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Background Children with congenital heart disease (CHD) frequently become malnourished due to many factors including hypermetabolic state, inadequate caloric intake, malabsorption, and fluid restriction as part of the hemodynamic intervention. The abnormal nutritional status may affect early outcome after pediatric cardiac surgery; we aim to prove the importance of nutritional assessment and patient nutritional preparation before performing pediatric cardiac surgery. Results We conducted a prospective observational cohort study from March 2013 till January 2015. All children from birth until 14 years of age admitted to the pediatric cardiac intensive care unit (PCICU) after cardiac surgery. Nutritional status was assessed preoperatively and prognostic nutritional index (PNI) was calculated. All post-operative outcome parameters, PCICU and hospital length of stay (LOS), ventilation time, the rate of infection, and ICU mortality were recorded. Two hundred fifty-nine children were evaluated. At admission, 179 patients (69%) had intake less than 50% of the recommended daily allowance (RDA) of calories intake. There was a statistically significant relationship between pre-admission RDA and the infection rate (P value 0.018). Severely malnourished patients had significantly longer ICU length of stay (LOS) (P value = 0.049). Similarly, weight and height percentiles have a significant effect on ICU LOS (P value 0.009 and 0.045) respectively. There was a significant relation between PNI ≥ 55 and the ICU LOS (P < 0.05), and ventilation time (P = 0.036). Delay in feeding postoperatively was associated with a higher risk of infection (P = 0.005), and higher mortality (P = 0.03). Conclusions Children with CHD were significantly malnourished preoperatively and had further weight loss postoperatively. Preoperative nutritional status and delayed postoperative enteral feeding were associated with a higher infection rate and mortality.

BACKGROUND Developing food-based dietary guidelines (FBDGs) for infants and toddlers is a complex task that few countries have attempted. OBJECTIVES Our objectives are to describe the process of food pattern modeling (FPM) conducted to develop FBDGs for the Dietary Guidelines for Americans, 2020-2025 for infants 6 to

BACKGROUND Americans are underconsuming essential nutrients while overconsuming several nutrients, including sodium, saturated fat, and added sugars. Suboptimal nutrition may be linked with mortality risk; however, few studies have evaluated the associations of underconsumed and overconsumed nutrients in a comprehensive manner among the US population. OBJECTIVES This study investigated the association between nutrient intake through diet and mortality focusing on adequacy, moderation, and macronutrient quality in US adults. METHODS Based on the 1999-2010 NHANES, 20,602 adults aged ≥30 y were followed up until December 2015. Nutrient intake was assessed using a 1-d 24-h dietary recall. Adequacy of major underconsumed nutrients in the United States was evaluated using the RDA (percent of RDA) or Adequate Intake (percent of AI). Overconsumed nutrients for which moderation is needed were assessed based on various dietary recommendations. Macronutrient quality was evaluated using the ratio of carbohydrates to dietary fiber, essential amino acids, and EPA + DHA. The association between nutrient intake and mortality was evaluated using Cox proportional hazards regression analysis. RESULTS Higher intakes of vitamin E, magnesium, iron, dietary fiber, and potassium relative to the RDA/AI were associated with lower all-cause mortality. High intake of vitamin A (tertile 3: ≥80.1% of RDA) was associated with lower mortality from cardiovascular disease (CVD; HR: 0.75; 95% CI: 0.57, 0.99) and cancer (HR: 0.76; 95% CI: 0.62, 0.94), and high intake of calcium (tertile 3: ≥87.8% of RDA) was inversely associated with cancer mortality (HR: 0.72; 95% CI: 0.56, 0.93). Higher intakes of essential amino acids and EPA + DHA evaluated as quartiles were inversely associated with all-cause and CVD mortality. CONCLUSIONS These findings suggest that higher intakes of underconsumed nutrients and improving macronutrient quality are associated with lower risk of CVD and cancer deaths in US adults.

The associations between selenium and liver stiffness and steatosis remain uncertain. This study aimed to explore the clinical relevance of selenium with liver stiffness and steatosis in adults from the 2017-2018 National Health and Nutrition Examination Survey. Subjects with excessive alcohol consumption and hepatitis B or C infection were excluded. Liver stiffness and steatosis were detected by transient elastography. Dietary selenium intakes and blood selenium concentrations were included as exposures. In multivariate analysis without adjustment for obesity, higher dietary selenium intakes (tertile 3 vs. tertile 1) were positively associated with liver stiffness in females (odds ratio (95% confidence interval): 2.64 (1.88-3.70)), and were positively associated with liver steatosis overall (1.54 (1.20-1.97)) and also in males (1.55 (1.06-2.26)). In multivariate analysis without adjustment for obesity, higher blood selenium concentrations (tertile 3 vs. tertile 1) were positively associated with liver steatosis overall (1.33 (1.02-1.76)) and also in males (1.56 (1.13-2.16)). After further adjustment for obesity, the abovementioned associations remain significant between dietary selenium intakes and liver stiffness in females (2.29 (1.69-3.12)) and liver steatosis overall (1.37 (1.01-1.86)), and between blood selenium concentrations and liver steatosis in males (1.67 (1.25-2.21)). Dose-response analysis showed that the abovementioned associations were linear. However, dietary selenium intakes meeting the recommended daily allowance (≥ 55 µg/day) were not associated with liver stiffness (0.99 (0.62-1.55)) and steatosis (1.01 (0.69-1.49)). In conclusion, higher dietary selenium intakes and blood selenium concentrations were positively associated with liver stiffness and steatosis, and obesity may partially account for the observed associations.

Purpose The aim of this study was to evaluate the nutrient content consumed by children and adolescents on home-prepared versus chef-prepared specific carbohydrate diets (SCD) as therapy for inflammatory bowel disease (IBD). Methods Dietary intake of two cohorts with active IBD initiating the SCD over 12 weeks was assessed. The home-prepared cohort received detailed guidance from dietitians on implementation of the SCD. The chef in the other cohort was knowledgeable in the SCD and prepared meals from a fixed set of recipes. Data from 3-day diet diaries at 4 different time points were collected. US Recommended Daily Allowances (RDA) were calculated for macronutrients, vitamins, and minerals. Results Eight participants on the homemade SCD and 5 participants on the chef-prepared SCD were included in analysis. Mean % RDA for energy intake was 115% and 87% for homemade and chef-prepared groups (p

Side effects of nutritional supplements, Edited by F. Anselmo, M.S. Driscoll Where on earth did the copy editor decide to do this?Abstract Vitamin and mineral supplement consumption is widespread. They are taken for a variety of conditions, including dermatologic disorders. Although consumers often assume these supplements are safe, excessive consumption of supplements may have deleterious effects. Such vitamin supplements include vitamin A, niacin, biotin, vitamin D, and vitamin E, and specific mineral supplements include zinc, copper, and iron. These supplements may have a number of potential adverse effects.

Canned sardine fish is consumed regularly in all countries. The levels of heavy metals which are present in the environment could constitute a hazard to food security and public health. These can be accumulated in aquatic animals such as fish. In this study, selected heavy metals: Copper (Cu), Nickel (Ni), Chromium (Cr), Zinc (Zn), Cadmium (Cd), Manganese (Mn), Lead (Pb) and Iron (Fe) were evaluated in Sardines that are commonly consumed in Nigeria. Eight different brands of canned sardines were purchased in Yenagoa and were taken to the Laboratory for heavy metal analysis. Standard wet digestion procedure was adopted for sample preparation while Atomic Absorption Spectrophotometer (AAS) technique was adopted for metal analysis. The results show that heavy metal concentrations of Fe in the samples were above World Health Organization (WHO) and United States Environmental Protection Agency (USEPA) permissible limits, while Zn was below the permissible limits. However, Pb, Cu, Cd, Cr, Ni and Mn were below detectable limits in all the samples. Daily intake of metal (DIM) values in the sardine samples for Zn and Fe were significantly lower than the recommended daily intake and the upper tolerable daily intake levels. The Health risk index (HRI), Target hazard quotient (THQ) and Hazard Index (HI) for Zn and Fe in this study were less than 1(˂1) for both adult and children, therefore, the canned sardines does not pose a potential human health risk concern for the consumers. However, the high Fe concentrations in all the sardine samples may cause public health concern as they are above WHO and USEPA tolerable limits.

PURPOSE To explore whether there is an association between dietary choline intake and odds of diabetic retinopathy (DR) in the US diabetic population. METHODS A cross-sectional study was conducted using the combined data of the National Health and Nutrition Examination Survey (NHANES) 2005-2008 of a complex, multistage, and probability-sampling design. Energy-adjusted choline intake was calculated separately for men and women using the residual method. Binary logistic regression adjusting for covariates was used to identify the variables associated with DR. RESULTS We included 644 male and 628 female diabetic subjects, which were equivalent to a weighted survey sample of 9,339,124 for males and 10,109,553 for females respectively. Female DR patients consumed more choline than non-DR patients (268.6 mg/d vs 250.9 mg/d; p = .046). The estimated prevalence of DR was 17.4%, 21.9%, and 29.7% across three levels of dietary choline intake in females, respectively. In multivariable logistic-regression models, the odds ratio (OR) of DR for female patients in the highest choline intake group was 2.14 (95% confidence interval [CI], 1.38-3.31; p = .001) compared with those in the lowest intake group. This association was positive but not statistically significant in males. CONCLUSION Higher intake of dietary choline is associated with increased odds of DR in females, but not in males. Further studies are warranted to investigate the direct role of choline in DR development and determine the recommended daily intake of choline for diabetic patients weighing the pros and cons of dietary choline consumption.

Background Emerging evidence suggests that a dietary protein intake higher than the current recommended dietary allowance of 0.8 g/kg body weight (BW)/d may be needed to maintain optimal muscle mass, strength, and function in older adults. However, defining optimal protein intake in this age group remains a challenge. Objective In this study we sought to describe the dietary protein intake in frail, prefrail, and robust older Taiwanese adults. Methods Data for 1920 older adults were collected from the Nutrition and Health Survey in Taiwan from 2014 to 2017. Dietary intake was assessed using the 24-h recall method. Frailty was determined using the modified Fried's criteria. Body composition was assessed using DXA. Sex-specific dietary protein intakes, measured as values/kg of BW, fat-free mass (FFM), and lean mass (LM), were estimated for the 3 age groups (65-69, 70-79, and ≥80y) and the 3 frailty levels. Results In both males (P for trend = 0.034) and females (P for trend = 0.015), there were significant downward trends for protein intake/kg of BW with the severity of frailty. The age-adjusted protein intake/kg of BW was still significant in males (P for trend = 0.009), but no longer in females. This phenomenon was also seen for protein intake at lunch and dinner but not at breakfast. Age-adjusted trends for protein intake/kg FFM or LM were not significant in either sex. The median protein intake in robust older males and females was 1.21 and 1.19 g/kg BW/d, respectively, and the mean intakes were even higher. Conclusion Median protein intake in robust Taiwanese older adults was approximately 1.2 g/kg BW/d, with higher mean values. The protein adequate intake in Taiwanese older adults was higher than the current recommended daily allowance (RDA) level but within the RDA range derived from the state-of art indicator amino acid oxidation technique.

The paper examined the incidence, depth and severity of food insecurity among farming household in Sokoto, Nigeria. Data was collected with aid of questionnaire from a total of 440 farming households comprising of (220 beneficiaries and 220 non-beneficiaries of BOA) were randomly selected using four multistage sampling techniques. The data generated was analysed using FGT index. The result for the incidences of food insecurity as indicated by head count ratio shows that 39.55% and 48.18% of food insecure farming households beneficiary and nonbeneficiary respectively were not able to meet their recommended daily allowance (RDAs) which is 2,250 kcal valued at N278.40/person equivalent to 0.87 USD. The coefficient of food insecurity depth (gap) shows that 19% of beneficiary and 44% of non-beneficiary food insecure farming households are below the recommended daily calorie requirement. The severity of food insecurity shows that 3.6% of beneficiaries’ food insecure farming households are most food insecure in the study area as compared with 19% non-beneficiaries’ food insecure farming households. High incidence, depth and severity of food insecurity among non-beneficiary food insecure farming households, indicated that BOA has impacted on beneficiary farming households by increasing their food security status. Therefore, this study recommends financial policies that ensure financial support to farming households most especially non-beneficiary in the study area.

Introduction: Obesity is associated with nonalcoholic fatty liver disease (NAFLD) in children. Our aim was to analyze the association of dietary and sociodemographic factors with NAFLD in obese children and adolescents. Materials and methods: Thirty-three obese patients from 6-16 years of age were included in the present analytic cross-sectional study. Obesity was diagnosed with a body mass index z-score > 2 SD. NAFLD was estimated by liver ultrasound, serum amino transferases, and elastography. The sociodemographic variables were evaluated using validated questionnaires. Diet was estimated through two 24-h recall dietary surveys focused on the quantity of food energy, simple sugars, polyunsaturated fatty acids (PUFAs), and antioxidants. Results: Hepatic steatosis was identified by abdominal ultrasound in 13 patients (39.4%) and the serum alanine aminotransferase level was above the upper reference value in 54.2%. A higher educational level in both parents, greater monthly food expenditure, and a higher socioeconomic level were associated with NAFLD. Overall, simple sugar and saturated fat consumption was above the recommended daily intake, whereas vitamin E and PUFA consumption was below those parameters. Conclusions: NAFLD was identified in one-third of the cases. There was an association between NAFLD and sociodemographic variables. Both groups had an increased intake of simple sugars and a reduced intake of PUFAs. The selective occurrence of NAFLD could be related to a genetic predisposition that has been demonstrated in a Mexican population. Resumen: Introducción y objetivo: La obesidad se asocia con el hígado graso no alcohólico (HGNA) en niños. El objetivo fue explorar la asociación de factores dietéticos y sociodemográficos con el HGNA en niños y adolescentes obesos. Material y métodos: Treinta y tres pacientes obesos de 6-16 años fueron incluidos en este estudio transversal analítico. El diagnóstico de obesidad se realizó con puntuación z del índice de masa corporal > 2 DE. El HGNA se estimó con ultrasonido hepático, aminotransferasas séricas y elastografía. Las variables sociodemográficas se evaluaron con cuestionarios validados. La dieta se estimó mediante dos encuestas dietéticas por recordatorio de 24 horas enfocadas a la cantidad de energía, azúcares simples, ácidos grasos poliinsaturados (PUFAS) y antioxidantes. Resultados: En 13 pacientes (39.4%) se identificó esteatosis hepática por ultrasonido abdominal; 54.2% tuvieron una concentración sérica de alanina aminotransferasa por arriba de la referencia. El nivel educativo superior de ambos padres, el mayor gasto familiar mensual en alimentos y el mayor nivel socioeconómico se asociaron con HGNA. En el grupo total, el consumo de azúcares simples y grasas saturadas fue excesivo y el consumo de vitamina E y PUFAS estuvo por debajo del parámetro. Conclusiones: Se identificó HGNA en un tercio de los casos. Se demostró asociación entre HGNA y variables sociodemográficas. Ambos grupos tuvieron una ingesta aumentada de azúcares simples y disminuida de PUFAs. La ocurrencia selectiva de HGNA se podría relacionar a predisposición genética demostrada en población mexicana.

Docosahexaenoic acid (DHA) is the predominant omega‐3 long‐chain polyunsaturated fatty acid found in human brain and eyes. There are a number of studies in the literature showing the health benefits of DHA. It is critical throughout all life stages from the need for fetal development, the prevention of preterm birth, and the prevention of cardiovascular disease to the improvements in the cognitive function and the eye health of adults and elderly. These benefits might be related to the modulation of gut microbiota by DHA. In addition, there are some discrepancies in the literature regarding certain health benefits of DHA, and this review is intended to explore and understand these discrepancies. Besides the variations in the DHA contents of different supplement sources, bioavailability is crucial for the efficacy of DHA supplements, which depends on several factors. For example, DHA in phospholipid and triglyceride forms are more readily to be absorbed by the body than that in ethyl ester form. In addition, dietary lipids in meals and emulsification of DHA oil can increase the bioavailability of DHA. Estrogens stimulated the biosynthesis of DHA, whereas testosterone stimulus induced a decrease in DHA. The roles of DHA through human lifespan, the sources, and its recommended daily intake in different countries are also discussed to provide a better understanding of the importance of this review., DHA is critical for all life stages from fetal development to elderly health. The recommended intake of DHA depends on many factors, such as regions, age groups, and genders. DHA supplements are mainly from fish, krill, and algal oils, and the bioavailability of DHA depends on its chemical structure and matrix.

In July 2018, the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária, ANVISA, in Portuguese) published new regulations for food supplements, leading to changes both in the sales denomination and labeling statements, and in the composition of these products. Among dietary supplements, those containing vitamins are the most consumed by the population. The objective of the present work is to discuss the changes in the parameters established for the products containing vitamins, mainly in relation to the required and allowed concentrations of micronutrients, and to verify the impact of these changes for the population since the publication of the new standards. Until July 2018, vitamin-based products containing between 15% and 100% of the recommended daily intake (RDI) of these micronutrients were classified as vitamin supplements; above this dosage, they were considered medicines. The new legislation changed the minimum and maximum limits allowed for vitamin food supplements. Taking into account the maximum vitamin limits established for adults, the most relevant differences were the increase in these limits in a proportion of 100, 76 and 43 times in regarding vitamins E, B6 and C respectively, when compared to those previously established. For the required minimum limits, the major difference was observed for vitamin D, with a four-fold increase in its concentration. In conclusion, changes in legislation can influence the health of the population, so the ideal amounts of vitamin in supplements and the recommendation to consume these products require extensive discussion and reflection.

Graphical abstract, Highlights • Jous are ethnic food beverages of North-East India. • It is the first study on the metal content and health risk assessment of the Jous. • Maximum permissible limits of metals were within the permissible range. • Estimated Daily Intake of Jous were within the limits prescribed by WHO. • No lifelong health risk was associated with consumption of Jou., Food beverage consumption is a worldwide age-old practice. It is also a common run-through habit among the tribes of North Eastern parts of India. The food beverage group Jou is a traditionally fermented rice-based beverage by Bodo community of Assam, the largest plain tribe. It is not only consumed by Bodos on regular basis but also widely used in their socio-cultural activities. Joubidwi (JB, fermented product), Joufinai (JF, preserved product) and Jougwran (JG, distilled) are the three varieties of Jou. Herewith, it had been reported; the concentrations of metals such as Cd, Co, Cr, Cu, Fe, K, Mn, Na, Ni, Pb and Zn in the three varieties of Jou to make people aware about the possible health benefits as well as the risks associated with the consumption of Jou. The metal contents were estimated using ICP-OES after digesting the samples with 10:1 mixture of concentrated nitric and concentrated sulfuric acid. The estimated daily intakes (EDI) of metals from consumption of JB, JF and JG were also within the recommended daily allowances (RDA). From the estimated target hazard quotient (THQ) values, it was observed no health risk associated with the consumption of Jou; whereas total target hazard quotient (TTHQ) of Joufinai were associated with more health risks. Metal concentrations of all metals in Bodo beverages was lower in comparison with barely based and wheat based beverages.

The purpose of the research is development of functional cold sauces using milk whey with the addition of vegetable powders. The prospects for the production of functional cold sauces using milk whey and vegetable powders obtained by infrared drying have been shown. Foreign literature on the research topic has been analyzed, current trends in the production of products for functional nutrition have been highlighted. The urgency of using local raw materials of plant and an- imal origin has been proved. The authors describe the process of obtaining vegetable powders, study the effect of infrared drying on the chemical composition of the produced powders, compare different methods of cutting vegetables and methods of drying, analyze the yield of raw materials and technological characteristics of grinding dried vegetables. The assortment of sauces and their application has been considered. It has been proposed to design a new sauce that has advantages over the most popular cold sauce – mayonnaise. The basic recipe and a new one are presented, with the replacement of ingredients and addition of a functional component. Microscopic examination of sauces has been carried out, differences in structure depending on the raw materials used have been considered. Organoleptic characteristics, their compliance with regulatory documents and differences have been determined. The physicochemical indicators have been investigated. The criteria have been revealed that comply with GOST, and by which the recipe should be finalized. The amount of vitamin C has been determined, the recommended daily intake calculated, taking into account the daily requirement. Calorie content and shelf life have been calculated, and the optimal recipe determined. The main features of the sauce for functional purposes are as follows: the content of dietary fiber, imparting a functional orientation; preservation of the beneficial properties of root crops (vitamins, minerals, etc.) due to infrared drying; lower calorie content; lack of eggs (important for allergy sufferers); the possibility of widespread use in the design of culinary products.

Food and nutrition security interventions have struggled to supply sustainable protein-rich animal source foods in refugee camps due to high costs required and limited resources. Therefore, crickets farming was extended to refugee settings in Kenya as a potential source of protein and income. This paper discusses how cricket farming was introduced in Kakuma refugee camp and the utilization of crickets as food or feed. A thriving cricket colony was established in a site managed by DanChurchAid (DCA) in Kakuma refugee camp. The cricket colony was used to produce and supply cricket eggs to recruited and trained households who belonged to seven different nationalities. The project beneficiaries were selected using purposive sampling based on a set of predefined characteristics. Each household was provided with a cricket-rearing starter kit consisting of wooden pens, hides (carton egg trays), pin-head crickets, feed and water dispenser (cotton wool). Each household harvested 0.5 – 3.0 kg of fresh cricket per cycle of 1–2 months which was used as food (55.65%) or feed (44.35%). The crickets were processed by either sun drying, blanching or frying. The most dominant processing method was the combination of sun drying and frying that constituted 52.17% of the total processing. There was a significant correlation (P 30% of the recommended daily intake of protein and other micronutrients for women and children of different ages. Crickets showed a huge potential in mitigating food and nutrition insecurity in the camp although further efforts are required to strengthen the crickets value chain as food or feed.

The objective of the present study was to increase by dietary means the long-chain polyunsaturated fatty acid (LC-PUFA) n-3 content in selected meat products. Fatty acid (FA) composition, texture, sensory characteristics, and oxidative stability were determined in the Vienna sausages (V-sausages) and Bologna-type salami (B-salami) produced from the meat of six pigs fed a standard feed (control, C) and six pigs fed a standard feed enriched with 8% of fish oil (F), respectively. The saturated FA content in the unheated FV and FB products was decreased (p

Background and objective: Methylmalonic acidemia (MMA) and propionic acidemia (PA) are inborn errors of metabolism. While survival of MMA and PA patients has improved in recent decades, long-term outcome is still unsatisfactory. A protein restricted diet is the mainstay for treatment. Additional amino acid mixtures (AAM) can be prescribed if natural protein is insufficient. It is unknown if dietary treatment can have an impact on outcome. Design: We performed a nationwide retrospective cohort study and evaluated both longitudinal dietary treatment and clinical course of Dutch MMA and PA patients. Protein prescription was compared to the recommended daily allowances (RDA); the safe level of protein intake as provided by the World Health Organization. The association of longitudinal dietary treatment with long-term outcome was evaluated. Results: The cohort included 76 patients with a median retrospective follow-up period of 15 years (min -max: 0-48 years) and a total of 1063 patient years on a protein restricted diet. Natural protein prescription exceeded the RDA in 37% (470/1287) of all prescriptions and due to AAM prescription, the total protein prescription exceeded RDA in 84% (1070/1277). Higher protein prescriptions were associated with adverse outcomes in severely affected patients. In PA early onset patients a higher natural protein prescription was associated with more frequent AMD. In MMA vitamin B12 unresponsive patients, both a higher total protein prescription and AAM protein prescription were associated with more mitochondrial complications. A higher AAM protein prescription was associated with an increased frequency of cognitive impairment in the entire. Conclusion: Protein intake in excess of recommendations is frequent and is associated with poor outcome. 0 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Consumption of yerba mate occurs mostly in the form of hot infusion (chimarrao). Water solubility of elements found in commercialized yerba mate is needed to establish nutritional value and risks associated with potentially toxic elements. In this study, yerba mate products marketed in three Brazilian states (Parana, Santa Catarina, and Rio Grande do Sul) for chimarrao were analyzed. Total (dry product) and hot water-soluble concentrations of Al, As, B, Ba, Ca, Cd, Co, Cs, Cu, Fe, K, Li, Mg, Mn, Mo, Ni, P, Pb, Rb, S, Se, Sr, Ti, V, and Zn were determined by inductively coupled plasma mass spectroscopy (ICP-MS). Total concentrations of the ten top elements followed the order of K>Ca>Mg>Mn>P>S>Al>Fe>Ba>Zn. The most soluble elements were B, Cs, Ni, Rb, and K, with values greater than 80%. The lowest water-soluble elements were V, Fe, and Ti (values

Geophagic clay consumption, which is an age-long cultural practice by humans and animals in many parts of the world, and particularly in Nigeria, may have long time health effects on the consumers. This is particularly so because of the relatively high concentration of harmful minerals and toxic elements. This study sought to determine the mineralogical and trace element compositions of geophagic clay in Uteh-Uzalla area, which is underlain by the Benin Formation of Oligocene to Miocene age, in order to evaluate the potential health risk associated with the consumption of the clay. Sixteen clay samples were collected from mine face profiles of an open pit, analysed for mineral and trace element compositions, using x-ray diffraction technique and ultra-trace inductively coupled plasma mass spectrometry (ICP-MS) methods, respectively. The mean mineral concentration in % includes kaolinite, quartz and smectite (64.88, 19.98, and 9.54), respectively, among other minerals. And the mean concentrations in mg/kg for Cu (15.0), Pb (14.4), Zn (30.9), Co (8.9), Mn (39.4) and Th (10.5) among other elements were found in the clay. From the trace elements results when compared with health risk indices by Agency for Toxic Substances and Diseases Registry (ATSDR): Minimum Risk Level, recommended daily intake and estimated daily intake, it was found that the elements are far above the daily oral intake requirement. Also, considering the relatively low pH (acidic) values that were exhibited by the clays, harmful minerals and elements contained in the clay may be bioavailable in the internal system among those who are frequently involved in the consumption of the clay.

Summary Background & aims Dietary minerals have significant effects on the risk of cardiovascular disease. However, the results of previous studies were not uniform across different countries. The current study aims to determine the causal effects of dietary calcium, zinc, and iron intakes on coronary artery disease (CAD) among Nepalese men. Methods A matched case–control study was carried out at Shahid Gangalal National Heart Center. Dietary intakes of 466 male participants over the past 12 months were evaluated using a semi-quantitative customized food frequency questionnaire. G-estimation and inverse probability treatment weighting (IPTW) analyses were performed to determine the causal odds of CAD due to dietary calcium, zinc, and iron intakes. Results Daily dietary calcium, zinc, and iron intakes were categorized into two groups: less than versus more than the median value and less than versus equal or more than recommended daily allowance (RDA). In G-estimation, dietary calcium intake was inversely associated with CAD in both medians (OR: 91; 91%CI: 0.86, 95) and RDA categories (OR: 0.88: 95%CI: 0.84, 0.97). However, in IPTW analysis, only median calcium intake was significantly associated with CAD (OR: 7; 91%CI: 0.5, 98). We observed a significant inverse association of equal or more than RDA of dietary zinc intake with CAD (OR: 0.91: 95%CI: 0.87, 0.96 in G-estimation, OR: 0.73: 95%CI: 0.66, 0.82 in IPTW); however, more than median dietary zinc intake showed inverse but not significant association with CAD in both analyses. Dietary iron intake was inversely but not significantly associated with CAD in G-estimation in both groups. Nevertheless, in IPTW analysis, equal or more than RDA iron intake was significantly positively (OR: 1.4; 95%CI: 1.14, 1.73) related to CAD. Conclusions A significant inverse association of dietary zinc intake above RDA indicates the potential protective effect of higher dietary zinc against CAD. However, causal odds of CAD are inconsistent across the median or RDA of calcium and iron intakes. Therefore, cohort and randomized clinical trial studies with a large sample size are recommended to substantiate these nutrients’ causal link with CAD development in the Nepalese population.

Adequate magnesium intakes are associated with lower diabetes, hypertension, and cardiovascular disease (CVD) risk but are low in modern diets. Magnesium DRIs, estimated using standard reference body weights (SRBWs) lower than current mean US adult body weights (BWs), need revision. Magnesium DRIs assume variance at 10% CV, whereas balance study data suggests 20–30% CV. Here, estimated average requirements (EARs), the DRI measure estimating average magnesium requirements for healthy adults, were corrected using 2011–2014 mean US adult BWs. Magnesium EARs (in mg magnesium/d) increased 17% for men (330–350 to 386–409) and 25% for women (255–265 to 319–332). RDAs, the DRI measure meant to cover the magnesium needs of 98% of healthy adults, were calculated using BW-corrected EARs given 3 CV levels: 1) 10% (assumed in 1997 DRIs), 2) 20% (model-derived variance from USDA magnesium studies), and 3) 30% (using USDA plus older human magnesium balance data). BW-corrected magnesium RDAs (in mg magnesium/d) rose from 400–420 and 310–320 for men and women, respectively, to 1) 463–491 and 383–398 (16.5% and 23.5% increases), 2) 540–573 and 447–465 (35.5% and 44.5% increases), and 3) 617–654 and 511–531 (55% and 65.5% increases). These recalculations move magnesium intakes estimated to prevent disease into ranges found in traditional diets and to intake levels shown to lower hypertension, diabetes, and CVD risk. In conclusion, mean BW rises over the last ≥20 y and data-driven estimates of CV indicate that reliable US adult magnesium RDAs are ≥60–235 and 70–210 mg magnesium/d higher for men and women, respectively, than the current 1997 RDAs. US adult BMIs are 25 with actual mean BWs. Adjustments for rising BW are necessary for magnesium DRIs to remain useful tools for defining magnesium intake adequacy/deficiency.

Introduction 1 in 2 women and 1 in 5 men will suffer a fragility fracture. Research into calcium and vitamin D supplements has found no consistent evidence to suggest that they reduce the risk of osteoporotic fractures. There has been little research to suggest that dietary calcium is effective at reducing the risk osteoporotic fractures, but supplements have been linked to increased risk of cardiovascular disease and urinary stones. Bisphosphonates have been shown to reduce the risk of osteoporotic fractures and are usually taken in combination with calcium and vitamin D supplements given that deficiencies must be corrected prior to starting. This study set out to assess the dietary calcium intake of patients who attend the falls clinic and explore their attitudes towards dietary change, as an alternative or adjunct to a calcium and vitamin D tablet. Methods Data was collected during private interviews conducted with patients who attended the falls clinic. The Edinburgh University Centre for Genomic and Experimental research (CGEM) food frequency calculator was used to calculate dietary calcium intake. Microsoft Excel was used to collate and analyse the data. Results No association was found between dietary calcium intake, age and sex. We did find that mean dietary calcium intake was significantly less than the recommended daily amount for adults with osteoporosis, with 80% not getting their recommended daily intake (p Conclusion This study has identified a group of patients who will hopefully benefit from a leaflet on sources of dietary calcium and as result improve their bone health.

Edible insects are a suitable source of valuable nutrients that can meet the nutritional requirements for humans. Published scientific data on their nutritional value has been on the rise in the last decade. There are, however, huge disparities in the nutrient values found in the publications hence the need to appraise the data for quality, collate the results, and give an opinion on the nutrient potential of the insects. Nutritional data were searched systematically from published research articles using Google Scholar, PubMed, Scopus, and Web of Science. A total of 483 published scientific journal articles were obtained and screened for quality based on European Food Information Resource (EuroFIR) guidelines with data from 26 articles meeting the criteria by scoring above 17.5 out of 35 points. A total of 91 insect species in 135 data lines were identified in the search. The results showed a wide variety of nutrient content among different species. The highest and the lowest recorded values for macronutrients were; Carbohydrates: 94.01g/100g, 0.1g/100g; Protein: 81.11g/100g, 1.11g/100g; and Fat: 77.01g/100g, 2.11g/100g. The highest energy value was 762 Kcal/100g and the lowest was 268.3 Kcal/100g. The highest and lowest values for fatty acids were; SFA: 733.46mg/100g, 17.50mg/100g; MUFA: 165.80mg/100g, 5.67mg/100g; and PUFA: 1514.32mg/100g, 3.70mg/100g. For minerals, potassium had the highest reported value of 2515mg/100g while copper had the lowest reported value of 0.0073mg/100g. Among the vitamins, vitamin E had the highest recorded value of 0.925mg/100g while vitamin C had the lowest recorded value of 0.0046mg/100g. The highest recorded value for amino acids was 96.02mg/g of protein for leucine and the lowest reported value was 1.19mg/g of protein for methionine+cysteine. The data shows a great variation even within species and regions, attributable to diet (feeding regime), sex, geographical source, and growth stage. The quality of published data was deficient leading to a high number of papers not meeting the EuroFIR criteria, majorly attributed to the number of analytical samples used during analysis However, the data indicate that edible insects are a good source of nutrients and can be used to fight undernutrition with some insect species providing a significant contribution to the Recommended Daily Allowance. Researchers need to address themselves to data quality when conducting nutritional analysis.

Background Clinical practice guidelines of dietary management are designed to promote a balanced diet and maintain health in patients undergoing haemodialysis but they may not reflect patients’ preferences. We aimed to investigate the consistency between the dietary intake of patients on maintenance haemodialysis and guideline recommendations. Methods Cross-sectional analysis of the DIET-HD study, which included 6,906 adults undergoing haemodialysis in 10 European countries. Dietary intake was determined using the Global Allergy and Asthma European Network (GA2LEN) Food Frequency Questionnaire (FFQ), and compared with the European Best Practice Guidelines. Consistency with guidelines was defined as achieving the minimum daily recommended intake for energy (≥ 30 kcal/kg) and protein (≥ 1.1 g/kg), and not exceeding the maximum recommended daily intake for phosphate (≤ 1000 mg), potassium (≤ 2730 mg), sodium (≤ 2300 mg) and calcium (≤ 800 mg). Results Overall, patients’ dietary intakes of phosphate and potassium were infrequently consistent with guidelines (consistent in 25% and 25% of patients, respectively). Almost half of the patients reported that energy (45%) and calcium intake (53%) was consistent with the guidelines, while the recommended intake of sodium and protein was consistent in 85% and 67% of patients, respectively. Results were similar across all participating countries. Intake was consistent with all six guideline recommendations in only 1% of patients. Conclusion Patients on maintenance haemodialysis usually have a dietary intake which is inconsistent with current recommendations, especially for phosphate and potassium.

Background Maternal malnutrition is a global concern whose consequences for newborns are intrauterine growth retardation, fetal hypotrophy and exposure to risks of pathologies in adulthood. Objective The aim of this study was to assess and compare the diet quality and nutritional status of pregnant women at the time of childbirth while assessing their newborn's weight at birth. Materials and methods The study involved 400 parturient, divided into two groups of 200 each, the controls who have just given birth to newborns of normal weight and the cases who have just given birth to babies of low birth weight (LBW). Information on food intakes and dietary habits were collected using questionnaires and anthropometric parameters were measured. Results The mean body mass index (BMI) of the cases was 25.93 ± 2.64 kg/m2 vs. 28.25 ± 2.75 kg/m2 in the controls. The dietary diversity and variety scores were higher in the controls than in the cases. Indeed means were 6.87 ± 1.30 vs. 8.88 ± 1.35 food groups for the diversity scores and 11.77 ± 1.57 vs. 15.90 ± 2.09 food items for the variety scores in the cases and the controls respectively. The average daily intakes of folates, calcium, iron and zinc were lower than the Recommended Daily Allowances (RDA) for both groups. The daily calcium intake represents only 1/5th of the RDI for the cases and 1/3 for the controls. Average dietary iron intake was insufficient at only 49% of the daily requirement for cases vs. 66.88% for controls while folates accounts for 64.33% of the RDA for the cases. Conclusion Data from this study shows that the diets of women who have given birth to low birth weight infants are poorly diversified, poorly varied, and poor in certain nutrients essential for a successful pregnancy and childbirth.

In recent years, significant progress has been made at the global level in eliminating of iodine deficiency. However, until recently, there has been a gap in methods for estimating iodine intake with industrially processed foods (IPF) produced with iodized salt (IS). The aim of this work was to study the iodine consumption with IPF and kitchen salt by the adult population and pregnant women in Armenia and Moldova. Material and methods. For modeling iodine consumption, a special matrix based on MS Excel spreadsheets was used, into which data on the average per capita daily consumption of the main IPF, salt content in IPF, the share of IPF produced with IS in the total volume of their consumption, percentage of households using IS, and the iodine content in salt according to the national standard were entered. Results and discussion. The estimated average daily salt consumption per capita of the adult population of Armenia was 10.6 g. Due to the use of IS in 93% of households and in the production of 82% of bakery products, 7% of cheese, 83% of meat products, 44% of canned vegetables and 5% of pasta, iodine intake in adults was 149% of the recommended daily allowance (RDA). Bakery products and iodized kitchen salt were the main sources of iodine (66 and 70% of the RDA respectively), and the share of other IPF did not exceed 13%. In Moldova, salt consumption was 11.9 g per day. Due to the use of IS for the production of 50% bakery products, 12% of canned vegetables and 20% of pasta, iodine consumption in adults in Moldova amounted to 74% of RDA almost entirely due to bakery products and kitchen salt (37 and 35% of the RDA respectively). The median urinary iodine concentration indicated adequate iodine intake in both countries and was significantly higher in Armenia (242 μg/L) than in Moldova (136 μg/L). A planned 30% reduction in salt intake may lead to an inadequate reduction in iodine intake in pregnant women. Conclusion. Adequate iodine intake among the adult population of Armenia and Moldova is ensured mainly through the use of IS in households and in the production of bakery products.

Improving the quality of nutrition for children with gluten intolerance in preschool institutions is an important state task. Relevant adjustment of the diet enables to reduce the risk of the celiac syndrome. Balanced nutrient composition of diet is necessary for the harmonious growth and development of a child. The aim of the research was to develop specialized diet for children with gluten intolerance and celiac desease in municipal preschool educational institutions. Material and methods. A study of the 10-days full-day menu of children aged 3 to 7 years was carried out. To compose the specialized menu, we used the computational program "MDOU Calculate menu. Universal program for kindergarten". Technological maps of dishes in municipal preschool educational institutions were used. The calculation of the supply of the diet with vitamins, minerals and trace elements and the deviation of the nutritional and energy value of the diet from the recommended daily intake was made. Results. The necessity of developing a specialized diet for children 3-7 years old with a confirmed diagnosis of celiac disease, as well as for children on a gluten-free diet has been substantiated. A specialized daily food ration has been developed, consisting of four meals. Analysis of the nutritional and energy value of the dishes offered in the menu showed the minimum deviation of the obtained indicators from recommended daily intake. The necessity of introducing the developed diet into the system of specialized nutrition in preschool educational institutions has been substantiated. Conclusion. The results of the work indicate that under the conditions of state funding, there is a possibility of adjusting the existing food rations for the full-fledged socialization of children with various diseases.

Introduction The purpose of this study was to demonstrate the feasibility of a phototherapy kiosk (PK) to engage community adults in health promotion and to stimulate production of circulating 25-hydroxyvitamin (OH)D as effectively as a vitamin D3 oral supplement (OS). Although optimal production of vitamin D comes from sun exposure, ultraviolet B radiation with a wavelength of 290 to 320 nm penetrates exposed skin and may produce vitamin D3 using a PK. Materials and Methods A prospective study was conducted with adults randomized to either six PK treatments or D3 OS for 10 weeks. Serum 25(OH)D was drawn at baseline, 10 weeks, and 14 weeks. Primary outcome was serum 25(OH)D level. Mann–Whitney test was used to assess continuous data and Chi squared test for pairwise comparisons of categorical data. Significance was set at P Results With 18% attrition, final sample size was 88; OS, n = 45, PK, n = 43. Sample was mostly female (60%), median age 35 years, with no differences observed between groups for age, race/ethnicity, marital status, military affiliation, or season of enrollment. Median daily intake of calcium and vitamin D was well below the recommended daily allowance for each nutrient, and group. Baseline median serum 25(OH)D levels were similar. By 10 weeks, PK median level was 30 ng/mL (interquartile range [IQR] 25.8-37.0) and OS was 26 ng/mL (IQR 21.5-30.5), P = .02. The difference in 25(OH)D levels persisted at 14 weeks; the PK group returned to baseline, 27 ng/mL (IQR 22.0-32.5), and OS group declined to 21 ng/mL (IQR 17.0-30.0), P = .02. Conclusion Programmed ultraviolet B phototherapy appears to be an efficacious alternative to oral vitamin D supplementation with consistent use.

Roselle—Hibiscus sabdariffa L. leaves at different stages of growth, calyces and seeds were analyzed for nutritional and anti-nutritional factors. All the treatments contained a good but varied proportion of carbohydrate in a range of 26.93–54.13%, crude protein from 5.7 to 27.06%, crude fat 1.16–13.09%, crude fibre 15.75–36.10%, energy 631.36–1065 kJ, ash 6.08–13.74% and moisture content 6.00–9.7%. The vitamins A, C and E were also found to be present in all the treatments in a different but substantial amount. The calcium, magnesium and iron contents in all the treatments were higher than the recommended daily allowance of 1250, 350, and 15 mg for adults, while the phosphorus and sodium values in all the treatments were below 1000 and 1500 mg RDA for adults. However, the Na + /K + for all the treatments were lower than 1. The values of anti-nutrients in the samples were small except post-flowering red which had high phytate content of 21.02%, although this can be easily reduced during processes like boiling and cooking. Thus, both cultivars of roselle contain high nutritional, elemental, and vitamins compositions and small content of anti-nutrients.

Various instant foods for the elderly began to be developed. Binte biluhuta is an indigenous nusantara soup from Gorontalo with the main ingredient are corn and skipjack. The unique characteristic of soup is potential became special food that can be served for elderly, how ever the calcium content that is very low and the presence of oxalic acid still being abstacle. Fish bone was a natural source of calcium. The research objectives were to design special nutrient instant food for elderly based on binte biluhuta indigenous food from Gorontalo enriched with fish bone nanomineral. The research included calcination of fish bones at a temperature of 600 ?C for 6 hours and reduced the size with nanomilling became nanomineral. Binte biluhuta cream soup was designed according to the Recommended daily intake (RDI) of the elderly. Characteristics quality was determined in order to develop microwave cooking. Particle size of nanomineral catfish bone was 70-100 nm, white color and contained 852000 ± 15.08 mg/Kg calcium, phosphorus 146300 ± 43.89 mg/Kg and magnesium 4410 ± 0.44 mg/Kg. Binte biluhuta instant cream soup with rasio of corn and fish 15: 1 served using microwave cooking and fortified 0.84 g nanomineral fish bone from 30 g binte biluhuta instant cream soup, contained 57470.39 ± 57.87 mg/Kg amino acids and 1.08 ± 0.06 mg/Kg oxalic acid. Binte biluhuta instant cream soup as much 30 g can fulfilled the needs of elderly calcium 51.47% and energy 88.65 Kcal.

Vitamin A is a fat-soluble vitamin. It is essential for vision, especially dark adaptation, immunity, bone growth and reproduction, maintain surface of cornea and sclera, and epithelial integrity of respiratory, urinary and gastro intestinal tract. Vitamin A also has a role in gene expression. Recommended daily allowance for children ranges from 400 to 700 μg. Normal plasma retinol levels are 20–50 μg/dL. Deficiency results in problems in the eye and vision, cellular differentiation, and functionality of the humoral and cell mediated immune system.World Health Organization recommends supplementation approaches in children between 6 and 59 months of age in certain populations at risk of deficiency.

Iron fortification is an effective strategy that can be implemented to ensure supply and intake of iron for the public at large. Even though iron-fortified foods are widely available in the Sri Lankan market, the quantification of iron in those foods is not under the regulations of the food authorities in Sri Lanka. Therefore, this study aims to quantify the concentration of iron in selected iron-fortified foods available in the local market and determine their contribution to the recommended daily allowances (RDA) per serving. The iron content in most popular powdered milk, biscuits, and breakfast cereals among the children of 15-16 years in Horana Divisional Secretariat was analyzed using atomic absorption spectroscopy, and its contribution to RDA was calculated. The average iron values of iron-fortified milk powder (IFMP), iron-fortified biscuit (IFB), and iron-fortified breakfast cereals (IFBC) were found to be 18.08 ± 9.53, 7.88 ± 0.07, and 17.78 ± 7.47 mg/100 g, respectively. The average estimated daily intake (EDI) per serving of IFMP, IFB, and IFBC was 3.61 ± 1.75, 2.13 ± 0.06, and 5.60 ± 1.45 mg, respectively. The highest contribution to the RDA can be obtained by a single serving of IFBC. Only less than half of the tested products have compatible iron levels with their labeled information. Iron-fortified foods which were studied have a high amount of iron, and they can make from 5% to 35% contribution to RDAs in young children, adolescents, and adults even by a single serving.

This study was designed to evaluate heavy metal status in commonly consumed foodstuffs collected from two divisional cities, viz., Chottogram and Mymensingh of Bangladesh and to assess potential human health risks through the consumption of those foodstuffs. A total of 90 food samples were analyzed for Cu, Zn, Ni, Pb, Mn, and Fe contents by an atomic absorption spectrophotometer. The calculated per capita per day dietary intakes of Cu and Mn from rice and Mn’s same value through spinach consumption in both cities were higher than the recommended daily allowances (RDA) for an adult human. Similarly, the computed daily metal intake (DMI) values of Pb for both males and females were also higher than the upper tolerable intake level (UTIL) through the consumption of rice collected from Mymensingh city. The average calculated hazard index (HI) values for males and females due to dietary intake of rice were 47.67 and 93.30 in Chottogram city and 97.98 and 192.04 in Mymensingh city, respectively. The present study identified rice as the most contaminated food item, followed by spinach, brinjal, and lentil. Still, dietary intakes of beef, broiler, and fish samples collected from both the cities were found as safe or less hazardous. Among the individual metals, Mn was the most dominant metal present in different foodstuffs collected from both the cities and contributed significant risk to the people. Finally, the study concluded that Bangladesh’s food consumption patterns should be changed and advised to incorporate more proteins in regular diet charts by reducing carbohydrates.

Excessive consumption of dietary salt is the leading cause of cardiovascular disease and hypertension. The average salt intake is approximately twice more than the recommended daily allowance. Given the harmful effects of overconsumption of salt, the dietary concern about salt consumption has encouraged the WHO, along with many international and national health agencies to encouraged food industries to lower their salt use. Several studies have focused on formulation of low salt food products. However, due to the crucial functions provided by salt (flavour, texture and shelf-life) salt reduction strategies must be carefully considered. This review highlights numerous approaches for salt reduction in foods which include the use of salt enhancers, salt replacers and bitterness inhibitors and plant based seasonings.

The collective findings from human microbiome research, randomized controlled trials on specific microbes (i.e., probiotics), and associative studies of fermented dairy consumption provide evidence for the beneficial effects of the regular consumption of safe live microbes. To test the hypothesis that the inclusion of safe, live microbes in the diet supports and improves health, we propose assessment of the types and evidentiary quality of the data available on microbe intake, including the assembly and evaluation of evidence available from dietary databases. Such an analysis would help to identify gaps in the evidence needed to test this hypothesis, which can then be used to formulate and direct initiatives focused on prospective and randomized controlled trials on live microbe consumption. Outcomes will establish whether or not the evidence exists, or can be generated, to support the establishment of dietary recommendations for live microbes.

Summary Background & aims Children on long-term tube-feeding often need special treatment for oral feeding transitioning. Rapid tube-weaning programs usually result in short-term reductions in food intake and weight loss. This study examined the long-term effects of a “Graz-model” based weaning program on nutritional status and growth. Methods Children aged 0.5–13.0 years on long-term enteral nutritional support (ENS) participated in a three-week multidisciplinary weaning treatment. Data were collected at baseline, after completing the program, and at six and 12 months. Height/length, weight and BMI z-scores were determined according to the WHO growth standards. Energy and protein intake were assessed and presented as % of recommended daily allowance (RDA) values. Results Study participants (n = 58) were 64% male. Four children did not complete the three-week program due to acute illnesses. Complete weaning (from 100% ENS to 100% oral) was achieved in 22 children and partial weaning (at least 80% reduction of ENS) in 23 children. No demographic or clinical success predictors were identified. Thirty of the 45 weaned children completed the 12-month follow-up. A significant reduction in energy intake was observed at the three-week time-point [mean (SE): 56 (5.8)% versus 80 (4.7)%, p = 0.001]. This was followed by improvements in eating skills leading to energy intake at 12 months which did not significantly differ from baseline (p = 0.392). Mean (SE) baseline protein intake was 187 (13.0) %RDA. No significant difference from baseline were noted at 12 months (p = 0.301). Estimated mean (SD) height-, weight- and BMI z-scores at baseline were −2.11(0.28), −1.48(0.25), −0.13(0.31), respectively. No significant differences in growth data were observed over time. Conclusions Short-term reductions in nutritional intake and body weight observed after an intensive weaning program were reversible, and growth patterns were stable over 12 months. Further follow-up is recommended to ensure continued positive development in these children.

Physiological changes that occur after spinal cord injury (SCI) are profound and affect almost every organ system in the human body. Energy balance is significantly altered due to motor paralysis, spasticity or flaccidity, neurogenic sarcopenia, neurogenic osteopenia, sympathetic nervous system disruption, and blunted anabolism. Energy expenditure is markedly reduced, whereas hypothalamic control of appetite and satiety is diminished, resulting in discordant energy intake. Ultimately, neurogenic obesity ensues as the result of a positive energy balance. Even though nutritional guidelines for persons with SCI have been available since 2009, the necessity for body composition assessment and total daily energy expenditure was insufficiently addressed such that most individuals with SCI continued in positive energy balance despite “adherence” to the guidelines. Macronutrients must be carefully assessed to optimize caloric intake, while micronutrient consumption may need to be supplemented in order to meet recommended daily allowances. Such a diet would emphasize foods with low caloric yet high nutrient density. This article reviews current literature regarding nutritional requirements for SCI and provides a straightforward plan for implementing more rigorous dietary interventions meant to address the obesity crisis in this especially vulnerable population.

Over the last few decades, there have been significant dietary and lifestyle changes worldwide. In Morocco, these changes have led to serious nutritional disorders and increased risk of morbidity and mortality particularly among vulnerable groups such as women of childbearing age. We aimed to assess the average daily energy and macronutrient intakes and to investigate their association with socioeconomic factors and weight status among women aged 19–49 years in urban areas. A total of 542 women attending public health centers were recruited. Socioeconomic and demographic data were collected using a questionnaire. Anthropometric measurements were taken using standardized equipment. Food consumption data were obtained through the 24-hour dietary recall method, and the macronutrient composition of foods was estimated based on the Moroccan food composition table and the Nutrilog software. The average daily energy intake among the study population was 1591 kcal, composed of 56% from carbohydrates, 28% from fats, and 16% from protein. Reported energy intake by the majority of women (81.5%) was lower than recommended daily allowances for energy. There was a significant positive correlation between educational level and energy (p=0.001), carbohydrates (p=0.001), proteins (p=0.004), and fats intakes (p=0.032), respectively. A significant negative association of household size with protein intakes was also observed (p=0.034). Carbohydrates, proteins, and fats intakes tended to decrease; however, these associations were not statistically significant. Further studies and appropriate interventions are needed to address the trends in energy and macronutrients intakes in the development of policy initiatives aimed at nutrition education and chronic disease prevention among childbearing age women.

BACKGROUND: Only a limited number of studies have examined the vascular and postprandial effects of α-linolenic acid (ALA, C18:3n-3). Therefore, we performed a well-controlled trial focusing specifically on the effects of ALA on vascular function and metabolic risk markers during the fasting and postprandial phase in untreated (pre-)hypertensive individuals.METHODS: In a double-blind randomized, placebo-controlled parallel study, 59 overweight and obese adults (40 men and 19 women, aged 60 ± 8 years) with a high-normal blood pressure or mild (stage I) hypertension consumed daily either 10 g of refined cold-pressed flaxseed oil, providing 4.7 g ALA (n = 29), or 10 g of high-oleic sunflower (control) oil (n = 30) for 12 weeks.RESULTS: As compared with the high-oleic oil control, intake of flaxseed oil did not change brachial artery flow-mediated vasodilation, carotid-to-femoral pulse wave velocity, retinal microvascular calibers and plasma markers of microvascular endothelial function during the fasting and postprandial phase. Fasting plasma concentrations of free fatty acid (FFA) and TNF-α decreased by 58 μmol/L (P = 0.02) and 0.14 pg/mL (P = 0.03), respectively. No differences were found in other fasting markers of lipid and glucose metabolism, and low-grade systemic inflammation. In addition, dietary ALA did not affect postprandial changes in glucose, insulin, triacylglycerol, FFA and plasma inflammatory markers after meal intake.CONCLUSION: A high intake of ALA, about 3-5 times the recommended daily intake, for 12 weeks decreased fasting FFA and TNF-α plasma concentrations. No effects were found on other metabolic risk markers and vascular function during the fasting and postprandial phase in untreated high-normal and stage I hypertensive individuals.

Objective High calorie foods and beverages, which often contain caffeine, contribute to child overweight/obesity. We evaluated the results of an educational intervention to promote healthy growth in very young children. Secondarily, we used detailed diet data to explore the association of nutrient intake with the early development of overweight and obesity. Methods Mothers were obese Latina women, enrolled prenatally, and their infants. Specially trained community health workers provided breastfeeding support and nutrition education during 10 home visits, birth to 24 months. At follow-up, age 18 to 36 months, we measured growth and completed detailed diet recalls (1–7 recall days/child). Results Of 174 infants randomized, 106 children were followed for 24 to 36 months. The educational intervention did not prevent overweight/obesity. Forty-two percent of children became overweight or obese. Fifty-eight percent of children consumed caffeine on at least 1 recall day. Mean intake was 0.48 mg/kg/day. Caffeine correlated with higher consumption of calories, and added sugar and decreased intake of protein, fiber and dairy. Compared with days without caffeine, on days when caffeine was consumed, children ingested 121 more calories and 3.8 gm less protein. Children frequently consumed less than the recommended daily intake of key nutrients such as fiber, vegetables, whole fruit, and vitamins. Conclusions Caffeine was a marker for increased intake of calories and decreased intake of key nutrients. When discussing dietary intake in early childhood, practitioners should screen for nutrient deficiency in young children and recommend limiting the intake of caffeinated foods and beverages.

The use of wild plants for food in the rural communities of Uganda is widespread. This is attributed to food scarcity, perceived nutritional value, medicinal and health benefits and cultural preservation. However, the claims on the nutritional value of some wild edible plant species have not been fully validated. In cognizance of this, the macroelement, beta-carotene and ascorbic acid profile of five wild plants commonly used for food in and around eight forest reserves of Teso-Karamoja region, Uganda, were analysed. The plants prioritized for analysis were Vigna kirkii (Baker) J.B. Gillett, Maerua angolensis D.C., Leptadenia hastata (Schumach. & Thonn.) Decne, Senna obtusifolia (L.) H.S. Irwin & Barneby and Dioscorea sp.). The macro-element, ascorbic acid and beta-carotene composition of these plants was analyzed in triplicate. The variance in parameter means was analysed using one-way Analysis of Variance in SPSS ver. 16.0. The results showed that all the means of species were significantly different at the p=0.05 level. The highest macro-nutrient means were 80.74±0.34 %/100 g moisture content in V. kirkii, 3.95±0.23 g/100 g ash content in M. angolensis, 19.04±0.37 Kcal gross energy in M. angolensis, 27.93±0.85 g/100 g dietary fibre in L. hastata, 3.40±0.13 g/100 g crude fat in L. hastata, 65.43±2.91 g/100 g carbohydrate in Dioscorea sp., 36.37±0.42 g/100 g crude protein in M. angolensis. The highest ascorbic acid mean was 14.71±3.56 mg/100 g in M. angolensis while beta-carotene was 1082.1±0.08 μg/100 g in S. obtusifolia. These results show that these wild edible plants have a significantly variable nutritional value. Some of the macro elements can sufficiently meet the Recommended Daily Allowance (RDA) and Adequate Intakes (AI) for certain life stages and groups if consumed in ideal quantities. This information is vital in enhancing food and nutrition security awareness in the community and uplifting the social appeal and acceptability of these plants. This can be enhanced by investigating the micro-nutrients of public health significance, anti-nutrient factors, and toxic compounds in these plants. Key words: Nutritional value, wild edible plants, macro-nutrient, ascorbic acid, betacarotene,Teso-Karamoja, Uganda

Purpose The purpose of this paper aims to assess the intake of dietary selenium among Jordanian adults in Madaba Governorate. Design/methodology/approach The authors conducted a cross-sectional study in Madaba Governorate. Convenience sampling was done at Madaba Governorate for this study. The subjects comprised 500 subjects (325 women and 175 men) aged from 18 to 60 years. A 24-h recall (24-HR) and Food Frequency Questionnaire (FFQ) were used to estimate the selenium intake in the studied population. Findings Mean of dietary selenium was more than the recommended amount by at least 2.5-fold in both methods FFQ and 24-HR (p = 0.004), while no significant difference was observed in selenium consumption per day for women and men respectively using FFQ. The results indicated that selenium consumption is higher than the RDA among Madaba population. A moderate correlation was found between both methods for all subjects, women and men, respectively (p < 0.05). Originality/value The authors conclude that the selenium intake in Jordanian population is significantly above the RDA. However, future studies are required to correlate this high intake with health benefits and exclude toxic effects of Selenium.

This study aimed at improving the quality and nutrient density of a Kenyan fermented maize meal snack (mkarango) through soy fortification to alleviate protein‐energy malnutrition (PEM) in children. Nine variations of the snack were prepared by replacing 0, 30, and 50% maize with soy and fermenting each for 0, 3, and 5 days at ambient temperature. To establish the physico‐chemical characteristics, the proximate composition, bulk density, water, and oil absorption capacities and titratable acidity were determined. Consumer acceptability was evaluated using a panel of 55 individuals. Fortification of maize with 50% soy increased protein, lipid, and ash content by 256, 284, and 78%, respectively, while carbohydrates reduced by 30%. Fermentation increased lipids and slightly reduced carbohydrate content. Energy ranged from 1,600 to 1641 kJ/100 g. Oil absorption capacity and bulk density reduced with fortification and fermentation while water absorption capacity increased. Fermentation reduced pH by 29 and 31% after days 3 and 5, respectively. There was no significant difference at p ≤ .05 between liking of the fortified snacks and the conventional mkarango, but increase in number of fermentation days reduced the overall acceptance. All fortified snack variations meet more than half the Recommended Daily Allowance for children aged 0.5 to 10 years. Fortification and fermentation improve nutrient density of snacks in terms of proteins, lipids, and ash as well as the functional properties. Preference for all fortified snacks was above average. The soy fortified fermented snack has the potential to alleviate protein‐energy malnutrition in developing countries., The nutrient density and functional properties of a Kenyan fermented maize meal snack (mkarango) was improved through soy fortification to alleviate protein‐energy malnutrition (PEM) in children. Fortification and fermentation improved nutrient density in terms of protein, lipid, ash and energy as well as functional properties such as water absorption capacity, and hence, there was no difference in liking of the fortified snack by children, compared to the conventional one. All fortified snack variations meet more than half the Recommended Daily Allowance for children aged 0.5 to 10 years, and therefore, it has the potential to alleviate PEM.