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Background: A lifelong gluten‐free (GF) diet to manage coeliac disease is recognised to be challenging. This paper comprises two studies: study one aimed to report the opinions of adults with coeliac disease on review provision and explore factors influencing dietary adherence. Study two aimed to report dietetic provision for adults with coeliac disease. Methods: A cross‐sectional online survey was completed by 722 adults with coeliac disease, including validated dietary adherence, health literacy and quality‐of‐life questionnaires. An online and paper survey designed to capture the provision of dietetic services to adults with coeliac disease was completed by 88 dietetic departments within the United Kingdom. Results: Only 26% of adults with coeliac disease were offered annual reviews. In contrast, 85% considered reviews important, with 62% preferring dietetic provision. Those who considered reviews important had lower health literacy, greater dietary burden, poorer GF dietary adherence and lower GF food knowledge (all p < 0.05) compared with those who did not consider reviews important. GF dietary adherence was associated with health literacy, self‐regulatory behaviours, dietary burden and GF food knowledge; 53% agreed with the 'cost of GF food restricts what I eat'; they had poorer GF dietary adherence compared with those who disagreed (p < 0.001). More than 72% of dietetic coeliac review provision provided content on improving access to GF foods and eating out of the home. Conclusions: A subpopulation of adults with coeliac disease have a greater need for support and guidance, which supports the viewpoint that limited resources should be targeted towards patients with the most need for support to enable successful disease management. Key points: The majority of adults with coeliac disease were not receiving healthcare reviews for coeliac disease, whereas 85% would like to have reviews.Adults living with coeliac disease who had lower health literacy, poorer gluten‐free (GF) food knowledge and poorer GF dietary adherence score rated healthcare reviews as important.A varied provision of dietetic services for coeliac disease reviews was evident across the United Kingdom. [ABSTRACT FROM AUTHOR]

Background: There is a lack of simple tools that could allow members of the general population to estimate their own dietary patterns and to associate them with unfavourable health outcomes. The present study aimed to develop and validate a simple self‐administered tool, called the Easy Diet Screener (EDS), that would identify healthy and unhealthy dietary patterns and evaluate their association with unfavourable blood and anthropometric parameters (i.e. values outside the recommended values). Methods: In total, 259 adult people (31−50 years of age) participated in this observational study. They filled out an online version of the EDS questionnaire; those who scored highly were assigned to the healthy dietary pattern (HDP) group, whereas those with a low score were assigned to the western dietary pattern (WDP) group. The dietary records, anthropometric and biochemical parameters were evaluated in a subset of 200 participants who obtained similar score in the repeated EDS (paper version). Results: People assigned to HDP on the basis of EDS had significantly better diet quality than those assigned to WDP, with values of the Healthy Eating Index being 76.9 ± 9.2 and 58.7 ± 10.5, respectively. People classed as WDP had a higher risk of too high serum low‐density lipoproteins [odds ratio (OR) = 2.65], triglycerides (OR = 3.67), body mass index (OR = 2.87) and percentage of fat tissue (OR = 3.98) than did people in the HDP. Conclusions: EDS is an easy tool for quickly identifying healthy and western dietary patterns that are associated with lipid profile and body adiposity. Key Points: The newly developed Easy Diet Screener (EDS) distinguishes people with healthy and unhealthy dietary patterns.People classed as having an unhealthy/western dietary pattern on the basis of EDS have a higher risk of an undesirable lipid profile and body fat content.EDS can be used by anyone willing to self‐evaluate his or her diet because no nutritional knowledge is required to use it. [ABSTRACT FROM AUTHOR]

Background: As a nutritious food‐providing protein, essential fatty acids, vitamin D, iodine and choline eggs have historically been central to an infant weaning diet. However, food poisoning scares and allergy concerns have contributed to low consumption among infants aged 6–12 months. Methods: This paper presents a secondary data analysis of infant egg exposure and intake using three weaning data sets: a 7‐day food frequency questionnaire (n = 297), a 24‐h recall (n = 180) and a 3‐day weighed food diary (n = 71). Egg introduction, frequency of consumption and intake in grams were analysed for infants aged 6–8, 9–10 and 11–12 months). Comparisons were made by whether infants were following a baby‐led approach to weaning (where infants self‐feed family foods) or a traditional approach where pureed foods are given alongside finger foods. Data were collected in the United Kingdom between 2015 and 2018. Results: Our data showed that despite introduction being recommended from the start of weaning at 6 months of age by the Department of Health, just 54% of infants aged 6–8 months had ever been offered eggs. Average egg intake was one to two times per week, increasing with age. However, in terms of frequency and grams consumed, our data suggest a small increase in consumption compared with previous research, although limitations of our smaller sample size should be noted. Finally, a baby‐led approach was associated with increased exposure and consumption; baby‐led infants consumed eggs twice as frequently as spoon‐fed infants. Conclusions: The findings have important implications for public health messaging and for supporting families in introducing solid foods. Key points: Despite introduction being recommended from the start of weaning at age 6 months, just 54% of infants aged 6–8 months had ever been offered eggs.Only 40% of infants aged 6–8 months and about two‐thirds of those aged 9–12 months had consumed eggs in the last week. Those who had consumed eggs most commonly did so once or twice a week.Infants following a baby‐led weaning approach who self‐feed family foods were introduced to eggs at an earlier stage of weaning and consumed eggs twice as frequently as spoon‐fed infants. [ABSTRACT FROM AUTHOR]

Background: Evidence demonstrating efficacy of dietary interventions for autism spectrum disorder (ASD) remains inconsistent. Recent research on the ketogenic diet (KD) for the treatment of ASD has suggested a benefit. Children with ASD often demonstrate ritualised food‐specific behaviours, taste and texture aversions, and an increased prevalence of food restrictions and allergies. There is a need to investigate how these features contribute to initiation and adherence of the KD. Two surveys were administered to assess the feasibility of utilising the KD for ASD. Methods: First, paper surveys were given to caregivers of children presenting to outpatient neurology clinics. Next, experienced clinicians were recruited and surveyed online using Qualtrics. Chi‐squared analysis was used to compare ASD and non‐ASD caregiver responses. Descriptive metrics were used to present clinician responses. Responses to each question were evaluated individually. Results: One hundred and fourteen surveys were collected from caregivers. There were no significant differences in (1) stated feasibility of adopting a new diet, (2) a carbohydrate restricted diet, (3) diet restrictions, (4) documented allergies or (5) personal/cultural restrictions between groups with and without ASD. Seventy clinician responses were collected. The majority (67.4%) indicated that feasibility for a child with ASD to adopt a KD for any reason depends on ASD severity. Some respondents 73% rated adherence to the KD as more difficult compared to age‐matched controls, whereas 26% considered it similar. Multiple familial and child characteristics were rated as increasing the difficulty of successful KD. Conclusions: The results of the present study suggest that it is feasible for children with ASD to adopt a KD, and success is highly individualised to child and family. Key points: Key points assessing the feasibility of using the ketogenic diet in autism spectrum disorderRates of reported feasibility of adopting either a new diet, or a carbohydrate restricted diet, were similar between caregivers of children with autism spectrum disorder (ASD) and without ASD. A majority of caregivers of children with ASD indicated they either would be willing to try, or that it would be feasible, to adopt a carbohydrate restricted diet.Most experienced clinicians indicated the feasibility of adopting a carbohydrate restricted diet depended on ASD severity. Multiple factors were rated by experienced clinicians as contributing to increased difficulty for a child with ASD to successfully adopt a Ketogenic.The results suggest that it is feasible for children with ASD to adopt a ketogenic diet, and success is highly individualised to child and family. [ABSTRACT FROM AUTHOR]

Background: Assessment of dietary intake is fundamental for evaluating the interrelationships between diet and disease. The present study aimed to develop and validate the semiquantitative Cypriot food frequency questionnaire (CyFFQ). Methods: A 171‐item paper‐and‐pencil semiquantitative interview‐administered FFQ was developed, including local foods and culturally specific meals commonly consumed among Cypriot adults. FFQ reproducibility was assessed by comparing the energy‐adjusted daily macro‐ and micronutrients intake at baseline (FFQ1) and 1 year later (FFQ2) using a Wilcoxon matched pairs signed rank test and intraclass correlation coefficients (ICCs) in a random sample of Cypriot adults. FFQ relative validity was evaluated by comparing the intake as estimated by FFQ2 with that obtained from the average of three 24‐h recalls taken over the year between FFQ1 and FFQ2. Associations between nutrient intakes estimated using FFQ2 and the 24‐h recalls were assessed using Spearman rank correlation and Bland–Altman plots were used to assess agreement between the FFQ and the 24‐h recalls. Results: Among eligible participants, 68 (78%) completed the study (44.1% males, aged 30.5–47.5 years). The energy‐adjusted intakes of macro‐ and micronutrients did not significantly differ between the two FFQs, excluding magnesium. The FFQ2 and the averaged 24‐h recalls were significantly correlated for most macro‐ and micronutrients. The median (interquartile) ICC for all macro‐ and micronutrients was 0.46 (0.38–0.52) (p < 0.05). Agreement was satisfactory (>30%) for most micro‐ and macronutrients. Bland–Altman plots also confirmed good agreement between the two methods. Conclusions: The CyFFQ is a valid and reliable tool for assessing dietary consumption in Cypriot adults. Key points: Culturally applicable dietary intake assessment tools are necessary to evaluate the relationships between diet and health/disease aspects.The present study aimed to develop and validate the semiquantitative Cypriot food frequency questionnaire (CyFFQ).After developing a 171‐paper‐and‐pencil semiquantitative interview‐administered FFQ, including local and culturally specific meals, both reproducibility and relative validity were assessed in a random sample of Cypriot adults.In statistical analysis comparing the FFQ provided to the participants at baseline and 1 year later, energy‐adjusted intakes of macro‐ and micronutrients did not significantly differ between the two FFQs, with the exception of magnesium. A comparison between the energy‐adjusted daily macro‐ and micronutrients intake 1 year later (FFQ2) and the average of three 24‐h recalls provided between baseline and FFQ2 showed significant correlation and agreement, using various methods, for most macro‐ and micronutrients.Our findings indicate that the CyFFQ is a valid and reliable tool for assessing dietary consumption in Cypriot adults and thus can be used in future research. [ABSTRACT FROM AUTHOR]

Background Estimates of energy requirements are needed in weight management and are usually determined using prediction equations. The objective of these two systematic reviews was to identify which equations based on simple anthropometric and demographic variables provide the most accurate and precise estimates of (1) resting energy expenditure (REE) and (2) total energy expenditure ( TEE) in healthy obese adults. Methods Systematic searches for relevant studies in healthy adults with body mass index ( BMI) ≥25 kg m−2 and published in English were undertaken using Cinahl, Cochrane Library, OpenGrey, PubMed and Web of Science (completed March 2014). Search terms included metabolism, calorimetry, obesity and prediction equations. Data extraction, study appraisal and synthesis followed guidelines from PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Results From 243 REE papers and 254 TEE papers identified, 21 and four studies, respectively, met the inclusion criteria. (1) The most accurate REE predictions varied with BMI subgroup: WHO (weight and height) ≥25 and ≥30 kg m−2; Mifflin 30-39.9 kg m−2; Henry ≥40 kg m−2. The most precise REE predictions were obtained using Mifflin in BMI 30-39.9 and ≥40 kg m−2, where approximately 75% of predictions were within 10% of measured REE. (2) No accurate or precise predictions of TEE were identified. Conclusions No single prediction equation provides accurate and precise REE estimates in all obese adults. Mifflin equations are recommended in this population, although errors exceed 10% in 25% of those assessed. There is no evidence to support the use of prediction equations in estimating TEE in obesity. [ABSTRACT FROM AUTHOR]

Presents a questionnaire on the principles of dietary management of gestational diabetes. Purpose of the paper; Type of questions found; Return address of the completed questionnaires.

Inuit in Nunavut (NU) and Inuvialuit in the Northwest Territories (NWT), Canada, were traditionally nomadic peoples whose culture and lifestyle were founded on hunting and gathering foods from the local environment, primarily land and marine mammals. Lifestyle changes within the last century have brought about a rapid nutrition transition, characterised by decreasing consumption of traditional foods and an associated increase in the consumption of processed, shop-bought foods. This transition may be attributed to a multitude of factors, such as acculturation, overall food access and availability, food insecurity and climate change. Obesity and risk for chronic disease are higher in the Canadian Arctic population compared with the Canadian national average. This present review describes the study population and methodologies used to collect data in order to study the nutrition transition amongst Aboriginal Arctic populations and develop Healthy Foods North (HFN), a novel, multi-institutional and culturally appropriate programme that aims to improve dietary adequacy and reduce risk of chronic disease. Included in this special issue of the Journal of Human Nutrition and Dietetics are papers describing dietary intake patterns, physical activity levels, dietary behaviours, chronic disease prevalence and psychosocial factors that potentially mediate behaviour. A further paper describes how these data were utilised to inform and develop Healthy Foods North. [ABSTRACT FROM AUTHOR]

Presents a questionnaire related to the paper 'Socioeconomic differences among Australian adults in consumption of fruit and vegetables and intakes of vitamins A, C and folate,' and designed for continuing professional development in dietetics.

Background Short food questions are appealing to measure dietary intakes. Methods A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. Results Most questions assessed foods or food groups ( n = 29), with the most commonly assessed being fruit ( n = 22) or vegetable intake ( n = 23), dairy foods and discretionary foods ( n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency ( n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. Conclusions The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development. [ABSTRACT FROM AUTHOR]

Presents a questionnaire for the continuing professional development paper 'Intensive lifestyle intervention combined with the choice of pharmacotherapy improves weight loss and cardiac risk factors in the obese.' Contact information.

Background Orofacial granulomatosis ( OFG) is a rare disease of unknown cause. A cinnamon- and benzoate-free diet is successful in up to 72% of patients. Phenolic acids are among the chemical constituents restricted in this diet, which avoids some but not all of these structurally similar compounds. The present study aimed to: (i) develop a novel diet low in phenolic acids; (ii) implement this in a small clinical trial; and (iii) assess its nutritional adequacy. Methods A literature review identified 10 papers quantifying phenolic acids from which 91 10-mg phenolic acid exchanges were devised. A phenolic acid exclusion diet with precautionary micronutrient supplementation was designed and implemented in 10 patients. Phenolic acids were excluded for 6 weeks and were reintroduced at a rate of one exchange every second day for 6 weeks. Wilcoxon matched pairs tests analysed disease outcomes measured by an oral disease severity scoring tool at weeks 0, 6 and 12. Nutritional adequacy was assessed, excluding micronutrient supplementation, at weeks 0 and 6, and compared intakes with dietary reference values. Results The diet was nutritionally inadequate for a range of micronutrients. Seven of 10 patients responded. Mean [standard deviation (SD)] severity scores improved from week 0-6 [20.8 (9.39) and 10.1 (5.72); P = 0.009] and were maintained in five patients who completed the reintroduction [6.6 (3.13) and 7.2 (5.54); P = 0.713]. Conclusions A low phenolic acid diet with micronutrient supplementation holds promise of a novel dietary treatment for OFG. Further work is required in larger studies to determine long-term outcomes. [ABSTRACT FROM AUTHOR]

Background Interprofessional education (IPE) is a novel teaching and learning initiative where students of more than one health profession learn interactively together. However, despite its potential for improving interprofessional relationships, there is little information regarding the participation of student dietitians in IPE. The aim of this paper was to consider the reaction of student dietitians to an IPE course in order to stimulate debate between dietitians regarding the issues relating to IPE. Methods Student dietitians participated in an IPE course consisting of seven sessions on communication and ethics in health care together with students of medicine and nursing. Student dietitians completed an evaluation questionnaire following each session that surveyed their reaction to the session using both a Likert scale and free-text comments. Results Twenty-six student dietitians completed the IPE course. All sessions were rated positively for interest value ( P ≤ 0.14), learning experience ( P ≤ 0.036) and value for clinical practice ( P ≤ 0.05). The limited number of free-text comments indicated some positive experiences regarding interprofessional learning, teaching content and teaching strategy. Conclusions This is one of very few evaluations to describe the reaction of student dietitians to IPE. Student dietitians had largely positive reactions to the IPE course. Further research is required to evaluate whether these positive reactions were a direct consequence of the inclusion of students from other health professions and whether these translate into positive effects on learning, behaviour and results. The opportunities for the dietetic profession posed by students’ involvement in IPE are discussed. [ABSTRACT FROM AUTHOR]

Background: People with ileostomy are frequently advised to avoid specific foods and food groups, making it plausible that they are at risk of a range of nutrition‐related adverse health consequences. Despite this there has been no recent study in the United Kingdom describing dietary intake, symptoms and food avoidance in people with ileostomy or post‐reversal. Methods: A cross‐sectional study was conducted at different time points in people with ileostomy and reversal. Participants were recruited at 6–10 weeks post‐formation (n = 17) and ≥12 months with established ileostomy (n = 16) and with reversal (n = 20). In all participants, ileostomy/bowel‐related symptoms in the previous week were assessed using a study‐specific questionnaire. Dietary intake was assessed using three online diet recalls or 3‐day dietary records. Food avoidance and reasons for food avoidance were assessed. Data were summarised using descriptive statistics. Results: Participants reported a few ileostomy/bowel‐related symptoms in the previous week. However, over 85% of participants reported avoiding foods, particularly fruits and vegetables. At 6–10 weeks the most common reason was being advised to do so (71%), although 53% avoided foods due to gas. At ≥12 months the most common reasons were foods visible in the bag (60%) or advised to do so (60%). Reported intakes of most nutrients were comparable to population medians, apart from lower fibre in people with ileostomy. Intakes of free sugars and saturated fats were above recommended levels in all groups, due to high consumption of cakes and biscuits and sugar‐sweetened drinks. Conclusion: After the initial healing period, foods should not be automatically excluded unless found to be problematic after reintroduction. There may be a need for healthy eating advice for people with established ileostomies and post‐reversal, targeting discretionary high‐fat, high‐sugar foods. Key points: People with ileostomy reported a few symptoms, but food avoidance was common, particularly of fruits and vegetables. The most common reason for avoiding a food was being advised to do so.Reported intakes of most nutrients were comparable to population medians, apart from fibre in people with ileostomy, mainly due to the low consumption of fruits and vegetables.People with ileostomy and ileostomy reversal reported high intakes of cakes, biscuits and sugar‐sweetened drinks, which resulted in diets high in saturated fat and free sugars. There may be an unmet need for dietary advice targeting high‐fat, high‐sugar discretionary foods in this population. [ABSTRACT FROM AUTHOR]

Background: Lack of adherence is a primary reason people fail to maintain a healthy diet or lose weight. Multiple environmental factors, including aggressive marketing and convenience of nutrient‐poor food, undermine people's best intentions. The aim was to assess the feasibility, acceptability and impact of food prescriptions in which participants' exposure to commercial food outlets is reduced, because the groceries are delivered with weekly menu plans and recipes. Methods: This is a series of pre‐post pilot proof‐of‐concept studies. We recruited 37 members of Kaiser Permanente interested in improving their diet or losing weight. Weekly meal plans meeting more than 90% of recommended dietary allowances were designed to be low cost, in line with Supplemental Nutrition Assistance Program (SNAP) allowances. Five separate pilots targeted different populations. Participants were required to provide 24‐h dietary recalls (ASA24) before and during the interventions. Weight management pilot participants had height, weight and blood pressure measured before and after 4‐week pilots and followed sustainability guidelines, limiting meat and dairy. Results: Across pilots, the healthy eating index improved (+21.1 points; 95% CI [confidence interval] 15.9, 26.3). For the weight management pilots, most participants lost weight (average 10.3 lbs for men, 5.7 lbs for women; 95% CI −10.2, −5.4). The majority of participants liked the programme and considered it the easiest weight loss programme they ever tried. Conclusions: These pilots suggest that meal planning and grocery delivery can be affordable and acceptable and could ultimately have a major impact on diet‐related chronic diseases. Longer‐term studies are needed to confirm how long compliance will endure. Key points: Healthy groceries meeting recommended dietary allowances and sustainability guidelines are affordable and fall within Supplemental Nutrition Assistance Program maximum allotments for <2000 calories per person per day.Menu planning and grocery delivery resulted in significant improvements in the healthy eating index.For overweight/obese individuals, 1500‐calorie meal plans/groceries resulted in significant weight loss among most participants. [ABSTRACT FROM AUTHOR]

Background: Coeliac disease (CeD), a common autoimmune condition, requires strict adherence to a gluten‐free diet (GFD). Adherence to the GFD has been associated with quality of life (QOL). However, there may be other diet‐related concerns, such as overall diet patterns, including diet quality or ultra‐processed food (UPF) consumption, possibly associated with QOL among people with CeD following a GFD that have not been examined. Methods: Diet quality was determined based on 24‐h diet recalls of a cross‐sectional prospectively recruited sample of 80 participants (50 adults and 30 teens) with biopsy‐confirmed CeD ('Study Sample') using the Healthy Eating Index and Alternate Mediterranean Diet score. The amount of UPF consumed was assessed using Nova, a food processing classification system. QOL was measured using Celiac Disease‐Specific Quality of Life (CDQOL) and Celiac Disease Pediatric‐Specific Quality of Life (CDPQOL). The Study Sample's diet patterns were compared with National Health and Nutrition Examination Survey (NHANES) groups (25 adults reporting prior CeD and GFD; 51 adults with new CeD and no GFD; 15,777 adults and 2296 teens without CeD). The relationship of the Study Sample's diet patterns with CDQOL/CDPQOL was assessed using analysis of covariance. Results: The Study Sample's diet patterns were suboptimal but generally favourable compared with all NHANES groups. Compared to Study Adults with the highest tertile of UPF, those with the lowest tertile had significantly higher CDQOL (mean: 67.6 vs. 78.3, p < 0.001). Compared to Study Teens with the lowest tertile of AMED, those with the highest tertile had significantly higher CDPQOL (mean: 67.0 vs. 79.9, p < 0.01). Conclusions: Maintaining high diet quality and minimising UPF may be important for CeD‐specific QOL among individuals with CeD maintaining a GFD. Key points: In a sample with coeliac disease, diet quality was moderately high, with concerning amounts of ultra‐processed foods (UPFs).They consumed higher‐quality diets and less UPFs than the representative population.Higher quality of life was associated with a higher diet quality and less UPF consumption. [ABSTRACT FROM AUTHOR]

Background: Beverage intake in employees is important to quantify due to the potential of dehydration to increase the risk of errors and reduced work performance. This systematic review aimed to (1) characterise existing fluid intake measurement tools used in the workplace setting or among free‐living, healthy adults of working age and (2) report the current validation status of available assessment tools for use in a UK setting. Methods: Three electronic databases were searched for publications measuring beverage intake using a defined tool or method. Additional studies were identified by hand from trial registers, grey literature and reference lists. Eligibility was determined using predefined inclusion/exclusion criteria. Study quality was assessed using a modified Strengthening the Reporting of Observational Studies in Epidemiology framework. Narrative synthesis was performed. Results: The review identified 105 studies. The most frequently reported beverage assessment methods were total diet diaries/records (n = 22), fluid specific diaries/records (n = 18), food and fluid frequency questionnaires (n = 17), beverage‐specific frequency questionnaires (n = 23) and diet recalls (n = 11). General dietary measurement tools (measuring beverages as part of total diet) were used in 60 studies, and 45 studies used a beverage‐specific tool. This review identified 18 distinct dietary assessment tools, of which 6 were fluid/beverage specific. Twelve tools published relative validity for a beverage‐related variable and seven tools for total daily fluid intake (from whole diet or from beverages only). Conclusions: Several fluid intake assessment tools were identified; however, few have been fully evaluated for total beverage intake, and none in a UK working population. Key points: Beverage intake in employees is important to quantify due to the potential of dehydration to increase the risk of errors and reduce work performance.Existing studies that measure beverage intake in free‐living, working‐age adults tend to use whole dietary assessment tools, such as diet records or recalls, rather than beverage‐specific measurement tools.Few dietary assessment tools have been validated and reliability tested against beverage intake, and none has been evaluated in a UK working‐adult population. [ABSTRACT FROM AUTHOR]

Background: Dietary composition influences the composition of the gut microbiota in healthy adults. Little is known about the effect of dietary patterns on gut microbiota composition in pregnancy. This cross‐sectional study aimed to investigate the associations between two diet quality scores adapted from the Australian Recommended Food Score (ARFS) and the Mediterranean Dietary Score (MDS) with the composition of the gut microbiota in pregnant women with excess body fat at 28 weeks' gestation. Methods: Women from the Study of Probiotics IN Gestational diabetes (SPRING) who had completed a food frequency questionnaire (FFQ; n = 395) were classified according to tertiles of ARFS and the MDS. Higher dietary pattern scores in both the ARFS and the MDS represent better diet quality. Gut microbiota composition was assessed using 16S rRNA gene amplicon sequencing and analysed using MicrobiomeAnalyst in a subset of 196 women with faecal samples. Results: No significant difference was found in alpha or beta diversity. A higher ARFS was associated with a higher abundance of Ruminococcus and lower abundance of Akkermansia, whereas a higher MDS was associated with a higher abundance of Ruminococcus and Butyricicoccus, though these changes disappeared after correction for multiple testing. Conclusion: These results suggest that dietary patterns defined by the ARFS and MDS were not associated with gut microbiota composition in pregnant women classified as overweight and obese at 28 weeks' gestation within this study. Key points: This is the first study to investigate the relationship between two distinct dietary patterns and gut microbiota composition in women with overweight and obesity at 28 weeks' gestation.Compared with other cohorts, pregnant women's overall diet quality was low; even in the highest tertile of Australian Recommended Food Scores (ARFS), women still had a diet low in nutrients, fibre and diversity of foods eaten. Mediterranean Diet Scores (MDS) had higher means in the nonbeneficial, low‐fibre, component scores of dairy and meat, lower component mean scores in the beneficial, high‐fibre components of fruit and nuts, and vegetables representing a westernised version of the MD pattern.No significant associations were observed between the MDS or ARFS tertiles and overall diversity of the gut microbiota or genus abundance. [ABSTRACT FROM AUTHOR]

Background: Previous findings from research investigating the role of antenatal nutrition in preventing postpartum depression (PPD) are inconsistent. Our primary aim was to investigate the association between pregnancy diet quality and PPD. Our secondary aim was to investigate associations between (a) diet quality and depression during pregnancy and (b) depression during pregnancy and PPD. Methods: This analysis represents data from 73 women participating in the Microbiome Understanding in Maternity Study (MUMS) cohort in Sydney, Australia, which followed women from Trimester 1 of pregnancy to 1‐year postpartum (PP). Participants' diet quality was assessed using the Australian Eating Survey at Trimester 1 and 3 to calculate diet quality, known as the Australian Recommended Food Score (lower diet quality defined as score <39; higher diet quality ≥39). Depression was assessed using the Edinburgh Depression Scale at Trimesters 1, 2, 3 and 6 weeks PP (defined as score ≥11). Results: Depression scores during pregnancy were significantly associated with depression score 6 weeks PP (Trimester 1: r = 0.66, Trimester 2: r = 0.69, Trimester 3: r = 0.67; all p < 0.001). Diet quality during pregnancy was not significantly correlated with 6‐week PPD score. In unadjusted analysis, diet quality during pregnancy was not associated with pregnancy depression scores. When adjusted for age, parity and Trimester 1 body mass index, Trimester 1 physical activity levels and gestational weight gain, higher Trimester 3 diet quality was associated with reduced Trimester 3 depression only. Conclusions: Depression scores during pregnancy were positively associated with PPD, highlighting the importance of screening for depression during pregnancy and postnatally. Larger longitudinal prospective studies may elucidate the association between diet quality and PPD. Highlights: Depression during pregnancy was associated with postpartum depression score, highlighting the importance of adhering to routine screening guidelines throughout the perinatal period.Although diet is clearly important for the health of both the mother and the developing foetus during pregnancy, our analysis of data from the Microbiome Understanding in Maternity Study (MUMS) cohort did not find any associations between diet quality and depression. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) often experience symptoms that affect their ability to eat. This may contribute to weight loss and increased risk of malnutrition. The present study aimed to quantify the extent of nutrition impact symptoms (NIS) in the population and a scoring system of NIS was incorporated in the tool used to identify malnutrition. Methods: In this cross‐sectional study, members of the Norwegian Parkinson's Association, with any PD diagnosis and stage of illness, were invited to respond to an online 24‐item questionnaire. Questions from two validated questionnaires, comprising the abridged Patient‐Generated Subjective Global Assessment (aPG‐SGA) and the Radboud Oral Motor Inventory for Parkinson's disease (ROMP), were adapted to an online format. Results: The questionnaire was sent to 3047 members, of which 508 persons (17%) responded (61% men). In total, 59% were categorised as well‐nourished, 34% at risk of malnutrition and 6.5% as malnourished. One quarter of all participants reported symptoms that affected food intake. The most frequent symptoms were constipation (14.2%) and dry mouth (13.4%). Malnourished participants reported a mean ± SD of 3.4 ± 1.4 symptoms versus 0.1 ± 0.3 per well‐nourished participant. Malnourished participants had more swallowing problems than well‐nourished participants, with a mean ± SD total ROMP score of 15.5 ± 6.0 versus 9.0 ± 2.9 (p < 0.001). As the number of points in the ROMP score increased by one, the points in the aPG‐SGA score increased with 37% (95% confidence interval = 0.309–0.428). Conclusions: Risk of malnutrition was largely related to NIS, especially dysphagia in people with PD. Symptoms affecting food intake should be systematically mapped and treated in conjunction with PD to prevent malnutrition. Highlights: Symptoms affecting the food intake, malnutrition risk and malnutrition are commonly seen in patients with Parkinson's disease (PD).The present study highlights the fact that, despite being common, malnutrition may be unrecognised, under‐reported and untreated in PD patients.The results suggest that swallowing problems in PD are important for the development of malnutrition risk and malnutrition.Nutrition impact symptoms and weight loss should be systematically assessed in patients with PD.There is a need for more research investigating the relationship between malnutrition and nutritional impact symptoms in PD patients. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate the association between vegetable consumption, in total as well as per type/category, and 10‐year type‐2 diabetes mellitus (T2DM) incidence. Methods: The ATTICA study was conducted during 2001–2012 in 3042 apparently healthy adults living in Athens area, Greece. A detailed biochemical, clinical, and lifestyle evaluation was performed; vegetable consumption (total, per type) was evaluated through a validated semi‐quantitative food frequency questionnaire. After excluding those with no complete information of diabetes status or those lost at the 10‐year follow‐up, data from 1485 participants were used for the current analysis. Results: After adjusting for several participants' characteristics, including overall dietary habits, it was observed that participants consuming at least 4 servings/day of vegetables had a 0.42‐times lower risk of developing T2DM (hazard ratio [HR] = 0.42; 95% confidence interval [CI] = 0.29–0.61); the benefits of consumption were greater in women (HR = 0.29; 95% CI = 0.16–0.53) compared to men (HR = 0.56; 95% CI = 0.34–0.92). Only 33% of the sample consumed vegetables 4 servings/day. The most significant associations were observed for allium vegetables in women and for red/orange/yellow vegetables, as well as for legumes in men. Conclusions: The intake of at least 4 servings/day of vegetables was associated with a considerably reduced risk of T2DM, independently of other dietary habits; underlying the need for further elaboration of current dietary recommendations at the population level. Highlights: Intake of ≥ 400 g day–1 of vegetables was associated with a reduced risk of T2DM In women, the most significant associations were observed for allium vegetables In men, the most significant associations were for red/orange/yellow vegetables Increment by 100 g day–1 was associated with a 14% lower risk in women Increment by 100 g day–1 was associated with a 5% lower risk in women. [ABSTRACT FROM AUTHOR]

Background: Food parenting practices, behaviours and food availability at home are associated with children's food choices; however, these associations have been mainly studied for each parenting practice separately and focused mostly on healthy populations. The aim of the study was to identify patterns of parenting practices (including data regarding food availability at home, food and physical activity–related behaviours and rewards) and to investigate their cross‐sectional associations with children's food choices in families at high risk for type 2 diabetes (T2D). Methods: Data of parents and children (n = 2278), from the Feel4Diabetes study conducted in six European countries, were collected using validated questionnaires. The data analysed included children's food choices, food availability at home and food and physical activity–related parenting practices. Four patterns of parenting practices were identified using principal component analysis, and associations between those components and children's food choices were assessed using adjusted, individual linear regressions. Results: Parenting patterns focusing on unhealthy habits, such as allowing unhealthy snacks and unlimited screen time, providing higher availability of unhealthy foods at home, rewarding with snacks and screen time, were positively associated with children's unhealthy food choices (consumption of savoury/sweet snacks, fizzy drinks, etc.). The parenting patterns providing fruit/vegetables at home, consuming fruit, and being physically active with the child were positively associated with children's healthier food choices (consumption of fruit, vegetables, whole grain cereals, etc.). Conclusions: Public health initiatives should focus on high‐risk families for T2D, assisting them to adopt appropriate parenting practices and behaviours to promote healthier food choices for children. Key points: Food and lifestyle–related parenting practices are associated with children's food choices in healthy populations; little is known in families at high‐risk for type 2 diabetes (T2D).Four parenting patterns (PP1–PP4) in high‐risk families for T2D were created, including healthy or unhealthy food, physical activity and screen‐related habits, and food availability at home.A more authoritative parenting pattern (high availability of fruits and vegetables at home, consumption of fruit/vegetables with the child, being active with the child) was positively associated with healthy children's food choices, including fruit and vegetables, whole grains, and fish.More permissive and/or neglectful parenting patterns (allow and reward with screen time and unhealthy snack consumption, high availability of unhealthy foods) were positively associated with children's choices of sugary snacks and drinks, red meat, and non‐whole grains. [ABSTRACT FROM AUTHOR]

Background: Integrating digital dietary assessment within dietetic care could save time and reduce costs, at the same time as increasing patient engagement. The present study explores the feasibility of implementing a web‐based dietary assessment tool, myfood24 (https://www.myfood24.org), into routine healthcare. Methods: This mixed methods feasibility study recruited dietitians and patients from a National Health Service (NHS) hospital outpatient setting. Patients completed and shared three online 24‐h dietary recalls in advance, which were used as a dietary assessment by dietitians. Recruitment data were collected and questionnaires on technology, usability, and acceptability were completed. Patient interviews and focus groups with dietitians were conducted. Results: Eleven dietitians working in allergy, bariatrics, diabetes, oncology, general, renal, infectious diseases, and coeliac services took part with 39 patients. Recruitment rates were highest in bariatrics and lowest in renal and oncology. Compared to other studies, completion rates were good, with 29 (74.4%) completing three recalls despite lower technology readiness and software usability scores than in similar studies. Illness and difficulty with technology were reasons for non‐completion. Opportunity to receive nutritional feedback from the tool and share this with a dietitian motivated patients to complete the record accurately. Consultation times were shortened in approximately one‐third of appointments and a higher proportion of time was spent on nutritional education compared to usual practice. However, mean preparation time increased by 13 min per appointment because dietitians found nutritional analysis reports difficult to interpret. Conclusions: It is feasible to introduce a digital dietary assessment tool into NHS dietetic practice. However, further development is needed to ensure that the tool is suitable for healthcare. Key points: This is likely to be the first study in the UK investigating the use of digital dietary assessment in clinical dietetic practice. Seven different clinical specialities were included. Recruitment rates were highest in bariatrics and lowest in oncology and renal where ill health was given as a main reason for non‐participation. Non‐completers had low technology readiness scores, which may suggest this tool could be used to identify individuals who may need more technological support. Dietitians reported that clinic preparation time took longer than usual care, but time was saved in one‐third of consultations and more time was available for patient education. The intervention was moderately acceptable to patients and dietitians, although tailoring the software to clinical care and the availability of an app would likely improve this further. [ABSTRACT FROM AUTHOR]

Background: There is a lack of a valid and reliable instrument that measures objective and subjective knowledge of evidence‐based dietetic practices (EBDP) among registered dietitian nutritionists (RDNs). The present study aimed to develop and assess the validity and reliability of an EBDP Questionnaire (EBDPQ) with objective knowledge items (i.e., quiz items) among RDNs in the USA. Methods: Subscales from four existing evidence‐based practice (EBP) instruments were combined and modified for dietetics. Content and face validity and internal consistency were used to assess the full survey. Survey responsiveness and test–retest reliability were evaluated within the objective knowledge subscale. Content experts (n = 11) and nutrition professionals (n = 16) completed validation reviews. Doctoral students enrolled in a research course (n = 12) were used to analyse survey responsiveness. Internal and test–retest relability analyses utilised RDN participants (time point 1, n = 482; time point 2, n = 335). Results: Content validation resulted in a 38‐item questionnaire. Average percent agreement among face validity reviewers was 95.1%. Only the pre‐validation version of the objective knowledge subscale resulted in significantly higher post‐course scores (Mdn = 11.50) compared to the pre‐course (Mdn = 9.75, p = 0.05). The validated instrument had excellent internal consistency (Cronbach's α = 0.91); however, the objective knowledge subscale was low (Cronbach's α = 0.41). A good degree of reliability was found between the two time points (intraclass correlation coefficient = 0.71). Conclusions: The EBDPQ demonstrated adequate validity and reliability among RDNs. Future research should assess construct validity, with the responsiveness and objective knowledge subscale requiring additional evaluation through an EBDP course. Key points: Subjective measures may not adequately estimate the knowledge of evidence‐based dietetic practices (EBDPs) among dietitians.Subscales from four evidence‐based practice instruments, including both subjective and objective (i.e., quiz items) measures, were adapted for the dietetics practitioner.This instrument demonstrated adequate validity and reliability among dietitians; however, the objective knowledge subscale was low (Cronbach's α = 0.41), likely as a result of too few items and variation in EBDP exposure and training among participants.Future research should assess construct validity and further evaluate the reliability and responsiveness of the objective knowledge subscale. [ABSTRACT FROM AUTHOR]

Background: Dietary management plays an important role in patients with kidney failure. Current dietary habits of Australians and New Zealanders (ANZ) and Malaysians with chronic kidney disease (CKD Stage 4–5) have not been adequately investigated. We report the dietary habits of people with advanced CKD and their adherence to country‐specific dietary guidelines. Methods: Participants with CKD Stage 4–5, enrolled in the Omega‐3 Fatty Acids (Fish oils) and Aspirin in Vascular access Outcomes in Renal Disease (FAVOURED) trial, completed a lifestyle questionnaire at baseline on their dietary intake. Results: Of 567 participants, 538 (ANZ, n = 386; Malaysian, n = 152; mean ± SD age 54.8 ± 14.3 years, 64% male) completed the questionnaire. Dietary fruit and vegetable intakes were higher in ANZ participants; 49% (n = 189) consumed ≥2 serves day–1 of fruit and 61% (n = 235) ate ≥2 serves day–1 of vegetables compared to 24% (n = 36) and 34% (n = 52) of Malaysians, respectively (p < 0.0001). Only 4% (n = 15) of ANZ participants met Australian Dietary recommendations of two fruit and five vegetable serves day–1. Fish consumption was higher in Malaysians with 83% (n = 126) consuming ≥2 serves week–1 compared to 21% (n = 81) of ANZ participants (p < 0.001). Red meat intake was higher in ANZ participants; however, chicken consumption was similar; 48% (n = 185) consumed >2 chicken serves week–1 and 65% (n = 251) ate >2 serves week–1 of red meat compared to 43% (n = 65) and 15% (n = 23) of Malaysians, respectively. Conclusions: Significant regional variation in dietary intake for fruit, vegetables and animal protein is described that likely reflects cultural and economic differences. Barriers to meeting recommended dietary intakes require further investigation. Key Points: Dietary management plays an important role in the management of patients with kidney failure.Current dietary habits of Australians, New Zealanders and Malaysians with advanced chronic kidney disease have not been adequately investigated.Dietary fruit and vegetable intakes were significantly higher in Australia and New Zealand (ANZ) participants then Malaysian participants.Fish consumption was higher in Malaysians compared to ANZ participants.The significant regional variation in dietary intake for fruit, vegetables and animal protein likely reflects cultural and economic differences.Dietary intakes of both fruit and vegetables were inadequate by national recommendations but similar to the general population in both the ANZ and Malaysia cohorts.Barriers to meeting recommended dietary intakes require further investigation. [ABSTRACT FROM AUTHOR]

Background: The interplay between cardiovascular disease (CVD) genetic risk indexed by a polygenic risk score (PRS) and diet quality still requires further investigation amongst older adults or those with established or treated CVD. The present study aimed to evaluate the relative contribution of diet quality, measured using the Australian Recommended Food Score (ARFS) and PRS, with respect to explaining variation in plasma lipids CVD outcomes in the Hunter Cohort. Methods: The study comprised a secondary analysis of cross‐sectional data from the Hunter Cohort study. Single‐nucleotide polymorphisms from previously derived polygenic scores (PGSs) for three lipid classes were obtained: low‐density lipoprotein, high‐density lipoprotein and triglycerides, as well as PRS for coronary artery disease (CAD) from the PGS catalogue. Regression modelling and odds ratios were used to determine associations between PRS, ARFS and CVD risk. Results: In total, 1703 participants were included: mean ± SD age 66 ± 7.4 years, 51% female, mean ± SD total ARFS 28.1 ± 8 (out of 74). Total diet quality and vegetable subscale were not significantly associated with measured lipids. By contrast, PGS for each lipid demonstrated a markedly strong, statistically significant correlation with its respective measured lipid. There was a significant association between CAD PRS and 5/6 CVD phenotypes (all except atrial fibrillation), with the largest effect size shown with coronary bypass. Adding dietary intake as a covariate did not change this relationship. Conclusions: Lipid PGS explained more variance in measured lipids than diet quality. However, the poor diet quality observed in the current cohort may have limited the ability to observe any beneficial effects. Future research should investigate whether the diet quality of older adults can be improved and also the effect of these improvements on changes in polygenic risk. Key points: The Australian Recommended Food Score (ARFS) had little association with lipid and cardiovascular disease (CVD) endpoints.Lipid polygenic score (PGS) explained more variance in measured lipids than diet quality.The lipid PGS was associated with all three lipid parameters and some CVD endpoints, especially high cholesterol.Coronary artery disease polygenic risk score was associated with CVD endpoints angina, coronary bypass, heart attack, high cholesterol and hypertension and some lipid parameters (high‐density lipoprotein cholesterol). [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is a multidimensional consequence of environmental and genetic factors. Cholesteryl ester transfer protein (CETP) Taq1B polymorphism has been reported as a main predictor of dyslipidaemia, comprising an important complication in persons with T2DM. However, diet could affect T2DM patients metabolic health. Methods: We investigated the combination of gene–diet effects on some metabolic biomarkers. In our cross‐sectional study, blood samples of 220 patients were collected. Dietary indices (healthy eating index, dietary quality index and dietary phytochemical index) were obtained from a validated semi‐quantitative food frequency questionnaire. CETP Taq1B polymorphism was genotyped by a polymerase chain reaction‐restriction fragment polymorphism method. Data were analysed by analysis of covariance. Results: The interaction between the CETP Taq1B polymorphism and dietary indices on low density lipoprotein/high density lipoprotein was significant (p < 0.001 both crude and adjusted models). In addition, the interaction between polymorphism and dietary quality index on total antioxidant capacity (p = 0.004 crude model, p = 0.005 after adjusting) and pentraxin 3 (p = 0.01 both crude and adjusted models) was significant. Also, the interaction between polymorphism and healthy eating index on waist circumference (p = 0.005 both crude and adjusted models) and dietary phytochemical index on interleukin‐18 (p = 0.03 crude model) was significant. Conclusions: Our results indicated the effect of CETP Taq1B polymorphism on some inflammatory and anthropometrics markers (total antioxidant capacity, pentraxin 3, interleukin‐18, low density lipoprotein/high density lipoprotein and waist circumference) with high and low adherence to dietary incides. Highlights: The role of different genotypes of CETP Taq1b on lipid profile is undeniable.CETP Taq1b polymorphism might change the effect of adherence to dietary patterns.The interaction between CETP Taq1b genotypes and dietary indices on metabolic biomarkers could be different in people with T2DM, even when they have healthy adherence to dietary patterns.Beside metabolic biomarkers such as TAC, PTX3, IL‐18, central obesity and lipid profile might be under the effect of the interaction between CETP Taq1b genotypes and dietary indices in T2DM individuals. [ABSTRACT FROM AUTHOR]

Introduction: Acute pancreatitis (AP) is a medical emergency that is common, poorly understood and carries a significant risk of death. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) undertook a comprehensive report into the current management of AP in the UK. The study aimed to provide a more detailed analysis of the findings related to nutritional assessment and support. Methods: The data presented here were analysed from the core dataset used in the NCEPOD study. Adult patients admitted between January and June 2014 with a coded diagnosis of AP were included. A clinical and organisational questionnaire was used to collect data and submitted case notes subjected to peer review. Nutritional data, including assessment and provision of support, were analysed. Results: One hundred and forty‐seven out of 168 (87.5%) hospitals had a nutrition team in place. A screening nutritional assessment was performed in only 67.4% (368/546) of patients. Subsequent referral to a dietitian and nutrition team input occurred in 39% (201/521) and 25% (143/572) of patients, respectively. Supplemental nutrition was considered and used in 240/555 (43.2%) patients. Overall management of the patients' nutrition was considered adequate by the case reviewers in only 281/332 (85%) of cases and by the clinicians in 77% (421/555) of cases. Conclusions: Many patients do not receive adequate nutritional assessment and, in up to 23% of cases, nutritional intervention is not adequate. Pancreatic exocrine insufficiency is likely under recognised and undertreated. Nutritional strategies to support early intervention and to support clinicians outside of tertiary pancreatic centres are warranted. Key points: Nutritional assessment remains poor in patients with acute pancreatitis.Pancreatic exocrine insufficiency is under recognised and under treated in acute pancreatitis.Nutritional management was considered inadequate by 23% of managing clinicians.Further work to support and develop nutritional management is required. [ABSTRACT FROM AUTHOR]

Background: The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem‐solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened. Methods: The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression. Results: Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002). Conclusions: Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records. Key points: The nutrition care process (NCP) and its associated terminology comprises a problem‐solving framework central to modern dietetic practice.The present study used a validated questionnaire to investigate independent predictors of NCP knowledge and use in dietitians internationally.Although some predictors, such as recency of qualification, clinical work and country of residence are not easily modifiable, others are, including peer support, NCP use as workplace requirement and influence from national dietetic associations.National associations should commit to specific tactics that support the NCP such as evidence‐based training programs run by suitably qualified professionals. [ABSTRACT FROM AUTHOR]

Background: The low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet is an effective dietitian‐led treatment for irritable bowel syndrome (IBS). An increasing demand of IBS patient referrals has warranted group FODMAP education led by specialist dietitians. Psychological co‐morbidities are common in IBS, although how the low FODMAP diet influences psychological outcomes is not understood. The present study aimed to evaluate symptom related outcomes of the diet following group education and assess its effect on psychological profiles. Methods: An observational, prospective study was conducted in 55 IBS patients who attended FODMAP Restriction and FODMAP Reintroduction group sessions. Data were collected at baseline and follow‐up after FODMAP Restriction and analysed using descriptive and McNemar's tests. Primary outcome was evaluated by IBS Symptom Severity Score (IBS‐SSS). Secondary psychological outcomes included anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and risk of eating disorder questionnaire (SCOFF). Results: After FODMAP Restriction, 27 of 55 (54%) patients reported clinically relevant symptom improvement, as defined by a reduction in the IBS‐SSS ≥50 points, whereas no differences were recorded in the proportion of patients identified with clinical anxiety (p = 1.000) or clinical depression (p = 0.375). Positively, no increased risk of an eating disorder was observed. Conclusions: The present study provides data supporting the efficacy of the low FODMAP diet in IBS patients who attended dietitian led group education settings in tertiary care. Clinically significant improvements in gastrointestinal symptoms were observed, although with no impact on clinical levels of anxiety, depression or the risk of an eating disorder. Highlights: Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) Restriction is effective in improving gastrointestinal symptoms in irritable bowel syndrome (IBS) via a dietitian led group education setting based in tertiary care.No impact on clinical levels of anxiety, depression or the risk of an eating disorder was observed at follow‐up.Furthermore, baseline Hospital Anxiety and Depression Scale (HADS) was not predictive of symptom improvement in response to FODMAP Restriction.The SCOFF questionnaire lacks practical clinical use in assessing risk of eating disorders and, additionally, did not relate to diet adherence.A subset of patients do experience a worsening of gastrointestinal symptoms when restricting FODMAPs, which does not appear to be related to the psychological factors measured. [ABSTRACT FROM AUTHOR]

Background: Past research has focused on the relationship between mothers' and children's eating habits, although little is known about fathers as potential agents. The present study aimed to investigate the relationship between fathers' and children's fruit and vegetable (FV) intake in the context of fathers' education level and family income insecurity. Methods: Cross‐sectional analysis using baseline data from the multicentre Feel4Diabetes Study were collected in 2016. Participants were parent‐dyads (fathers, n = 10,038) and school children (n = 12,041) from six European countries. Socio‐demographic and dietary data were collected using questionnaires. Associations were assessed applying the multinomial logistic regression model. Results: Overall, European children have low FV intake, especially in Southern European countries (Greece, Spain and Hungary). Children with fathers consuming FV daily were more likely to consume fresh fruit (odds ratio [OR] = 2.75; 95% confidence interval [CI] = 1.95–3.88) and vegetables (OR = 2.55; 95% CI = 1.80–3.60) 1–2 times per day. After adjusting for paternal educational level and family income insecurity significant associations remained for fresh fruit (ORadj = 2.59; 95% CI = 1.82–3.69) and vegetables (ORadj = 1.98; 95% CI = 1.38–2.86). Country differences showed that fathers' educational level and income insecurity might be important factors worth considering for FV intake in Greece. Conclusions: The present study showed that fathers' FV intake was positively associated with children's daily intake of these foods. Implementation of future population‐based strategies promoting FV intake not only in mothers, but also in fathers could be an effective public health initiative to increase FV intake in children. Policy‐makers should give special attention to families dwelling in Southern European regions. Highlights: Fruit and vegetable (FV) intake is an essential component of a healthy diet with respect to overall health benefit effects, strengthening the immune system, and ensuring optimal growth and development in children.European children have low FV intake, especially in Southern European countries (Greece, Spain, and Hungary), and are not meeting the recommended FV intake of at least 400 g day–1.The present study showed that children with fathers consuming FV daily were more likely to consume fresh FVs 1–2 times per day.Implementation of future population‐based strategies promoting FV intake not only in mothers, but also in fathers could be an effective public health initiative to increase FV intake in children. Policy‐makers should give special attention to families dwelling in Southern European regions. [ABSTRACT FROM AUTHOR]

Background: A baby‐led approach to weaning (BLW) encompasses self‐feeding and self‐selecting graspable foods, offering an alternative to traditional weaning (TW). This cross‐sectional study explored adherence to characteristics of BLW and differences in food group exposure and nutrient intake between babies following either TW or BLW. Methods: Nutritional data were collected via multiple‐pass 24‐h recall, following parental completion of an online survey. Results: Infants were grouped according to age (6–8 months; TW [n = 36] and BLW [n = 24]) and (9–12 months; TW [n = 24] and BLW [n = 12]). BLW babies were more likely to be breast fed (p = 0.002), consumed a higher percentage of foods also consumed by their mother (p = 0.008) and were fed less purees (p < 0.001) at 6–8 months. TW babies were spoon fed more (p ≤ 0.001) at all ages. Amongst babies aged 6–8 months, total intake (from complementary food plus milk) of iron (p = 0.021), zinc (p = 0.048), iodine (p = 0.031), vitamin B12 (p = 0.002) and vitamin D (p = 0.042) and both vitamin B12 (p = 0.027) and vitamin D (p = 0.035) from complementary food alone was higher in babies following TW. Compared to TW, BLW babies aged 6–8 months had a higher percentage energy intake from fat (p = 0.043) and saturated fat (p = 0.026) from their milk. No differences in nutrient intake were observed amongst infants aged 9–12 months. Few differences were observed between groups in their number of exposures to specific food groups. Conclusions: TW infants had higher intakes of key micronutrients at 6–8 months, although there were few differences in nutritional intake at 9–12 months or food group exposure between babies following TW or BLW. BLW appears to be socially desirable. Guidance for parents is required, along with larger, longer‐term studies, which explore the potential impact of BLW in later childhood. Highlights: Babies following baby‐led weaning (BLW) were more likely to be breast fed, consumed a higher percentage of foods also consumed by their mother, were fed fewer purees and were less likely to be spoon fed at 6–8 months, than babies following traditional weaning (TW). This is consistent with both previous research and the general ethos of BLW.More parents self‐reported following BLW than were identified more objectively by researchers, with over 55% of TW parents reporting following BLW. This may indicate that the ethos or key tenets of BLW are misunderstood or that BLW is socially desirable amongst parents in this study.Intakes of key nutrients (iron, zinc, iodine, vitamin B12 and vitamin D) were higher amongst babies aged 6–8 months following TW compared to those following BLW. Intakes of vitamin B12 and vitamin D were higher from complementary food alone (when not including nutrients from milk).Fewer differences in nutrient intake or the way in which babies were fed were observed amongst babies aged 9–12 months, than amongst babies aged 6–8 months, indicating that older babies were more likely to have transitioned towards self‐feeding and the family diet, regardless of weaning style.As expected, younger TW infants had more exposures to iron‐fortified infant cereal and commercially produced baby foods but overall, food group exposure varied little between groups. [ABSTRACT FROM AUTHOR]

Introduction: Perceptions of hospital meal quality can influence patient food intake. Understanding what patients prioritise and what they think of current meals can support menu development. The present study assessed patients' food and food‐related priorities for hospital meals and their sensory experience using the Hospital Food Experience Questionnaire (HFEQ). Factors independently associated with the HFEQ were determined. Methods: Cross‐sectional study (n = 1087 patients; 16 Ontario hospitals). Patients completed the HFEQ at a single meal. Descriptive statistics determined the importance of food traits and ratings of a served meal using 22 HFEQ questions (five‐point Likert scales, total score 110). Bivariate and multivariable linear regression tested the association between patient and hospital characteristics and HFEQ score. Results: Most food traits were rated as 'important' (4) or 'very important' (5) by two‐thirds or more of patients. Patients typically rated served meal items as 'good' (4). Mean HFEQ score was 90.60 (SD 10.83) and was associated with patient and hospital traits in multivariable analyses (F42,556 = 2.34, p < 0.001). Older and woman‐identifying patients were more likely to have a higher score. Foodservice models were associated with HFEQ. Cold‐plated rethermed food resulted in the lowest HFEQ. Local food use > 10% was associated with lower HFEQ score, whereas larger hospitals had a higher score. Conclusions: Patients prioritised taste, freshness and food that met their dietary needs. Meal sensory ratings were average. A gap exists between what patients want in hospital meals and what they receive. Attention to patient demographics and food delivery that retains sensory properties and supports choice may increase HFEQ score. [ABSTRACT FROM AUTHOR]

Background: Web-based surveys are becoming increasing popular. The present study aimed to assess the reliability and validity of the Web-Survey of Physical Activity and Nutrition (Web-SPAN) for self-report of height and weight, diet and physical activity by youth. Methods: School children aged 11-15 years (grades 7-9; n = 459) participated in the school-based research (boys, n = 225; girls, n = 233; mean age, 12.8 years). Students completed Web-SPAN (self-administered) twice and participated in on-site school assessments [height, weight, 3-day food/pedometer record, Physical Activity Questionnaire for Older Children (PAQ-C), shuttle run]. Intraclass (ICC) and Pearson's correlation coefficients and paired samples t-tests were used to assess the test-retest reliability of Web-SPAN and to compare Web-SPAN with the on-site assessments. Results: Test-retest reliability for height (ICC = 0.90), weight (ICC = 0.98) and the PAQ-C (ICC = 0.79) were highly correlated, whereas correlations for nutrients were not as strong (ICC = 0.37-0.64). There were no differences between Web-SPAN times 1 and 2 for height and weight, although there were differences for the PAQ-C and most nutrients. Web-SPAN was strongly correlated with the on-site assessments, including height (ICC = 0.88), weight (ICC = 0.93) and the PAQ-C (ICC = 0.70). Mean differences for height and the PAQ-C were not significant, whereas mean differences for weight were significant resulting in an underestimation of being overweight/obesity prevalence (84% agreement). Correlations for nutrients were in the range 0.24-0.40; mean differences were small but generally significantly different. Correlations were weak between the web-based PAQ-C and 3-day pedometer record ( r = 0.28) and 20-m shuttle run ( r = 0.28). Conclusions: Web-SPAN is a time- and cost-effective method that can be used to assess the diet and physical activity status of youth in large cross-sectional studies and to assess group trends (weight status). [ABSTRACT FROM AUTHOR]

Background: In the UK, more than one in five children are overweight on starting school. An elevated body mass index (BMI) in childhood increases the likelihood of developing many health and social issues. The Lifestyles, Eating and Activity for Families (LEAF) programme is a weight management service for clinically obese children under the age of 7 years and their families. This study evaluates the effectiveness of the LEAF programme by measuring BMI z‐score change, the reduction in calorific beverage consumption and user satisfaction. Methods: Data were collected over 6 years from 2012 and children who met the local weight management pathway criteria were recruited. Contact time was typically 20 h over 12 months and included home and clinic‐based assessment by the multidisciplinary team and community‐based intervention through six group sessions. This study compared baseline and post‐intervention BMI z‐scores (zBMI) for 65 children, as well as daily total calorific intakes from beverages for 41 children, and, in addition, 20 parents completed user satisfaction questionnaires. Results: There was a highly significant reduction in both mean zBMI (0.5; p < 0.001) and mean total calories from beverages (199; p < 0.001) across the intervention period. There was no significant correlation between zBMI and beverage calorific trends. Families who completed user satisfaction questionnaires reported that they had changed their dietary habits and 90% would recommend the programme to others. Conclusions: This initial evaluation indicates that the LEAF programme was effective in reducing the zBMI of a group of clinically obese young children. Keywords obesity epidemic, young children, intervention, multidisciplinary [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that dietary interventions can improve symptoms in people with irritable bowel syndrome (IBS), although most data explore the short‐term (immediate) impact. Data on long‐term (>6 months) impact are limited, especially from primary care settings. The present study aimed to investigate the long‐term effect of dietetic‐led interventions for IBS delivered in primary care. Methods: A service evaluation of a dietetic‐led IBS clinic was completed, analysing data on symptom severity, stool frequency and consistency, and healthcare input. Data were collected before and immediately after dietary intervention as part of patients' routine clinical appointments. Long‐term data were collected via a postal questionnaire at least 11 months later. Results: In total, 211 patients responded to the long‐term follow‐up questionnaire at a median of 13 months (interquartile range 12–16 months) post follow‐up appointment. Of these, 84% had been advised to follow a low FODMAP (i.e., fermentable oligosaccharides, disaccharides, monosaccharides and polyols carbohydrates) diet. All symptoms were reported significantly less frequently short term, and all except heartburn and acid regurgitation remained so over the long term. The four most commonly reported bowel symptoms reduced in frequency were abdominal pain (62%), bloating (50%), increased wind (48%) and urgency to open bowels (49%) (p < 0.001). The percentage of patients reporting satisfactory relief of gut symptoms was 10% at baseline and 55% at long‐term follow‐up (p < 0.001). Visits to a general practitioner were reduced (from 96% to 34%; p < 0.001), as were those to the gastroenterologist (from 37% to 12%; p = 0.002), during the year prior to long‐term follow‐up compared to the year prior to dietary intervention. Conclusions: Patients with IBS who received dietetic‐led interventions in primary care reported long‐term symptoms improvements that may result in reduced healthcare usage. [ABSTRACT FROM AUTHOR]

Presents a questionnaire on Continuing Professional Development for members of the British Dietetic Association which appeared in the "Journal of Human Nutrition and Dietetics. Requirements for submission of the questionnaire; Qualifications.

Background: The present study aimed (i) to assess changes in dietary intake (DI), physical activity (PA) and body weight (BW) in breast cancer patients during chemotherapy; (ii) to describe how women explained, experienced and dealt with these potential changes; and (iii) to eventually develop lifestyle intervention strategies tailored to the women's personal needs during chemotherapy. Methods: A longitudinal parallel mixed‐method design was used with quantitative assessment of changes in dietary intake (24‐h recall, Appetite, Hunger, Sensory Perception questionnaire), physical activity (Short Questionnaire to Assess Health‐enhancing physical activity, Multidimensional Fatigue Inventory) and BW (dual‐energy X‐ray absorptiometry), in addition to qualitative interviews with 25 women about these potential changes during chemotherapy. Results: Most women who perceived eating less healthily with low energy intake (EI) and being less active before diagnosis continued to do so during chemotherapy, according to quantitative measurements. They struggled to maintain sufficient energy intake. Despite a lower than average reported EI, they unexpectedly gained weight and explained that fatigue made them even more inactive during chemotherapy. Active women usually managed to stay active because exercise was very important to them and made them feel good, although they also suffered from the side‐effects of chemotherapy. They found more ways to deal with taste, smell and appetite problems than women with a lower energy intake. Conclusions: The combination of the quantitative and qualitative data provided more insight into the changes in dietary intake, physical activity and BW during chemotherapy. The women's explanations showed why some women remain active and others need support to deal with changes in lifestyle factors such as healthy nutrition and fatigue. [ABSTRACT FROM AUTHOR]

Background: Recommendations for dietary fibre intake in patients with inflammatory bowel disease are highly variable. Despite the potential benefits of prebiotic fibres on the gut microbiome, many patients with inflammatory bowel disease follow a low fibre diet. The present study comprehensively evaluated intakes of total and prebiotic fibres in patients with inflammatory bowel disease, aiming to determine the adequacy of fibre intake and factors that may influence intake. Methods: Outpatients with a formal diagnosis of inflammatory bowel disease were recruited to this multicentre cross‐sectional study. Habitual dietary fibre intake including prebiotic fibre types was measured using a validated comprehensive nutrition assessment questionnaire. Adequacy of total fibre intake was compared with Australian Nutrient Reference Values. Multiple linear regressions were performed to determine factors influencing fibre intake. Results: Of 92 participants, 52% had Crohn's disease, 51% were male and the mean age was 40 years. Overall, only 38% of the cohort consumed adequate total fibre (median 24 g day−1, interquartile range 18.5–32.9 g day−1). Adequate fibre consumption was significantly less common in males than females (21.3% versus 55.6%, P = 0.002). Resistant starch intake (median 2.9 g day−1, interquartile range 2.1–4.8 g day−1) was significantly less than the proposed recommendations (20 g day−1). Disease‐related factors such as phenotype and disease activity were not found to influence fibre intake. Conclusions: Patients with inflammatory bowel disease habitually consume inadequate fibre, particularly prebiotic fibre resistant starch. The potential deleterious effects of low prebiotic intake on the gut microbiome and disease‐related outcomes in inflammatory bowel disease are unknown and warrant further research. [ABSTRACT FROM AUTHOR]

Background: Breast milk is the feed of choice for premature infants, although its nutritional composition is not always sufficient to meet their raised nutritional requirements. The addition of a multi‐nutrient breast milk fortifier (BMF) to breastmilk is recommended; however, international guidelines on the use of BMF are inconsistent. The present study aimed to explore the use of BMF in preterm infants by paediatric dietitians in the UK. Methods: A questionnaire was designed and sent to members of the British Dietetic Association neonatal specialist group (n = 100) using a secure online platform. Descriptive statistics were calculated. Results: Forty dietitians completed the survey, all of whom used BMF. Local hospital BMF guidelines were available to 77.5% (n = 31). The most commonly used criteria for commencing BMF were: tolerating a feed volume of 150 mL kg−1 day−1 (72.5%, n = 29), a gestational age <34 weeks (67.5%, n = 27) and a birth weight <1500 g (60%, n = 24). The primary contraindication for the use of BMF was necrotising enterocolitis (NEC). The majority of respondents used standard fortification, with individualised fortification available to only 12.5% (n = 5). The most common indicators for discontinuing BMF were on discharge home (67.5%, n = 27), satisfactory growth (65%, n = 26) or feeding directly from the breast (62.5%, n = 25). Conclusions: Although BMF is used more proactively in UK neonatal units than previously, variation in practice remains. Individualised fortification is very uncommon and caution remains regarding risk of NEC. The development of national guidelines on the use of BMF would help to standardise nutritional care in neonatal units. [ABSTRACT FROM AUTHOR]

Background: To date, research on the dietary patterns of individuals with potential orthorexic symptoms is lacking. This cross‐sectional pilot study aimed to explore the feasibility of assessing dietary patterns with psychological traits and states of individuals with possible orthorexic tendencies. Methods: Dietary intakes of 10 individuals (two males and eight females) were assessed using 24‐h recall. Mean age of participants was 28.3 years; mean body mass index was 21.2 kg m–2. Nutrient intakes were compared with current dietary guidelines and the Eatwell Guide (Public Health England, 2016). Participants completed the ORTO‐15, the Eating Attitude Test (EAT‐26), the Obsessive‐Compulsive Inventory‐Revised edition (OCI‐R), Paulhus's Spheres of Control (SoC), the Rosenberg's Self‐Esteem Scale (RSES) and the Multidimensional Body‐Self Relations Questionnaire (MBSRQ). Results: High levels of disparity across participants' psychometric scores and 24‐h recall results were observed. There was no single pattern of self‐imposed dietary restrictions among participants. Described dietary practices failed to meet the guidelines for several nutrients. Conclusions: The results of this pilot study suggest that an extensive investigation of the diets of individuals with possible orthorexic tendencies in a large‐scale study would contribute to the understanding of this condition. In addition, the use of multiple psychometric instruments is recommended for diagnosing orthorexic nervosa. [ABSTRACT FROM AUTHOR]

Background: The first 2 years of life represent a critical phase for growth and development, with the quality of the diet at this stage having repercussions throughout adulthood. The present study aimed to develop an Index for Measuring the Quality of Complementary Feeding (IMQCF) for infants, as well as to evaluate diet quality and its effects on the nutritional status of preterm infants. Methods: This cross‐sectional study was conducted at a Brazilian University Hospital. The data were extracted by care protocol of outpatient preterm infants at 2 years of corrected age (CA). Dietary data were collected from 24‐h recalls. The diet quality was assessed by the IMQCF composed of nine items based on a Brazilian Food Guide for children aged <2 years. Response options were scored 0–100, with scores closer to 100 representing a better quality diet. Association with growth indicators (Z‐scores for weight‐ and length‐for‐age (WAZ and LAZ) were evaluated via tests of mean difference and multiple linear regression. Results: The median complementary feeding (CF) score was 72.2 (61.1–77.8) A shorter breastfeeding duration or infant formula use and the early introduction of wheat‐based foods, ultra‐processed foods and cow's milk in the preterm's diet were the main factors interfering in the adequacy of diet. There was an association between the quality of the diet score and WAZ (0.44; 95% confidence interval = 0.03–0.85; P = 0.03). Conclusions: The introduction of poor quality food in the first 2 years of life interfered with the CF quality of preterm infants and can affect nutritional status at 2 years of CA, possibly in the long term. [ABSTRACT FROM AUTHOR]

Background: Although a high‐salt diet is associated with high risk of chronic diseases such as hypertension, stroke and cardiovascular disease, little is known about the relationship between a high‐salt diet and the risk of primary liver cancer (PLC). Consequently, we prospectively assessed the association of high perceived salt intake with the risk of PLC in the Kailuan Study. Methods: In total, 97 006 participants who were healthy adults or free living adults at the baseline (2006) were included in the present study. The data of perceived salt intake were collected via questionnaire and classified into three categories: <6 g day−1 for low salt intake, 6–10 g day−1 for intermediate salt intake, >10 g day−1 for high‐salt intake. PLC including hepatocellular carcinoma and intrahepatic cholangiocarcinoma (excluding liver metastasis), and was confirmed by review of medical records. We used a Cox proportional hazards model to analyse the association between high perceived salt diet and the risk of PLC after adjusting for possible confounders, including age, gender, body mass index, high sensitivity‐C‐reactive protein, low‐density lipoprotein‐cholesterol, total cholesterol, triglycerides, alanine aminotransferase, HbsAg positive, cirrhosis, fatty liver, hypertension, diabetes, drinking status, smoking status and physical exercise. Results: During the follow‐up period of 1 113 816 person‐years, 397 PLC events were diagnosed. After adjusting for most potential confounders, subjects in intermediate salt intake and high salt intake had a multivariable hazard ratio and 95% confidence interval of 1.49 (0.97–2.29) and 1.98 (1.22–3.22) (P for trend = 0.0042), respectively, compared to low salt intake. Conclusions: A higher perceived salt intake was associated with a higher risk of PLC. [ABSTRACT FROM AUTHOR]

Background: Although widely acknowledged that adequate maternal nutrition is important for mother and baby, limited research has focussed on women with severe mental illnesses (SMI) in pregnancy. The present study reports on nutritional factors and food choices and investigates barriers and facilitators to healthy nutritional choices by pregnant women with SMI. Methods: A prospective mixed method study was undertaken of 38 pregnant women with SMI, including a cross‐sectional survey, a food frequency questionnaire and 12 postnatal qualitative interviews, with integrated analysis of all data. Results: Elevated rates of obesity (35%) were found, with 82% of women having above the recommended gestational weight gain. Despite perceived knowledge, 32% of women did not meet any of the Five Food Group serving recommendations for pregnancy and consumed above‐recommended levels for processed (19%) and sugar snacks (51%). Thematic analysis identified four main barriers: a discrepancy between knowledge and action, food cravings, mental health, and physical health. During pregnancy, food cravings were reported in 66% of women, psychological distress in 71% and physical distress in 37%. Screening identified 19% with potential eating disordered behaviours. Despite the challenges, several facilitators were identified and covered three themes: access to a dietitian, information delivery and support, and comprehensive care. Discussion: Women with SMI in pregnancy struggle with issues of obesity, gestational weight gain, food cravings and possible eating disorder behaviours. They have additional challenges when pregnant, with management of their mental health and physical health having a direct impact. Interventional strategies in this population should incorporate findings from this research. [ABSTRACT FROM AUTHOR]

A quiz concerning continuous professional development is presented.

Background: Some local areas in England stopped have gluten‐free prescriptions for coeliac disease. An explanatory mixed‐methods study has investigated the impact of these changes. Methods: A cross‐sectional survey with 1697 participants was followed by 24 qualitative interviews. The survey included questions on the use of prescriptions and healthcare services, as well as the Coeliac Disease Assessment Questionnaire (CDAQ) to assess quality of life. The survey data were analysed by descriptive statistics, analysis of variance and regression analysis, and the interviews were analysed by thematic analysis. Findings from the interviews guided the survey analysis. Results: Dietary burden was significantly different between prescribing and nonprescribing areas, with little impact on other aspects of quality of life. Survey participants in nonprescribing areas who felt more impacted by the prescription changes reported a lower quality of life. Satisfaction with and use of services was lower in nonprescribing areas. Interviews indicated that, after initial frustrations, most people adapted to the changed prescription policy. However, there was a clear preference for gluten‐free prescriptions to be available, in particular for staple foods. Conclusions: The main quality of life impact was on Dietary burden. It is encouraging that most participants in the present study maintained a good quality of life. However, issues of worse experiences of care, lower follow‐up opportunities and inequity arose, and these should be taken into consideration in decisions on gluten‐free food prescriptions. The new guidelines for the National Health Service in England have retained prescriptions for bread and flour mixes, which is more limited than the range of staple foods preferred in the present study. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate levels of nutrient intakes, including dietary antioxidant quality (DAQ) score, among Saudi females with and without knee osteoarthritis (OA). We also aimed to examine the relationship between nutrient intakes and knee OA severity. Methods: One hundred female participants with symptomatic primary knee OA were matched for age with 100 apparently healthy females and were sequentially recruited from the Orthopaedics Department, Faculty of Medicine, King Abdulaziz University Hospital, Saudi Arabia, in a case–control study design. Radiographic disease severity of OA was assessed by the Kellgren–Lawrence grading system. Symptomatic severity was evaluated according to the Western Ontario McMaster University Osteoarthritis scores. Dietary intake was assessed using a prevalidated food frequency questionnaire. The DAQ score was calculated considering the risk of an inadequate intake (<2/3 reference nutrient intake) for selenium, zinc, vitamins A, C and E. Results: A higher intake of saturated fatty acids [15.4 (0.3) as a mean (SD) percentage of energy supplied] and monounsaturated fatty acids [16.6 (0.2) as a percentage of energy supplied] than the recommendations was evident among the study population. OA patients consume less antioxidants than non‐OA subjects as determined by their DAQ score [8.41 (0.1) versus 9.17 (0.1), P < 0.0001]. After adjusting for potential confounders, DAQ score, and monounsaturated and polyunsaturated fatty acids, most of the micronutrient intakes were found to be negatively associated with the prevalence of radiographic knee OA. Conclusions: Dietary antioxidants could be implicated in the development and progression of knee OA. Modifying dietary fatty acids may be one way of reducing the development and subsequent burden of knee OA. [ABSTRACT FROM AUTHOR]

Background: Short‐term trials with a low‐FODMAP (fermentable oligosaccharides disaccharides monosaccharides and polyols) diet (LFD) show promising results in the symptomatic management of irritable bowel syndrome (IBS). The present study investigated the long‐term adherence to an LFD diet, factors associated with adherence, and associations between LFD and quality of life (QOL), IBS symptoms and disease course on a long‐term basis. Methods: A retrospective cross‐sectional study was conducted. Two hundred and thirty‐four patients were enrolled from Ghent University hospital. Health‐related QOL, long‐term adherence to the LFD, disease course and IBS symptoms were assessed using a validated and self‐developed questionnaire. Results: Ninety (38.5%) patients completed the questionnaires. The median time span between the first dietary consultation and completion of the questionnaires was 99.5 weeks (approaching 2 years). The predominant disease course was mild IBS with an indolent course (43.0%). Eighty percent reported still following a diet in which certain FODMAP‐rich food types are avoided. Eighty patients (88.9%) were satisfied that they follow or had followed the diet. The IBS‐QOL did not differ between patients following the diet strictly and patients deviating from the diet (P = 0.669). Patients still following the LFD experienced less severe abdominal pain than patients who stopped following the diet (P = 0.044). Conclusions: The long‐term adherence and satisfaction with the LFD is high in patients with IBS. Nevertheless, patients indicated that it was difficult to follow the LFD in daily life. Practical issues, social factors and the absence of symptoms were indicated as the main reasons for a drop in adherence. [ABSTRACT FROM AUTHOR]

Background: Higher Dietary Inflammatory Index (DII®) scores are associated with increased morbidity and mortality. However, little is known about the effects of DII on mortality in Mediterranean countries. Therefore, in the present study, we aimed to investigate the potential association between DII scores and overall, cancer and cardiovascular disease (CVD) mortality in people living in a Mediterranean area. Methods: DII scores were calculated using a validated food‐frequency questionnaire. DII scores were then categorised into tertiles. Mortality was ascertained via death certificates. The association between DII scores with overall and cause‐specific mortality was assessed via a multivariable Cox's regression analysis and reported as hazard ratios (HRs) with their 95% confidence intervals (CIs). Results: The study included 1565 participants (mean age 65.5 years; females 44.7%). After a median follow‐up of 12 years (2005–2017), 366 (23.4%) participants died. After adjusting for 17 potential confounders, people with higher DII scores had an increased risk of death compared to those in the lowest (most anti‐inflammatory) tertile (HR = 1.38; 95% CI = 1.04–1.82 for the second tertile; HR = 1.38; 95% CI = 1.03–1.86 for the third tertile). Each 1 SD increase in DII score increased the risk of death by 13%. No association was found between DII scores and cancer or CVD death when considered separately. Conclusions: Higher DII scores were associated with a significantly higher mortality risk, whereas the association with cause‐specific mortality was less clear. These findings highlight the potential importance of diet in modulating inflammation and preventing death. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the principal cause of mortality and disability in Iranian adults. We aimed to evaluate the relationship between dietary patterns and CVD incidence in a large sample of adults in northeastern Iran. Methods: The present study comprised a prospective study of 5706 CVD‐free men and women aged 35–65 years who participated in a cohort study. All of the participants were followed up for a 6‐year period. Dietary patterns were derived from a 65‐item validated food frequency questionnaire and the factor analysis method was used to determine dietary patterns. Results: We identified two major dietary patterns: (i) a Balanced dietary pattern (a high intake of green leafy vegetables, other vegetables, fruits, dairy products, red meats, poultry, seafoods, legumes and nuts, as well as a low intake of sugar) and (ii) a Western dietary pattern (a high intake of sugar, tea, egg, snacks, fast foods, potato, carbonated beverages, pickled foods, organs meat and butter) by factor analysis. The hazard ratio (HR) and 95% confidence intervals (CIs) of total CVD in the highest versus lowest tertiles of the Balanced pattern were 1.29 (95% CI = 0.67–2.47; P = 0.44). The HR and 95% CIs of CVD in the highest versus lowest tertiles of Western pattern were 2.21 (95% CI = 1.08–4.45; P = 0.03). Conclusions: During the 6‐year follow‐up, we found that adherence to a Balanced dietary pattern was not significantly associated with CVD events. However, adherence to a Western dietary pattern was associated with a significantly increased risk of CVD events and its associated risk. [ABSTRACT FROM AUTHOR]