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Objective: The objective of the study was to compare the potential dietary impact of proposed and final front-of-pack labelling (FOPL) regulations (published in Canada Gazette I (CG1) and Canada Gazette II (CG2) , respectively) by examining the difference in the prevalence of foods that would require a 'High in' front-of-pack nutrition symbol and nutrient intakes from those foods consumed by Canadian adults., Design: Foods in a generic food composition database ( n 3676) were categorised according to the details of FOPL regulations in CGI and CGII , and the differences in the proportion of foods were compared. Using nationally representative dietary survey data, potential intakes of nutrients from foods that would display a 'High in' nutrition symbol according to CGI and CGII were compared., Setting: Canada., Participants: Canadian adults (≥ 19 years; n 13 495)., Results: Compared with CGI , less foods would display a 'High in' nutrition symbol (Δ = -6 %) according to CGII (saturated fat = -4 %, sugars = -1 %, sodium = -3 %). Similarly, potential intakes of nutrients-of-concern from foods that would display a 'High in' nutrition symbol were reduced according to CGII compared with CGI (saturated fat = -21 %, sugars = -2 %, sodium = -6 %). Potential intakes from foods that would display a 'High in' nutrition symbol were also reduced for energy and nutrients-to-encourage, including protein, fibre, calcium and vitamin D., Conclusions: Changes to FOPL regulations may have blunted their potential to limit intakes of nutrients-of-concern; however, they likely averted potential unintended consequences on intakes of nutrients-to-encourage for Canadians (e.g. calcium and vitamin D). To ensure policy objectives are met, FOPL regulations must be monitored regularly and evaluated over time.

This study investigates the impact of habitual late calorie intake on glucose metabolism in adults with overweight or obesity and diet or metformin-controlled prediabetes or type 2 diabetes independently of body weight, fat mass, energy intake or diet composition. Participants (n = 26) were classified as Later Eaters (LE) if ≥45% daily calories were consumed after 5 pm and Early Eaters (EE) if not, based on daily caloric intake assessed over 2-wk. EE and LE did not differ in anthropometrics or daily energy intake, but LE consumed more carbohydrates (p = 0.038) and fats (p = 0.039) after 5 pm. Fasting glucose, insulin, and C-peptide did not differ between groups but LE exhibited higher glucose concentrations after an oral glucose tolerance test (p = 0.001), even after adjusting for body weight, fat mass, energy intake and diet composition (p < 0.05). Glucose results remained when participants with T2D were excluded (p = 0.031). After diabetes status adjustment, differences in glucose concentrations were higher in LE for time 30 (p = 0.028) and 60 min (p = 0.036). LE, compared to EE, had poorer glucose tolerance, independent of body weight, fat mass, daily energy intake and diet composition. ClinicalTrials.gov: NCT04465721., (© 2024. The Author(s).)

Background: According to the World Health Organization report, immigrants are at increased risk of malnutrition. Nutritional deficiencies in pregnancy are a public health concern and around 20 to 30 percent of pregnant women suffer from it worldwide. There has not been any investigation about the effect of any intervention on improving nutritional intake in pregnant Afghan immigrant women. Therefore, the present study was conducted to determine the effect of nutrition education based on the Health Belief Model (HBM) on food intake in pregnant Afghan immigrant women., Methods: A semi-experimental study study was conducted on 116 Afghan immigrant pregnant women who have the inclusion criteria, were referred to health center No. 2 in Mashhad, Iran in June 2022 until February 2023, and were randomly assigned to the intervention (56) and control (56) groups. The demographic, HBM questionnaire and the standard 24-h food reminder questionnaire were the research tools. The intervention consisted of four sessions of 45-60 min of nutrition education based on the Health Belief Model in groups of 8-10 people. The questionnaires were completed before, immediately, and one month after the intervention by the research units. Data were analyzed with SPSS version 21 software., Results: The intake of energy, protein, carbohydrates, and micronutrients such as iron, calcium, zinc, and vitamin D increased in the intervention group immediately and one month after the intervention significantly compared to before the intervention (P < 0.05). Although all these nutrients intake had a significant decrease in control group women (P < 0.05)., Conclusions: Nutrition education based on the health belief model is effective in the nutritional intake of Afghan immigrant pregnant women. According to the importance of getting enough nutrients in pregnancy and its effects on the mother and fetus's health, nutrition education based on the Health Belief Model model is suggested for these mothers., Trial Registration: It is registered in the Iranian clinical trials database under the code: IRCT20220629055312N1, Date of first registration: 25/07/2022., (© 2024. The Author(s).)

Background: Many countries have introduced school food standards to improve the dietary intakes of school-aged children. England has school food standards (SFS) legislation in place but little is known about how well secondary schools comply with this. We aimed to assess compliance with the SFS legislation in English secondary schools and explore the impact of the SFS on pupils' nutritional intake., Methods: We conducted a cross-sectional study with English secondary schools from 2019 to 2022. We compared SFS compliance and pupil nutritional intake in schools mandated or not mandated to comply with the SFS legislation, and explored the association between school compliance and pupil nutritional intake. We assessed the percentage of SFS (%SFS) complied with by reviewing school food menus and observing food served in school canteens. We assessed pupil nutritional intake using a 24-hour dietary recall measure (Intake24) and estimated intakes of free sugar (primary outcome) and other nutrients/foods. We used adjusted multilevel models to compare pupil intakes in the SFS-mandated and SFS-non-mandated schools, and to explore the association between school SFS compliance and pupil intakes., Results: 36 schools (23 not mandated and 13 mandated to comply with the SFS) and 2,273 pupils participated. The median %SFS complied with was 63.9% (interquartile range 60.0-70.0%). This was similar for SFS-non-mandated (64.5%) and SFS-mandated schools (63.3%). Compliance was highest for standards applying to lunchtime (median = 81.3%) and lowest for those applying across the whole school day (median = 41.7%). It was also lower for standards restricting high fat, sugar and energy-dense items (median = 26.1%) than for standards aiming to increase dietary variety (median = 92.3%). Pupils from SFS-mandated schools had a lower mean lunchtime intake of free sugar (g) (adjusted mean difference: -2.78g; 95% CI: -4.66g to -0.90g). There were few significant associations between %SFS complied with and pupil nutritional intake., Conclusions: English secondary schools do not fully comply with SFS legislation regardless of whether they are mandated to comply. Schools and caterers may require monitoring and support to fully comply. There is little evidence that SFS compliance is associated with better pupil nutritional intake. Food environments outside of school also need to be considered., Study Registration: ISRCTN68757496 (17-10-2019)., (© 2024. The Author(s).)

Background: One in eight females will be diagnosed with breast cancer in their lifetime. While medical advances have increased the likelihood of survival, up to 90% of females will gain weight during and after treatment increasing the risk of breast cancer recurrence and obesity related co-morbidities in survivorship. Behavioral lifestyle interventions focused on diet with or without physical activity can provide breast cancer survivors non-pharmacological options to decrease weight gain and cardiometabolic risk., Method: A PubMed search was conducted to identify all behavioral lifestyle interventions focused on diet or diet combined with physical activity longer than 4 weeks of duration in breast cancer survivors that included body weight as an outcome. This review aims to summarize the effects on body weight, body composition and cardiometabolic risk markers are summarized., Results: Based on the review, there is high heterogeneity in type and duration of the intervention to affect weight and cardiometabolic risk in survivorship. Calorie restriction with and without physical activity appears to promote weight loss among breast cancer survivors. However, the effects on cardiometabolic factors are less clear., Conclusion: Future studies should be powered for both body weight and cardiometabolic effects. Researchers should also consider interventions that are: 1) less complex, 2) recruit a more racially and ethnically diverse sample, 3) integrate resistance training, 4) implement the intervention in closer proximity to diagnosis, 5) target weight management in this population before it occurs and 6) analyze body composition in addition to body weight measurements., (© The Author(s) 2024. Published by Oxford University Press.)

Background and Objective: Nutrition is a basic need for athletes; thus, adequate dietary intake is crucial for maintaining overall health, facilitating training adaptations and boosting athletic performance. Accurate dietary assessment tools are required to minimize the challenges faced by athletes. This study verifies the validity and reproducibility of a 157 item semi-quantitative food frequency questionnaire (FFQ) among Lebanese athletes. This is the only Arabic questionnaire in Lebanon that estimates food consumption for athletes which can also be used in Arabic speaking countries. There has been no previous validated food frequency questionnaire that estimated food consumption for athletes in Lebanon., Methods: A total of 194 athletes were included in the study to assess the validity of the food frequency questionnaire against four days dietary recalls by comparing the total nutrient intake values from the food frequency questionnaire with the mean values of four 24-hour dietary recalls using Spearman correlation coefficient and Bland Altman plots. In order to measure the reproducibility, the intra class correlation coefficients were calculated by repeating the same food frequency questionnaire after one month., Results: The intra-class correlation coefficient between the two-food frequency questionnaires ranged from average (0.739 for carbohydrates) to good (0.870 for energy (Kcal)), to excellent (0.919 for proteins) concerning macronutrients and ranged from average (0.688 for vitamin D), to excellent (0.952 for vitamin B12), indicating an acceptable reproducibility. Spearman's correlation coefficients of dietary intake estimate from the food frequency questionnaire and the four dietary recalls varied between 0.304 for sodium, 0.469 for magnesium to 0.953 for caloric intake (kcal). Bland-Altman plots illustrated a percentage of agreement ranging between 94.3% for fats to 96.4% for proteins., Conclusion: This food frequency questionnaire has a reliable validity and reproducibility to evaluate dietary assessments and is an appropriate tool for future interventions to ensure the adoption of adequate eating strategies by athletes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Sannan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Emotional eating (EE) is particularly prevalent in overweight or obese women, who may turn to food as a way to cope with stress, sadness, or anxiety. Limited research has been conducted on the association between EE and nutritional intake. Therefore, present study was designed to explore this association in adult women with overweight and obesity., Methods: In this cross-sectional study, the relationship between EE and nutritional intake in 303 overweight and obese women (aged 18-50 years) was examined. The researchers used the validated semi-quantitative Food Frequency Questionnaire (FFQ) to assess participants' nutritional intake and the Dutch Eating Behavior Questionnaire (DEBQ) to evaluate their eating behavior. To determine the association between EE and nutritional intake, we employed the multiple linear regression analysis., Results: The frequency of high intensity EE was 64.4% among the study participants and the mean total score of EE subscale of DBEQ was 2.32 ± 0.81. The total score of EE was positively associated with the energy intake (β = 0.396, P = 0.007), even after adjusting for age and BMI. In addition, a significant inverse association was found between the score of EE and the daily intake of calcium (β= -0.219, P = 0.026), riboflavin (β= -0.166, P = 0.043), and vitamin B12 (β= -0.271, P = 0.035), independent from energy and age. Also the results showed a significant positive association between the score of EE and the frequency of daily intake of cracker, muffin, cake, cream cake, pastry, candy, ice cream, pickles, melon, hydrogenated vegetable oil, peanut, salted and roasted seeds, and corn-cheese puff snack., Conclusion: This study found that overweight or obese women with higher intensity of EE might have a higher intake of energy and a lower intake of dietary calcium, riboflavin and vitamin B12. Integrating a balanced diet with psychotherapy is suggested to help individuals with EE reducing the urge to eat in response to emotions., (© 2024. The Author(s).)

Background: Gastrointestinal dysfunction is a common complication of medical nutrition therapy in critically ill patients. Whether prone positioning leads to a deterioration in gastrointestinal function has not been fully clarified. Thus, we aimed to analyze the influence of prone positioning on the tolerance of medical nutrition therapy., Methods: We conducted a retrospective analysis of 102 SARS-CoV-2 infected patients with venovenous extracorporeal membrane oxygenation support (VV ECMO). Gastric residual volume (GRV) was used to assess the tolerance of enteral nutrition., Results: Nutritional data were collected for 2344 days. Undernutrition was observed in 40.8%, with a significantly higher incidence on days in prone position (48.4% versus 38.6%, p < 0.001). On days in supine position, significantly more calories were administered enterally than on days in prone position ( p < 0.001). The mean GRV/24 h was 111.1 mL on days in supine position and 187.3 mL on days in prone position ( p < 0.001). Prone positioning was associated with higher rates of GRV of ≥500 mL/24 h independent of age, disease severity at ECMO start, ECMO runtime and ICU length of stay (adjusted hazard ratio: 4.06; 95%CI: 3.0-5.5; p < 0.001)., Conclusions: Prone position was associated with lower tolerance of enteral nutrition, as indicated by an increased GRV. As a result, reduced enteral nutritional support was administered.

Objective: To investigate the relationship between childhood consumption of ultra-processed foods and symptoms of hyperactivity/inattention in adolescents from São Leopoldo, a city in southern Brazil., Methods: Data were collected at four distinct stages: when participants were 12-16 months old in 2001 and 2002 and later when they were 3-4, 7-8, and 12-13 years old. During the interview at 12-16 months, mothers were asked about the introduction of sugar in their child's diet. Two 24-hour recall surveys were conducted with children aged 3-4, 7-8, and 12-13 years to assess their consumption of ultra-processed foods. At the age of 12-13 years, the participants completed the Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire (SDQ), which screens for mental health problems., Results: Among the 173 adolescents, 22.5% exhibited hyperactivity symptoms. The consumption of ultra-processed foods in grams, kilocalories, and as a percentage of energy intake at 3-4 years old were found to be predictors of hyperactivity/inattention symptoms (RR: 0.81, 95%CI: 0.69-0.95; RR: 1.01, 95%CI: 1.00-1.02; RR: 1.02, 95%CI:1.01-1.02; RR: 1.25, 95%CI:1.04-1.51, respectively)., Conclusion: The consumption of ultra-processed foods at an early age was associated with hyperactivity and inattention symptoms in adolescence.

Exercise is an essential component of body mass management interventions. Overnight-fasted exercise (FASTex) acutely enhances fat oxidation compared with fed exercise (FEDex). However, consistent FASTex training does not typically further enhance body mass loss, suggesting the induction of energy compensation responses. The present study aimed to test the effects of FASTex or FEDex on the components of energy balance (i.e., energy intake (EI), energy expenditure (EE), and appetite) and interstitial glucose metrics across four days., Methods: Twelve (10 men, 2 women) healthy, physically active participants (age 22.6 + 1.2 years (mean ± SD); BMI 22.5 ± 2.8 kg ⋅ m -2 ) were studied twice, across four days, after a 75-min run either FASTex or FEDex. Daily EI was obtained after subtracting leftovers from the provided food. Daily fasting appetite was measured by visual analogue scales. Activity- and total- EE (AEE & TEE, respectively) were estimated by combining heart rate and accelerometry. Continuous glucose monitoring was used to capture daily interstitial glucose metrics and Likert scales were utilised to quantify fatigue, stress, sleep quality, and muscle soreness levels., Results: No differences between conditions were observed for EI (FASTex = 15.0 ± 0.1 vs FEDex = 15.0 ± 0.4 MJ⋅day -1 ; p = 0.865), AEE (FASTex = 7.6 ± 1.1 vs FEDex 7.8 ± 1.3 MJ⋅day -1 ; p = 0.223) and TEE (FASTex = 15.9 ± 3.4 vs 14.9 ± 4.5 MJ⋅day -1 ; p = 0.136). Additionally, no condition effects for appetite (p > 0.05) and interstitial glucose (p = 0.074) were observed., Conclusion: FASTex did not differ from FEDex in the response of components of energy balance or interstitial glucose across four days, suggesting that both exercise approaches could be used interchangeably., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Unfavourable changes occur in children's health behaviours and outcomes during the summer holidays. This systematic review aimed to determine the effectiveness of summer holiday programs in mitigating these changes., Methods: Six databases (MEDLINE, JBI, PsychINFO, Embase, ERIC and Scopus) were systematically searched for experimental controlled studies that investigated programs of at least 5 days' duration conducted exclusively during the summer holiday period on school-aged children (5-18 years). Primary outcomes were moderate-vigorous physical activity and energy intake. Secondary outcomes were sedentary behavior, diet quality, adiposity, and cardiorespiratory fitness. Risk of Bias was assessed using the PEDro tool. Effect sizes were calculated using random-effects meta-analysis with narrative synthesis of effects by student or program characteristics., Results: Ten studies (two randomised controlled trials, and eight non-randomised controlled trials) involving 1,446 participants were included. Summer programs had a significant moderate effect on reducing sedentary behaviour (g= -0.59, 95%CI= -1.16, -0.03) and significant small effects on improving moderate-to-vigorous physical activity (g = 0.35, 95%CI = 0.02, 0.67) and adiposity (g= -0.25, 95% CI = -0.39, -0.10). No significant change was detected for cardiorespiratory fitness (g = 0.43, 95%CI= -0.32, 1.17), energy intake (g= -0.06, 95% CI -2.33, 2.22), or diet quality (g = 0.20, 95%CI= -0.43, 0.83). Summer program effectiveness did not appear to differ by child sociodemographic or program characteristics. Concerns regarding bias and high heterogeneity impacted results., Conclusions: Summer programs show potential in promoting healthier movement behaviours in children and supporting healthy body weight during the summer months. Although evidence from the included studies has limitations, these programs produced small to moderate effect sizes and present promising health intervention opportunities for children. Future research with more rigorous study designs and comprehensive reporting is needed to confirm these findings and better understand the impact of summer programs on children's health., Prospero Registration: CRD42023409795., (© 2024. The Author(s).)

Objective: To compare nutritional value and aspects with environmental impact of high-protein (HP) and 'normal-protein' (NP) ultra-processed foods (UPF)., Design: 299 HP and 286 NP products were evaluated regarding aspects of nutritional value, energy density, Nutri-Score, number of additives as well as hyper-palatability and price. Environmental impact of HP UPF was addressed by analysing protein sources and the use of environmentally persistent non-nutritive artificial sweeteners., Setting: Cross-sectional market analysis in German supermarkets and online shops., Participants: 299 HP and 286 NP UPF products., Results: HP compared to NP UPF had a lower energy density, a lower content of sugar, total and saturated fat, whereas fibre and protein content (62·2 % animal protein) were higher (all P < 0·001). HP products therefore had a higher prevalence of Nutri-Score A (67·2 % v . 21·7 %) and a lower prevalence of Nutri-Score E (0·3 % v . 11·2 %) labelling (both P < 0·001). By contrast, salt content and the number of additives (environmentally persistent sweeteners, sugar alcohols, flavourings) were higher in HP compared to NP UPF ( P < 0·001). When compared to HP products, twice as many NP were identified as hyper-palatable (82·5 % v . 40·5 %; P < 0·001). The price of HP was on average 132 % higher compared to NP UPF ( P < 0·001)., Conclusions: While major adverse aspects of UPF regarding nutritional profile and hyper-palatability are less pronounced in HP compared to NP products, higher salt content, increased number of additives and negative environmental effects from frequent use of animal protein and environmentally persistent sweeteners are major drawbacks of HP UPF.

Background: The inhalation of cooking-generated aerosols could lead to translocation to the brain and impact its function; therefore, the effects of cooking-generated aerosols on healthy adults were investigated using an electroencephalograph (EEG) during the 2 h period post-exposure. Methods: To explore any changes from the impact of exposure to cooking-generated aerosols on the human brain due to the absence of food intake during exposure, we divided the study participants into three groups: (A) no food intake for 2 h (2 h-zero calorie intake), (B) non-zero calorie intake, and (C) control group (simulated cooking). Results: The ultrafine particle concentrations increased from 9.0 × 10 3 particles/cm 3 at the background level to approximately 8.74 × 10 4 particles/cm 3 during cooking. EEGs were recorded before cooking (step 1), 60 min after cooking (step 2), 90 min after cooking (step 3), and 120 min after cooking (step 4). Comparing the non-zero calorie group with the control group, it was concluded that exposure to cooking-generated aerosols resulted in a 12.82% increase in the alpha band two hours post-exposure, compared to pre-exposure. The results revealed that zero calorie intake after exposure mitigated the impacts of cooking-generated aerosols for the alpha, beta3, theta, and delta bands, while it exacerbated effects on the whole brain for the beta1 and beta2 bands. Conclusions: While these are short-term studies, long-term exposure to cooking-generated ultrafine particles can be established through successive short-term exposures. These results underscore the need for further research into the health impacts of cooking-generated aerosols and the importance of implementing strategies to mitigate exposure., Competing Interests: The authors declare no conflict of interest.

Background/objectives: Energy availability (EA) is essential for maintaining physiological functions, significantly influencing athletes' health and performance. Nutritional behaviors, however, vary across sports. This study aims to assess EA levels in athletes from different disciplines, focusing on the relationship between EA and body composition in endurance athletes compared to rugby players., Methods: This study involved 18 endurance athletes (15 men, 3 women) and 36 rugby players (all men). Data were gathered through interviews, questionnaires, and bioimpedance analysis. Energy intake (EI) was measured with a 24 h dietary recall, and exercise energy expenditure (EEE) was calculated using the IPAQ questionnaire. EA was calculated as EA = (EI - EEE)/fat-free mass (FFM), with results categorized into clinical, subclinical, and optimal ranges., Results: The endurance group had a lower average FFM (57.81 kg) compared to the rugby players (67.61 kg). EA was also significantly lower in endurance athletes (11.72 kcal/kg FFM) than in rugby players (35.44 kcal/kg FFM). Endurance athletes showed more restrictive nutritional behavior with lower EI and higher EEE, but both groups maintained body composition within normal ranges., Conclusions: Endurance athletes exhibit greater nutritional restrictions compared to rugby players, though their body composition remains healthy. Further research is required to investigate the long-term effects of low EA on performance, injury risk, and potential impairment when EA falls below the optimal threshold of 45 kcal/kg FFM/day.

Background: Infant growth trajectories reflect current health status and may predict future obesity and metabolic diseases. Human milk is tailored to support optimal infant growth. However, nutrient intake rather than milk composition more accurately predicts growth outcomes. Although the role of protein leverage in infant growth is unclear, protein intake is important for early infancy growth., Materials and Methods: This study of exclusively breastfeeding mothers with allergies ( n = 161) from the Infant Fish Oil Supplementation Study assessed relationships between intake of human milk macronutrients and infant growth. Human milk fat, protein and lactose concentrations were measured at 3 months postpartum, and infant daily intakes were estimated using an average milk intake of 800 mL/day., Results: Higher human milk protein:energy ratio was associated with higher weight-for-age z-score at 2.5 years compared to 3 months and higher body mass index-for-age z-score change (6 months to 1 year compared to 3-6 months). Maternal atopy and birth season (summer) were negatively associated with human milk lactose concentration. Passive smoke exposure was associated with reduced energy and fat concentrations and increased lactose:energy ratio., Conclusions: Our results indicate that intake of human milk macronutrients may impact early childhood growth.

Background and Objective: Tools to accurately and efficiently measure dietary intake in Nigeria are lacking. We aimed to develop and assess the usability of a new online dietary assessment tool for Nigeria-myfood24 West Africa., Methods: We developed the myfood24 West Africa database using data from existing food composition tables, packaged foods labels and research articles. The development followed seven steps: identified data sources, selected foods, processed/cleaned the data, calculated the nutrient content of recipes, created and allocated portion sizes, quality-checked the database and developed food accompaniments. To pilot the tool, we recruited 179 university staff in Nigeria using a cross-sectional design. Usability was assessed using a questionnaire that included the System Usability Scale (SUS) and a feedback session., Results: The database included 924 foods, with up to 54 nutrients and 35 portion-size images allocated to foods. Sixty percent of the data were sourced from the 2019 West Africa Food Composition Table, 17% from back-of-pack labels of packaged foods, 14% from the 2017 Nigerian Food Composition Table, 5% from generated recipes and 4% from the published literature. Of the participants, 30% (n = 53) self-recorded their food intake, with a total of 1345 food and drink entries from both self- and interviewer-collected data. The mean SUS score of 74 (95% CI: 68,79) indicated good usability. The feedback showed that the tool was user-friendly, educational and included a variety of local foods., Conclusions: This new tool will enhance the dietary assessment of the Nigerian population. More work will expand coverage to include more foods from the region.

Objective: Medical nutrition therapy is an essential component of management of type 1 diabetes (T1D). This study evaluated adherence of children with T1D to ISPAD 2018dietary recommendations., Methods: Dietary assessmentconducted for 75 children with T1D of duration > 1-year., Results: Adherence to the recommendations was observed in 40% of participants. Mean (SD) % calorie intake from carbohydrate, fat and protein was 51.93 (6.08), 32.42 (5.66) and 15.95 (2.45), respectively. 68% participants had an energy deficit of >10% of the estimated average requirement. Children in "Adherent" group had significantly lower energy intake from carbohydrates [50.26 (2.11) % vs. 53.18(7.39) %], saturated fats (<10%) and higher from proteins [16.74 (1.68) % vs. 15.42 (2.75) %] as compared to "Non-adherent" group (p <0.05). The mean (SD) HbA1c (%) was significantly lower in the "Adherent" group [7.5 (0.50) vs 9.17 (1.12)]., Conclusion: Diet inlarge proportion of Indian children with T1D doesn't meetthe ISPAD recommendations.

Background: College athletes are often overlooked for metabolic syndrome (MetS), as their increased physical activity is assumed to reduce their disease risk. However, energy or macronutrient imbalance has been shown to increase risk independent of activity. The purpose of this investigation was to assess the current dietary habits of Division III female athletes and determine their associations with body composition and MetS. Secondly, we sought to determine whether dietary intake and dietary protein source (i.e., animal- and plant-based, ABP and PBP) and quality were associated with MetS, as estimated by the Simple Method for Quantifying Metabolic Syndrome (siMS) score and the siMS risk score, and whether protein pacing was associated with body composition in Division III female athletes., Methods: Stepwise linear regression determined whether age (years), body mass (kg), body mass index (BMI; kg/m 2 ), ABP (g/d), PBP (g/d), ABP:PBP, ratio of high-quality to low-quality ABP (ABP QR), relative energy intake (kcal/kg/d), and relative protein, carbohydrate, and fat intake (g/kg/d) were predictors of siMS score and siMS risk score., Results: Twenty-five athletes (19.6 ± 1.3 years; 65.9 ± 7.0 kg; 23.5 ± 2.0 kg/m 2 ; ABP 71.7 ± 28.2 g/d; PBP 30.0 ± 12.2 g/d) were included in the analyses. An inverse relationship was observed between PBP and the siMS score (F 1, 22 = 5.498, p = 0.028) and siMS risk score (F 1, 22 = 7.614, p = 0.011). The models explained 20% and 26% of the variance in siMS score and siMS risk score, respectively., Conclusions: PBP was associated with lower MetS risk in Division III female athletes, while ABP, regardless of quality, was unrelated. These associations were independent of physical activity in this cohort of Division III female athletes.

Background/objectives: Attention bias (AB) toward food is associated with obesity, but it is unclear if programs designed to reduce AB can impact adolescents' eating behavior. We investigated whether a two-week, smartphone-delivered attention retraining (AR) program (vs a control program) altered food AB in adolescent girls with overweight., Methods: Participants completed three food-cue visual-probe trainings/day. The AR and control programs directed attention away from food stimuli during 100% and 50% of trainings, respectively. Before and after completion of the programs, girls completed a food-cue visual-probe task while undergoing magnetoencephalography (MEG), and then a laboratory test meal., Results: Sixty-eight adolescents were randomized; 58 completed post-program visits. There was minimal effect of condition on AB scores (β [95%CI] = -1.9 [-20.8, 16.9]; d = -0.06). There was a small effect of condition on energy intake (EMM control = 1017 kcal, EMM AR = 1088 kcal, d = 0.29). Within the AR group, there was slightly blunted initial engagement in brain areas associated with reward response and subsequent increased goal-directed attention and action control., Conclusions: We found preliminary support for efficacy of an intensive smartphone-delivered AR program to alter neural correlates of attention processing in adolescent girls with overweight or obesity. Studies with larger sample sizes are needed to elucidate if AR trainings disrupt the link between food AB and eating behavior.

Plant-derived proteins are often deficient in essential amino acids and have lower rates of digestibility than animal-derived proteins. Blending different plant-derived proteins could compensate for these deficiencies and may augment postprandial aminoacidemia over single-source plant proteins. This study assessed plasma amino acids and appetite hormones, appetite sensations and ad libitum energy intake following ingestion of a pea-rice protein blend (BLEND), compared with pea-only (PEA) and whey (WHEY) protein. In a randomised, double-blind, crossover design, ten healthy adults (M n 4, F n 6; mean (sd) age 22 (sd 3) years; BMI 24 (sd 3) kg·m 2 ) ingested 0·3 g·kg·body mass -1 of BLEND, PEA or WHEY. Arterialised venous blood samples and appetite ratings were obtained in the fasted state and over 240 min postprandially. Energy intake was measured via an ad libitum buffet-style test meal. Mean plasma essential amino acid incremental AUC was higher in WHEY, compared with PEA ( P < 0·01; mean diff (95 % CI): 44 218 (15 806, 72 631) μmol·240 min·l -1 ) and BLEND ( P < 0·01; 14 358 (16 031, 101 121) μmol·240 min·l -1 ), with no differences between PEA and BLEND ( P = 0·67). Plasma ghrelin and glucagon-like peptide-1, appetite ratings and a d libitum energy intake responses did not differ between treatments ( P > 0·05 for all). Ingestion of a pea-rice protein blend did not augment postprandial aminoacidemia above pea protein, perhaps attributable to marginal differences in essential amino acid composition. No between-treatment differences in appetite or energy intake responses were apparent, suggesting that the influence of protein ingestion on perceived appetite ratings and orexigenic hormonal responses may not be solely determined by postprandial plasma aminoacidemia.

Snacking is a common dietary behaviour among adolescents contributing to more than one quarter of their total energy intake; however, the relationship between snacks and diet quality remains unclear. Hence, this study aimed to examine the characteristics of snacks among adolescents with different levels of diet quality. Dietary data collected from a nationally representative sample of Australian adolescents (12-18 years old, n = 935) using one 24-hour dietary recall in the National Nutrition and Physical Activity Survey were analysed. Snacks were defined based on participant-identified eating occasions, and diet quality was assessed using the Dietary Guideline Index for Children and Adolescents (DGI-CA). Marginal means and proportion of snack characteristics including snack frequency, snack energy density (ED), and commonly consumed foods at snack from the five food groups and discretionary foods at snack across DGI-CA tertiles (highest tertile indicating high guideline adherence) were estimated for both boys and girls using linear regression and logistic regression. Differences in means were tested using the F-test. The results showed no significant differences in the mean frequency of snacks across tertiles of DGI-CA scores. The mean ED of snacks decreased as DGI-CA scores increased in both boys (lowest tertile = 8.4, 95% CI [7.1, 10.0] kJ/g, highest tertile = 6.3 [5.4, 7.4] kJ/g) and girls (lowest tertile = 9.0 [7.8, 10.3] kJ/g, highest tertile = 5.9 [5.1, 6.9] kJ/g). As diet quality improved, the proportion of adolescents consuming discretionary (i.e., unhealthy) foods and foods from the five food group foods as snacks decreased and increased, respectively. In conclusion, adolescents with higher diet quality consumed snacks with a lower ED while lower proportion of them consume discretionary foods, and higher proportion of them consume from the five food groups. Encouraging the consumption of foods from the five food groups with lower ED as snacks presents an opportunity to enhance adolescent diet quality., (© 2024. The Author(s).)

Objective: To assess associations between self-reported advertising exposure to foods high in fats, salt and sugar and household purchases of energy, nutrients and specific product categories., Design: A cross-sectional design was used. Advertising exposure data were gathered using a questionnaire administered to the main shopper of each household, and purchase data from supermarkets and other stores for these households were accessed for a 4-week period during February 2019., Setting: Households in London and the North of England., Participants: Representative households ( N 1289) from the Kantar Fast Moving Consumer Goods Panel. Main shoppers were predominantly female (71 %), with a mean age of 54 years (±13)., Results: Linear regression models identified that exposure to foods high in fats, salt and sugar advertising through traditional mediums (including broadcast and print), but not digital, transport, recreational or functional mediums, was associated with greater purchases of energy (9779 kcal; 95 % CI 3515, 16 043), protein (416 g; 95 % CI 161, 671), carbohydrate (1164 g; 95 % CI 368, 1886) and sugar (514 g; 95 % CI 187, 841). Generalised linear models showed that individuals who reported exposure to sugary drink advertising were more likely to purchase sugary drinks (1·16; 95 % CI 2·94, 4·99) but did not purchase more energy or nutrients from sugary drinks. There was no evidence of associations between exposure to advertising for sugary cereals or sweet snacks and purchases from these categories., Conclusions: There was a strong influence of traditional advertising and sugar-sweetened beverage advertising on household food and drink purchases, thus supporting the need for advertising restrictions across traditional formats and for sugary drinks specifically.

Predictions of microbial crude protein (MCP) synthesis for beef cattle generally rely on empirical regression equations, with intakes of energy and protein as key variables. Using a database from published literature, we developed new equations based on the intake of organic matter (OM) and intakes or concentrations of crude protein (CP) and neutral detergent fiber (NDF). We compared these new equations to several extant equations based on intakes of total digestible nutrients (TDN) and CP. Regression fit statistics were evaluated using both resampling and sampling from a simulated multivariate normal population. Newly developed equations yielded similar fit statistics to extant equations, but the root mean square error of prediction averaged 155 g (28.7% of the mean MCP of 540.7 g/d) across all equations, indicating considerable variation in predictions. A simple approach of calculating MCP as 10% of the TDN intake yielded MCP estimates and fit statistics that were similar to more complicated equations. Adding a classification code to account for unique dietary characteristics did not have significant effects. Because MCP synthesis is measured indirectly, most often using surgically altered animals, literature estimates are relatively few and highly variable. A random sample of individual studies from our literature database indicated a standard deviation for MCP synthesis that averaged 19.1% of the observed mean, likely contributing to imprecision in the MCP predictions. Research to develop additional MCP estimates across various diets and production situations is needed, with a focus on developing consistent and reliable methodologies for MCP measurements. The use of new meta-omics tools might improve the accuracy and precision of MCP predictions, but further research will be needed to assess the utility of such tools.

Background/Objectives: Very low birth weight (VLBW) infants may require enhanced nutrition, even during complementary feeding. However, there are limited data on macronutrient intake during this period, particularly concerning the individual timing of the introduction of solid foods in a representative VLBW infant population. Methods: This prospective observational study analyzed macronutrient intake in VLBW infants with a gestational age < 32 weeks based on whether solid foods were introduced early (<17 weeks corrected age (CA)) or late (≥17 weeks corrected age) Nutritional intake was analyzed using a 24 h recall at 6 weeks CA and 3-day dietary records at 12 weeks, 6, 9, and 12 months CA. Results: In total, 115 infants were assigned to the early and 82 to the late group. The timing of solid food introduction did not affect macronutrient intake, except for a lower fat and higher carbohydrate intake (% of energy) in the early group at 12 weeks and 6 months CA: early vs. late, fat-12 weeks: 47.0% vs. 49.0%, 6 months: 39.2% vs. 43.3%; carbohydrates-12 weeks: 44.9% vs. 43.2%, 6 months: 51.3% vs. 48.0%. Apart from docosahexaenoic acid (DHA) and arachidonic acid (AA), dietary intake recommendations were met in both groups. While nutrient intakes varied significantly between breastfed and formula-fed infants, those with comorbidities exhibited similar nutrient intake levels compared to those without. Conclusions: Our findings suggest adequate macronutrient intakes in VLBW infants irrespective of the timing of solid introduction. However, there is a notable need to enhance dietary intakes of DHA and AA. Future research is crucial to assess whether current nutrient intakes are sufficient for VLBW infants with comorbidities.

Objective: This study aimed to assess and comparatively analyse two menus from a Young Offenders Institution (YOI). One menu from 2019, and one from 2022, with the objective of identifying any improvements in meeting dietary guidelines. Design: Cross-sectional and comparative analysis. Setting: United Kingdom, a YOI in Northern England. Participants: YOI Menus. Results: Analysis of 30 dietary components identified that 25 exceeded the dietary guidelines (P < 0.05) for the 2022 menu, with five failing to meet the guidelines (P < 0.05). When compared to the 2019 menu, the 2022 menu showed improvements in saturated fat, sodium, and vitamin D. Despite the improvement, vitamin D levels remained below dietary guidelines (P < 0.01). Salt and energy content were reduced in the 2022 menu (P < 0.05); however, they were still above the dietary guidelines (P < 0.01). Free sugars were significantly above dietary guidelines for both menus, with no significant change between the 2019 and 2022 menu (P = 0.12). Conclusion: The 2022 menu has demonstrated progress in alignment with meeting dietary guidelines, particularly in reducing calories, fat, saturated fat, salt, sodium, and chloride, as well as increasing vitamin D. Despite improvements, calories, free sugars, salt, saturated fat, sodium, and chloride are still exceeding dietary guidelines, posing as potential health risks., Competing Interests: The authors have no conflicts of interest to declare., (© The Author(s) 2024.)

Objectives: The association between ultra-processed foods (UPF) consumption and cognitive performance needs to be better characterized in adolescents, especially in low-income settings, where the cost of human capital is high. This study investigated the association between cognitive performance and UPF in adolescents from the countryside of the Brazilian Northeast., Methods: Adolescents (15-18 years old) from three public high schools were included. Food intake was assessed using three 24-hour dietary recalls. The classification of foods as UPF was determined according to the Nova classification. Cognitive performance was evaluated using the Non-Verbal General Intelligence Test., Results: 116 adolescents were included, of which 50 (43.1%) showed low cognitive performance. The average energy intake was 1973.5 kcal, with 24.2% coming from UPF. Participants with low cognitive performance consumed 26.5% (95% CI: [22.2; 30.7]%) of daily energy intake from UPF compared to 22.5% ([18.8; 26.2]%) of those with medium-high cognitive performance ( P = 0.17), without differences in energy and macronutrient intake., Conclusion: Despite similar UPF consumption compared to the Brazilian average, no association was found between UPF consumption and cognitive performance in this low-income adolescent sample., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 dos Santos, de Melo, Costa, de Almeida, Silva, Ferro, Paula, Macena and Bueno.)

Protein increases satiety by, among other things, increasing the content of certain amino acids in the blood. Plant proteins generally have a lower digestibility than meat proteins. The digestibility increases after extrusion; thereby, extrusion potentially also increases the satiating effect. We investigated subjective appetite and ad libitum energy intake (adlib&#95;EI) following ragú "bolognaise" meals with three different protein sources. We hypothesized that the satiating effect of texturized vegetable proteins (TVP) was comparable to that of animal protein (Meat) and that TVPs would have a stronger satiating effect than non-texturized legume proteins (Green). Test meals were theoretically designed to be similar in weight, energy (kJ), macronutrients and fiber. The in vitro protein digestibility (IVPD) and the amino acid composition were analyzed. A randomized, single-blinded, three-way, cross-over study including 25 healthy men was carried out. There were no significant differences between the three meals in terms of subjective appetite. The adlib&#95;EI was significantly lower after the TVP meal (758 kJ) than after the Meat meal (957 kJ), with the Green meal in between (903 kJ). The IVPD was significantly higher in the Meat meal (30.72%) than in the Green meal (20.17%), with the TVP meal in between (21.05%). In conclusion, the TVP meal had a higher long-term satiating effect than a similar meal with meat.

Sea otters are keystone predators whose recovery and expansion from historical exploitation throughout their range can serve to enhance local biodiversity, promote community stability, and buffer against habitat loss in nearshore marine systems. Bioenergetics models have become a useful tool in conservation and management efforts of marine mammals generally, yet no bioenergetics model exists for sea otters. Previous research provides abundant data that can be used to develop bioenergetics models for this species, yet important data gaps remain. Here we review the available data that could inform a bioenergetics model, and point to specific open questions that could be answered to more fully inform such an effort. These data gaps include quantifying energy intake through foraging by females with different aged pups in different quality habitats, the influence of body size on energy intake through foraging, and determining the level of fat storage that is possible in sea otters of different body sizes. The more completely we fill these data gaps, the more confidence we can have in the results and predictions produced by future bioenergetics modeling efforts for this species., Competing Interests: The authors have no conflicts of interest to disclose., (© The Author(s) 2024. Published by Oxford University Press and the Society for Experimental Biology.)

Objectives: This study aimed to compare diet-induced obesity (DIO) models in zebrafish and investigate the complications and differences between sexes in biochemical and inflammatory parameters., Methods: Adult animals of both sexes were divided into four groups ( n = 50) and fed for eight weeks: control group 1: Artemia sp. (15-30 mg/day/fish); control group 2: commercial fish food (3.5% of average weight); obesity group 1: pasteurized egg yolk powder + soybean oil (5% of average weight); obesity group 2: Artemia sp. (60-120 mg/day/fish). Dietary intake, caloric intake and efficiency, body mass index, biochemical, inflammatory, behavioral, histopathological, and stereological parameters, and inflammation-related gene expression were investigated., Results: Obesity group 1 was the most indicated to investigate changes in the anxious behavioral profile ( p < 0.05), triglyceride elevation [52.67 (1.2) mg/dL], adipocyte hypertrophy [67.8 (18.1) µm 2 ; p = 0.0004], and intestinal inflammation. Obesity group 2 was interesting to investigate in terms of weight gain [167 mg; p < 0.0001), changes in fasting glucose [48.33 (4.14) mg/dL; p = 0.003), and inflammatory parameters [IL-6: 4.24 (0.18) pg/mL; p = 0.0015]., Conclusions: Furthermore, both DIO models evaluated in the present study were effective in investigating hepatic steatosis. The data also highlighted that sex influences inflammatory changes and fasting blood glucose levels, which were higher in males ( p > 0.05). The results show new metabolic routes to be explored in relation to DIO in zebrafish.

Assessment of prisoners' diet showed that it is deficient in calories as well as in Recommended Daily Allowance values. Caloric value was about 64.9% deficient considering one serving (plate per time) taken. A quantitative-qualitative mixed approach was adopted. Convenient purposive sampling was employed to recruit 112 participants. For quantitative assessment a descriptive cross-sectional study design and semistructured data collection tool was used, and for qualitative evaluation, caloric and RDA value of different nutrients were calculated and in-depth interviews were conducted. Analysis showed that the diet provided was deficient in caloric and RDA values, thus the prison authority should design a proper strategy to ensure proper nutritional status of prisoners.

Nutrition plays a key role in maintaining health and physical condition, particularly for active individuals, including athletes. It can therefore be assumed that individuals performing physically demanding tasks during the organization of sporting events, such as volunteers, should also pay attention to their nutrition. While the importance of diet for athletes has been widely studied, the impact of nutrition on sports volunteers remains under-researched. Volunteers often have to cope with varying degrees of physical and mental exertion, which may affect their nutritional needs. A qualitative study was conducted using in-depth individual interviews (IDIs) with 17 sports volunteers who had experience in organizing various sporting events. Participants were purposefully selected based on specific inclusion criteria, which included active involvement in sports volunteering (with a minimum of two years of experience in volunteer activities) as well as volunteering experience at sports events of various scales. The interviews aimed to understand the eating habits, dietary awareness, and impact of nutrition on health and physical fitness. The data were transcribed and subjected to thematic analysis, focusing on coding responses and identifying recurring themes. Most participants did not place much importance on their diet, making random food choices due to a busy lifestyle and lack of time. Only a few volunteers consciously adjusted their diet when they had knowledge of the physically demanding tasks they were expected to perform during their volunteer work. The majority of volunteers relied on less reliable sources of nutritional information, such as blogs or social media, rather than credible sources of knowledge. This study revealed that many individuals involved in sports volunteering are unaware of the impact of diet on their fitness and health. There is a need for nutritional education for this group to improve their awareness of the importance of a balanced diet in the context of increased physical activity. It is also advisable to provide better nutritional conditions during sporting events and to promote the use of professional sources of information about healthy eating.

Introduction: Eating disorders (EDs) are debilitating mental illnesses that can lead to significant medical complications from malnutrition. Eating disorders are on the rise in Asia and the prevalence is expected to increase. The aim of this study was to understand the characteristics of local patients and evaluate our current inpatient nutritional rehabilitation protocol for anorexia nervosa (AN)., Methods: Retrospective descriptive data were gathered from 47 patients diagnosed with AN. Patients with admissions were further stratified according to their nutritional management based on whether they were on the AN protocol or standard hospital care. Data on their rate of weight gain, length of stay and calorie prescription were collected., Results: Similar to previous studies, the majority of AN patients were female (96.7%). However, the age at presentation of AN in this study, as compared with previous local studies, had decreased (14 vs. 16 years). We also found that patients on the AN protocol were prescribed a higher amount of calories than those given standard care (2,700 vs. 2,317 calories). Patients on the AN protocol achieved a higher rate of weight gain per week (1.15 vs. 0.29 kg) and had a shorter length of hospital stay (23 vs. 36 days)., Conclusion: Patients with AN appear to be presenting at a younger age. Medical stabilisation of AN patients can be achieved more quickly through a higher calorie inpatient AN treatment protocol. Future local studies examining actual calorie consumption, its effect on weight gain trajectory, severity of refeeding syndrome and time to remission will be beneficial., (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)

Excessive caloric intake and obesity due to high-fat (HFD) and high-disaccharide (HDD) diets have been recognized as major contributing factors to dyslipidemia and metabolic dysfunction-associated steatotic liver disease (MASLD). However, the effect of HFD and HDD without excessive caloric intake is obscure. The aim of the study was to evaluate the effect of physiological caloric intake delivered through HFD and HDD on liver and lipid profiles. The study was performed on 6-week-old male and female (50/50%) Sprague Dawley rats, receiving either a standard (controls, n = 16), HFD (n = 14) or HDD (n = 14) chow. All groups received the same, standard daily calorie rations, titrated weekly to the age of growing rats, for 12 weeks. A panel of metabolic in vivo measurement were performed, followed by histological, biochemical and molecular biology assays on tissues harvested from sacrificed rats. There was no significant difference between the groups in body weight. In contrast to controls, HFD and HDD groups showed metabolic dysfunction-associated steatohepatitis (MASH) characterized by liver steatosis, inflammation, ballooning of hepatocytes and fibrosis. These changes were more pronounced in the HFD than in the HDD group. The HFD group showed significantly higher serum LDL than controls or HDD rats. Furthermore, the HFD group had higher liver protein levels of low-density lipoprotein receptor (LDLR) but lower plasma levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) than the controls or HDD group. There were no differences between sexes in evaluated parameters. The excessive caloric intake and obesity are not prerequisites for the development of MASH and dyslipidemia in rats. The liver changes induced by the HFD and HDD diets exhibit differences in severity, as well as in the expression patterns of LDLR and PCSK9. Notably, these effects are independent of the sex of the rats., (© 2024. The Author(s).)

The authors highlight well-known and hypothesized pathophysiologic mechanistic links underlying obesity and the various pediatric disorders across multiple organ systems with which it is associated. Obesity is attributed to an imbalance in energy intake versus expenditure; there is growing knowledge regarding its multifactorial origins, dysfunctional physiologic processes, and adverse health consequences. Individuals with obesity exhibit variations in metabolic rate, genetic predisposition, and hormonal regulation, influencing diverse responses in regulating energy balance. Understanding the complex mechanistic relationships surrounding the pathophysiology of obesity assists in its consideration as a disease process, allowing pediatric health practitioners to manage its sequelae more effectively., Competing Interests: Disclosure F.C. Stanford has served as a consultant to Calibrate, GoodRx, Pfizer, Eli Lilly, Boehringer Ingelheim, Gelesis, Vida Health, Life Force, Ilant Health, Melli Cell, Novo Nordisk. Other sources of support: University of Colorado School of Medicine–Anschutz Medical Campus and the University of Colorado Nutrition Obesity Research Center, The Nutrition Obesity Research Center at the University of Colorado, Harvard University School of Medicine, Harvard University (NORCH), and the NORCH Diversity Scholars Program. Authors' contributions: S.W. Waldrop, A.A. Ibrahim, J. Maya, and C. Monthe-Dreze contributed equally to writing and editing this work. F.C. Stanford provided editorial and supervisory expertise., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The nutritional content of food in carceral institutions is important because it influences weight gain and health during incarceration. This systematic review assessed the available quantitative data and nutritional analyses of food in carceral institutions. Methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement with four phases (identification, screening, eligibility, and inclusion). Nine articles were selected. Most carceral institutions provided adequate nutrition for micronutrients, except for vitamin D (inadequate) and sodium (excessive). Most menus followed recommendations for macronutrients. Food from the commissary stores is high in calories, sugar, fat, and sodium. Most menus are adequate according to Dietary Reference Intakes. Changing menus drastically to meet nutritional targets may lead to consuming more food from commissary, potentially leading to poorer eating. For some menus, minor adjustments could bring the nutritional content closer to recommendations.

Background: To provide seamless nutritional support from early adulthood to late adulthood in Japan, this study aimed to identify aging-related changes in protein and fat intake and meal types., Methods: Birth cohort analysis was conducted in this study. The protein intake, protein-to-energy ratio, fat intake, and fat-to-energy ratio in men and women from their 20s to 60s in 2001 was calculated using the data of the National Health and Nutrition Survey in Japan between 2001 and 2019 (n = 139,876, 47.0% men, mean age: 54.9 and 55.4 years for men and women, respectively). The intakes were calculated for every subsequent year, the aging-related changes were identified by age group, and the 99 food groups were classified into staple-focused meal types through factor analysis. The weighted average component value per 1 g of each food group was calculated, multiplied by the food weight, and totaled to determine the mean intake by meal type and to confirm the aging-related changes. The year when the slope changed before and after was identified through Joinpoint regression analysis., Results: The protein intake, protein-to-energy ratio, fat intake, and fat-to-energy ratio initially declined or remained unchanged with aging in almost all generations (20s to 60s in 2001) but began to increase after 8-15 years. The food groups were classified into rice, noodle, and bread types. The protein and fat intake from the noodle type initially showed a decreasing trend but began to increase with aging after 8-15 years in almost all generations in both sexes (p < 0.05 for difference in slope)., Conclusions: The increase of protein intake and protein-to-energy ratio and fat intake and fat-to-energy ratio over time observed among Japanese adults may be related to the increased intake of food groups from noodle type meals. Thus, considering the type of staple food (i.e., rice, noodles, or bread) and its combination with other foods when adhering to a balanced diet is necessary., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Nutrition-related health disparities plague prisons in the United States. Unregulated and inadequate prison menus may contribute to noncommunicable chronic health conditions in this vulnerable population. The purpose of this research was to assess nutrition offerings provided by prison menus. Researchers requested the most current version of all master menus and associated nutrition analyses for gendered and age-centric (pediatric vs geriatric) menus. Menu and nutrient data were extracted and entered into a spreadsheet for analysis. Prisons serve gendered or nongendered menus to the general population, and 52.9% of prisons offer nongendered menus where males and females receive the same meals. This approach provides excess calories and saturated fat to females. Sodium was served in excess to both males and females. Fruit and vegetable servings on all gendered menus fell short of recommendations. The average prison menu inappropriately offers calories, sodium, and fruit and vegetable servings in a one-size-fits-all menu development method without considering gender, age, and physical activity. Interpretation and application of Dietary Guidelines for Americans are inconsistent. Nutrition guidelines recommending appropriate nutrients and food groups should be developed and available to corrections systems and dietitians. Current prison menu development practices yield inappropriate nutrition for prison populations.

Purpose: We quantified levels of ultra-processed food (UPF) consumption and investigated consumption patterns in a representative sample of UK adolescents., Methods: We used data from 4-day food diaries from adolescents in the UK National Diet and Nutrition Survey (NDNS) (2008/09-2018/19). UPF were identified using the NOVA classification. We estimated the percentage of Total Energy Intake (%TEI) and the absolute weight (grams). Linear regression models quantified differences in UPF consumption across survey years and its association with participant's individual characteristics. This was an analysis of the repeated cross-sectional data from the UK NDNS Rolling Programme waves 1-11 (2008/09-2018/19). A total of 2991 adolescents (11-18y) with complete information on dietary intake were included., Results: Mean UPF consumption was 861 (SD 442) g/d and this accounted for 65.9% (SD 13.4%) of TEI. Between 2008 and 2019, mean UPF consumption decreased from 996 to 776 g/d [ - 211 (95%CI  - 302;  - 120)] and from 67.7% to 62.8% of TEI [ - 4.8% (95%CI  - 8.1;  - 1.5)]. Higher %TEI was consumed by adolescents with lower socioeconomic status; white ethnicity and living in England North. A higher weight of UPF consumption (g/d) was associated with being male, white, age 18y, having parents with routine or manual occupation, living in England North, and living with obesity., Conclusion: Average energy intake from UPF has decreased over a decade in UK adolescents. We observed a social and regional patterning of UPF consumption, with higher consumption among adolescents from lower socioeconomic backgrounds, from a white ethnicity and living in England North. Our findings suggest inequalities associated with UPF intake and factors that might lie beyond individual choice., (© 2024. The Author(s).)

Background and Aims: The inconsistent data on thiamine status in obese subjects necessitates an examination of genes associated with intestinal absorption of thiamine. We aimed to reveal thiamine status in obese subjects and examine the expression of SLC19A2/3 genes encoding thiamine transporters and Sp1 transcription factor., Methods and Results: Thirty-five adult obese subjects and 11 healthy controls were included in this cross-sectional study. Small intestine epithelial cells were used for quantitative RT-PCR analysis of the gene expression. The daily thiamine and energy intake were assessed with a food frequency questionnaire. Thiamine phosphate esters were hydrolyzed to free thiamine, and liquid chromatography with a tandem mass spectrometry-based method was used to measure total thiamine in whole blood. Daily energy intake according to body weight and daily carbohydrate intake were not significantly different between groups after adjustment for sex. Although daily thiamine intake was significantly lower in the obesity group (p = 0.015), obese subjects had significantly higher whole blood thiamine levels than controls (44.96 ± 14.6 ng/mL and 33.05 ± 8.6 ng/mL, p = 0.002). There was a significant positive correlation between whole blood thiamine and BMI (r = 0.342, p = 0.020). SLC19A2 gene expression was lower in those with BMI ≥35 kg/m 2 (p = 0.036). A significant positive correlation was found between SLC19A2 expression and whole blood thiamine level (r = 0.310, p = 0.038)., Conclusion: A possible association between intestinal thiamine intake and total thiamine in whole blood was determined. The transcriptional changes of genes encoding the high-affinity membrane thiamine transporters, especially SLC19A2, probably play a role in this relationship., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background: Intensive care unit (ICU) protein benchmarks are based on mortality and morbidity; whether these targets also support functional recovery is unknown. We assessed whether different protein doses influenced patients' functional capacity, measured by the Chelsea Physical Assessment score (CPAx)., Methods: Single-center retrospective cohort study on ICU survivors with length of stay ≥7 days admitted between October 2014 and September 2020. Eligible patients were divided according to protein intake (g/kg/day): low (<0.8), medium (0.8-1.19), high (1.2-1.5), and very high (>1.5). Protein dose effect on CPAx was assessed at ICU discharge with analysis of covariance adjusting for age, illness severity, hospital length of stay before ICU admission, time to start nutrition support, and mechanical ventilation duration. We also investigated effect modification by energy intake and nutrition status., Results: Enrolled patients (n = 531) were similar for age, nutrition status, and illness severity across groups. CPAxs were nonlinearly associated with protein doses and similar among low, medium, and very high groups. The CPAx for the high group was statistically different (P = 0.014), indicating that the data of three groups could be pooled. Mean CPAx difference remained statistically significant after adjusting for confounding variables (3.9 ± 1.8, P = 0.029 in the four-group model, and 2.7 ± 0.9, P = 0.003 in the pooled two-group model). Energy intake was equivalent between groups and did not modify CPAx. The high group had superior CPAx in both well-nourished and malnourished patients, indicating nutrition status was not an effect modifier., Conclusion: Protein dose 1.2-1.5 g/kg/day was associated with superior functional capacity at ICU discharge compared with other doses. Neither energy intake nor nutrition status modified functional capacity across groups; therefore, the results appear to be influenced by 1.2-1.5 g/kg/day., (© 2024 American Society for Parenteral and Enteral Nutrition.)

Background & Aims: For children and adolescents undergoing hematopoietic stem cell transplant (HSCT), adequate protein and energy intake is essential to mitigate malnutrition risk. However, little is known about optimal requirements, including adequate dietary protein intake in this population. We conducted an international benchmarking survey and a scoping review to explore current practices in determining protein requirements (PR) and examine existing evidence for PR and dietary protein intake in pediatric HSCT., Methods: Twelve pediatric oncology centers were surveyed to elicit current practices in determining PR in pediatric HSCT. A scoping review then collected sources of evidence from six databases (MEDLINE, Embase, CINAHL, PubMed, Cochrane Library and Web of Science) and grey literature (Google Scholar)., Results: Survey data revealed variable practices in determining PR for pediatric HSCT patients. Four centers (44%) used the American Society for Parenteral and Enteral Nutrition (ASPEN) Nutrition Support in Pediatric Critically Ill Patient Guidelines 2009 and four (44%) used local guidelines or their national nutrient reference values (NRV). The scoping review included nineteen studies. The review highlighted a broad range of PR used in this population, ranging from 0.8 to 3.0 g/kg/d. Practices regarding the documentation and frequency of collecting protein intake data varied. Only five studies reported estimated protein requirement (EPR) status and just two studies met EPR. No clinical guidelines on PR in pediatric HSCT were identified., Conclusions: Given the existing gap in evidence, the optimal amount of protein required for children and adolescents undergoing HSCT remains unknown. To establish specific, evidence-based PR guidelines, comprehensive research is needed. Future investigations should prioritize evaluating current clinical practices, assessing the gap between actual protein intake and EPR, and understanding the relationship between protein intake, protein status, and the impact on treatment outcomes. Addressing these research priorities is crucial for bridging the current evidence gap, thereby enabling the development of enhanced and personalized nutritional support for children and adolescents undergoing HSCT., Competing Interests: Declaration of competing interest There are no conflicts of interest to this study., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background: Children who are critically ill are often reliant on enteral and oral nutrition support. However, there is limited evidence to guide "what" to prescribe, and current practice is unknown. The primary objective of this study was to describe enteral nutrition prescription in children ≤2 years of age in the pediatric intensive care unit (PICU). The secondary objectives were to describe oral nutrition support practices and factors associated with the use of increased energy and protein density nutrition support., Methods: Children ≤2 years of age admitted to participating PICUs over a 2-week period in June 2021 were enrolled. Data were collected on PICU admission days 1 to 7, 14, 21, and 28 on the mode of nutrition, enteral and oral nutrition support prescription, and dietitian intervention., Results: Eighty-four children were included (49 [58%] male; 79 [94%] ≤1 year of age). Enteral nutrition was administered to 79 (94%) children (with expressed breast milk in 45 [57%]). Forty-three children received formula as enteral nutrition. Increased energy and protein density formulas were provided to 14 (33%) children enterally, with concentrated standard infant formula powder being the most common (5 [12%]). Among children offered oral intake (22; 26%), three (14%) received oral nutrition support. Children who received increased energy and protein density enteral nutrition were more likely to receive dietitian intervention (P = 0.002)., Conclusion: In children ≤2 years of age admitted to PICU, expressed breast milk was provided to half of those requiring enteral nutrition and oral nutrition support prescription was infrequent. One third of children receiving formula via enteral nutrition received an increased energy and protein density feed, and this was strongly associated with dietitian intervention., (© 2024 The Author(s). Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.)

Introduction: Suboptimal nutrition promotes unfavorable outcomes in trauma patients, particularly among those aged 60 and over. While many institutions employ predictive energy equations to determine patients' energy requirements, mounting evidence shows these equations inaccurately estimate caloric needs. In this pilot randomized controlled trial, we sought to quantify the discrepancy between predictive equations and indirect calorimetry (IC)-the gold standard for determining energy requirements-in the older adult trauma population., Methods: This is a nested cohort study within a pilot randomized control trial in which 32 older adult trauma patients were randomized 3:1 to receive IC-guided nutrition delivery versus standard of care. IC requirements of patients in the intervention arm were compared to Mifflin St. Jeor (MSJ), Harris-Benedict (HB), and the American Society for Parenteral and Enteral Nutrition-Society of Critical Care Medicine (ASPEN-SCCM) predictive energy equations., Results: Twenty patients underwent IC to assess measured resting energy expenditure (mREE), yielding a mean (standard deviation) mREE of 23.1 ± 4.8 kcal/kg/d. MSJ and HB gave mean predictive resting energy expenditures of 17.5 ± 2.0 and 18.5 ± 2.0 kcal/kg/d in these patients, demonstrating that IC-derived values were 32.1% and 25.0% higher, respectively. When patients were stratified by body mass index (BMI), MSJ, and HB more severely underestimated caloric requirements in individuals with BMI <30 versus BMI 30-50. While the mean mREE fell within the mean predictive resting energy expenditure range prescribed by ASPEN-SCCM equations (21.4 ± 4.1 to 26.2 ± 4.3 kcal/kg/d), individuals' IC-derived values fell within their personal range in 8 of 20 cases., Conclusions: The MSJ and HB predictive energy equations consistently and significantly underpredict metabolic demands of older adult trauma patients compared to IC and perform worse in lower BMI individuals. ASPEN-SCCM equations frequently overpredict or underpredict resting energy expenditure. While these findings should be confirmed in a larger randomized control trial, this study suggests that institutions should prioritize IC to accurately identify the metabolic demands of older trauma patients., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aims/hypothesis: Understanding the impact of the overall construct of ultra-processed foods on diabetes risk can inform dietary approaches to diabetes prevention. In this study, we aimed to evaluate the association between ultra-processed food consumption and risk of diabetes in a community-based cohort of middle-aged adults in the USA. We hypothesised that a higher intake of ultra-processed foods is associated with a higher risk of incident diabetes., Methods: The study included 13,172 participants without diabetes at baseline (1987-1989) in the Atherosclerosis Risk in Communities (ARIC) study. Dietary intake was assessed with a 66-item semiquantitative food frequency questionnaire, and foods were categorised by processing level using the Nova classification system. Ultra-processed food was analysed categorically (quartiles of energy-adjusted intake) and continuously (per one additional serving/day). We used Cox regression to evaluate the association of ultra-processed food intake with risk of diabetes with adjustment for sociodemographic characteristics, total energy intake, health behaviours and clinical factors., Results: Over a median follow-up of 21 years, there were 4539 cases of incident diabetes. Participants in the highest quartile of ultra-processed food intake (8.4 servings/day on average) had a significantly higher risk of diabetes (HR 1.13; 95% CI 1.03, 1.23) compared with participants in the lowest quartile of intake after adjustment for sociodemographic, lifestyle and clinical factors. Each additional serving of ultra-processed food consumed daily was associated with a 2% higher risk of diabetes (HR 1.02; 95% CI 1.00, 1.04). Highest quartile consumption of certain ultra-processed food groups, including sugar- and artificially sweetened beverages, ultra-processed meats and sugary snacks, was associated with a 29%, 21% and 16% higher risk of diabetes, respectively, compared with the lowest quartile., Conclusions/interpretation: We found that a higher intake of ultra-processed food was associated with higher risk of incident diabetes, particularly sugar- and artificially sweetened beverages, ultra-processed meats and sugary snacks. Our findings suggest interventions reducing ultra-processed food consumption and specific food groups may be an effective strategy for diabetes prevention., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Our understanding of the pathophysiology of obesity remains at best incomplete despite a century of research. During this time, two alternative perspectives have helped shape thinking about the etiology of the disorder. The currently prevailing view holds that excessive fat accumulation results because energy intake exceeds energy expenditure, with excessive food consumption being the primary cause of the imbalance. The other perspective attributes the initiating cause of obesity to intrinsic metabolic defects that shift fuel partitioning from pathways for mobilization and oxidation to those for synthesis and storage. The resulting reduction in fuel oxidation and trapping of energy in adipose tissue drives a compensatory increase in energy intake and, under some conditions, a decrease in expenditure. This theory of obesity pathogenesis has historically garnered relatively less attention despite its pedigree. Here, we present an updated comprehensive formulation of the fuel partitioning theory, focused on evidence gathered over the last 80 years from major animal models of obesity showing a redirection of fuel fluxes from oxidation to storage and accumulation of excess body fat with energy intake equal to or even less than that of lean animals. The aim is to inform current discussions about the etiology of obesity and by so doing, help lay new foundations for the design of more efficacious approaches to obesity research, treatment and prevention., (© 2024 The Author(s). Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Background: Crossover studies can induce order effects, especially when they lack a washout period., Objectives: We performed secondary analyses comparing groups of subjects randomly assigned to different diet orders in 2 inpatient crossover studies originally designed to compare within-subject differences in ad libitum energy intake. One study compared minimally processed low-carbohydrate (LC) compared with low-fat (LF) diets, and the other matched macronutrients and compared minimally processed food (MPF) with ultraprocessed food (UPF) diets., Methods: Diet order group comparisons of changes in body weight and body composition, and differences in energy expenditure and food intake were assessed over 4 wk in 20 adults randomly assigned to either the LC followed immediately by the LF diet (LC → LF) or the opposite order (LF → LC), and 20 adults randomly assigned to either the MPF followed by the UPF (MPF → UPF) diets or the opposite order (UPF → MPF)., Results: Subjects randomly assigned to LC → LF lost 2.9 ± 1.1 kg more body weight (P <0.001) and 1.5 ± 0.6 kg more body fat (P = 0.03) than the LF → LC group, likely because the LC → LF group consumed 921 ± 304 kcal/d less than the LF → LC group (P = 0.003). These energy intake differences were driven by the last 2 wk (-1610 ± 312 kcal/d; P < 0.0001), perhaps because of carryover effects of gut adaptations during the first 2 wk arising from large differences in the mass of food (1296 ± 215 g/d; P <0.00001) and fiber consumed (58 ± 6 g/d; P <0.00001). There were no significant diet order effects on energy intake, body weight, or body composition changes between UPF → MPF and MPF → UPF groups., Conclusions: Diet order significantly affected energy intake, body weight, and body fat in a 4-wk crossover inpatient diet study varying in macronutrients, but not in a similarly structured study varying in ultraprocessed foods. This trial was registered at clinicaltrials.gov as NCT03407053 and NCT03878108., (Published by Elsevier Inc.)

Our study aims to define resting energy expenditure (REE) and describe the main nutritional patterns in a single-center cohort of children with Smith-Magenis syndrome (SMS). REE was calculated using indirect calorimetry. Patients' metabolic status was assessed by comparing measured REE (mREE) with predictive REE (pREE). Patients also underwent multidisciplinary evaluation, anthropometric measurements and an assessment of average energy intake, using a 3-day food diary, which was reviewed by a specialized dietitian. Twenty-four patients (13 M) were included, the median age was 9 years (IC 95%, 6-14 years), 84% had 17p11.2 deletion, and 16% had RAI1 variants. REE was not reduced in SMS pediatric patients, and the mREE did not differ from the pREE. In patients with RAI1 variants (16%, n = 3/24), obesity was more prevalent than those with 17p11.2 deletion (100% vs 38%). Lower proteins intake and higher total energy intake were reported in obese and overweight patients, compared to healthy weight children. No significant difference was found between males and females in energy or macronutrient intake., Conclusions: In SMS, the onset of obesity is not explained by REE abnormalities, but dietary factors seem to be crucial. Greater concern should be addressed to patients with RAI1 variants. A better understanding of the molecular mechanisms causing obesity in SMS patients could set the basis for possible future targeted therapies., What Is Known: • More than 90% of SMS patients after the age of 10 are overweight or obese., What Is New: • Onset of overweight and obesity in SMS pediatric patients is not explained by abnormal resting energy expenditure. • The development of syndrome-specific dietary guidelines for SMS patients should be of utmost relevance and are highly needed., (© 2024. The Author(s).)

Purpose: Taxes on unhealthy foods can help improve population health in the United Kingdom (UK), but the health effects of food substitutions resulting from these taxes are often unclear. We investigated the potential impacts of a salt and sugar tax on hypothetical intra-category food substitutions, cost, body-mass index (BMI), and environmental footprints., Methods: Purchase panel data from Kantar (2017) were used to determine the most popular foods high in salt or sugar within eight 'salt-intensive'/'sugar-intensive' food categories. Within food categories, the most popular lower salt (≤ 1.5 g salt/100 g product) and lower sugar (≤ 22.5 g sugar/100 g product) substitutes were also identified. Hypothetical swaps between high salt/sugar foods and lower salt/sugar substitutes were explored, focusing on changes to cost, caloric intake and BMI, and environmental impacts in the UK population., Results: The suggested intra-category substitutions were largely like-for-like and did not accrue an added overall cost to consumers. The substitutions reduced calorie intake by about 200 kcal/day and lowered the prevalence of overweight and obesity in the UK from approximately 60-65% to about 40-45%. The proposed food substitutions led to a total reduction of -2.7Mt of greenhouse gases, ∼ -500.000 ha of land, -0.5km 3 of blue water, -12km 3 of scarcity weighted water, ∼ -12.000t of phosphorus, and nearly - 14.000t of sulphur dioxide over one year for the UK population due to reductions in calorie intake., Conclusion: Food substitutions following a tax on salt and sugar could lead to significant benefits for health and the environment, without necessarily resulting in major changes to people's expenditure on familiar salty and sugary snacks., (© 2024. The Author(s).)

Background: Frailty, a prevalent geriatric syndrome, presents challenges exacerbated by malnutrition. Nutritional Management Interventions (NMIs) offer hope in frailty reversal, necessitating exploration of their multi-dimensional outcomes., Objectives: Assess NMIs' impact on frail and pre-frail older adults across diverse outcomes., Methods: A systematic review and meta-analysis of 13 studies (2012-2023) evaluated NMIs' effects on physical, dietary, psychological, and frailty aspects. Literature quality was assessed, and data analyzed with Review Manager 5.3., Results: A total of 13 studies involving participants were included in the analysis. Participants numbered 968, with the intervention group averaging 77.05±0.77 years and the control group 78.75±0.8 years. Compared to control groups,NMIs significantly increased body weight (SMD = 0.26, P = 0.03) and improved gait speed (SMD = 0.18, P = 0.03). Protein intake showed significance for interventions≤12 weeks (SMD = 1.04, P < 0.001). No significant differences in energy intake (SMD = 0.20, P = 0.60), but >12 weeks NMIs reduced energy intake (SMD = -0.73, P = 0.006). No significant differences in depressive symptoms, frailty scores, BMI, TUG, Handgrip Strength, or SPPB., Conclusion: This meta-analysis underscores NMIs' potential benefits for frail and pre-frail older adults. Personalized, multidimensional interventions are recommended despite study limitations, emphasizing extended interventions and diverse assessments for holistic care., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

People often fail to acknowledge external influences on their food intake, but there might be some circumstances in which people are willing to report that those external factors influenced their behavior. This study examined whether participants who believed that they had overeaten would indicate that the portion size they were served influenced their food intake. Participants (119 women) ate a pasta lunch at two separate sessions, one week apart. At the second session, participants were randomly assigned to receive either a regular portion of pasta (the same portion as the first session) or a large portion of pasta (a portion that was twice the size), and to receive false feedback about their food intake indicating that they had either eaten about the same as or substantially more than they had at the previous session. Participants were then asked to indicate the extent to which the amount of food served influenced how much they ate at that second session. Compared to participants who were informed that they had eaten the same amount across the two sessions, those who were informed that they ate more at the second session reported a stronger influence of the amount of food served if they also received a large portion of pasta, but not if they received a regular portion of pasta. These findings suggest that the willingness to implicate external influences (e.g., portion size) on one's food intake may be driven by a self-serving bias, providing an "excuse" for overeating. However, the external cue must be salient enough to be a plausible explanation for one's behavior., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)