food, there is a lack of scientific evidence on its health benefits. Hence, we aimed to investigate the effects of tsumire intake on organ weight and biomarker levels in Sprague–Dawley rats for 84 d as a preliminary study. Six-week-old male Sprague–Dawley rats were divided into two groups: group I, fed normal diets, and group II, fed normal diets with 5 % dried tsumire. Throughout the administration period, we monitored their body weight and food intake; at the end of this period, we measured their organ weight and analysed their blood biochemistry. No significant differences were observed with respect to body weight, food intake, organ weight and many biochemical parameters between the two groups. It was found that inorganic phosphorus and glucose levels were higher in group II rats than in group I rats. On the other hand, sodium, calcium, amylase and cholinesterase levels were significantly lower in group II than in group I. Interestingly, we found that the levels of aspartate aminotransferase, alanine transaminase, lactate dehydrogenase and leucine aminopeptidase in group II were significantly lower than in group I, and that other liver function parameters of group II tended to be lower than in group I. In conclusion, we consider that the Japanese traditional food, ‘tsumire,’ may be effective as a functional food for human health management worldwide.