Search

Abstract Computing the food component (nutrient) amount in 100 kilocalories, 100 grams or 100 milliliters, the reference amount customarily consumed (RACC), or 50 grams of food demonstrates the food component amount of some foods unsuitably. So, selecting some foods based on them may elevate the hazards of some chronic diseases. Computing the food component amount and assessing suitable levels of food components and the nutritional quality according to the Codex Alimentarius Commission (CAC), the United States Food and Drug Administration (FDA), and the suggested procedure were implemented on 8,596 food cases, 29 food components, and 25 food categories. Selecting some foods under the FDA and CAC to reach sufficient intakes of positive food components surpassed energy demands. Selecting some foods under the CAC did not satisfy the demands of positive food components. Some foods that satisfied the demands of positive food components were not suitable food selections under the CAC. Selecting some foods under the FDA or CAC surpassed the demands of negative food components (including cholesterol, energy, fat, saturated fat, and sodium). Some foods that did not surpass the demands of negative food components were not suitable food selections under the CAC or FDA. Due to the vulnerabilities of selecting foods on the basis of the reference amounts of food, fast foods under the CAC and FDA in serving size (the serving size or serving is obtained from the RACC), spices and herbs under the CAC in 100 grams or 100 milliliters, and vegetables and vegetable products under the CAC in 100 kilocalories obtained the highest average scores for nutritional quality based on positive food components (including vitamins, protein, dietary fiber, and minerals, excluding sodium) among food categories for children aged four years and older and adults. Graphical Abstract

Computing the food component (nutrient) amount in 100 kilocalories, 100 grams or 100 milliliters, the reference amount customarily consumed (RACC), or 50 grams of food demonstrates the food component amount of some foods unsuitably. So, selecting some foods based on them may elevate the hazards of some chronic diseases. Computing the food component amount and assessing suitable levels of food components and the nutritional quality according to the Codex Alimentarius Commission (CAC), the United States Food and Drug Administration (FDA), and the suggested procedure were implemented on 8,596 food cases, 29 food components, and 25 food categories. Selecting some foods under the FDA and CAC to reach sufficient intakes of positive food components surpassed energy demands. Selecting some foods under the CAC did not satisfy the demands of positive food components. Some foods that satisfied the demands of positive food components were not suitable food selections under the CAC. Selecting some foods under the FDA or CAC surpassed the demands of negative food components (including cholesterol, energy, fat, saturated fat, and sodium). Some foods that did not surpass the demands of negative food components were not suitable food selections under the CAC or FDA. Due to the vulnerabilities of selecting foods on the basis of the reference amounts of food, fast foods under the CAC and FDA in serving size (the serving size or serving is obtained from the RACC), spices and herbs under the CAC in 100 grams or 100 milliliters, and vegetables and vegetable products under the CAC in 100 kilocalories obtained the highest average scores for nutritional quality based on positive food components (including vitamins, protein, dietary fiber, and minerals, excluding sodium) among food categories for children aged four years and older and adults. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of dietary guidance based on marketing theory of 4Cs in patients with dysphagia after first-ever stroke. Methods A total of 100 patients with dysphagia after first-ever stroke admitted to the Department of Neurology of Hechi Hospital of Traditional Chinese Medicine from January 2021 to June 2022 were selected as the study objects, and were randomly divided into control group (50 cases) and observation group (50 cases) according to the digital table method. The control group received routine dietary care for post-stroke dysphagia. In the observation group, dietary guidelines based on the marketing theory of 4Cs were constructed, and the intervention lasted for 6 months. The swallowing function and quality of life of patients in the two groups were observed and compared before and after intervention for 6 months. The effect of interventions was evaluated, and the incidence of complications during intervention was observed. Results After 6 months of intervention, observation group had a better outcome of Water-swallowing test compared with that in the control group(P

Objective To explore the effect of a new type of low-protein enteral nutrition on the nutritional status of patients with chronic kidney disease in stage 3-4 under the guidance of individualized diet. Methods Sixty follow-up outpatients in West China Hospital of Sichuan University were randomly divided into the experimental group and the control group. The two groups were followed up on intervention day 0, day 45, and day 90. According to the principle of intentional analysis, the generalized estimation equation was used to analyze the between-group differences, time change trend, and interaction effect, and the principle of data analysis in accordance with the scheme was used to further verify the stability of results. Results There was no significant difference in nutritional adequacy, clinical effectiveness, and anthropometric indexes between the test group and the control group (P > 0.05). During the intervention period, when the energy intake was stable, the intake of protein (於=17.680, P<0,001) and sodium salt (=21.427, P<0»001) decreased significantly, while the total protein (於=18,075, P<0.001), calcium (护=9.43& P=0,009), phosphorus (护=13.866; P=0.001), and uric acid (於=9,005, P=0.011) fluctuated within the normal range. The results of data analysis in accordance with the scheme were basically consistent with those of intentionality analysis. Only the time change trend of upper arm muscle circumference (於=6.435: P=0.040) and the comparison of energy ratio between groups (於=4.47& P=0.034) were significantly different. Conclusion The new low-protein enteral nutrition preparation is not inferior to the total nutritional formula food for special medical use in improving the nutritional status of patients and delaying the progression of the disease. The use of enteral nutrition under dietary guidance is beneficial to the clinical nutrition management of patients with chronic kidney disease. [ABSTRACT FROM AUTHOR]

Grains, essential for maintaining good health, contain short-chain carbohydrates like fructans, which can contribute to disorders in some individuals. Understanding and managing these FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols) are essential for enhanced dietary guidance and well-being. The primary objective of the study was to establish safe portion sizes for grains and rice within low-FODMAP diets. A comprehensive analysis of fructan levels in diverse commercial cereal products contributes to an understanding of the potential digestive impact of FODMAPs in grains and supporting enhanced dietary guidance for individuals with FODMAP-related disorders. Various grains, like white and brown rice, barley, wheat groats, and buckwheat, highlight the challenges of handling fructans in a low-FODMAP diet. Fructans to heat-induced degradation, as demonstrated in bulgur, emphasize the need to consider cooking methods for managing their intake. Identification of potentially safe grains, like white long-grain rice and arborio rice, is significant, but caution is advised with barley groats and couscous, stressing personalized dietary decisions. Correlation analyses linking color parameters, moisture content, and fructan levels in cooked grains reveal a positive relationship, suggesting water content's potential impact on fructan stability and grain hydration properties. In conclusion, the study provides valuable insights into the intricate details of FODMAPs in grains, supporting the development of dietary strategies that enhance both health and sensory satisfaction. [ABSTRACT FROM AUTHOR]

Dietary guidance promotes plant-based foods, yet minimal research has examined intake in children. This study examined plant-based food intake in preschool-aged children using plant-based dietary index (PDI) metrics and related these metrics to nutrient and food group intakes. Dietary data were collected from preschool-aged children (n = 283, 3.45 ± 1.22 years) from the Guelph Family Health Study at baseline using the Automated Self-Administered 24-Hour Dietary Assessment Tool. Food intake servings were assigned to 16 food groups for calculation of overall PDI (oPDI), healthful PDI (hPDI), and less healthful (lhPDI) scores and summarized into tertiles for energy-adjusted comparisons. For oPDI, participants in the highest vs. lowest tertile had higher intakes of nutrients and food groups to encourage (e.g., dietary fiber, fruits) as well as lower intakes of nutrients to encourage (e.g., calcium, vitamin D). For hPDI, participants in the highest vs. lowest tertile had higher intakes of nutrients and food groups to encourage and lower intakes of those to limit (e.g., saturated fat, sweets and desserts). For lhPDI, participants in the highest vs. lowest tertile had higher intakes of nutrients and food groups to limit and lower intakes of those to encourage. These results can inform dietetic practice for dietary guidance that promotes plant-based foods in children. [ABSTRACT FROM AUTHOR]

The objective of this project was to develop a brief self-administered dietary screener, in English and French, to rapidly assess alignment of adults' dietary intake with the 2019 Canada's Food Guide healthy food choices recommendations. In consultation with Health Canada and external advisors (n = 15), guiding principles were defined. Existing screeners were scanned, and the healthy food choices recommendations were mapped to inform questions and response options. Cognitive interviews were conducted in English (n = 17) and French (n = 16) with adults aged 18–65 years from April to June 2021 to assess understanding of questions and face validity; recruitment emphasized variation in sociodemographic characteristics. Face and content validity were assessed with experts in nutrition, surveillance, and public health (n = 13 English, 3 French) from April to May 2021. The testing indicated that the screener was well understood overall but informed refinements to improve comprehension of the questions and their alignment with the healthy food choices recommendations. The resulting Canadian Food Intake Screener/Questionnaire court canadien sur les apports alimentaires includes 16 questions to rapidly assess alignment of intake with the 2019 Canada's Food Guide healthy food choices recommendations, including healthy foods and foods to limit, in situations in which comprehensive dietary assessment is not feasible. The Canadian Food Intake Screener was developed to rapidly assess alignment of adults' dietary intake over the past month with the Food Guide's healthy food choices recommendations. The screener was developed and evaluated through an iterative process that included three rounds of cognitive interviews in each of English and French, along with ongoing feedback from external advisors and face and content validity testing with a separate panel of content experts. The 16-question screener is intended for use with adults, aged 18–65 years, with marginal and higher health literacy in research and surveillance contexts in which comprehensive dietary assessment is not possible. [ABSTRACT FROM AUTHOR]

The Canadian Food Intake Screener/Questionnaire court canadien sur les apports alimentaires was developed to rapidly assess alignment of adults' dietary intake over the past month with the 2019 Canada's Food Guide's healthy food choices recommendations. From July to December 2021, adults (n = 154) aged 18–65 years completed the screener and up to two 24 h dietary recalls. The screener scoring system was aligned with the Healthy Eating Food Index-2019 (HEFI-2019), to the extent possible. Analysis of variance compared screener scores among subgroups with known differences in diet quality. Using the recall data, the National Cancer Institute multivariate method was used to model HEFI-2019 components, with the screener score as a covariate, and the correlation coefficient between screener and total HEFI-2019 scores was estimated. The mean screener score was 35 points (SD = 4.7; maximum 65), ranging from 26 (1st percentile) to 45 (99th percentile). Differences in scores in hypothesized directions were evident by gender identity (p = 0.06), perceived income adequacy (p = 0.07), education (p = 0.02), and smoking status (p = 0.003). The correlation between screener and HEFI-2019 scores was 0.53 (SE = 0.12). The screener's moderate construct validity supports its use for rapid assessment of alignment of adults' intake with the healthy food choices recommendations when comprehensive dietary assessment is not possible. The Canadian Food Intake Screener was developed to rapidly assess alignment of dietary intake with the Canada's Food Guide-2019 healthy food choices recommendations. Scoring is aligned with the Healthy Eating Food Index-2019 to the extent possible. Among a sample of adults, reasonable variation in screener scores was noted, mean screener scores differed between some subgroups with known differences in diet quality, and a moderate correlation between screener scores and total Healthy Eating Food Index-2019 scores based on repeat 24 h dietary recalls was observed. The Canadian Food Intake Screener has moderate construct validity for rapid assessment of overall alignment of adults' dietary intake with the Canada's Food Guide-2019 healthy food choices recommendations. [ABSTRACT FROM AUTHOR]

This paper reviewed the Chinese herbal medicine hot package therapy and nursing management for a patient with cold-dampness stasis type abdominal pain caused by chronic pelvic inflammatory disease. Based on the Traditional Chinese Medicine syndrome differentiation and identification of syndrome type, the Chinese herbal medicine hot package therapy combined with comprehensive interventions such as dietary care, life support, and psychological care were carried out to relieve the cold-pain symptoms and improve the recovery of the patient. (本文总结1例采用中药热奄包治疗寒湿瘀滞型慢性盆腔炎腹部冷痛的护理经验, 基于中医辨证, 确定患者证型, 通过开展中药热奄包治疗, 并配合饮食护理、生活护理、心理护理等综合护理干预, 有助于减轻患者腹部冷痛, 加快患者恢复。)

This paper summarized the nursing measures of a patient with furuncle of the nose treated with Tradition Chinese Medicine (TCM) collapse stains. The nursing assessment, application method and cautions of collapse stains, compostion of Chinese herbs, dietary guidance and psychological intervention were reviewed. Through the active intervention of the external treatment of Tradition Chinese Medicine, the level of nasal boils decreased, pain was relieved, and good results were achieved. (本文总结1例中药塌渍治疗鼻疖患者的护理经验, 包括护理评估、中药塌渍操作方法、药方组成、注意事项以及饮食指导、心理干预等护理措施。基于辨证施护理念, 通过中药塌渍外治法积极干预, 并辅以相关护理措施, 能有效改善患者鼻疖症状, 减轻疼痛。)

This paper summarized the experience of continuous glucose monitoring and nursing of a child with hepatic glycogen storage disease (GSD). Continuous dynamic monitoring of blood glucose changes was conducted to provide a basis for treatment. The medical care team focused on asymptomatic hypoglycemia assessment and provided care for hypoglycemia, dietary intervention, psychological support and health education. (本文总结1例肝糖原累积症(GSD)患儿动态血糖监测及护理经验。基于持续动态的监测血糖变化, 为合理治疗提供依据, 积极开展低血糖护理、饮食干预、心理支持及健康教育等。)

Diabetes management relies on effective evidence-based advice that informs and empowers individuals to manage their health. Alongside other cornerstones of diabetes management, dietary advice has the potential to improve glycaemic levels, reduce risk of diabetes complications and improve health-related quality of life. We have updated the 2004 recommendations for the nutritional management of diabetes to provide health professionals with evidence-based guidelines to inform discussions with patients on diabetes management, including type 2 diabetes prevention and remission. To provide this update we commissioned new systematic reviews and meta-analyses on key topics, and drew on the broader evidence available. We have strengthened and expanded on the previous recommendations to include advice relating to dietary patterns, environmental sustainability, food processing, patient support and remission of type 2 diabetes. We have used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to determine the certainty of evidence for each recommendation based on findings from the commissioned and identified systematic reviews. Our findings indicate that a range of foods and dietary patterns are suitable for diabetes management, with key recommendations for people with diabetes being largely similar for those for the general population. Important messages are to consume minimally processed plant foods, such as whole grains, vegetables, whole fruit, legumes, nuts, seeds and non-hydrogenated non-tropical vegetable oils, while minimising the consumption of red and processed meats, sodium, sugar-sweetened beverages and refined grains. The updated recommendations reflect the current evidence base and, if adhered to, will improve patient outcomes. [ABSTRACT FROM AUTHOR]

Dried fruits contain many bioactive compounds broadly classified as phytochemicals including phenolics, flavonoids, carotenoids, proanthocyanidins, stilbenes, chalcones/dihydrochalcones, and phytoestrogens. These compounds have antioxidant effects that may benefit health. Dried fruits are also a diverse group of foods with varying fibre contents. The evaluation of the biological activity of these bioactive compounds, including their bioaccessibility and bioavailability, may contribute to the understanding of the health effects of dried fruits. Limited evidence suggests that dried fruits (raisins, cranberries, dates, and prunes) affect human gut microbiota composition in a potentially beneficial manner (in terms of effects on Bifidobacteria, Faecalibacterium prausnitzii, Lactobacillus, Ruminococcaceae, Klebsiella spp., and Prevotella spp.). There is little epidemiological evidence about the association of dried fruit consumption with cardiovascular disease incidence and mortality, as well as the risk of type 2 diabetes or obesity. Clinical trial evidence for the effects of dried fruit consumption on cardiovascular risk factors, including glycaemic control, is mixed. Clinical trial evidence suggests prunes might preserve bone mineral density in postmenopausal women. Consumption of dried fruits is associated with higher-quality diets. Studies are needed to increase our understanding of the health effects of dried fruits and the underlying biological mechanisms. [ABSTRACT FROM AUTHOR]

Grains, essential for maintaining good health, contain short-chain carbohydrates like fructans, which can contribute to disorders in some individuals. Understanding and managing these FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols) are essential for enhanced dietary guidance and well-being. The primary objective of the study was to establish safe portion sizes for grains and rice within low-FODMAP diets. A comprehensive analysis of fructan levels in diverse commercial cereal products contributes to an understanding of the potential digestive impact of FODMAPs in grains and supporting enhanced dietary guidance for individuals with FODMAP-related disorders. Various grains, like white and brown rice, barley, wheat groats, and buckwheat, highlight the challenges of handling fructans in a low-FODMAP diet. Fructans to heat-induced degradation, as demonstrated in bulgur, emphasize the need to consider cooking methods for managing their intake. Identification of potentially safe grains, like white long-grain rice and arborio rice, is significant, but caution is advised with barley groats and couscous, stressing personalized dietary decisions. Correlation analyses linking color parameters, moisture content, and fructan levels in cooked grains reveal a positive relationship, suggesting water content’s potential impact on fructan stability and grain hydration properties. In conclusion, the study provides valuable insights into the intricate details of FODMAPs in grains, supporting the development of dietary strategies that enhance both health and sensory satisfaction.

Nutrition security - access to food that promotes well-being and prevents or treats disease, particularly among racial and ethnic minority populations, lower income populations, and rural and remote populations - is a national priority. Leading causes of death and disability in America, such as heart disease, stroke, cancer, and diabetes that disproportionately affect minorities are linked to preventable diet-related risk factors. Mounting evidence indicates that adherence to a lower-carbohydrate dietary pattern is associated with weight maintenance, improved blood glucose and insulin control, lower blood pressure, reduced markers of inflammation, and a more favorable lipid profile. Additionally, prior concerns regarding the higher fat and cholesterol content of this dietary pattern are less founded in modern research. The inclusion of a lower-carbohydrate option that meets all essential nutrient requirements aligns with the contemporary movement toward more flexibility and precision nutrition. Most important, a lower-carbohydrate option positions the Dietary Guidelines for Americans to more accurately reflect the current scientific evidence and more effectively address the metabolic health of the nation. Further, it has the potential to improve nutrition security by addressing metabolic diseases that disproportionately affect people from historically marginalized racial, ethnic, socioeconomic, and cultural backgrounds. Given that most American adults are living with at least one diet-related chronic metabolic disease, updating the Dietary Guidelines for Americans to recognize and reflect the poor health status of the general population is prudent and urgent.

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper summarized the nursing measures of a patient with grade 2 phlebitis treated with Traditional Chinese Medicine collapse stains. The nursing assessment, application method and cautions of collapse stains, composition of Chinese herbs, dietary guidance and psychological intervention were reviewed. Through the active intervention of the external treatment of Traditional Chinese Medicine, the level of phlebitis decreased, pain was relieved, and good results were achieved. (本文总结1例中药塌渍治疗静脉炎患者的护理措施和体会, 包括护理评估、中药塌渍操作方法、药方组成、注意事项以及饮食指导、心理干预等护理措施。基于辨证施护理念。通过中药塌渍外治法积极干预, 并辅以相关护理措施, 患者静脉炎症状明显好转, 疼痛减轻。)

This paper reported the acupoint application and nursing management for relief of low back pain in a patient with chronic kidney disease. The prescription of Chinese herbal medicine used in acupoint application, operation method and cautions were introduced. A set of targeted interventions including nursing assessment, illness observation, psychological nursing and dietary guidance were carried out for relief of low back pain and improve the activity of daily living of the patient. (本文总结1例慢性肾脏病腰酸腰痛患者应用穴位贴敷治疗的护理经验, 主要包括穴位贴敷的药方组成、操作方法、注意事项以及相关护理评估、病情观察、心理干预、饮食指导等措施。通过穴位贴敷配合针对性护理措施, 能够有效改善患者腰酸腰痛症状, 提高日常活动能力。)

There is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as "ultraprocessed" and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets. [ABSTRACT FROM AUTHOR]

Abstract Background Diet, as a modifiable factor, plays an important role in cognitive function. However, the association between adherence to the 2015–2020 Dietary Guidelines for Americans (DGA), measured by Healthy Eating Index (HEI)-2015, and cognitive function remains unclear. This study aims to explore whether HEI-2015 is associated with various cognitive domains and whether such association is modified by age, gender, or ethnicity in the US adults aged 60 years or older using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Methods HEI-2015 scores were calculated from 24-h dietary recall interviews. Cognitive function was evaluated by Digit Symbol Substitution Test (DSST, a measure of processing speed), Animal Fluency Test (AFT, a measure of executive function), a subtest from Consortium to Establish a Registry for Alzheimer’s disease (CERAD, a measure of memory), and a composite-z score calculated by summing z scores of individual tests. The associations between HEI-2015 scores and cognitive performance were explored using multiple linear regression models. Results A total of 2450 participants aged 60 years or older were included. Participants with higher HEI-2015 scores were more likely to have higher DSST, AFT as well as composite-z scores (P

The Nutrition Evidence Systematic Review (NESR) team conducts nutrition- and public health-related systematic reviews and is within the USDA's Center for Nutrition Policy and Promotion. NESR has collaborated with scientific experts to conduct systematic reviews on nutrition and public health topics for more than a decade and is uniquely positioned to share recommendations with the research community to strengthen research quality and impact, especially the evidence base that supports public health nutrition guidance, including future editions of the Dietary Guidelines for Americans. Leveraging the expertise of NESR and its systematic review process resulted in the following recommendations for the research community: a) use the strongest study design feasible with sufficient sample size(s); b) enroll study participants who reflect the diversity of the population of interest and report participant characteristics; c) use valid and reliable dietary assessment methods; d) describe the interventions or exposures of interest and use standard definitions to promote consistency; e) use valid and reliable health outcome measures; f) account for variables that may impact the relationship between nutrition-related interventions or exposures and health outcomes; g) carry out studies for a sufficient duration and include repeated measures, as appropriate; and h) report all relevant information to inform accurate interpretation and evaluation of study results. Implementing these recommendations can strengthen nutrition and public health evidence and increase its utility in future public health nutrition systematic reviews. However, implementation will require additional support from the entire research community, including scientific journals and funding agencies. [ABSTRACT FROM AUTHOR]

Objective: Are diets with a greater environmental impact less healthy? This is a key question for nutrition policy, but previous research does not provide a clear answer. To address this, our objective here was to test whether American diets with the highest carbon footprints predicted greater population-level mortality from diet-related chronic disease than those with the lowest.Design: Baseline dietary recall data were combined with a database of greenhouse gases emitted in the production of foods to estimate a carbon footprint for each diet. Diets were ranked on their carbon footprints and those in the highest and lowest quintiles were studied here. Preventable Risk Integrated Model (PRIME), an epidemiological modelling software, was used to assess CVD and cancer mortality for a simulated dietary change from the highest to the lowest impact diets. The diet-mortality relationships used by PRIME came from published meta-analyses of randomised controlled trials and prospective cohort studies.Setting: USA.Participants: Baseline diets came from adults (n 12 865) in the nationally representative 2005-2010 National Health and Nutrition Examination Survey.Results: A simulated change at the population level from the highest to the lowest carbon footprint diets resulted in 23 739 (95 % CI 20 349, 27 065) fewer annual deaths from CVD and cancer. This represents a 1·83 % (95 % CI 1·57 %, 2·08 %) decrease in total deaths. About 95 % of deaths averted were from CVD.Conclusions: Diets with the highest carbon footprints were associated with a greater risk of mortality than the lowest, suggesting that dietary guidance could incorporate sustainability information to reinforce health messaging. [ABSTRACT FROM AUTHOR]

BackgroundThe significance of periconceptional nutrition for optimizing offspring and maternal health and reducing social inequalities warrants greater understanding of diet quality among US women.ObjectiveOur objective was to evaluate racial or ethnic and education inequalities in periconceptional diet quality and sources of energy and micronutrients.DesignCross-sectional analysis of data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort.Participants and settingNulliparous women (N=7,511) were enrolled across eight US medical centers from 2010 to 2013.Main outcome measuresA semiquantitative food frequency questionnaire assessing usual dietary intake during the 3 months around conception was self-administered during the first trimester. Diet quality, measured using the Healthy Eating Index-2010 (HEI-2010), and sources of energy and micronutrients were the outcomes.Statistical analysesDifferences in diet quality were tested across maternal racial or ethnic and education groups using F tests associated with analysis of variance and χ2 tests.ResultsHEI-2010 score increased with higher education, but the increase among non-Hispanic black women was smaller than among non-Hispanic whites and Hispanics (interaction P value

Purpose of Review: To summarize recent evidence from randomized controlled feeding trials (RCTs) on the effects of consuming plant- and animal-based protein-rich foods on cardiovascular health of adults. Recent Findings: Results from meta-analyses of RCTs exemplify the importance of considering relative effects of protein-rich foods, i.e., when intake of one food increases, intake of another food likely decreases. Results from short-term RCTs showed that overall diet quality is more influential for improving cardiovascular disease (CVD) risk factors than intake of a single protein-rich food, e.g., red meat. Yet, assessing long-term CVD risk associated with intake of a single protein-rich food as part of a dietary pattern is methodologically challenging. While accumulating evidence suggests gut microbiota as a potential mediator for such effects, current knowledge is preliminary and restricts causal or functional inferences. Summary: A variety of protein-rich foods, both plant- and animal-based, should be consumed as part of nutrient-dense dietary patterns to meet nutrient needs and improve cardiovascular health for adults. [ABSTRACT FROM AUTHOR]

Visual perception plays a key role in the selection of nutritious and healthy foods. Color, as one of the most important senses of vision, can be used as an indicator of food quality/defects and grade. It is recommended consumers include various colors in their plate to obtain various vitamins and minerals. Color is also thought to be related to antioxidant capacity. Within this regard, this study investigated the relationship between color and antioxidant capacity in various fruits and vegetables. The results indicate the color hues analyzed by computer vision based image analysis can be related with TAC of fruits and vegetables, but with some limitations and can be used as a guide for food selection to increase daily antioxidant intake. Most of fruits and vegetables having hue values above 180° and below 20°, have high antioxidant capacity (>10 mmol TE/kg fresh weight). The results also emphasized the importance of the serving size of fruits and vegetables in terms of their contribution to daily antioxidant intake. Based on these results, fruits and vegetables could be categorized into low-, medium-, and high-antioxidant groups according to their TAC and potential contributions to fulfill the recommended daily antioxidant intake. Finally, daily antioxidant intake was evaluated with a healthier scenario created by doubling vegetable portion and reducing fruit portion by half in the meal.

Background: Diet, as a modifiable factor, plays an important role in cognitive function. However, the association between adherence to the 2015-2020 Dietary Guidelines for Americans (DGA), measured by Healthy Eating Index (HEI)-2015, and cognitive function remains unclear. This study aims to explore whether HEI-2015 is associated with various cognitive domains and whether such association is modified by age, gender, or ethnicity in the US adults aged 60 years or older using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014.Methods: HEI-2015 scores were calculated from 24-h dietary recall interviews. Cognitive function was evaluated by Digit Symbol Substitution Test (DSST, a measure of processing speed), Animal Fluency Test (AFT, a measure of executive function), a subtest from Consortium to Establish a Registry for Alzheimer's disease (CERAD, a measure of memory), and a composite-z score calculated by summing z scores of individual tests. The associations between HEI-2015 scores and cognitive performance were explored using multiple linear regression models.Results: A total of 2450 participants aged 60 years or older were included. Participants with higher HEI-2015 scores were more likely to have higher DSST, AFT as well as composite-z scores (P<0.05). Significant interaction effects were identified between HEI-2015 and ethnicity in specific cognitive domains (Pinteraction<0.05). Among HEI-2015 components, higher intakes of whole fruits and seafood and plant protein were associated with better cognitive performance (P<0.05).Conclusion: Higher adherence to DGA is associated with better cognitive performance, especially regarding processing speed and executive function among the US adults aged 60 years or older. [ABSTRACT FROM AUTHOR]

Despite improvements in food production and healthcare services, the burden of malnutrition in Uganda has for the last 30 years remained unacceptably high with rates of stunting (chronic undernutrition) and anemia (proxy for micronutrient deficiency) currently estimated at 29% and 53%, respectively among young children aged 6-59 months. Considering that both undernutrition and over nutrition are greatly attributed to monotonous diets characterized by limited dietary diversity and overdependence on starchy refined grains or roots as staples, there is need to improve the population's awareness of appropriate dietary practices. To improve nutrition education, the Infant and Young Child-feeding national counseling cards for community volunteers (IYCF cards) that were developed by United Nations Children's Fund (UNICEF), are currently the standard package used in Uganda's health sector to educate caregivers on appropriate child-feeding practices. In this study, the effectiveness of a three-group food guide was evaluated against IYCF cards. A randomized, controlled intervention trial engaged three randomly selected distant groups of child-caregiver pairs (n=40) concurrently in one of three treatments namely: (i) nutrition education using a threefood group guide (FG), (ii) nutrition education using age-appropriate IYCF cards, and (iii) negative control group that engaged in hair-plaiting sessions. At baseline, all groups had randomly selected caregivers of children aged 6-14 months and were met once a week for five consecutive weeks during the intervention. Caregivers were interviewed at baseline and 2 months after the interventions to determine changes in child-feeding practices while their children were concurrently measured to determine changes in their nutritional status. At baseline, caregivers in the three treatment arms exhibited inappropriate child-feeding practices indicated by low child-feeding index (CFI) scores, which were also related to poor nutritional status of their children. After the interventions, children in FG group were given more varied animal-source foods than those in IYCF cards group (p = 0.02). Compared to controls, caregivers in FG group gave their children significantly more snacks (p = 0.01), their child-feeding practices indicated by CFI scores significantly improved (p = 0.001) and their children exhibited better growth patterns indicated by weight-for-age (p = 0.02) and MUAC-forage (p = 0.03) Z-scores. These findings, therefore, indicate that the three-group food guide is more likely to improve child-feeding practices and growth patterns than IYCF cards. Hence, there is need to integrate the food guide into IYCF materials to foster child-feeding practices and growth. [ABSTRACT FROM AUTHOR]

Background: The 2015–2020 Dietary Guidelines for Americans (DGA) recommends consuming low-fat or fat-free dairy foods due to concerns about energy and saturated fat intake. It also recommends consuming no more than 10% of daily calories from saturated fat.Objective: The objective was to assess the impact of replacing one serving of fat-free dairy foods in the Healthy U.S.-Style Eating Pattern (HUSEP) from the DGA with one serving of whole- or reduced-fat dairy foods. We hypothesized that this replacement would keep the HUSEP within calorie, saturated fat, and sodium limits.Methods: Utilizing the same modeling procedures as the 2015–2020 DGA, we assessed the nutrient composition of seven alternative models of the 2000-calorie HUSEP. These models replaced all three servings of dairy foods in the HUSEP with an updated fat-free dairy composite (Model 1) or one of three fat-free dairy servings in the HUSEP with: a whole-fat dairy food composite, a reduced-fat/low-fat dairy food composite, whole milk, reduced-fat milk, whole-fat cheese, or reduced-fat cheese (Models 2–7).Results: In all models, the amount of saturated fat did not exceed 10% of total calories, but the amount of energy increased by 45–94 calories. While still lower than current average intake (3,440 mg/d), sodium amounts in four of the seven models exceeded the 2,300 mg/d recommended intake level.Conclusions: Some reduced- and whole-fat dairy foods, especially milk, can fit into calorie-balanced healthy eating patterns that also align with saturated fat recommendations. Allowing some flexibility in fat level of dairy food servings aligns with the recommendations that calories from solid fats and added sugars are best used to increase the palatability of nutrient-dense foods.

This review of whole grain and dietary fiber recommendations and intake levels was presented at the symposium on whole grains, dietary fiber, and public health, convened in Beijing, China, on May 11, 2018. The review reflects on inconsistencies among the definitions of whole grains and fiber as well as recommended intake levels in different countries. The lack of consistent dietary recommendations from authoritative sources may delay the regional implementation and consumer adoption of diets that include whole grains and fiber. Currently, few countries include specific intake recommendations for whole grain, and even among those countries with guidance the recommendations can be vague and qualitative. As a result of the well-documented associations between increasing whole grain intake and reduced disease risk, there is compelling evidence to create dear, actionable dietary recommendations for both whole grains and fiber. Furthermore, work is ongoing to develop uniform standards for whole grain and whole-grain food to ensure recommendations are being met. Health and regulatory authorities are encouraged to acknowledge the public health benefits that could be derived from strong, dear whole-grain and dietary fiber recommendations; examine existing definitions (whole grain as an ingredient, whole-grain food, and dietary fiber); and adopt the most appropriate approach to best serve public health needs for their respective populations. [ABSTRACT FROM AUTHOR]

The aim of this article is to review the definitions and regulations for dietary fiber and whole grains worldwide and to discuss barriers to meeting recommended intake levels. Plant foods, such as whole grains, that are rich in dietary fiber are universally recommended in dietary guidance. Foods rich in dietary fiber are recommended for oil, but dietary recommendations for whole grains and dietary fiber depend on definitions and regulations. Official recommendations for dietary fiber in the United States and Canada are denoted by dietary reference intakes (DRIs), which are developed by the Institute of Medicine. An adequate intake (A!) for dietary fiber was based on prospective cohort studies of dietary fiber intake and cardiovascular disease risk that found 14 grams of dietary fiber per 1000 kilocalories protected against cardiovascular disease (CVD). This value was used to set Als for dietary fiber across the life cycle based on recommended calorie intakes. Actual intakes of dietary fiber are generally about half of the recommended levels. Recommendations for whole grain intake are equally challenging, as definitions for whole grain foods are needed to set recommendations. The 2005 Dietary Guidelines for Americans recommended that half of all grain sewings be whole grains, but usual intakes are generally less than 1 serving per day, rather than the recommended 3 servings per day. Scientific support for whole groin recommendations is based on the same prospective cohort studies and links to CVD protection used to inform dietary fiber guidance. Thus, dietary fiber is a recommended nutrient and whole grains are a recommended dietary pattern in dietary guidance in North America and around the world. Challenges for attaining recommended intakes of dietary fiber and whole grains include low-corbohydrate diets, low-gluten diets, and public health recommendations to avoid processed foods. [ABSTRACT FROM AUTHOR]

Objective: To determine availability of nutrition information for cancer patients and survivors from Irish healthcare organisations, cancer charity and support groups and assess its quality and readability. Design: Cross‐sectional. Setting: The National Health Service Executive websites were searched, as were the sites of the ten largest cancer charities/support groups identified through the Benefacts website. An additional internet search was conducted to ensure no large organisations/support groups were missed (February 2019). Quality of nutrition content was assessed using an evidence‐based checklist and readability assessed using two validated formulas. Results: Thirty‐two websites were identified, five contained nutrition information for cancer patients (15.6%), and three for cancer survivors (9.3%). The quality of the nutrition content ranged from 19.5 to 29/40 (mean ± SD, 23.2 ± 3.2; median = 21, interquartile range (IQR) = 7). There was a lack of practical strategies for implementation. Only 40% of material had an acceptable readability level (sixth–seventh grade level). Readability scores (mean ± SD) were 68.5 ± 6.0 for Flesch Reading Ease Score and 7.8 ± 1.1 for Flesch–Kincaid Grade Level Score. Conclusion: There is limited nutrition information on Irish health and cancer websites and in particular very few tailored to cancer survivors. Irish health and cancer organisations should consider providing nutrition information that is easily accessible to all. [ABSTRACT FROM AUTHOR]

Background and Objectives: To evaluate the effect of oral nutritional supplementation (ONS) on the postdischarge nutritional status and quality of life (QoL) of gastrointestinal cancer patients after surgery.Methods and Study Design: A multi-center study was conducted on gastrointestinal cancer patients who received surgical treatment from 2013-2015. All patients were screened using the Nutrition Risk Screening 2002 (NRS 2002) to assess nutritional risk. Patients with nutritional risk were randomized into two groups: patients in the study group (n=55) were given dietary guidance and ONS, control group (n=59) received only dietary guidance. Anthropometric measurements, nutrition-related laboratory tests, and gastrointestinal function scores were also collected and analyzed using Student's t test and analysis of variance (ANOVA). In addition, the EQ-5D was used to evaluate patients' QoL.Results: Compared with baseline measurements, the body weight of patients in the study group increased by 1.35±0.53 kg and 1.35±0.73 kg at 60 and 90 days, which were significantly higher than those in the control group (-1.01±0.54 kg, and -1.60±0.81 kg at 60 and 90 days). The results from ANOVA showed that only weight and BMI differed significantly between the study and control groups and also between different measurement times (p<0.01). No differences were found for the other indicators or QoL between the study groups.Conclusions: ONS may improve the weight and BMI of surgically treated gastrointestinal cancer patients postdischarge. However, these effects had little impact on patients' QoL. [ABSTRACT FROM AUTHOR]

As part of the revision of the 2007 Eating Well with Canada's Food Guide, a literature scan on statistical modeling approaches used in developing healthy eating patterns for national food guides was conducted. The scan included relevant literature and online searches, primarily since the 2007 Canada's Food Guide was released. Eight countries were identified as utilizing a statistical model or analysis to help inform their healthy eating pattern, defined as the amounts and types of food recommended, with many common characteristics noted. Detail on international modeling approaches is presented, highlighting similarities and differences as well as strengths and challenges. [ABSTRACT FROM AUTHOR]

The NOVA food categorisation recommends 'avoiding processed foods (PF), especially ultra-processed foods (UPF)' and selecting minimally PF to address obesity and chronic disease. However, NOVA categories are drawn using non-traditional views of food processing with additional criteria including a number of ingredients, added sugars, and additives. Comparison of NOVA's definition and categorisation of PF with codified and published ones shows limited congruence with respect to either definition or food placement into categories. While NOVA studies associate PF with decreased nutrient density, other classifications find nutrient-dense foods at all levels of processing. Analyses of food intake data using NOVA show UPF provide much added sugars. Since added sugars are one criterion for designation as UPF, such a proof demonstrates a tautology. Avoidance of foods deemed as UPF, such as wholegrain/enriched bread and cereals or flavoured milk, may not address obesity but could decrease intakes of folate, calcium and dietary fibre. Consumer understanding and implementation of NOVA have not been tested. Neither have outcomes been compared with vetted patterns, such as Dietary Approaches to Stop Hypertension, which base food selection on food groups and nutrient contribution. NOVA fails to demonstrate the criteria required for dietary guidance: understandability, affordability, workability and practicality. Consumers' confusion about definitions and food categorisations, inadequate cooking and meal planning skills and scarcity of resources (time, money), may impede adoption and success of NOVA. Research documenting that NOVA can be implemented by consumers and has nutrition and health outcomes equal to vetted patterns is needed. [ABSTRACT FROM AUTHOR]

It is the position of the Society for Nutrition Education and Behavior that environmental sustainability should be inherent in dietary guidance, whether working with individuals or groups about their dietary choices or in setting national dietary guidance. Improving the nutritional health of a population is a long-term goal that requires ensuring the long-term sustainability of the food system. Current environmental trends, including those related to climate change, biodiversity loss, land degradation, water shortages, and water pollution, threaten long-term food security and are caused in part by current diets and agricultural practices. Addressing these problems while producing more food for a growing population will require changes to current food systems. Dietary choices have a significant role in contributing to environmental impacts, which could be lessened by consuming fewer overconsumed animal products and more plant-based foods while reducing excess energy intake and the amount of food wasted. Discussion of sustainability within governmental dietary guidance is common in many countries, is consistent with previous US guidelines, and is within the scope of authorizing legislation. Dietary choices are a personal matter, but many American consumers are motivated by a concern for the environment and would welcome sound advice from credentialed nutrition professionals. More opportunities are needed for developing such interdisciplinary knowledge among nutritionists. [ABSTRACT FROM AUTHOR]

Introduction: Insulin resistance (IR) and pancreatic beta-cell dysfunction are core pathophysiologic features of type 2 diabetes mellitus (T2DM). Select lifestyle and pharmacologic interventions, including weight loss, physical activity, a Mediterranean diet intervention, and hypoglycemic agents, have been shown to prevent or delay T2DM. However, dietary factors other than weight loss may also impact risk, mainly through effects to enhance insulin sensitivity, although some may also directly or indirectly impact pancreatic beta-cell function. Areas covered: A literature review of observational studies and randomized controlled trials (RCTs) was conducted, and the research indicates dietary factors showing promise for reducing T2DM risk include higher intakes of cereal fibers, unsaturated fatty acids, magnesium, and polyphenols (e.g. anthocyanins), while reducing dietary glycemic load, added sugars, and high-sugar beverages. Expert commentary: While these dietary factors are mainly supported by evidence from observational studies and RCTs of surrogate markers for T2DM, they are consistent with current recommendations to emphasize consumption of whole grains, nuts, seeds, legumes, seafood, fruits, and vegetables, while limiting intakes of saturated fatty acids, refined carbohydrates, and processed meats. Additional dietary intervention RCTs are needed to assess the efficacy of these promising dietary interventions for delaying or preventing the onset of T2DM. [ABSTRACT FROM AUTHOR]

This investigation follows the shift in US “healthy diet” guidance from prevention of nutritional deficiencies to prevention of chronic diseases. In particular, it shows how the Dietary Goals for Americans, first published in 1977, came to be based on the relatively new science of nutritional epidemiology of chronic disease, a methodology of statistical analysis whose most influential datasets relied primarily on white health professionals deeply invested in cultural norms surrounding dietary health. With this scientific authority, health differences among subpopulations came to be blamed on a lack of agency at best, if not poor judgment and personal failure. [ABSTRACT FROM AUTHOR]