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In developing countries, deficiencies of micronutrients are thought to have a major impact on child development; however, a consensus on the specific relationship between dietary zinc intake and cognitive function remains elusive. The aim of this systematic review was to examine the relationship between zinc intake, status and indices of cognitive function in children and adults. A systematic literature search was conducted using EMBASE, MEDLINE and Cochrane Library databases from inception to March 2014. Included studies were those that supplied zinc as supplements or measured dietary zinc intake. A meta-analysis of the extracted data was performed where sufficient data were available. Of all of the potentially relevant papers, 18 studies met the inclusion criteria, 12 of which were randomised controlled trials (RCTs; 11 in children and 1 in adults) and 6 were observational studies (2 in children and 4 in adults). Nine of the 18 studies reported a positive association between zinc intake or status with one or more measure of cognitive function. Meta-analysis of data from the adult’s studies was not possible because of limited number of studies. A meta-analysis of data from the six RCTs conducted in children revealed that there was no significant overall effect of zinc intake on any indices of cognitive function: intelligence, standard mean difference of

Background: Fluid and water intake have received limited attention in epidemiological studies. The aim of this study was to compare the average daily consumption of foods and beverages in adults of selective samples of the European Union (EU) population in order to understand the contribution of these to the total water intake (TWI), evaluate if the EU adult population consumes adequate amounts of total water (TW) according to the current guidelines, and to illustrate the real water intake in Europe. Methods: Three national European dietary surveys have been selected: Spain used the Anthropometry, Intake, and Energy Balance Study (ANIBES) population database, Italy analyzed data from the Italian National Food Consumption Survey (INRAN-SCAI 2005-06), and French data came from the NutriNet-Sante database. Mean daily consumption was used to compare between individuals. TWI was compared with European Food Safety Authority (EFSA) reference values for adult men and women. Results: On average, in Spain, TWI was 1.7 L (SE 22.9) for men and 1.6 L (SE 19.4) for women; Italy recorded 1.7 L (SE 16.9) for men and 1.7 L (SE 14.1) for women; and France recorded 2.3 L (SE 4.7) for men and 2.1 L (SE 2.4) for women. With the exception of women in France, neither men nor women consumed sufficient amounts of water according to EFSA reference values. Conclusions: This study highlights the need to formulate appropriate health and nutrition policies to increase TWI in the EU population. The future of beverage intake assessment requires the use of new instruments, techniques, and the application of the new available technologies.

A systematic review and meta-analysis of available randomized controlled trials (RCTs) was conducted to evaluate the effect of zinc (Zn) intake on mental and motor development in infants. Out of 5500 studies identified through electronic searches and reference lists, 5 RCTs were selected after applying the exclusion/inclusion criteria. The influence of Zn intake on mental and motor development was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of Zn intake, intervention duration, nutritional situation, and risk of bias. Indices of mental and motor development assessed were the Mental Development Index (MDI) and Psychomotor Development Index (PDI). Additionally we carried out a sensitivity analysis. The pooled β was -0.01 (95 %CI -0.02, 0) for MDI and 0 (95 %CI -0.03, 0.02) for PDI, with a substantial heterogeneity in both analyses. When we performed a meta-regression, the effect of Zn supplementation on MDI changed depending on the dose of supplementation. Regarding PDI, there was a differential effect of Zn intake depending on intervention duration, dose of supplementation, nutritional situation, and risk of bias. Zn supplementation showed a negative, weak and significant effect on PDI score in those studies with a length of 4 to 20 weeks (β= -0.05; CI 95 % -0.06 to -0.04). In conclusion, no association was found between Zn intake and mental and motor development in infants. Further standardized research is urgently needed to clarify the role of Zn supplementation upon infant mental and motor development, particularly in Europe.

A systematic review and meta-analysis of available RCTs was conducted to evaluate the effect of zinc (Zn) intake on serum/plasma Zn status in infants. Out of 5500 studies identified through electronic searches and reference lists, 9 RCTs were selected after applying the exclusion/inclusion criteria. The influence of zinc intake on serum/plasma Zn concentration was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of zinc intake, intervention duration, nutritional status and risk of bias. From each selected study, final measures of serum/plasma Zn were assessed. RESULTS: The pooled β of status was 0.09 (95%CI 0.06 to 0.12). However, a substantial heterogeneity was present in the analyses (I2=95%; p=0.00001). When we performed a meta-regression, the effect of Zn intake on serum/plasma Zn status changed depending on the duration of the intervention, the dose of supplementation and the nutritional situation (p ANCOVA= 0.005; 20 weeks). A positive effect was seen also when doses ranged from 8.1 to 12 mg/day. In all cases, the pooled β showed high evidence of heterogeneity. CONCLUSION: Zinc supplementation increases serum/plasma Zn status in infants, although high evidence of heterogeneity was found. Further standardized research is urgently needed to reach evidence-based conclusions to clarify the role of zinc supplementation upon infant serum/plasma Zn status, particularly in Europe.

Introduccion: Las recomendaciones de ingesta total de agua adecuada (Atwi) han sido propuestos por la Agencia Europea de Seguridad Alimentaria (AESA) y el Instituto de Medicina (IOM) de los Estados Unidos de America. Sin embargo, hay diferencias en el enfoque utilizado para apoyarlos: IOM recomendacion se basa en la ingesta media observada en NHANES III (Tercera Nacional de Salud y Nutricion de Encuesta) y la recomendacion de la EFSA en una combinacion de la ingesta observados de 13 paises europeos diferentes. A pesar de estas recomendaciones de Atwi, el cientifi disponibles en la actualidad c evidencia no es suficiente para establecer un valor de corte que impida la enfermedad, reducir el riesgo de enfermedades cronicas o mejorar el estado de salud. Objetivo: Comparar el consumo medio diario de fluidos (agua y otras bebidas) en muestras selectivas de la poblacion de Mexico, Estados Unidos y Espana, la evaluacion de la cantidad de la ingesta de liquidos y la comprension de la contribucion de cada tipo de fluido a la ingesta de liquido total. Tambien tenemos como objetivo para determinar si se alcanzan los valores adecuados de admision (AI), como se defi nida por tres criterios diferentes: la OIM, la EFSA y la densidad del agua. Metodos: Se compararon tres estudios: desde Mexico, la Encuesta Nacional de Salud y Nutricion realizada en 2012 (NHNS 2012); de los Estados Unidos, el estudio NHANES III 2005-2010 y desde Espana el estudio con plomo ANIBES en 2013. Las diferentes categorias de bebidas fueron utilizados para establecer el patron de consumo de energia para cada pais. solo se ha seleccionado la poblacion adulta. TWI de cada estudio se comparo con la EFSA y las recomendaciones de la OIM de IA, asi como la aplicacion del criterio de la densidad del agua (ml / kcal). Resultados: El estudio estadounidense obtuvo el valor mas alto del total kcal / dia de alimentos y bebidas (2437 ± 13). Por otra parte, el porcentaje de la ingesta diaria de energia procedente de las bebidas era, para los adultos estadounidenses, 21%. Mexico era un poco por detras con el 19% y el estudio Espana ANIBES registrado solo el 12%. ANIBES mostro valores signifi cativamente bajas AI para la poblacion en general, pero aun mas alarmante en el caso de los varones. Solo el 12% de los hombres, en contraste con el 21% de las mujeres, no satisface el criterio de la AESA. El criterio de la OIM alcanza menos aun con los valores mas altos para la ingesta diaria recomendada. En contraste, 60% de la poblacion estadounidense alcanzo la ingesta recomendada del criterio IOM. Sin embargo, los datos disponibles no permiten calcular el porcentaje alcanzado por el criterio de la AESA. Los datos del estudio mexicana no permitieron la realizacion de comparaciones con la OIM o con la AESA. Sin embargo, los criterios de densidad del agua (ml / kcal) fue mayor que 1. Conclusion: Hay una diferencia notable entre las tres poblaciones en terminos de TWI. Por otra parte, dentro de la misma poblacion, los valores de adecuacion de TWI claramente modificadas cuando se evaluaron utilizando diferentes criterios. Mas Se requiere evidencia cientifi ca para la produccion de las recomendaciones de ingesta de agua mejor definidas en el futuro, asi como mas estudios centrados en los patrones de consumo de bebidas en diferentes configuraciones.

We assess the repeatability and relative validity of a Spanish beverage intake questionnaire for assessing water intake from beverages. The present analysis was performed within the framework of the PREDIMED-PLUS trial. The study participants were adults (aged 55–75) with a BMI ≥27 and

Background: Inadequate hydration is a public health issue that imposes a significant economic burden. In Spain, data of total water intake (TWI) are scarce. There is a clear need for a national study that quantifies water and beverage intakes and explores associations between the types of beverages and energy intakes. Methods: The Anthropometry, Intake and Energy Balance Study ANIBES is a national survey of diet and nutrition conducted among a representative sample of 2285 healthy participants aged 9–75 years in Spain. Food and beverage intakes were assessed in a food diary over three days. Day and time of beverage consumption were also recorded. Results: On average, TWI was 1.7 L (SE 21.2) for men and 1.6 L (SE 18.9) for women. More than 75% of participants had inadequate TWI, according to European Food Safety Authority (EFSA) recommendations. Mean total energy intake (EI) was 1810 kcal/day (SE 11.1), of which 12% was provided by beverages. Water was the most consumed beverage, followed by milk. The contribution of alcoholic drinks to the EI was near 3%. For caloric soft drinks, a relatively low contribution to the EI was obtained, only 2%. Of eight different types of beverages, the variety score was positively correlated with TWI (r = 0.39) and EI (r = 0.23), suggesting that beverage variety is an indicator of higher consumption of food and drinks. Conclusions: The present study demonstrates that well-conducted surveys such as the ANIBES study have the potential to yield rich contextual value data that can emphasize the need to undertake appropriate health and nutrition policies to increase the total water intake at the population level promoting a healthy Mediterranean hydration pattern., The ANIBES study was supported by Coca-Cola Iberia through an agreement with the Spanish Nutrition Foundation (FEN) who assisted with the technical advice. The current analysis included in this paper was financially supported by a Grant from the European Hydration Institute to the Canarian Foundation Science and Technology Park of the University of Las Palmas de Gran Canaria.

ObjectiveTo review evidence on the associations between vitamin B12intake and its biomarkers, vitamin B12intake and its functional health outcomes, and vitamin B12biomarkers and functional health outcomes.DesignA systematic review was conducted by searching electronic databases, until January 2012, using a standardized strategy developed in the EURRECA network. Relevant articles were screened and sorted based on title and abstract, then based on full text, and finally included if they met inclusion criteria. A total of sixteen articles were included in the review.SettingArticles covered four continents: America (n4), Europe (n8), Africa (n1) and Asia (n3).SubjectsPopulation groups included healthy infants, children and adolescents, and pregnant and lactating women.ResultsFrom the total number of 5815 papers retrieved from the initial search, only sixteen were eligible according to the inclusion criteria: five for infants, five for children and adolescents, and six for pregnant and lactating women.ConclusionsOnly one main conclusion could be extracted from this scarce number of references: a positive association between vitamin B12intake and serum vitamin B12in the infant group. Other associations were not reported in the eligible papers or the results were not provided in a consistent manner. The low number of papers that could be included in our systematic review is probably due to the attention that is currently given to research on vitamin B12in elderly people. Our observations in the current systematic review justify the idea of performing well-designed studies on vitamin B12in young populations.

The aims of the present study were to review the validity of dietary methods used to measure the usual long chain (LC) omega-3 polyunsaturated fatty acid (n-3 PUFA) intake of a population and to assess the usefulness of different biomarkers ofn-3 PUFA in healthy humans. Two systematic literature searches were conducted until May 2011 to update previous systematic reviews. The first literature search aimed to find studies validating the methodology used for measuring the dietary intake ofn-3 PUFA. The second search aimed to find human intervention studies in whichn-3 PUFA status changed after 2 weeks ofn-3 PUFA supplementation. Sixteen studies were identified for inclusion in the first review. Correlation coefficients between fatty acids in subcutaneous fat or blood lipids and dietary intake ofn-3 PUFA from different questionnaires were similar. Subcutaneous fat has been reported as the best reference method for some authors, and these studies showed moderate correlation coefficients with no dietary intake method being superior to any other. As for the evaluation of biomarkers of docosahexaenoic acid (DHA, 22 : 6n-3) and eicosapentaenoic acid (EPA, 20 : 5n-3) status in response to supplementation, the new search reaffirmed and reinforced the evidence supporting that plasma phospholipid DHA, erythrocyte DHA, and platelet DHA were all effective and robust biomarkers of DHA status. Our findings only confirmed earlier studies and did not provide evidence for reaching new conclusions.

The objective of the present study was to systematically review the literature exploring the associations between different dietary patterns obtained from Food Frequency Questionnaires during pregnancy and the development of health-related maternal and infant outcomes in the Framework of the EURRECA Network of Excellence. A systematic search was conducted on Pubmed for literature published up to September 2009. The search strategy resulted in an initial amount of 2048 articles. After applying the selection criteria, seven studies were finally identified. Five articles were based on prospective cohort studies and the other two were case-control studies. The methods used to elaborate the dietary pattern could be classified as hypothesis-oriented (three studies) or empirically-derived (four studies). The different food frequency questionnaires used for diet assessment were self-administered, semi-quantitative and had been previously validated, but just four studies employed questionnaires validated specifically for their use in a pregnant population. The divergent methods used to assess the dietary patterns make it difficult to compare results. However, some resulting recommendations can be applied when dietary patterns during pregnancy are analyzed: to employ a validated food frequency questionnaire designed for use in pregnancy, to consider the special role exerted by mineral and vitamin supplements in this particular population group, to adequately select the time in which dietary data is collected, to adjust the results for life-style and educational characteristics, and in the case of hypothesis-oriented dietary patterns, to correctly choose the components comprising the score.

Water is the main constituent of the human body. It is involved in practically all its functions. It is particularly important for thermoregulation and in the physical and cognitive performance. Water balance reflects water intake and loss. Intake of water is done mainly through consumption of drinking water and beverages (70 to 80%) plus water containing foods (20 to 30%). Water loss is mainly due to excretion of water in urine, faeces and sweat. The interest in the type and quantity of beverage consumption is not new, and numerous approaches have been used to assess beverage intake, but the validity of these approaches has not been well established. There is no standardized questionnaire developed as a research tool for the evaluation of water intake in the general population. Sometimes, the information comes from different sources or from different methodological characteristics which raises problems of the comparability. In the European Union, current epidemiological studies that focus exclusively on beverage intake are scarce. Biomarkers of intake are able to objectively assess dietary intake/status without the bias of self-reported dietary intake errors and also overcome the problem of intra-individual diet variability. Furthermore, some methods of measuring dietary intake used biomarkers to validate the data it collects. Biological markers may offer advantages and be able to improve the estimates of dietary intake assessment, which impact into the statistical power of the study. There is a surprising paucity of studies that systematically examine the correlation of beverages intake and hydration biomarker in different populations. A pilot investigation was developed to evaluate the comparative validity and reliability of newly developed interactive multimedia (IMM) versions compared to validated paper-administered (PP) versions of the Hedrick et al. beverage questionnaire. The study showed that the IMM appears to be a valid and reliable measure to assess habitual beverage intake. Similar study was developed in China, but in this case, the use of Smartphone technology was employed for beverage assessment.The methodology for measuring beverage intake in population studies remains controversial. There are few validated and reproducible studies, so there is still lacking an ideal method (ie, short, easy to administer, inexpensive and accurate) in this regard. Clearly, this is an area of scientific interest that is still in development and seems to be very promising for improving health research.El agua es el principal constituyente del cuerpo humano. Está implicado en prácticamente la totalidad de sus funciones. Es especialmente importante en la termorregulación y en el rendimiento físico y cognitivo. El balance de agua refleja la ingesta y la pérdida de agua. La ingesta se realiza principalmente a través del consumo de agua potable y de bebidas (70 a 80%) más el agua que contienen los alimentos (20 a 30%). La pérdida de agua se realiza gracias a su excreción a través de la orina, las heces y el sudor. El interés por el tipo y la cantidad de bebidas consumidas no es nuevo, y numerosos enfoques se han utilizado para evaluarla, pero la validez de estos enfoques no se han establecido correctamente. Aún no existe, en población general, un cuestionario estandarizado desarrollado como herramienta de investigación para la evaluación de la ingesta de agua. El uso de información de diferentes fuentes y diferentes características metodológicas plantea problemas de comparabilidad entre estudios. En Europa los estudios epidemiológicos actuales que se centran exclusivamente en el consumo de bebidas son escasos. Los biomarcadores de ingesta permiten evaluar objetivamente la ingesta dietética sin el sesgo producido por los errores del auto-reporte. Además permiten superar el problema de la variabilidad intra-individual. Algunos métodos para medir ingesta alimentaria utilizan biomarcadores para validar los datos que recoge. Los marcadores biológicos ofrecen ventajas y son capaces de mejorar las estimaciones de la evaluación de ingesta dietética. Sin embargo, existen muy pocos estudios que examinen sistemáticamente la correlación entre la ingesta de bebidas y los biomarcadores de hidratación en diferentes poblaciones. Utilizando el cuestionario de bebidas de Hedrick y col. se realizó un estudio piloto para evaluar la validez y fiabilidad de un modelo multimedia interactivo (IMM) y para compararlo con una versión en papel-auto administrado (PP). El estudio mostró que el IMM parece ser un modelo válido y fiable para evaluar la ingesta de bebidas habitual. Un estudio similar se realizó en China, pero en este caso, se empleó para evaluar ingesta de bebidas la tecnología Smartphone. Conclusión: La metodología para valorar el consumo de bebidas en estudios poblacionales sigue siendo un tema controvertido. Existen pocos estudios validados y reproducibles, por lo que todavía no se dispone de un método ideal (corto, fácil de administrar, económico y preciso). Esta es un área de interés científico que aún está en desarrollo y que parece ser muy prometedora para mejorar las investigaciones en el área de la salud.

A systematic review and meta-analysis of available randomized controlled trials (RCTs) was conducted to evaluate the effect of zinc (Zn) intake on growth in infants. Out of 5500 studies identified through electronic searches and reference lists, 19 RCTs were selected after applying the exclusion/inclusion criteria. The influence of Zn intake on growth was considered in the overall meta-analysis. Other variables were also taken into account as possible effect modifiers: doses of Zn intake, intervention duration, nutritional status, and risk of bias. From each select growth study, final measures of weight, length, mid upper arm circumference (MUAC), head circumference, weight for age z-score (WAZ), length for age z-score (LAZ), and weight for length z-score (WLZ) were assessed. Pooled β and 95% confidence interval (CI) were calculated. Additionally, we carried out a sensitivity analysis. Zn intake was not associated with weight, length, MUAC, head circumference, and LAZ in the pooled analyses. However, Zn intake had a positive and statistically effect on WAZ (β = 0.06; 95%CI 0.02 to 0.10) and WLZ (β = 0.05; 95%CI 0.01 to 0.08). The dose-response relationship between Zn intake and these parameters indicated that a doubling of Zn intake increased WAZ and WLZ by approximately 4%. Substantial heterogeneity was present only in length analyses (I(2) = 45%; p = 0.03). Zn intake was positively associated with length values at short time (four to 20 weeks) (β = 0.01; CI 95% 0 to 0.02) and at medium doses of Zn (4.1 to 8 mg/day) (β = 0.003; CI 95% 0 to 0.01). Nevertheless, the effect magnitude was small. Our results indicate that Zn intake increases growth parameters of infants. Nonetheless, interpretation of these results should be carefully considered.

BACKGROUND/OBJECTIVES:\ud \ud It is estimated that zinc deficiency affects 17% of the world's population, and because of periods of rapid growth children are at an increased risk of deficiency, which may lead to stunting. This paper presents a systematic review and meta-analysis of the randomised controlled trials (RCTs) that assess zinc intake and growth in children aged 1–8 years. This review is part of a larger systematic review by the European Micronutrient Recommendations Aligned Network of Excellence that aims to harmonise the approach to setting micronutrient requirements for optimal health in European populations (www.eurreca.org).\ud \ud SUBJECT/METHODS:\ud \ud Searches were performed of literature published up to and including December 2013 using MEDLINE, Embase and the Cochrane Library databases. Included studies were RCTs in apparently healthy child populations aged from 1 to 8 years that supplied zinc supplements either as capsules or as part of a fortified meal. Pooled meta-analyses were performed when appropriate.\ud \ud RESULTS:\ud \ud Nine studies met the inclusion criteria. We found no significant effect of zinc supplementation of between 2 weeks and 12 months duration on weight gain, height for age, weight for age, length for age, weight for height (WHZ) or WHZ scores in children aged 1–8 years.\ud \ud CONCLUSIONS:\ud \ud Many of the children in the included studies were already stunted and may have been suffering from multiple micronutrient deficiencies, and therefore zinc supplementation alone may have only a limited effect on growth.

Nutritional surveys frequently collect some data of consumption of beverages; however, information from different sources and different methodologies raises issues of comparability. The main objective of this review was to examine the available techniques used for assessing beverage intake in European epidemiological studies and to describe the most frequent method applied to assess it.Information of beverage intake available from European surveys and nutritional epidemiological investigations was obtained from gray literature.Twelve articles were included and relevant data were extracted. The studies were carried out on healthy adults by different types of assessments. The most frequent tool used was a 7-d dietary record. Only Germany used a specific beverage assessment tool (Beverage Dietary History).From the limited data available and the diversity of the methodology used, the results show that consumption of beverages is different between countries. Current epidemiological studies in Europe focusing on beverage intake are scarce. Further research is needed to clarify the amount of beverage intake in European population.

The databases searched included MEDLINE, EMBASE (both on Ovid) and the Cochrane Library CENTRAL from inception to March2013. Following the EURRECA protocol of screening and sorting, 2173 studies were assessed for eligibility criteria. Data was extractedfrom 19 studies across all population groups that met the inclusion and exclusion criteria (12 randomised controlled trials (RCTs), and7 observational studies). Meta-analysis of data extracted from 7 RCTs conducted in children was undertaken using Review Manager (5.2).A random effects model was used to investigate the impact of zinc intake on indices of cognitive function including intelligence (7 datasets from 862 children), executive function (7 data sets from a 942 children), and motor development (4 data sets from 622 children).The analysis yielded a pooled standard mean difference for the impact of zinc supplementation on intelligence of 0.06 (95% CI - 0.10,0.22) p = 0.47; executive function, 0.13 (95% CI, - 0.02, 029) p = 0.10 and motor development, - 0.05 (95% CI - 0.36, 0.26) p = 0.75.These results revealed that there was no signiÞcant overall effect of zinc supplementation on these cognitive function outcomes assessedin children.Due to the heterogeneity of the cognitive function test methodology, only a small number of studies could be included in the meta-analysis. To date, the evidence regarding the effect of zinc intake on cognitive function remains inconclusive. However, taking all thestudies per population as a whole there is some evidence for a positive association between zinc and cognitive function and there is a needfor further high quality RCTs to investigate this relationship.

Zinc was selected as a priority micronutrient for EURRECA, because there is significant heterogeneity in the Dietary Reference Values (DRVs) across Europe. In addition, the prevalence of inadequate zinc intakes was thought to be high among all population groups worldwide, and the public health concern is considerable. In accordance with the EURRECA consortium principles and protocols, a series of literature reviews were undertaken in order to develop best practice guidelines for assessing dietary zinc intake and zinc status. These were incorporated into subsequent literature search strategies and protocols for studies investigating the relationships between zinc intake, status and health, as well as studies relating to the factorial approach (including bioavailability) for setting dietary recommendations. EMBASE (Ovid), Cochrane Library CENTRAL, and MEDLINE (Ovid) databases were searched for studies published up to February 2010 and collated into a series of Endnote databases that are available for the use of future DRV panels. Meta-analyses of data extracted from these publications were performed where possible in order to address specific questions relating to factors affecting dietary recommendations. This review has highlighted the need for more high quality studies to address gaps in current knowledge, in particular the continued search for a reliable biomarker of zinc status and the influence of genetic polymorphisms on individual dietary requirements. In addition, there is a need to further develop models of the effect of dietary inhibitors of zinc absorption and their impact on population dietary zinc requirements. This is the peer-reviewed version of the article: Lowe Nicola M., Dykes Fiona C., Skinner Anna-Louise, Patel Sujata, Warthon-Medina Marisol, Decsi Tamas, Fekete Katalin, Souverein Olga W., Dullemeijer Carla, Cavelaars Adrienne E., Serra-Majem Lluis, Nissensohn Mariela, Bel Silvia, Moreno Luis A., Hermoso Maria, Vollhardt Christiane, Berti Cristiana, Cetin Irene, Gurinović Mirjana A., Novaković Romana, Harvey Linda, Collings Rachel, Hall-Moran Victoria, "EURRECA-Estimating Zinc Requirements for Deriving Dietary Reference Values" 53, no. 10 (2013):1110-1123, [https://doi.org/10.1080/10408398.2012.742863]

Dehydration occurs when the body loses more water than is taken in. It is often accompaniedby disturbances in the body’s mineral salt or electrolyte balance, especially in the concentrations ofsodium and potassium.Populations at particular risk of hypohydration are the very young, those engaged in professionswhere fluid homeostasis is regularly challenged and the elderly. Limited data are available on theprevalence of hypohydration, but there is evidence to suggest that this may be relatively commonamong the western elderly populations [1]. The percentage of population with inadequate intake ofwater may vary from 5% to 35% in the different European countries [2].The burden of disease from lack of access to clean water, poor sanitation and inadequate personaland food hygiene is well known, but consequences of inadequate water intake worldwide are farfrom being well understood. Recent research [3] into the risk of disease (bowel, metabolic and kidneydiseases), disability (cognitive function, physical performance, headache, falls and accidents) anddeath is confirming the importance of poor hydration to overall disease burden and quality of life ina worldwide perspective.Moreover, the number of hospitalizations for dehydration has steadily increased in recent decades.In this case, dehydration increases the healthcare burden in a direct way, as a disease itself. However,sometimes, dehydration appears as a comorbidity condition in a number of diseases. Dehydration hasbeen defined as the second most common comorbidity, occurring in 14% of all hospitalizations [4].In addition to its individual clinical impact; dehydration also represents an important public healthissue by imposing a significant economic burden. Depending on the degree or magnitude of thedehydration in hospitalized patients, costs may increase by 7% to 8.5% [5]. Higher cost will beassociated with an increase in hospital mortality, as well as with an increase in the utilization of intenseshort and long term care facilities, readmission rates and hospital resources, especially among thosewith moderate to severe hypernatraemia. Dehydration represents a potential target for interventionto reduce healthcare expenditures and improve patients’ quality of life [6]. However, the higher costof dehydration is not only in hospitalized patients. Dehydration is one of the major factors limitingathletic performance and even mild dehydration can have a significant impact on working capacityand productivity [7]. Some studies have suggested a possible link between dehydration and the rise inindustrial accidents during the summer, when workers are presumably thirstier [8]. A study publishedin 2004 found it had a real impact on performance in physical fields such as forestry, with slightlydehydrated workers being about 12% less productive than their fully hydrated peers [9].Improving drinking habits during working and leisure time and developing comprehensivehydration guidelines for healthcare professionals and patients would be a cost-effective means ofaddressing the burden of hypohydration in developed countries.Given the extent of the problem and its under-acknowledgment, will governments engage inresearch and awareness-raising strategy on the burden of hypohydration in the different countries and

We would like to thank you for the opportunity to answer to the Letter to the Editor from Ferreira-Pego, Babio and Salas-Salvado [1] regarding our recent publication entitled “Beverage Consumption Habits and Association with Total Water and Energy Intakes in the Spanish Population: Findings of the ANIBES Study” [2].[...]

The objective of the present study was to systematically review the literature exploring the associations between different dietary patterns obtained from Food Frequency Questionnaires during pregnancy and the development of health‐related maternal and infant outcomes in the Framework of the Eurreca Network of Excellence. A systematic search was conducted on Pubmed for literature published up to September 2009. The search strategy resulted in an initial amount of 2048 articles. After applying the selection criteria, seven studies were finally identified. Five articles were based on prospective cohort studies and the other two were case‐control studies. The methods used to elaborate the dietary pattern could be classified as hypothesis‐oriented (three studies) or empirically‐derived (four studies). The different food frequency questionnaires used for diet assessment were self‐administered, semi‐quantitative and had been previously validated, but just four studies employed questionnaires validated specifically for their use in a pregnant population. The divergent methods used to assess the dietary patterns make it difficult to compare results. However, some resulting recommendations can be applied when dietary patterns during pregnancy are analyzed: to employ a validated food frequency questionnaire designed for use in pregnancy, to consider the special role exerted by mineral and vitamin supplements in this particular population group, to adequately select the time in which dietary data is collected, to adjust the results for life‐style and educational characteristics, and in the case of hypothesis‐oriented dietary patterns, to correctly choose the components comprising the score.

Dietary Zn recommendations vary widely across Europe due to the heterogeneity of approaches used by expert panels. Under the EURopean micronutrient RECommendations Aligned (EURRECA) consortium a protocol was designed to systematically review and undertake meta-analyses of research data to create a database that includes ‘best practice’ guidelines which can be used as a resource by future panels when setting micronutrient recommendations. As part of this process, the objective of the present study was to undertake a systematic review and meta-analysis of previously published data describing the relationship between Zn intake and status in adults. Searches were performed of literature published up to February 2010 using MEDLINE, Embase and the Cochrane Library. Data extracted included population characteristics, dose of Zn, duration of study, dietary intake of Zn, and mean concentration of Zn in plasma or serum at the end of the intervention period. An intake–status regression coefficient ($\circ {>\beta }$) was estimated for each individual study, and pooled meta-analysis undertaken. The overall pooled $\circ {>\beta }$ for Zn supplementation on serum/plasma Zn concentrations from randomised controlled trials and observational studies was 0·08 (95 % CI 0·05, 0·11; P I2 84·5 %). An overall $\circ {>\beta }$ of 0·08 means that for every doubling in Zn intake, the difference in Zn serum or plasma concentration is $2^{ \circ {>\beta }}$ (20·08 = 1·06), which is 6 %. Whether the dose–response relationship, as provided in the present paper, could be used as either qualitative or quantitative evidence to substantiate the daily Zn intake dose necessary to achieve normal or optimal levels of biomarkers for Zn status remains a matter of discussion.

Objective The adoption of a Mediterranean diet (MD) pattern of eating is often described as a strategy to help prevent or manage hypertension. However, this dietary regimen has not been reviewed systematically for its efficacy against hypertension. Therefore, the purpose of this study was to analyze the effect of interventions of at least 1 year duration on blood pressure (BP) values through a systematic review and meta-analysis. The focus was on interventions comparing an MD with a low-fat diet. Design The authors accessed and searched PubMed and Scopus databases up to March, 2015. Randomized control trials comparing MD vs low-fat diet were included. The researchers assessed the methodological quality, extracted the valid data, and conducted the meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Results Six trials (more than 7,000 individuals) were identified. Meta-analysis showed that interventions aiming at adopting an MD pattern for at least 1 year reduced both the systolic BP and diastolic BP levels in individuals with normal BP or mild hypertension. The effect was higher for the systolic BP (–1.44 mm Hg) but also consistent for the diastolic BP (–0.70 mm Hg). However, the results have to be interpreted with caution owing to the reduced number of studies eligible for inclusion in this meta-analysis. This situation limited the statistical power of the analyses. Furthermore, in all analyses, the pooled effect estimation showed a high evidence of heterogeneity, which compromises the validity of the pooled estimates. Conclusions and Implications A positive and significant association was found between the MD and BP in adults. However, in all cases the magnitude of the effect was small. Based on this limited group of studies and their heterogeneity, the authors found insufficient convincing evidence to suggest that the MD decreased BP. Further standardized research is urgently needed to reach evidence-based conclusions to clarify the role of MD in BP management, particularly in Europe and other societies where prevalence of cardiovascular diseases is increasing.