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Low fluid intake and the consumption of sugar-sweetened beverages are among the risk behaviours in children that promote the development of non-communicable diseases. The aim of this study was to determine the beverage consumption of school-aged children and its contribution to daily energy and added sugars intake. Dietary intake was observed from dietary records, on three non-consecutive days, of 195 primary school children (52% boys; median 8.8 years) from the city of Zagreb. Total fluid intake included fluid from foods and beverages and was compared with Dietary Reference Values for the EU. The average daily fluid intake of children was 1168 mL (859 – 1563), of which 59.6% was from beverages. Only 14.4% of children reached the reference value for total daily fluid intake. Of the beverages, water (34.7%) contributes the most to daily fluid intake, followed by soft drinks (6.3%) and milk (6.1%). Milk and soft drinks contribute the most to the daily energy intake from beverages. Added sugars account for about 7.7% (5.5% – 10.4%) of children’s daily energy intake. Beverage consumption contributes to 26.5% of daily intake of added sugars, mainly soft drinks. In conclusion, children do not consume enough fluids, especially water. Although food is the main source of energy and added sugars in children’s diets, it is necessary to reduce the consumption of soft drinks.

To enhance recovery, athletes often consume ready-to-eat foods, specialized sports foods and/or supplements that belong to the group of ultra-processed foods (UPFs), which may affect their health. The aim of this study was to estimate consumption of UPFs in basketball players and to determine whether there is a difference in anthropometric characteristics, neuromuscular and cardiovascular fitness and microbiota composition between players in relation to the proportion of daily energy from processed foods. The study involved 17 elite male basketball players (>18 years) from Croatia during the competitive season. After cluster analysis of daily energy contribution from NOVA food groups, 35% of players were clustered into higher UPFs consumption group. No differences in anthropometric characteristics, neuromuscular and cardiovascular fitness were observed between players who consumed more UPFs and those who consumed less UPFs. Players with higher consumption of UPFs had lower abundance of the order Veillonellales-Selenomonadales in their respective microbiotas, more precisely, of family Veillonellaceae (p = 0.040) and the genus Agathobacter (p = 0.025). These results suggest that the consumption of UPFs did not affect athletes’ performance but does impact their gut microbiota. Further studies on this issue are warranted to establish nutritional guidelines for athletes regarding the consumption of UPFs.

Abstract Objective: This study aims at comparing two Italian case studies in relation to schoolchildren’s plate waste and its implications, in terms of nutritional loss, economic cost and carbon footprint. Design: Plate waste was collected through an aggregate selective weighting method for 39 d. Setting: Children from the first to the fifth grade from four primary schools, two in each case study (Parma and Lucca), were involved. Results: With respect to the served food, in Parma, the plate waste percentage was lower than in Lucca (P < 0·001). Fruit and side dishes were highly wasted, mostly in Lucca (>50 %). The energy loss of the lunch meals accounted for 26 % (Parma) and 36 % (Lucca). Among nutrients, dietary fibre, folate and vitamin C, Ca and K were lost at most (26–45 %). Overall, after adjusting for plate waste data, most of the lunch menus fell below the national recommendations for energy (50 %, Parma; 79 %, Lucca) and nutrients, particularly for fat (85 %, Parma; 89 %, Lucca). Plate waste was responsible for 19 % (Parma) and 28 % (Lucca) of the carbon footprint associated with the food supplied by the catering service, with starchy food being the most important contributor (52 %, Parma; 47 %, Lucca). Overall, the average cost of plate waste was 1·8 €/kg (Parma) and 2·7 €/kg (Lucca), accounting respectively for 4 % and 10 % of the meal full price. Conclusion: A re-planning of the school meals service organisation and priorities is needed to decrease the inefficiency of the current system and reduce food waste and its negative consequences.

Motivation for food choices is one of the most important determinant of eating behavior, because it comes from within the person. The aim of this study was to observe food choice motivations and estimate differences in demographic and health characteristics towards food choice motives in the adult population (n = 675; 54% women, ≥18 years) from urban setting. Food choice motivations were assessed using an online questionnaire validated by the EATMOT project. Using K-Means cluster analysis, participants were divided into two clusters of six motivational categories for food choices. Regarding the most and least important motivations, participants in cluster 1 chose food based on emotional motivations, and in cluster 2, they chose based on environmental and political motivations. In addition, younger and obese individuals had more pronounced emotional motivations. In conclusion, this study emphasizes the need to address emotional motivations for healthier food choices among overweight and young people. In addition, the prevalence of health motivations and growing awareness of sustainability indicate a willingness to take actions that benefit personal health and the environment. Apart from providing education, it is society’s responsibility to create an environment that promotes the implementation of acquired knowledge and changes in dietary habits.

In countries around the world, a dietary shift is observed in which the consumption of highly processed foods increases over unprocessed or minimally processed foods. The objective of this study was to observe the proportion of processed foods in the diet of school-aged children and to assess how this relates to sex, weight status and school meal consumption. The aim was to assess the impact of processed foods on overall diet quality in terms of ultra-processed foods contribution to total daily energy intake. Dietary intake was observed from dietary records for three non-consecutive days of 168 children (50.6% boys) aged 8.3 ± 0.5 years. All foods and beverages were classified into four groups according to NOVA food classification system. The contribution of each NOVA food group to total daily energy intake was calculated and the mean nutrient intake of children divided into terciles according to total daily energy intake from ultra-processed foods was compared. Anthropometric measurements were performed according to standard protocols, while sex and age z-scores were obtained using AnthroPlus software. Results show that unprocessed or minimally processed foods (38.1% kcal) and ultra-processed foods (38.1% kcal) had the highest proportion of dietary intake. There was no difference in NOVA food groups intake by sex or weight status, while number of school meals may contribute to the intake of processed culinary ingredients. Children who had higher energy intake from ultra-processed foods had lower intake of animal proteins (p=0.009), polyunsaturated fatty acids (p=0.014), vitamin A (p=0.027) and most minerals, but higher intake of carbohydrates (p=0.014) and copper (p=0.014) compared to children with lower energy intake from ultra-processed foods. In conclusion, school-aged children had equal share of energy from unprocessed or minimally processed foods and from ultra-processed foods. Higher share of energy from ultra-process foods may contribute to poor overall nutrition.

Preference could be the trigger for fruit and vegetable (FV) consumption in children and could be modified by appropriate intervention to increase the acceptance of FVs. The primary objective of this study was to investigate the effects of the three-year school-based multicomponent intervention “Nutri-školica” on the FV preferences of primary school children. It also aimed to explore whether a positive change in FV preferences could lead to an increase in actual FV consumption. The study was conducted in 14 primary schools from the city of Zagreb on 193 children (52.3% boys; age, 7.7 ± 0.4 years; n = 85 in the control group and n = 108 in the intervention group) who completed a preference questionnaire before and after the intervention with a 5-point hedonic smiley-face scale, where 5 means “I like it a lot.” The per-protocol approach was used for data analysis (28.3% of children from the study sample). After the intervention, children in the intervention group (before: 3.1 ± 0.8; after: 3.5 ± 0.8) increased their FV preferences significantly more than children in the control group (before: 3.2 ± 0.8; after: 3.3 ± 0.7). Children’s FV preferences changed most toward the varieties for which they had the least preferences at the beginning of the study. Participation in the intervention had a stronger effect on changing FV intake than change in FV preferences among primary school children. In summary, the present study highlighted that a targeted intervention can increase children’s FV preferences, but that participation in the intervention is substantial for increasing FV intake.

BackgroundSince the beneficial effects of fruit and vegetable (FV) consumption on health are well known due to the synergy of their nutrients and non-nutrients, it is crucial to have good tools to assess the FV intake. A food frequency questionnaire (FFQ) is an adequate method to estimate FV consumption, but it is necessary to relate this dietary method to the geographic and cultural environment. Therefore, this study presented the development of a semi-quantitative FFQ to estimate the FV intake in school-aged children who usually consume cooked homemade and school meals. It also aimed to evaluate the relative validity and reproducibility of the FFQ.MethodsSchool-aged children (baseline age 8 years) from 14 primary schools in the city of Zagreb participated in the study during the 2019/2020 school year. Parents/caregivers, together with the children, completed the FFQs and 3-day dietary records (3DDRs). The FFQ was designed to assess the consumption of eight food categories. The FFQ was validated using the 3DDR of 141 children (51.4% of boys), whereas the reproducibility test included the FFQ of 161 children (53.4% of boys).ResultsOf the eight food categories, FFQ overestimates the consumption of three and underestimates the consumption of three food categories (p < 0.05; Wilcoxon signed rank test) compared to the 3DDR. De-attenuated correlation coefficients estimated a significant relationship (0.217–0.384) between the FFQ and 3DDR. Cross-classification analysis revealed that overall, 28–41% of children were classified in the same quartile, whereas less than 10% of children were extremely misclassified for all food categories obtained from 3DDR and FFQ1. κw values showed fair agreement for all food categories. The Bland–Altman analysis results showed a relatively small bias for all food categories (median between -11.7 and -54.8 g), with no systematic patterns between the FFQ and 3DDR. No differences were found between food categories estimated with the FFQs on both occasions, and Spearman’s correlation coefficients ranged from 0.664 to 0.712 (p < 0.01). Cronbach’s alpha values (α > 0.700) indicate good internal consistency, and ICCs (range 0.724–0.826; p < 0.01) indicate good reproducibility of the FFQ.ConclusionThe results indicate reasonable relative validity and acceptable reproducibility of the FFQ for estimating FV consumption among school-aged children.

Insufficient consumption of fruit and vegetables was found in primary school children. To address this problem, a three-year school-based multicomponent intervention was conducted in 14 primary schools in the City of Zagreb. The aim of the study was therefore to evaluate one of the primary goals of the intervention—the increase in fruit and vegetable intake among primary school children. A total of 681 children were allocated to the intervention (n = 300 in the control group and n = 381 in the intervention group). The intervention included 23 interactive classroom workshops, 10 cross-curricular activities, 13 homework challenges, visual exposure with educational posters in classrooms, parent education via the website, and the implementation of new dishes into the school food system. Fruit and vegetable intake was assessed using a semi-quantitative food frequency questionnaire at baseline and after the intervention. Data were analyzed by per-protocol analysis. The study involved 259 children (50.2% girls; age 7.7 ± 0.4 years; n = 116 in the control group and n = 143 in the intervention group) who completed a food intake frequency questionnaire at both time points. Children in the intervention group showed a significant increase (p < 0.001) in total daily fruit and vegetable intake (before: 332.1 ± 164.9 g; after: 430.1 ± 186.7 g) compared to the control group (before: 350.2 ± 187.5; after: 382.6 ± 196.8) after the intervention. The increase in fruit and vegetable intake was achieved in 89% of children, while 25% more children reached the daily recommendation of 400 g. The use of the multicomponent intervention showed potential to increase fruit and vegetable intake in primary school children.

The population of older adults, especially those living in the nursing homes, is growing. The sedentary lifestyle and possible poor nutrition in nursing homes place residents (NHRs) at risk for body composition impairments, malnutrition, and, subsequently, numerous chronic diseases. The aim of this study was to assess body composition (including body fluids) and dietary intake in NHRs. The association between osteosarcopenic adiposity syndrome (OSA) and its components, osteopenic adiposity (OA), sarcopenic adiposity (SA), and adiposity-only (AD), and specific macro- and micro-nutrients was evaluated as well. The study included 84 participants (82.1% women), aged 65.3–95.2 years. Body composition was assessed with an advanced bioelectrical impedance device BIA-ACC® and dietary intake was assessed via 24-h recall and analyzed using “Nutrition” software. The majority (95%) of participants were overweight with a high body fat and low muscle and bone mass, leading to a high prevalence of OSA (>50%), OA (13%), and AD (26%). There were only a few participants with SA, and they were not analyzed. The highest extracellular water/total body water ratio was observed in the OSA participants, indicating a heightened inflammatory state. Participants in all three body composition categories had a similar nutrient intake, with protein, fiber, omega-3 fatty acids, and almost all micronutrients being far below recommendations. In conclusion, a high prevalence of OSA among NHRs accompanied by a poor dietary intake, could place these residents at a very high risk for COVID-19 infections. Therefore, optimization of body composition and nutritional status should be included along with standard medical care in order to provide better health maintenance, particularly in the COVID-19 era.

It has been hypothesized that breakfast consumption is generally associated with healthy lifestyle behaviors, such as increased physical activity. The aim of this study was to examine the relations between breakfast consumption, adiposity measures and physical activity among adolescents. This investigation is a part of the Croatian physical activity in adolescence longitudinal study (CRO-PALS). This investigation is based on 802 participants (48% girls and 52% boys), aged between 15.2 and 16.0 years. Physical activity level and sedentary behaviors were assessed using the SHAPES questionnaire. Adiposity measures included the sum of four skinfolds, and multi-pass 24-h recall was used as the dietary assessment method. Participants who consumed breakfast had significantly lower body fat % (p = 0.011 for boys; p ≤ 0.001 for girls) compared to breakfast non-consumers. Physical activity has no mediating effect in the association of breakfast consumption on adiposity in boys (Sobel’s t = −0.541; p = 0.588) and girls (Sobel’s t = 1.020; p = 0.307). Breakfast consumption was negatively associated with adiposity only in the boys at the highest tertile of physical activity (p = 0.04). Physical activity has no mediating effect on the associations between breakfast consumption and adiposity, but has a moderation effect only in the most active boys. Breakfast consumption might exert beneficial effects only in the most active male adolescents, but not in the inactive ones.

The possible cardioprotective effects of translocator protein (TSPO) modulation with its ligand 4′-Chlorodiazepam (4′-ClDzp) in isoprenaline (ISO)-induced rat myocardial infarction (MI) were evaluated, alone or in the presence of L-NAME. Wistar albino male rats (b.w. 200–250 g, age 6–8 weeks) were divided into 4 groups (10 per group, total number N = 40), and certain substances were applied: 1. ISO 85 mg/kg b.w. (twice), 2. ISO 85 mg/kg b.w. (twice) + L-NAME 50 mg/kg b.w., 3. ISO 85 mg/kg b.w. (twice) + 4′-ClDzp 0.5 mg/kg b.w., 4. ISO 85 mg/kg b.w. (twice) + 4′-ClDzp 0.5 mg/kg b.w. + L-NAME 50 mg/kg b.w. Blood and cardiac tissue were sampled for myocardial injury and other biochemical markers, cardiac oxidative stress, and for histopathological evaluation. The reduction of serum levels of high-sensitive cardiac troponin T hs cTnT and tumor necrosis factor alpha (TNF-α), then significantly decreased levels of serum homocysteine Hcy, urea, and creatinine, and decreased levels of myocardial injury enzymes activities superoxide dismutase (SOD) and glutathione peroxidase (GPx) as well as lower grades of cardiac ischemic changes were demonstrated in ISO-induced MI treated with 4′-ClDzp. It has been detected that co-treatment with 4′-ClDzp + L-NAME changed the number of registered parameters in comparison to 4′-ClDzp group, indicating that NO (nitric oxide) should be important in the effects of 4′-ClDzp.