Abstract: Objective: The aim of the study was to identify dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Malaysia. Methods: A validated food frequency questionnaire was used to assess dietary patterns. Results: Multivariate analyses show that age and physical activity (PA) levels were emerged as positive determinants of healthy-based food pattern in Malay (All, p<0.001), whereas higher consumption of eating-out from home (EatOut) and fast food (All, p<0.05) were negative determinants. High weekly breakfast skipping (p<0.001) and EatOut (p<0.01) were positively associated with a western-based pattern, whereas age (p<0.001) and household income (p<0.05) were negative determinants. Higher frequency of daily snacking (p<0.05) was emerged as positive determinant of local-based food pattern. For Chinese adolescents, age (p<0.001), PA levels (p<0.001) and maternal education level (p<0.05) emerged as positive determinants for the healthy-based pattern, whereas high EatOut and fast food intakes (All, p<0.01) were negative determinants. Higher weekly consumption of EatOut (p<0.01), fast food (p<0.05) and carbonated beverages (p<0.05), and daily snacking practice (p<0.01) were positively associated with higher western-based food pattern, whereas age (p<0.01) was inversely associated. Conclusion: These findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy western-based food pattern that is high in fat, sugar and salt contents, and consequently increase the risk of developing obesity and metabolic-related disorders during these critical years of growth.

Data show that preschoolers consume few vegetables, fruits, whole grains, and nuts. We investigated whether a properly planned kindergarten menu can contribute to optimized daily intake of healthy foods. In this cross-sectional experimental study, we designed a 5-day prototype kindergarten menu with consistently followed dietary guidelines and randomly divided six invited kindergartens into a prototype group that received the prototype menu (PG, n=4) and a control group that used their regular menu (CG, n=2). From the participating kindergartens, we invited healthy 5-6-year-old children to participate. Outside of kindergarten, participants ate as usual. All completed a 7-day dietary record of foods consumed inside and outside of kindergarten. We used the Dietary Assessment Tool OPEN to analyze the average daily intake of seven food groups and compare it to the dietary guidelines. Fifty-seven participants completed the study, 40 from PG and 17 from CG. The average daily intake of vegetables (54% vs. 28%), whole grains (100% vs. 47%), and nuts (104% vs. 4%) was significantly higher (p&lt;0.05) in participants from PG compared with guideline recommendations than in participants from CG. Average daily intake of fruits, meats, dairy products, and refined grains did not differ significantly between study groups. Only kindergarten diet made a significant contribution, as intake outside of kindergarten did not show significant differences. The study demonstrates the importance of a well-planned menu in kindergartens and can serve as a basis for future interventions aimed at improving the nutritional environment in childcare facilities.

Dietary fiber has been associated with health benefits, therefore, the availability of validated tools to assess food consumption associated with high-fiber foods would allow the quantification of the intake of this functional nutrient, the identification of risk groups and target populations, and the development of public policies and/or programs aimed at improving the health of the population. In this study, a fiber intake short food frequency questionnaire (FFQ) was translated into Spanish and its content validity was determined by a group of experts, to subsequently conduct a pilot test including 198 subjects aged 36+12.5 years, residing in Chile (46 men and 150 women), with the purpose of quantifying dietary fiber intake. The global assessment of the FFQ revealed a validity coefficient of 0.98+0.02; after the application of the pilot, mean dietary fiber intake in adult Chilean residents was of 13 g per day, with similar results to those found in the National Food Consumption Survey 2010 (12.5 g per day in men, and 11.5 g in women). The FFQ is a quick and valid tool to classify people on the basis of their habitual dietary fiber intake.

A low calcium intake is associated with an increased fracture risk. We assessed the dietary calcium intake in a cohort of Italian individuals evaluated for low bone mineral density (BMD). A 7-day food-frequency questionnaire was administered to 1793 individuals consecutively referred at a Centre of the Italian Society for Osteoporosis, Mineral Metabolism and Skeletal Diseases for low BMD. In 30.3% (544/1793) and 20.9% (374/1793) of subjects the calcium intake was inadequate ( <700 mg/day) and adequate (>1200 mg/day), respectively. Patients with calcium intake <700 mg/day showed a higher prevalence of diabetes mellitus, idiopathic hypercalciuria and food allergy/intolerance (8.1%, 5.1%, 7.2%, respectively) than patients with calcium intake >700 mg/day (5.3%, 3.0%, 4.1%, respectively, p<0.04 for all comparisons), also after adjusting for age, gender and BMI. In 30.3% of fractured subjects the calcium intake was <700 mg/day. In Italy, a low calcium intake is highly prevalent in individuals at risk for low BMD. Importantly, an inadequate calcium intake is highly prevalent even in patients with history of fragility fractures. Only about a fifth of patients at risk for low BMD reported an adequate calcium intake

The aim of the study was to investigate the association between maternal dietary iron intake during pregnancy and the gut microbiota characteristics of both the mother and neonate in a well-characterized cohort. A total of 95 mother-neonate dyads were included in our study, with basic information collected through questionnaires. A semi-quantitative Food Frequency Questionnaire (FFQ) was used to assess maternal dietary intake during pregnancy, and maternal dietary iron intake was categorized into &lt;20 mg/d and ≥20 mg/d groups. Fecal samples were collected from the mother in the third trimester and the neonate, allowing for assessment of the community profile and diversity of gut microbiota via 16S rRNA amplicon sequencing. Then, a comparison between different maternal dietary iron intake groups was conducted, adjusting for delivery mode (VD, vaginal delivery; CS, cesarean section) and other potential confounding factors. No significant differences in community profile and diversity were observed for the maternal gut microbiota in different dietary iron intake groups. In neonate fecal samples, the Shannon (P = 0.044) and Simpson (P = 0.010) diversity indices of the gut microbiota were higher in the maternal dietary iron intake ≥20 mg/d group, while Simpson diversity presented the same tendency in vaginal delivery (P = 0.041) after stratification. The relative abundance of the core genus Bifidobacterium showed a significant difference between groups (4.69 [1.19–12.77] vs. 13.98 [3.44–27.28]; P = 0.044). The abundance of Lactobacillus was different in the ≥20 mg/d group under both delivery modes (VD: beta = 2.9, w = 4.13; CS: beta = 2.77, w = 3.8). Our findings suggest that adequate dietary iron intake during pregnancy may promote beneficial bacterial colonization and increase the biodiversity of the neonate gut microbiota.

Vitamin K is a multifunctional micronutrient essential for human health, and deficiency has been linked to multiple pathological conditions. In this study we aimed to develop and validate a new food frequency questionnaire (FFQ) to estimate total vitamin K intake, over the course of a 30-day interval, in a Portuguese, Mediterranean-based, population. We conducted a prospective study in a non-random sample of 38 healthy adult volunteers. The FFQ was designed based on a validated Portuguese FFQ used in nationally representative studies and on literature reviews, to include foods containing ≥ 5μg of vitamin K/100g and foods with a lower vitamin K content, yet commonly in-cluded in a Mediterranean diet. Vitamin K intake was estimated from 24h recalls and six days of food records. The final FFQ included 54 food items which, according to regression analyses, explains 90% of vitamin K intake. Mean differences in vitamin K intake based on food records (80±47.7 μg/day) and on FFQ (96.5±64.3 μg/day) were statistically non-significant. Further, we found a strong correlation between both methods (r= 0.7; p=0.003). Our results suggest that our new FFQ is a valid instrument to assess the last 30-days of vitamin K intake in the Portuguese Mediterranean population.

The gut microbiota has been suggested as an important factor in the pathogenic mechanisms of amyotrophic lateral sclerosis (ALS). This study aimed to investigate whether the intake of different kinds of dietary fiber was related to the disease progression rate (∆FS) and survival time. In total, 272 sporadic ALS patients diagnosed according to the revised EI Escorial criteria were recruited from March 2011 and were followed-up until the occurrence of events or the end of September 2020. The events included percutaneous endoscopic gastrostomy, tracheostomy, and death. Dietary fiber intake was calculated based on a 24-hour dietary recall and classified according to five major fiber-rich foods: vegetables, fruits, grains, legumes, and nuts/seeds. Among the total participants, the group with ∆FS values lower than the mean ∆FS (0.75) was noted in the highest tertiles of total and vegetable fiber intake. Participants with the highest tertile of vegetable fiber intake showed longer survival in the Kaplan–Meier analysis (p = 0.033). Notably, vegetable fiber intake was negatively correlated with pro-inflammatory cytokine (interleukin [IL]-1β, IL-6, and monocyte chemoattractant protein-1) levels in the cerebrospinal fluid. This study showed that vegetable fiber intake could influence the disease progression rate and survival time. Further clinical trials are needed to confirm whether dietary fiber supplementation improves the prognosis of ALS.

Widespread patterns of poor dietary behavior are a key factor causing the increasing prevalence of chronic diseases around the world. Research provides initial insights into the potential of food literacy (FL) to empower individuals to improve their dietary behavior. Yet, studies on FL interventions in working adults are scarce. This study aimed to investigate the short- and long-term effects of a comprehensive 3-week workplace health promotion program (WHPP) on FL and dietary intake (DI) and to examine the association between FL and DI in a sample of 144 German office workers (30.0% female). Using two random intercept mixed linear regression models, we found significant strong improvements for both FL (β = 0.52, p &lt; .0001) and DI (β = 0.63, p &lt; .0001) after the WHPP when compared to baseline. Significant long-term improvements at 18 months where strong for FL (β = 0.55, p &lt; .0001) and small for DI (β = 0.10, p &lt; .0001). FL showed a significant moderate effect on DI across all measurement time points (β = 0.24, p &lt; .0001). Our study fills a gap of long-term findings in the literature on FL interventions, offers insights into underlying mechanisms, and provides recommendations for effective WHPPs.

Vitamin C is an essential enzyme cofactor and antioxidant with pleiotropic roles in human physiology. Circulating vitamin C concentrations are lower in people with diabetes mellitus suggesting a higher dietary requirement for the vitamin. We interrogated the NHANES 2017/2018 and EPIC-Norfolk datasets to compare vitamin C requirements between those with and without diabetes mellitus using dose-concentration relationships fitted with sigmoidal (four parameter logistic) curves. The NHANES cohort (n=2828 non-supplementing adults) comprised 488 (17%) participants with diabetes (self-reported or HbA1c ≥6.5%). The participants with diabetes had a lower vitamin C status (median [IQR]) than those without (38 [17, 52] µmol/L vs 44 [25, 61] µmol/L, p&lt;0.0001), despite comparable dietary intakes between the two groups (51 [26, 93] mg/d vs 53 [24, 104] mg/d, p=0.5). Dose-concentration relationships indicated that the group without diabetes reached adequate vitamin C concentrations (50 µmol/L) with an intake of 81 (72, 93) mg/d, whilst the those with diabetes required an intake of 166 (126, NA) mg/d. In the EPIC-Norfolk cohort, comprising 20692 non-supplementing adults, 475 (2.3%) had self-reported diabetes at baseline. The EPIC cohort had lower a BMI than the NHANES cohort (26 [24, 28] kg/m2 vs 29 [25, 34] kg/m2, respectively). Correspondingly, the EPIC participants without diabetes required a lower vitamin C intake of 64 (63, 65) mg/d while those with diabetes required 129 (104, NA) mg/d to reach adequate circulating vitamin C status. C-reactive protein concentrations were strongly correlated with body weight and BMI and provided a surrogate biomarker for vitamin C requirements. In conclusion, people with diabetes have 1.4- to 1.6-fold higher requirements for vitamin C than those without diabetes. This corresponds to additional daily vitamin C intake requirements of ~30-40 mg for people with diabetes.

This study represents the first to examine the nutritional status of Moroccan football players. The aim of this research is to assess the energy and macronutrient intake of professional players from a club competing in the Moroccan professional league "Botola-Pro." Moreover, the study tries to find the potential correlation between nutritional intake and physical performance. A total of 27 professional players participated in a seven consecutive-day study, during a microcycle of the preseason period. The dietary intake was evaluated using the self-reported, complemented by a 24-hour recall. The InBody 120 bioelectrical impedance was employed for assessing body composition measurements, while the Yo-Yo test was utilized to evaluate physical performance; which estimates the maximal oxygen consumption level (VO2max). Among these players, their protein intake levels aligned with recommendations (1.6 to 2.2 g/kg of Body Mass). On the other hand, fat intake slightly surpassed the recommended values. However, carbohydrate intake was relatively subdued compared to recommendations of the Union of European Football Associations (UEFA) in the pre-season training phase. A positive correlation was observed (P-value of &lt; 0.001 and R=0.831) between carbohydrate intake and the measure of VO2max. This suggests that an increase in carbohydrate consumption is associated with enhanced performance, especially within the range of 6 to 8 g/kg BM per day. Conversely, a negative correlation was identified (P-value of &lt; 0.01 and R= − 0.847) between the percentage of dietary fat and the VO2max. The findings of this study highlight areas of nutrition that could be enhanced among professional football players to optimize their performance. In effect, nutritional education is necessary for this category of athletes. Thus, an individual care approach is strongly recommended.

The purpose of this study was to (a) compare macro- and micronutrient intakes between male and female CD patients (b) compare micronutrient intakes of CD patients to a representative population of healthy individuals, and; (c) describe Mediterranean diet scores (P-MDS) of male and female CD patients in remission recruited from an IBD clinic in Calgary, AB. Consecutive patients with ileal and/or colonic CD in endoscopic remission were recruited for participation in this cross-sectional study. Sixty-seven patients were enrolled, with a mean age of 45, and a BMI ≥ 25. Compared with the healthy population, patients with CD had similar energy, protein, carbohydrate and total fat intake. However, PUFA, omega-6 and 3 and MUFA were lower in CD patients and dietary fibre intake was higher. Vitamins C, D, thiamin, niacin, magnesium, phosphorus, zinc and potassium were all significantly lower in all CD patients compared to a healthy population. Few patients with CD met P-MDS criteria for olive oil, vegetable, legumes, and fish intake or consuming Sofrito sauce (mean 4.5, SD=1.1 in males and 4.7, SD=1.8 in females). Patients with CD in remission have suboptimal dietary intakes and patterns and targeted dietary interventions may be beneficial in this population to improve intake.

In light of the globally increasing prevalence of diet-related non-communicable diseases (NCDs), new scalable and non-invasive dietary monitoring techniques are urgently needed. Automatically collected digital receipts from loyalty cards have the potential to serve as an objective and automatically traceable digital biomarker for individual food choice behavior and do not require patients to manually log each individual meal item. Until recently, such electronic purchase records were hard to collect for researchers and were only validated in national empirical studies. Multiple quantitative indicators for purchase quality have been suggested, but so far no comparison has validated the potential of these alternative indicators to discriminate between health-beneficial and -detrimental food choices. With the introduction of the General Data Privacy Regulation in the European Union, millions of consumers gained the right to access their purchase data in a machine-readable form, representing a historic chance to leverage purchase data for scalable monitoring of food choices. This study hence is the first study comparing the calibration capacity and validating the discrimination potential of previously suggested purchase indicators for the nutritional quality of purchased groceries, incl. HEI-2015, HETI, GPQI, and FSA-NPS DI. To assess the indicators' potential, 464 study participants were asked to complete a validated food frequency questionnaire (FFQ) and to donate their digital receipts from the loyalty card programs of the two leading Swiss grocery retailers, representing 69\% of the national grocery market. 89 participants fulfilled the eligibility criteria, i.e. completed the FFQ and were frequent users of the loyalty card systems. Compared to absolute food and nutrient intake, correlations between density-based relative food and nutrient intake and food purchase data are stronger. Counterintuitively, although the frameworks of the HETI and the GPQI are centered around food groups, both indicators do not capture food group intake such as vegetables or sweets very well. The FSA-NPS DI has the best calibration and discrimination performance in classifying participants' consumption of nutrients and food groups, and seems to be a superior indicator to estimate nutritional quality of a user's diet based on digital receipts from grocery purchases in Switzerland.

A total of 779 samples of edible nuts (melon seeds, watermelon seeds, pumpkin seeds, and cantaloupe seeds) from southern cities of Punjab, Pakistan were collected from the summer and the winter seasons. The natural occurrence of aflatoxins (AFs) and vitamin E (tocopherols) levels were investigated using HPLC. The results have shown that 180 (43.4%) samples from the winter season and 122 (33.4%) samples from the summer season were found positive with AFs. The elevated average levels of total AFs (20.9±3.10 µg/kg) were observed in watermelon seeds without shell and the lowest average amount (15.9±3.60 µg/kg) were documented in melon seeds without shell samples from the winter season. The elevated average amount of total AFs 17.3±1.50 µg/kg were found in pumpkin seeds available as without shell. The results have documented a significant difference in total AFs levels in edible seeds available as shells versus without shells (α = 0.05 & 0.01). The highest dietary intake of 6.30 µg/kg/day was found in female individuals from pumpkin seeds (without shell) in the winter season and the value of 3.00 µg/kg/day were found in pumpkin seed without shell in summer season in female individuals. The highest amount of total tocopherol levels of 22.2 ± 7.70 ng/100g in pumpkin seeds samples from winter season and 14.5 ± 5.50 mg/100g were found in melon seeds samples from summer season. The variation of total tocopherol levels in edible seeds among the winter and summer seasons showed significant difference (p ≤ 0.0054), except watermelon seeds samples which shown non-significant difference (p ≥ 0.183).

A total of 744 samples of vegetable seeds and oil (soybean, sunflower, canola, olive, corn, and mustard) were collected for the presence of aflatoxin B1 (AFB1) and total aflatoxins (AFs). The results have shown that 92 (56.7%) samples of branded and 108 (57%) samples of non-branded edible seeds were observed to be contaminated with AFs. The maximum mean of AFB1 and total AFs in non-branded soybean seeds was 21.01 ± 4.70 and 36.37 ± 6.10 µg/kg, respectively. Furthermore, all samples of edible seeds have concentrations of AFB1 greater than the proposed limit of European Union (EU, 2 µg/kg) and 12 (7.40%) samples of branded seeds and 14 (7.40%) samples of non-branded seeds were found in the range ≥ 50 µg/kg. About 78 (43.3%) samples of branded edible oil and 103 (48.3%) sample of non-branded edible oil were observed to be positive with AFs, and the elevated average of AFB1 (14.29 ± 2.51 µg/kg) and total AFs (25.61 ± 7.50) µg/kg were found in non-branded soybean oil samples. Furthermore, 16 (8.88%) and 6 (3.33%) samples of branded vegetable oil have levels of total AFs in a range (21 - 50 µg/kg) and ≥ 50 µg/kg, respectively. The findings have indicated significant difference of AFs levels between branded and non-branded vegetable oil samples (t = 22.274 and p = 0.000) at α = 0.05 and significant difference of AFs levels in vegetable seeds and oil samples ( t = -17.75, p = 0.000) at α =0.05. The highest dietary intake was found in non-branded sunflower oil sample (0.90 µg/kg/day) in female individuals (16-22 age group), followed by the dietary intake of 0.69 µg/kg/day body weight in male individuals (16-22 age group).

Higher body weight is known to negatively impact plasma vitamin C status. However, despite this well-documented inverse association, recommendations on daily vitamin C intakes by health authorities worldwide do not include particular reference values for people of higher body weight. This suggests that people of higher body weight and people with obesity may be insufficient in vitamin C in spite of ingesting the amounts recommended by their health authorities. The current preliminary investigation sought to estimate how much additional vitamin C people with higher body weights need to consume in order to attain a comparable vitamin C status to that of a lower weight person consuming an average Western vitamin C intake. Data from two published vitamin C dose-concentration studies were used to generate the relationship: a detailed pharmacokinetic study with seven healthy non-smoking men and a multiple depletion-repletion study with 68 healthy non-smoking men of varying body weights. Our estimates suggest that an additional intake of 10 mg vitamin C/day is required for every 10 kg increase in body weight to attain a comparable plasma concentration to a 60 kg individual with a vitamin C intake of ~110 mg/day, which is the daily intake recommended by the European Food Safety Authority (EFSA). Thus, individuals weighing e.g. 80 and 90 kg will need to consume ~130 and 140 mg vitamin C/day, respectively. People with obesity will likely need even higher vitamin C intakes. As poor vitamin C status is associated with increased risk of several chronic diseases including cardiovascular disease, these findings may have important public health implications. As such, dose-finding studies are required to determine optimal vitamin C intakes for overweight and obese people.

The research aims to discover the natural occurrence of patulin (PAT) in selected citrus fruits from the central cities of Punjab and Pakistan's Northern cities. Total 2970 samples of twelve citrus fruits; kinnow, orange, grapefruits, bitter orange, mausami, red blood, pineapple, sweet orange, rough lime, sweet lime, kagzi lime and lemon were examined using liquid chromatography fitted with UV detector. The limit of detection (LOD) and quantification limit was 0.04 and 0.12 µg/kg, respectively. The results have shown that 56% of samples of citrus fruits from Punjab's central cities, Pakistan, were discovered to be infected from PAT. The elevated amounts of PAT ranging from 0.04 to 1150 µg/kg were found in citrus fruit samples from Multan cities. Furthermore, 31.7% of samples of citrus fruits from Northern cities of Pakistan were discovered to be infected with PAT, and the elevated amounts were found ranging from 0.04-320 µg/kg from Swat city. About 22.1% of samples of citrus fruits have levels of PAT greater than the suggested limits established by the European Union (EU). PAT's dietary intake levels ranged from 0.10-1.11 µg/kg bw/day from the central cities of Punjab, Pakistan, and 0.13-1.93 µg/kg bw/day were documented from Northern cities of Pakistan.

The research aims to discover the natural occurrence of patulin (PAT) in selected citrus fruits from the central cities of Punjab and Pakistan's Northern cities. Total 2970 samples of twelve citrus fruits; kinnow, orange, grapefruits, bitter orange, mausami, red blood, pineapple, sweet orange, rough lime, sweet lime, kagzi lime and lemon were examined using liquid chromatography fitted with UV detector. The limit of detection (LOD) and quantification limit was 0.04 and 0.12 µg/kg, respectively. The results have shown that 56% of samples of citrus fruits from Punjab's central cities, Pakistan, were discovered to be infected from PAT. The elevated amounts of PAT ranging from 0.04 to 1150 µg/kg were found in citrus fruit samples from Multan cities. Furthermore, 31.7% of samples of citrus fruits from Northern cities of Pakistan were discovered to be infected with PAT, and the elevated amounts were found ranging from 0.04-320 µg/kg from Swat city. About 22.1% of samples of citrus fruits have levels of PAT greater than the suggested limits established by the European Union (EU). PAT's dietary intake levels ranged from 0.10-1.11 µg/kg bw/day from the central cities of Punjab, Pakistan, and 0.13-1.93 µg/kg bw/day were documented from Northern cities of Pakistan

The study examined eating timing, diet, and the ratio of sleep phases in people with social jetlag (SJL). The study involved 83 participants who filled out a questionnaire, and 21 of them took part in the study of sleep phases by electroencephalography during the week. SJL was associated with a higher incidence rate of eating jetlag, eating phase delays, an increase in calorie intake after 9 p.m., a decrease in dietary fiber intake for breakfast, and melatonin-containing product consumption for dinner. Young people with SJL had a reduction in total sleep and light sleep phase duration by 60 and 36 min on work/school days and an increase in total sleep and REM sleep phase duration by 66 and 60 min on weekends, respectively. Young people consuming foods with more than 4234.5 ng of melatonin for dinner, compared with their peers consuming less than 313.2 ng of melatonin, showed a decrease in SJL and sleep debt by 54 and 90 min and an increase in the total sleep and the deep sleep phase duration by 66 and 30 min, respectively. Thus, the consumption of melatonin-containing foods for dinner is associated with a decrease in circadian misalignment and a sleep quality improvement.

We estimated the daily intakes of chlorpyrifos and cypermethrin via ingestion of indoor dust and outdoor soils using the Stochastic Human Exposure and Dose Simulation Model on a probabilistic approach for Taiwan’s homes. Variable information for the daily intake estimation, such as concentration, ingestion rate, body weight, was adopted from previous studies. Monte Carlo simulation was performed with 1,000,000 iterations to simulate a single daily intake, which was shown in terms of percentage of the Acceptable Daily Intake (ADI) of either insecticide. The daily intakes were minimal with a 99% probability; at 99.9th percentile, however, the total intakes leaped to 13.1% and 20.0% of the respective ADIs of chlorpyrifos and cypermethrin. The sensitivity analysis indicated that concentration was the most determinant variable. Compared to the data of daily intakes via dietary ingestion of vegetables derived from a previous study, the estimated intakes by this study were considerable at the highest percentile, which referred to insecticide residues few days after insecticide application. Consequently, the non-dietary ingestion exposure to either insecticide was negligible in most cases; nevertheless, for those with indoor insecticide applications, the daily intakes for young children could be of concern. Frequently home cleaning is recommended to reduce the exposure.

Background: Accurate estimation of dietary intake is challenging. But whilst some progress has been made in high-income countries, low- and middle-income countries (LMICs) remain behind, contributing to critical nutritional data gaps. This study aimed to validate an objective, passive image-based dietary intake assessment method against weighed food records in London, UK for onward deployment to LMICs. Methods: Wearable camera devices were used to capture food intake of eating occasions in 18 adults and 17 children of Ghanaian and Kenyan origin living in London. Participants were provided pre-weighed meals of Ghanaian and Kenyan cuisine and camera devices to automatically capture images of the eating occasions. Food images were assessed for portion size, energy, and nutrient intake, and relative validity of the method compared to the weighed food records. Results: Pearson and Intra-class correlation coefficient of estimates of intakes of food, energy and 19 nutrients ranged from 0.60 to 0.95 and 0.67 to 0.90, respectively. Bland-Altman analysis showed good agreement between the image-based method and weighed food record. Under-estimation of dietary intake by the image-based method ranged from 4 to 23%. Conclusions: Passive food image capture and analysis provides an objective assessment of dietary intake comparable to weighed food records.

This study investigated how broader parental factors including parental happiness, parental play engagement, and parenting stress are related to Korean children’s happiness and weight status across three years via indirect pathways through the children’s energy-related behaviors of healthy and unhealthy food intake, physical activity, and screen time. Data from 1551 Korean parent pairs and 7-yaer-old children in the Panel Study on Korean Children were analyzed. Path analysis and gender-based structural equation modeling were conducted. Maternal happiness was negatively related to child screen time. Maternal play engagement showed positive concurrent associations with child healthy food intake and physical activity and negative associations with screen time. Maternal parenting stress was negatively related to child healthy eating. There was one significant finding related to fathers’ role on children’s energy-related behaviors, happiness, and weight status: the positive association between parental happiness and boys’ unhealthy food intake. Child screen time was positively related to child weight status and negatively to child happiness at each age. Broader maternal parenting factors can serve as a protective factor for childhood happiness and weight status in 7-to 9-year-olds through being associated with a reduction in child screen time.

The time when a patient has mild cognitive impairment (MCI) is an important period for delaying the onset of dementia and has been the main target of dementia prevention research in recent years. The purpose of this study was to investigate the dietary intake and dietary patterns of MCI patients in Taiwan. In total, 40 subjects were enrolled in this cross-sectional study that was conducted from July 2019 to September 2021 at Linkou Chang Gung Memorial Hospital. Results of the clinical dementia rating (CDR) and mini-mental state examination (MMSE) were obtained from medical records. Participants were divided into two groups: a healthy group (MMSE ≥ 26 points, CDR=0) and an MCI group (MMSE ≥ 26 points, CDR=0.5). Results indicated that the MCI group had significantly higher copper and lower low-fat meat intake compared to the healthy group. Furthermore, the high MIND (Mediterranean-dietary approaches to stop hypertension intervention for neurodegenerative delay) diet score represented a lower risk of MCI. After adjusting for age and gender in the multivariate regression analysis, calcium and fruit intake levels were positively associated with the MMSE. In conclusion, the prevalence of MCI was closely associated with dietary intake, such as copper and calcium, as well as dietary patterns, particularly the MIND diet.

Healthy eating behaviour of women is critical not only for their health but also for their children's health and well-being. The present study examined the dietary pattern, nutrition knowledge and attitudes of working women in Western Province, Sri Lanka. In addition, identify the factors associated with Dietary Diversity Score (DDS). A cross-sectional study was conducted among 300 working women, aged 20-60 years, in Western Province, Sri Lanka. The data on so-cio-demography, dietary patterns, and nutrition-related knowledge and attitudes were collected. Overall, 38% of the women were overweight and 13% were obese. The median frequency of intake of chicken, fish, eggs, milk and milk products, green leafy vegetables and fruits were 2, 5, 2, 9, 5 and 10 respectively, per week. A large majority of the women (70%) had tea/coffee with sugar and snacks (60%) at least four times a week. Only a third of the women met the minimum DDS, while more than half of the women had good nutrition-related knowledge and attitudes. Multiple regression analysis showed that age and household income were significantly independently related to DDS, while attitudes were negatively associated. While there was a trend, the association of nutrition-related knowledge with DDS was not statistically significant (p=0.057). The overall F ratio (8.46) was highly significant (p=0.000) and the adjusted R2 was 0.093. The results demonstrated that a significant proportion of working women have good basic nutrition-related knowledge and attitudes, while two-thirds of them do not meet the minimum DDS. Furthermore, age, family income and knowledge were positively associated with DDS, while attitudes were negatively associated. Before designing any intervention, further research is needed using a qualitative approach to understand how nutrition knowledge and eating behaviour are related in this population group.

Sport nutrition knowledge has been shown to influence dietary habits of athletes. The purpose of the current study was to examine relationships between sport nutrition knowledge and body composition and examine potential predictors of body weight goal in collegiate athletes. Participants included National Collegiate Athletic Association Division III women (n=42, height: 169.9 ± 6.9 cm; body mass: 67.1 ± 8.6 kg; fat-free mass: 51.3 ± 6.6 kg; body fat %: 24.2 ± 5.3%) and men (n=25, height: 180.8 ± 7.2 cm; body mass: 89.2 ± 20.5 kg; fat-free mass: 75.9 ± 12.2 kg; body fat %: 13.5 ± 8.9%) athletes. Body composition was assessed via air displacement plethysmography. Athletes completed a validated questionnaire designed to assess sport nutrition knowledge and were asked questions about their perceived dietary energy and macronutrient requirements, as well as their body weight goal (i.e. lose, maintain, gain weight). Athletes answered 47.98 ± 11.29 % of questions correctly on the nutrition questionnaire with no differences observed between sexes (men: 49.52 ± 11.76% vs. women: 47.03 ± 11.04%; p=0.40). An inverse relationship between sport nutrition knowledge scores and body fat percentage (r = -0.330; p=0.008), and fat mass (r = -.268; p=0.032) was observed for all athletes. Fat mass (β = 0.224), BF % (β = 0.217), and BMI (β = 0.421) were all significant (p&lt;0.05) predictors of body weight goal in women. All athletes significantly (p&lt;0.001) underestimated daily energy (-1,360 ± 610.2 kcal/d), carbohydrate (-301.6 ± 149.2 g/d), and fat (-41.4 ± 34.5 g/d) requirements. Division III collegiate athletes have a low level of sport nutrition knowledge, which was associated with a higher BF %. Women athletes with a higher body weight, BF % and BMI were more likely to select weight loss as a body weight goal. Athletes also significantly underestimated their energy and carbohydrate requirements based upon the demands of their sport, independent of sex.

Exogenous miRNAs derived from dietary substances have been shown to be orally transferred to the mammalian system and proven to remain active to regulate host-gene expression. This way they have become an active area of research as functional food components and aspects for dietary supplementation. They are being studied as a new class of metabolically targeted therapeutics that work through diet manipulation and may hold promise for a therapeutic approach in reducing the risk of life-threatening diseases. However, a substantial amount of evidence also defies this dietary miRNA concept in terms of their absorption, bioavailability, cellular uptake and its physiological effects in the mammalian system. But recent advances in the identification of some unique sequence and structural characteristics of dietary miRNAs and a deeper understanding of their stability in host peripheral blood for its cellular uptake have strengthened the whole concept. The review comprehensively summarizes the mechanism for miRNA extracellular transport, absorption through the gastrointestinal tract (GI), stability in peripheral blood, and cellular uptake in mammalian cells. It recapitulates the shreds of evidence, related to the influence of dietary miRNAs on gene expression based on the source of the origin (plant vs animal), and compares their cross-kingdom behaviour in terms of their unique sequence and stem-loop structure properties that help them to get stabilized in the mammalian system. The review also summarizes the parameters required for maintaining the sustainable uptake and bioavailability of the dietary miRNAs with existing examples of successful in-vivo and in-vitro delivery of dietary miRNA for augmented therapy. Lastly, it provides an overview of the available and required databases, webserver, and tools that can be used for the successful identification of potential dietary miRNA candidates.

To date, most people prefer softer and stickier rice with high glycaemic index, which has led to the study of the association between the dietary fibre profile and the textural properties to balance between the eating quality, and health benefits. A slight variation was observed in the dietary fibre composition among rice varieties with different amylose content. The percentage of insoluble dietary fibre (IDF) in whole grain rice varied from 1.65–4.32 while the percentage of soluble dietary fibre (SDF) ranged from 0.26–1.37. We demonstrated that the SDF/IDF ratio was higher in soft texture rice with low amylose and it shared a negative correlation with hardness and chewiness of cooked whole grain rice determined by a texture analyser, which suggested that the distribution of SDF throughout the rice endosperm influences the reduction of the hardness of cooked rice. According to the importance of dietary fibre, we proposed a simple linear regression method to estimate the amount of IDF and total dietary fibre with r = 0.97 and 0.92, respectively, of whole grain rice based on its bran layer, determined by the alternative alkaline method. Furthermore, low amylose rice has higher content of -glucan and pectin, which are classified as soluble dietary fibre, than high amylose rice. The percentage of -glucan and pectin in whole grain rice ranged from 0.03 and 0.07 respectively, for high amylose rice to 0.14 and 0.27 respectively for low amylose rice,

Abstract: The contribution of breakfast to diet quality (DQ) can inform future dietary guidelines. This study examined breakfasts that were associated with highest-quality diets. Dietary data came from the first reported day of the National Health and Examination Survey (NHANES) 2011-2014 (n=14,488). DQ measures were the Nutrient Rich Foods Index (NRF9.3) and the USDA Healthy Eating Index 2015 (HEI 2015). Analyses of breakfast intakes were conducted by NRF9.3 tertiles and by age and socioeconomic groups. Four out of 5 NHANES participants ate breakfast. Breakfast provided 19-22% of dietary energy depending on age. Breakfast intakes of complex carbohydrates and total sugars were higher and intakes of protein and fats were lower relative to energy intakes. Breakfast provided more that 20% of daily intakes of B vitamins, vitamins A and D, folate, calcium, iron, potassium and magnesium. Eating breakfast was associated with higher NRF9.3d scores. Breakfasts associated with top tertile of NRF9.3d had more carbohydrates and less added sugars and fats. Such breakfasts had more fruit and juices, more whole grains, more milk and yogurt and less meat and eggs. Breakfast patterns that favored fruit, whole grains, and dairy were associated with healthiest diets.

Evidence shows that weightloss improves insulin sensitivity but few studies have examined the effect of macronutrient composition independently of weight loss on direct measures of insulin sensitivity. We randomised 89 overweight or obese women to either a standard diet (StdD) that was intended to be low in fat and relatively high in carbohydrate (n=42) or to a relatively high protein (up to 30% of energy), relatively high fibre (>30g/day) diet (HPHFib) (n=47) for 10 weeks. Advice regarding strict adherence to energy intake goals was not given. Insulin sensitivity and secretion was assessed by a novel method - the Dynamic Insulin Sensitivity and Secretion Test (DISST). Although there were significant improvements in body composition and most cardiometabolic risk factors on HPHFib, insulin sensitivity was reduced by 19.3% (95% CI: 31.8, 4.5%; p=0.013) in comparison with StdD. We conclude that the reduction in insulin sensitivity after a diet relatively high in both protein and fibre, despite cardiometabolic improvements, suggests insulin sensitivity may reflect metabolic adaptations to dietary composition for maintenance of glucose homeostasis, rather than impaired metabolism.

Anaemia is the most prevalent nutritional deficiency in the World and is associated with long-lasting developmental effects in children. Anaemia weakens the immune system and im-pairs cognitive development of children. Anaemia is multifactorial; therefore, anaemia’s pre-ventive/control measures should be evidence-based. This paper aimed to investigate the preva-lence and correlates of anaemia in preschool aged children at individual, maternal/household and community level in the Democratic Republic of Congo (DRC). Retrospective, nationally representative cross-sectional data, the 2013-2014 DRC Demographic and Health Survey (DHS) was used. Three -levels random intercept logistics regression models were fitted to the data using the outcome anaemia in children, defined as a haemoglobin concentration below 11dl with potential risk factors grouped at individual, maternal/household and community levels. Anaemia in children is a severe public health issue in the DRC, 63% of school-aged children are anaemic. Anaemia is highly prevalent amongst males, children with infections (fever/malaria and intestinal parasites), whose mothers are anaemic, from the poorest household, and whose drinking source of water is unclean, and who reside in provinces with recent/previous armed forces attacks. Results from this paper highlight the need for a clean and safe environment for children’s growth.

The aim of the present study was to investigate the acute effect of caffeine supplementation on performance in official soccer matches. In double-blind, randomized crossover design, 13 professional soccer players performed two complete matches, with Caffeine (CAF) (6 mg/kg) and placebo (PLA) supplementation. Two-way repeated measures ANOVA showed that there was no effect of supplementation on the total distance covered (p = 0.536; ŋp² =0.033) or the total distance covered at different speeds (p = 0.453; ŋp² = 0.048), acceleration or deceleration (p = 0.387; ŋp² = 0.063) number of sprints (p = 0.521; µ² = 0.035) Heart Rate mean (p = 0.484; ŋp² = 0.042) Heart Rate maximum (p = 0.110; ŋp² = 0.199), Rate Perceived Effort (p = 0.151) or efficiency index (p = 0.480). Therefore, acute caffeine supplementation not effective to increase the performance of soccer players in official matches.

Excessive intake of fat and fatty acids is associated with major health hazards such as obesity or chronic diseases. The aim of this study is to provide the first data on total fat, SFA and TFA intakes and their major food sources in Tunisian children. A total of 1200 children, aged 3 to 9 years old, were randomly selected from primary schools and kindergarten under a cross-sectional design. The 24hour recall method and food frequency questionnaire were used to assess dietary intake. The energy percentages of total fat, SFA and TFA in Tunisian children were respectively 29.6, 11.4 and 0.15. No sex differences were found. The WHO recommendations for total fat, SFA and TFA were adopted by 58 %, 39 % and 89 % of the study population, respectively. The leading food groups of fat and fatty acids were ultra-processed foods, bread and cereals and dairy products. The meat, fish, eggs and fish alternatives were the fifth main contributors to the total fat and SFA intakes in Tunisian children. The implementation of a relevant strategy for fat reduction, especially from ultra-processed foods, considered as low nutrient energy-dense products, is needed to promote health among children and prevent diet-related chronic diseases.

Creatine is a popular ergogenic aid among athletic populations with consistent evidence indicating that creatine supplementation also continues to be commonly used among adolescent populations. In addition, the evidence base supporting the therapeutic benefits of creatine supplementation for a plethora of clinical applications in both adults and children continues to grow. Among pediatric populations, a strong rationale exists for creatine to afford therapeutic benefits pertaining to multiple neuromuscular and metabolic disorders, with preliminary evidence for other subsets of clinical populations as well. Despite the strong evidence supporting the efficacy and safety of creatine supplementation among adult populations, less is known as to whether similar physiological benefits extend to children and adolescent populations, and in particular those adolescent populations who are regularly participating in high-intensity exercise training. While limited in scope, studies involving creatine supplementation and exercise performance in adolescent athletes generally report improvements in a number of ergogenic outcomes with limited evidence of ergolytic properties and consistent reports indicating no adverse events associated with supplementation. The purpose of this article is to summarize the rationale, prevalence of use, performance benefits, clinical applications, and safety of creatine use in children and adolescents.

Microalgae production is expensive and demands high volumes of water and energy to meet all market demands and yet the production of secondary metabolites using alternative media needs deeper studies. Among alternative media, the use of sugar cane vinasse has gained attention for microalgae cultivation. In this work, we’ve compared the biomass yield and secondary metabolites of Chlorella sorokiniana grown in a commercial medium (Sueoka) and in alternative medium prepared with cane vinasse (0.1%) supplemented with N, P2O5 and K2O (commercial formula 20-5-20 g.L-1). The production of microalgae biomass grown in an alternative medium was 2.2% lower, but reached its maximum growth point 14 days faster than the commercial medium. The average level of Phenolic compounds on the commercial medium were 6.02 ± 0.13 mg GAE .g-1 and increased to 15.28 ± 0.32 mg GAE.g-1when C. sorokinianawere grown in the vinasse medium. Same how, Flavonoids contents varied from 13.12 ± 1.33 to 72.30 ± 5.28 mg QE. g-1 to commercial and vinasse medium, respectively. The maximum AOA of C. sorokiniana grown in vinasse medium was 88.05% at a concentration of 1500 µg.mL-1 of extract, with IC50 at 357.7 ± 27.35 µg.mL-1. Different factors seem to induce variances on secondary metabolites synthesis, mostly stress due to QOD and ions added to the medium by vinasse. The authors recognize there are more investigations to be done, but increasing a natural and low cost pathway for flavonoids yield open up an interesting field for the bioprospection of microalgae.

Aim: This study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak. Methods: A cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults living in Kuwait (age range 18-73 years). Results: The overall prevalence of being overweight and obesity among participants was 37.2% and 33.1% respectively. The study identified significant changes in the dietary habits and lifestyle behaviours of participants during COVID-19. In general, there was an increase in the percentage of participants that consumed four or more meals a day, skipped breakfast, and engaged in frequent late night snacking. Moreover, there was a drastic decrease in the frequency of fast food consumption and an increase in the percentage of participants who had their main meal freshly made. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants. Conclusion: This study indicates that due to the increased prevalence of habits conducive to increased rates of being overweight and obesity during the COVID-19 outbreak, there is a high likelihood that the pandemic will further exacerbate the already widespread problem of obesity and being overweight in Kuwait.

Obesity is an issue of public health concern as it contributes to chronic non-communicable diseases despite the fact that it is preventable. Dietary practices and environment have been associated with increased risk of cardiovascular diseases, hypertension, overweight and obesity among young people. This study aimed to assess the dietary patterns associated with obesity among Babcock University students. A descriptive cross-sectional study was used to obtain data from 391 participants. Results reveal respondent’s knowledge was 12.06 ± 2.3 translating to an 80% prevalence performance, level of perception was 37.23 ± 9.23 with prevalence of 59.0%, dietary practices was 19.6 ± 5.23 with 59% prevalence. Factors influencing dietary practices revealed mean score of 15.2 ± 4.5 with 72.3% prevalence performance. The factors identified in this study has a great influence on dietary practices of the study participants. In conclusion Babcock University students have an excellent knowledge of dietary practices related to obesity. They also had good dietary practices. The identified factors had a great influence on the study participants.

Dietary supplements are more and more often used to increase daily intake of essential vitamins and minerals. These preparations are classified as special category of foods and are subject to food law, not pharmaceutical regulations. As a result the requirements to dietary supplements are much less restrictive than to medications. Also simple and inexpensive procedure of registration causes that the number of dietary supplements is widely spread every year. On every manufacturing phases of dietary supplements, there is a risk of contamination. One of the pollutions might be mercury which is classified as heavy metal. Its inorganic compounds damage kidneys and liver and methylmercury is easily absorbed from gastrointestinal system. Methylmercury is distributed in all tissues, also in nervous system. The aim of study was to determine the level of mercury in multivitamins and multiminerals preparations and to analyze the results. The study included 22 dietary supplements containing vitamins and minerals available on Polish market. Mercury was analyzed with atomic absorption spectrometry using AMA 254. The concentrations of Hg was 0.22–5.85 µg/kg (the average content was 2.40 µg/kg). The highest average mercury content was 4.51 µg/kg, whereas the lowest one was 0.31 µg/kg. The results was also analyzed in individual groups depending on main component and indication for use as well as pharmaceutical formulation. Also according to manufacturer’s recommendation, the dose of mercury taken with a single medicine was estimated for time of a day, a week, a month, 3 months and also a year. The findings were compared to limits defined in regulations of European Union and PTWI set by JECFA to assess the health risk. The results presented in this study proved that the amount of mercury in tested dietary supplements is much lower than the value of valid regulations. Analyzed supplements as long as they are used with the recommendation of manufacturer, do not pose a threat to human health.

Prebiotic dietary fiber supplements are commonly consumed to help meet fiber recommendations and improve gastrointestinal health by stimulating beneficial bacteria and the production of short-chain fatty acids (SCFAs), molecules beneficial to host health. The objective of this research project was to compare potential prebiotic effects and fermentability of five commonly consumed fibers using an in vitro fermentation system measuring changes in fecal microbiota, total gas production and formation of common SCFAs. Fecal donations were collected from three healthy volunteers. Materials analyzed included: pure beta-glucan, Oatwell (commercially available oat-bran containing 22% oat β-glucan), xylooligosaccharides (XOS), WholeFiber (dried chicory root containing inulin, pectin, and hemi/celluloses), and pure inulin. Oatwell had the highest production of propionate at 12 h (4.76 μmol/mL) compared to inulin, WholeFiber and XOS samples (p<0.03). Oatwell’s effect was similar to those of the pure beta-glucan samples, both samples promoted the highest mean propionate production at 24 h. XOS resulted in a significant increase in the genus Bifidobacterium after 24 h of fermentation (0 h: 0.67 OTUs; 24 h: 5.22 OTUs; p = 0.038). Inulin and WholeFiber increased the beneficial genus Collinsella, consistent with findings in clinical studies. All analyzed compounds were fermentable and promoted the formation of beneficial SCFAs.

The increase in the average lifespan and the consequent proportional growth of the elderly segment of society has furthered the interest in studying ageing processes. Ageing may be considered a multifactorial process derived from the interaction between genetic and environmental factors including lifestyle. There is ample evidence in many species that the maximum age attainable (maximum lifespan potential, MLSP) is genetically determined and several mitochondrial DNA polymorphisms are associated with longevity. Many studies have shown that most of the phenotypic characteristics observed in the aging process are the result of the occurrence, with age, of a low grade chronic pro-inflammatory status called "inflammaging", partially under genetic control. The term indicate that aging is accompanied by a low degree of chronic inflammatory, an up-regulation of inflammatory response and that inflammatory changes are common to many age-related diseases. Therefore, the theory of oxidation-inflammation was proposed as the main cause of aging. Accordingly, the chronic oxidative stress, that appears with age, affects all cells and especially those of the regulatory systems, such as the nervous, endocrine, and immune systems and the communication between them. This prevents an adequate homeostasis and, therefore, the preservation of health. It was also proposed that the immune system plays a key role in the aging process, specifically in the rate of aging, since there is a relationship between the redox state and functional capacity of immune cells and longevity of individuals. Moreover, the role of the immune system in senescence could be of universal application. A confirmation of the central role of the immune system in oxi-inflamm-aging is that the administrationintake? of adequate amounts of antioxidants in the diet improves immune function, decreases their oxidative stress, and consequently increases longevity. The promotion of healthy lifestyles is one of the major goals of governments and international agencies all over the world. Human molecular processes are influenced by both physiological pathways and exogenous factors which include, for instance, those originating from diet. Dietary intake has substantive effects on molecular processes of metabolic health. Nutrients can directly regulate physiological changes in human body. In fact, in addition to have an energetic and structural value, nutritional intake provides bioactive molecules which are selectively able to modulate specific metabolic pathways, noticeably affecting cardiovascular and neoplastic diseases development or progress. Numerous bioactive nutrients are being progressively identified and their chemopreventive effects are being described at clinical and molecular mechanism levels. Systematic analyses comprise all “omics” technologies (such as transcriptomics, proteomics and metabolomics) and the goal is to investigate bioactive molecules effects derived from the diet. Nutrigenomic knowledge on physiologic status and disease risk will provide both developments of better diagnostic procedures and of new therapeutic strategies specifically targeted on nutritionally relevant processes. The present review was aimed to understand the molecular mechanisms underlying beneficial effects of bioactive nutrients and nutrigenomics on age-related diseases.

Cancer survival continues to improve in high-income countries, partly explained by advances in screening and treatment. Previous studies have mainly examined the relationship between individual dietary components and cancer prognosis in tumours with good therapeutic response (breast, colon and prostate cancers). The aim of this review was to assess qualitatively (and quantitatively where appropriate) the associations of dietary patterns and cancer prognosis from published prospective cohort studies, as well as the effect of diet interventions by means of randomized controlled trials (RCT). A systematic search was conducted in PubMed, and a total of 35 prospective cohort studies and 14 RCT published between 2011 and 2021 were selected. Better overall diet quality was associated with improved survival among breast and colorectal cancer survivors; adherence to the Mediterranean diet was associated to lower risk of mortality in colorectal and prostate cancer survivors. A meta-analysis using a random-effects model showed that higher versus lower diet quality was associated with a 23% reduction in overall mortality in breast cancer survivors. There was evidence that dietary interventions, generally combined with physical activity, improved overall quality of life, though most studies were in breast cancer survivors. Further cohort and intervention studies in other cancers are needed to make more specific recommendations.

Inhalation of gasoline vapors (GV) is associated with developing various pathologies. Particularly, oil refinery and gas station workers are at greater risk of developing lung cancer, kidney cancer, bladder cancer, and hematological disorders, including acute myeloid leukemia. Therefore, preventing the harmful effects of GV and alleviating their consequences appear to be an important and timely issue. In this study, we investigated the potential of vitamin D3, turmeric powder and their combination to ameliorate the toxicity of gasoline fumes in rats. Separate groups of animals fed with a standard rodent diet, with or without supplementation of vitamin D3 (750 IU/kg of body weight) and/or turmeric powder (0.5%, w/w, in food), were untreated or treated with GV (11.5±1.3 cm3/h/m3/day) for 30, 60 or 90 days. Changes in the body weight were monitored weekly. Histological, biochemical, and hematological parameters were determined at the end of each treatment period. While exposure of rats to GV resulted in a time-dependent reduction in body weight, supplementation with vitamin D3, but not with turmeric root powder or their combination, partially prevented weight loss. Macroscopical and histological analyses showed pronounced time-dependent changes in the organs and tissues of GV-treated rats. These included alveolar wall collapse in the lungs, destruction of the lobular structure and hepato-cytolysis in the liver, shrinkage and fragmentation of glomeruli in the kidneys, and disorganization of the lymphoid follicles in the spleen. However, co-treatment with the nutritional supplements tested, especially vitamin D3, noticeably alleviated the above conditions. This was accompanied by a significant improvement in blood chemistry and hematological parameters. Collectively, our results demonstrate that the harmful effects of environmental exposure to GV can be reduced upon supplementation of vitamin D3. The fact that the protective activity of vitamin D3 alone was higher than that of turmeric root powder or the combined treatment suggests that combinations of these supplements may not always be more beneficial than each agent applied separately.

The objective was to conduct a scoping review and produce a publicly available database characterizing the design and reporting elements of the literature on dietary added sugars and select health outcomes. Relevant studies published from 1990 – 2021 were identified to create a database containing information on study and population characteristics, reported added sugars source and concentrations, diet energy balance, total energy intake, and outcome measures related to body composition, obesity, cardiovascular disease, and diabetes mellitus. There were 245 publications identified, 22% of which describe interventions and 78% describe observational studies. Publications pertaining to added sugars have risen dramatically since 2010, led by studies primarily assessing body composition (36%) or cardiovascular health (32%), including adults (65%), measuring liquid-only sources of added sugars (56%). Over 65% of studies reported total energy intake, 61% controlled for total energy intake in the design and analysis, and fewer than 5% of studies reported the energy balance of subjects. There has been a significant increase in research on added sugars since 2010, with substantial heterogeneity across all facets of methodology – study designs, exposures and outcomes of interest, terminology, and reporting of dietary intake data – thus limiting the ability to synthesize evidence in this scope of literature. This evidence map highlights gaps and important areas for improvement to strengthen the state of research to better inform future policies and dietary recommendations on added sugars.

Indian pangolins are insectivorous mammals with less-known ecology. Due to the lack of sufficient literature on their dietary ecology, captive raring of this species has become problematic. This article describes data on dietary composition and foraging habitats of the Indian Pangolin (Manis crassicaudata) in a tropical lowland forest-associated landscape in Southwest Sri Lanka. Five different types of habitats were investigated in this study: Forest, rubber plantation, cinnamon cultivation, oil palm plantation, and tea-dominated home gardens. Foraging preference of the Indian pangolin for each habitat was assessed using signs of foraging activities. To further observe the foraging habitat utilization of pangolins, photographic evidences were collected using Infrared (IR) active camera traps located in all the studied habitats. Faecal samples collected from same habitats were further examined to identify the dietary composition of Indian Pangolins. As termites and ants are major prey organisms of Indian pangolins, the digestibility of different body parts –heads, mouthparts, abdomens, and legs of termites and ants was also scrutinized. The findings of the study with regard to dietary ecology will be important for both captive feed preparation and future conservation planning of the species

Twelve overnight fasted, healthy, male volunteers received on separate days a test breakfast consisting of (A) 100 g fresh white bread (providing 50 g starch) and 250 mL drinking water, (B) the same bread with a supplement of 10 g alpha-cyclodextrin dissolved in the drinking water (250 mL), and (C) 250 mL drinking water containing 25 g alpha-cyclodextrin. Capillary and venous blood samples were collected before breakfast and at regular intervals for a period of 3 hours thereafter. Plasma glucose was determined in capillary blood and plasma insulin in venous blood samples. Breakfast (A) let to the expected rise in blood glucose and insulin concentrations. Breakfast (C) did not produce a significant glycemic and insulinemic response, demonstrating that alpha-cyclodextrin is not hydrolyzed to glucose in the human digestive tract. Mild intestinal symptoms after the ingestion of alpha-cyclodextrin were reported by 4 subjects. The postprandial rises of plasma glucose and insulin were significantly smaller after breakfast (B) than (A). Under the conditions of this study, alpha-cyclodextrin reduced the glycemic and insulinemic index of white bread by 57 and 55 %, respectively. The postprandial time profile of plasma glucose and insulin suggests that, in an initial phase, the digestion of starch is inhibited by alpha-cyclodextrin almost completely. Yet, despite the delayed and reduced digestion of starch, the intake of breakfast (B) was not associated with flatulence or any other gastrointestinal symptoms.

The aim of this study of patients with chronic kidney disease (CKD) is to assess the safety of daily consumption of walnuts on the physiological levels of phosphorous, potassium, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23), and to assess the short-term benefits of this intervention on risk factors associated with cardiovascular events. This led us to perform a prospective, randomized, cross-over, pilot clinical trial examined 13 patients with chronic kidney disease (CKD). Subjects were randomly assigned to a diet of 30 g of walnuts per day or the control diet. After 30 days, each group was given a 30-day washout period, and then switched to the alternate diet for 30 days. Urinary and serum levels of phosphorous and potassium, multiple vascular risk factors, and urinary inositol phosphates (InsPs) were measured at baseline and at the end of the intervention period. Our results showed that the walnut dietary supplement led to reduced blood pressure, LDL cholesterol, and serum albumin, but had no effect on the physiological levels of phosphorous, potassium, PTH, and FGF23. This is the first report to show that daily consumption of walnuts by patients with CKD does not alter their physiological levels of phosphorous, potassium, PTH, and FGF23. Consequently, this dietary supplement may prevent cardiovascular events in patients with CKD.

Background: Few studies have examined multifaceted aspects of fast food consumption and dietary patterns for their effects on obesity. We examined the independent associations of obesity with fast food consumption and dietary pattern in Korean adults. Methods: A total of 19,017 adults aged 19–64y participated from KNHANES 2010-2014. Fast food items were removed from diet and then dietary patterns were generated. Multivariate logistic regression analysis was used to examine the odds for overweight/obesity and central obesity according to fast food consumption and dietary patterns. Results: Fast food consumers were about 10% of Korean adults. Both of White rice and kimchi pattern and Meat and alcohol pattern were associated with low intakes of fiber, calcium, vitamin C, grains, fruit, and milk(p<0.05). Fast food consumers had higher the Meat and alcohol pattern and the Grains, fruit, and milk pattern, and they had lower the White rice and kimchi pattern than non-fast-food-consumers. Fast food consumer were not associated with overweight/obesity, whereas the participants with Meat and alcohol pattern had 14% higher overweight/obesity(95%CI:1.01,1.28) and 16% higher central obesity(95%CI:1.00,1.34). Conclusions: Fast food consumption was not directly associated with obesity, whereas the Meat and alcohol pattern had independent associations with overweight/obesity and central obesity among Korean adults.

The development of reliable Food Frequency Questionnaires (FFQs) requires detailed information about the level and variation of dietary food intake of the target population. However, these data are often limited. To facilitate the development of new high quality FFQs and validation of existing FFQs, we developed a comprehensive National Dietary Assessment Reference Database (NDARD) detailing information about the level and variation in dietary food intake of people 20-70 years old in the general Dutch population. This paper describes the methods and characteristics of the population included in the NDARD database. 1063 men and 985 women agreed to participate in this research. Dietary intake data were collected using different FFQs, web-based and telephone-based 24-hour recalls, as well as blood and urine-based biomarkers. The baseline FFQ was completed by 1647 participants whose mean BMI was 26±4 kg/m2; 1117 participants completed telephone-based recalls and 1781 participants completed web-based recalls. According to the baseline FFQ, the mean energy intake was 2051±605 kcal/day. The percentage of total energy intake from protein was 15±2 En%, from carbohydrates was 43±6 En%, and from fat was 36±5 En%. This database will enable researchers to validate existing FFQs and to develop new high quality dietary assessment methods.

Since its inception in 2019, COVID-19 has been associated with significant changes in lifestyle-related behavior, including physical activity, diet, and sleep, which are vital to maintaining our well-being. This study measures lifestyle-related behavior during the COVID-19 pandemic lockdown using a 21-item questionnaire. The responses were collected from March 2021 to September 2021. Four hundred sixty-seven participants were engaged in assessing the changes caused by the pandemic and their effect on BMI. The validity and reliability of the questionnaire were tested for 71 participants. Cronbach's alpha values for the questionnaire all exceeded 0.7, demonstrating good validity and internal consistency for it. The effect of each question regarding physical activity and dietary habits over the BMI difference was studied using ANOVA. The study shows that more than half of the participants reported snacking more between meals and increased their sitting and screen time, while 74% felt more stressed and anxious. These indications were the cause of the increase in the BMI rate for individuals in the lockdown. In contrast, 62% of the participants showed more awareness about their health by increasing the intake of immunity-boosting foods, and 56% of the participants showed an increase in the consumption of nutrition supplements. Females and married individuals tended to be healthier, so their BMI showed stability compared to others based on their gender and marital status.

High fructose and sugar-sweetened soft drink (SSSD) intakes are associated with elevated blood uric acid concentrations and increased risk of gout and cardiovascular disease. Fruits are naturally high in fructose but their effect on cardiometabolic risk is unknown. We examined the effect on serum uric acid and cardiometabolic risk factors of consuming fructose from either fruit or SSSD in overweight adults. 48 healthy, overweight (BMI≥ 28 kg/m²) men (n=21) and women (n=20) were randomised to either a fruit (n = 19) or SSSSD (n = 22) intervention for 4 weeks. The fruit group received 6 items of fresh and dried fruit per day and the SSSD group received 955ml of SSSD per day with treatments matched for energy and fructose content. Serum uric acid concentrations were significantly reduced in men in the fruit group compared to the SSSD group (difference 57.2 μmol/L [95% CI: 16.4, 98.0], p= 0.008) but there was no difference amongst women (1.3 μmol/L [95%CI: -9.5, 6.9], p= 0.295). There differences in weight change or other cardiometabolic risk factors. These findings suggest no need to restrict fruit intake in individuals with elevated serum uric acid concentrations, such as those with gout.

Micronutrient deficiencies (MNDs), also known as hidden hunger, affects more than a quarter of the global population. Agronomic biofortification helps to increase concentration of a target mineral in food crops and improve human mineral dietary intake. It is a means of providing nutrient dense foods to a larger population especially among rural resource poor settings, providing that they have access to mineral fertilizers. However, the feasibility of agronomic biofortification in combating hidden hunger depends on several factors besides fertilizer access, including crop type, genotype, climate, soils, and soil mineral interactions. Consideration of its effectiveness to increasing human mineral intakes to daily requirements and improvement to human health and the cost effectiveness the program is also important. In this paper we reviewed available literature regarding the potential effectiveness and challenges of agronomic biofortification to improve crop micronutrient concentrations and reduce hidden hunger.

Research on climacteric syndrome among middle-aged men remains scant than the research among women. Research is also scant on climacteric syndrome among older adults living alone, particularly men, who are more vulnerable than such females. This cross-sectional study investigated whether the prevalence of climacteric syndrome is associated with the type of household middle-aged men live in and identified the determinants of climacteric syndrome based on the household type. Six hundred middle-aged men living in multi-person households and 600 living alone were surveyed about general characteristics, diet-related factors, and climacteric syndrome. Data were analyzed using Pearson’s chi-squared test, Fisher’s exact test, and logistic regression. The risk of climacteric syndrome in single-person households was found to be 1.6 times higher than that among in multi-person households (p = 0.006). In multi-person households, income and breakfast frequency predicted climacteric syndrome (p < 0.05), while age, breakfast frequency, dinner frequency, and weekly eating out frequency predicted climacteric syndrome in single-person households (p < 0.05). Thus, dietary factors are more closely linked to the prevalence of climacteric syndrome in single-person households than in multi-person households. This highlights the need for climacteric syndrome interventions for middle-aged men whose health concerns may persist into older adulthood.

In the United States (US), tianeptine is sold as a dietary supplement under the trade name Tianaa™. Tianeptine is a synthetic drug prescribed by physicians as an antidepressant in parts of Europe, Asia and South America. The drug is not permitted for use by physicians in the US, be-cause it is a μ-opioid receptor agonist with a propensity for severe addiction. As incidence of Tianaa™ related opioid addiction across the southern US escalate, the current study aimed to quantify tianeptine in over the counter Tianaa™ White, Red, and Green products. The results of this investigation measured tianeptine levels between 3.1 to 10.9 mg per 531 mg capsules. Tianaa™ White capsules consistently contained the least tianeptine, while Green had the most. Close inspection of Tianaa™ products showed that capsule mass varied by as much as 16% from label claim, and the amount of tianeptine per capsule varied by as much as 35 % from the aver-age measured amount for each product. Tianaa™ Red contains kava leaf extract, which led to the identification of four kavapyrone components by mass spectrometry. The data presented pro-vide insight into tianeptine quantity and capsule mass variation for Tianaa™ supplements sold to customers naive to the risk of addiction.

Current nutritional guidelines for stomach cancer survivors (SCS) mainly focus on the influence of surgical resection of the stomach, with limited guidance regarding a wider range of food options. We aimed to investigate the factors associated with healthier dietary changes in Korean adult SCS. This cross-sectional study assessed dietary pattern change after cancer treatment for 11 food categories, using a self-administered questionnaire. A ‘healthier dietary change’ was operationally defined as reduced consumption of red and processed meat, grains, salt, and burnt food, and increased consumption of poultry, fish, vegetables, fruits, legumes, and dairy products. Among a total of 624 SCS, approximately 60% of participants reported healthier directional dietary changes in three or more food categories, while 9.1% reported no changes. There was no significant difference in dietary habit changes between surgery types. Multivariable adjusted analysis showed that elderly and long-term survivors were inversely associated with a healthier dietary change. SCS with higher educational achievement and income were more likely to make healthier changes in their intake of processed meat, vegetables, fruits, burnt food, or salt. SCS with higher levels of fear of cancer recurrence, anxiety, or depression were more likely to follow healthier dietary changes for fish, meat, fruits, grains, or burnt food. Change in dietary pattern varied across different food items and was associated with various characteristics of SCS. It is crucial to repeatedly provide SCS with information about healthier dietary patterns, considering their sociodemographic, clinical, and psychological characteristics.

Caffeine is a naturally occurring alkaloid found in various plants. It acts as a stimulant, antioxidant, anti-inflammatory and even an aid in pain management, and is found in several over-the-counter medications. This naturally derived bioactive compound is the best-known ingredient in coffee and other beverages, such as tea, soft drinks, and energy drinks, and is the most widely consumed substance worldwide. Therefore, it is extremely important to research the effects of this substance on the human body. With this in mind, caffeine and its derivatives have been extensively studied to evaluate its ability to prevent diseases and exert anti-aging and neuroprotective effects. This review is intended to provide an overview of the effects of caffeine on cancer, cardiovascular, immunological, inflammatory, and neurological diseases, among others. The heavily researched area of caffeine in sports will also be discussed. Finally, recent advances in the development of novel formulations, in the form of dietary supplements of caffeine and nanocarriers, to enhance the bioavailability of caffeine and its beneficial effects will be discussed. On the other hand, caffeine may contribute to elevated blood pressure, anemia, and migraine.

Starting from an original survey conducted in eight countries in 2021 (Canada, China, Germany, Italy, Russia, Spain, UK, and USA), this research explores the relationship between household food waste and dietary habits in a cross-country comparative perspective. 8,000 questionnaires were recorded from samples representative of adult population of each country through an online survey conducted between the 13th and the 24th of August. The questionnaires were built on the work of Waste Watcher International Observatory on Food and Sustainability, an international observatory of social, behavioral and lifestyles dynamics behind household food waste. Relationship between per capita self-reported amount of food waste (expressed in kilocalories) and self-declared dietary habits (Traditional, Healthy and Sustainable, Vegetarian, Smart, Confused) was estimated using multiple linear regression models. Results show that Smart diets are associated with higher values of food waste in Canada, Spain, UK and USA. Vegetarian diets are associated to lower food waste values in China, Germany, UK and USA but not in Italy, Russia and Spain. Since the share of population adopting a Smart diet is on average 2.7% of the sample, interventions for food waste reduction should focus on this specific type of consumers, often associated to larger amounts of food waste.

Heart failure (HF) has become a public health problem, but exact pathophysiology is still unknown. Western diet characterised with high sugar, high fat, red meat and processed meat, eggs, fried foods and sweetened beverages, may cause oxidative stress and inflammation, leading to oxidative dysfunction and adverse effects on cardiac-ultra-structure. However, only little is known about oxidative function of the of the myocardium and how oxidative dysfunction predispose Ca-overloading resulting in to physio-pathological remodelling leading to HF. Antioxidants such as flavonoids and polyphenolics, omega-3 fatty acids, vitamins, minerals as well as essential and nonessential amino acids that are rich in Indo-Mediterranean type of diets, may have protective roles in maintaining oxidative functions of the heart. The cardiac cells use fatty acids and glucose for the metabolic functions depending upon physiological and metabolic requirements. Apart from glucotoxicity, lipotoxicity is also damaging to cardiac cells which worsen in presence of deficiency of endogenous antioxidants and lower exogenous antioxidants in the diet. There is increased production of ceramide, advanced glycation end products (AGE) and triamino-methyl-N-oxide (TMAO) due to high sugar and high fat diets, leading to oxidative dysfunction and Ca-overloading. The biological changes may begin with physiological remodelling to pathological remodelling due to oxidative damages. High fat diet in combination with inducible nitric oxide synthase (NOSi) via N-arginine methyl ester has been found to preserve ejection fraction in a mouse model of HF. It is possible that increased supplementation of High Exogenous Antioxidant Restorative Treatment (HEART) diet; polyphenolics and flavonoids, vitamins, minerals, arginine, with omega-3 fatty acids, and cessation of red meat and egg may further improve the oxidative function of cardiac cells, resulting in the prevention and improvement in the earliest of the Six Stages of HF. Cohort studies and randomised, controlled trials would be necessary for demonstration of the role of HEART diet in the management of HF.

Objective: To explore sex differences in cardiovascular disease (CVD) related risk factors such as diabetes, hypertension, and demographic, anthropometric, biochemical, clinical, and nutritional differences among 40-60 years old Pakistani CVD patients.Design: This was a cross-sectional, descriptive study.Setting: The present study was conducted at the Mayo/King Edward Medical University (K.E.M.U) Hospital Cardiology Department (CCU-I & CCU-II), Lahore, from February 2020 to June 2020. A self-administered questionnaire was used for data collection.Participants: A random sample of 300 cardiac patients was included in the study. Patient records, food frequency questionnaire and 24-hour dietary recall was used to solicit information about demographic, anthropometric, biochemical, and clinical measurements; dietary intake parameters; and CVD risk factors such as hypercholesterolemia, hypertension, diabetes, and smoking. Results: Men CVD patients had higher BMI (33.43 kg/m² vs. 28.69 kg/m²) and higher prevalence of hypertension (81.1% vs. 59%), hypercholesterolemia (82.4% vs. 54.5%) and smoked more cigarettes (72.6% vs. 9%) as compared to women while there was higher prevalence of diabetes among women as compared to men (59% vs. 29.4%). There were 85% women vs. 80% men consuming white bread, while half of the men reported using meat daily, as compared to only 16.6% women. There were 51.5% women and 17% men who reported consuming fruits and vegetables daily. There were 40% men and 16% women who reported consuming soft drinks. Conclusion: The study showed significant sex differences in the nutritional status and risk factors of patients with CVD.

Dietary pattern (DP) and its relationship with disease biomarkers has received recognition in nutritional epidemiology investigations. However, DP relationships with adipokines (i.e., adiponectin and leptin) among breast cancer survivors remain unclear. Therefore, we assessed relationships between DP with high molecular weight (HMW) adiponectin and leptin concentration among breast cancer survivors. This cross-sectional study involved 128 breast cancer survivors who attended the oncology outpatient clinic at two main government hospitals in East Coast of Peninsular Malaysia. The serum concentration of HMW adiponectin and leptin were measured using enzyme-linked immunosorbent assay (ELISA) kits. Reduced rank regression method was used to analyze DP. Relationships between DP with HMW adiponectin and leptin were examined using regression models. Findings showed that a one-unit increase in the ‘energy-dense, high-saturated fat and low-fiber’ DP z-score was associated with a 0.41 µg/mL lower HMW adiponectin (95% CI: -0.806, -0.014) which was independent of age, BMI, cancer stage, duration since diagnosis, education level and occupation status. A similar relationship with leptin concentration was not observed. In conclusion, ‘energy-dense, high-saturated fat and low-fiber’ DP, which is characterized by high sugar-sweetened drink and fat-based spread but low intake of fruits and vegetables, is an unhealthy dietary pattern and unfavorable for HMW adiponectin concentration but not for leptin. These findings could serve as a basis in developing specific preventive strategies that are tailored to the growing population of breast cancer survivors.

Despite recent advances in immune-modulatory drugs, pharmacological therapies have been proven ineffective in severe presentations of multiple sclerosis (MS), including secondary progressive MS. At present, therapeutic interventions' performance is primarily focused on ameliorating symptoms to improve the patient's quality of life. Among complementary treatments, nutrition has been considered a decisive factor to control symptoms and enhance the wellness of MS patients. Although no special diets are associated with MS, the impact of diet and dietary supplements on the course of progressive forms of the disease have been studied during the last years. Fatigue is among the most common and disabling symptoms reported by MS patients. Fatigue has been defined in the Multiple Sclerosis Council for Clinical Practice Guidelines (MSCCPG, 1998) as a "subjective lack of physical and/or mental energy that the individual perceives as an interference with habitual and desired activities". This study aimed to compare the psychometric functioning of the "Fatigue Severity Scale" (FSS) and the "Modified Fatigue Impact Scale" (MFIS) in our sample of people with MS. Specifically, during chronic treatment, the change in these two parameters with two vitamin-rich dietary supplements (Citozym® and Ergozym®) was evaluated. The impact of these nutritional supplements revealed differences in antioxidant and anti-inflammatory parameters between treatment groups with subsequent improvement in fatigue. In conclusion, the results obtained have confirmed the effectiveness of complementary nutritional therapies, evaluated essentially based on hematological biomarkers, through which it is possible to act on disability to improve the quality of life of MS patients.

Cereals and their derivatives are the basis of human nutrition. However, cereals also contribute to the dietary exposure to toxic metals that may pose a risk. Strengthening food security and nutrition information is a high priority challenge for the Cape Verde Government. The toxic metals content (Cr, Ni, Sr, Al, Cd, Pb) has been determined in 126 samples of cereals and derivatives (rice, corn gofio, corn flour, wheat flour, corn, wheat) consumed in Cape Verde. Wheat flour samples stand out for registering the highest Sr (1.60 mg/kg), Ni (0.25 mg/kg) and Cr (0.13 mg/kg). The results show relevant Al levels (1.17 – 13.4 mg/kg) with its highest levels in corn gofio. The mean Pb average content in the cereals is 0.03 – 0.08 mg/kg with the highest level observed in corn gofio. The Al and Pb levels are lower in cereals without husks. A consumption of 100 g/day of corn gofio provide an intake of 1.34 mg Al/day (13.7% of the tolerable weekly intake established at 1 mg/kg bw/week) and 8 µg Pb/day (20% of the BMDL set at 0.63 µg/kg bw/day for nephrotoxic effects). The minimization of the dietary exposure of the Cape Verdean population to toxic metals is through the importation of higher quality cereals.

Over the past five years, the popularity of dietary nitrates as an ergogenic device among athletes has increased significantly. Hypoxic and acidic conditions that occur during exercise facilitate the conversion of nitrite to nitric oxide (NO) and increase the physiological efficiency of exogenously produced nitrite. After a few years of our team predicted experiments, as a nitric oxide precursor, amaranth (Amaranthus hypochondriacus) was identified as a source of dietary nitrates (concentrations 9-11%). The aim of this study was to evaluate the effect of single-dose and long- term doses of dietary nitrates from amaranth concentrate on the aerobic capacity of physically active young persons. Thirteen healthy and physically active young participants were randomized to experimental and placebo groups using a increasing cycling exercise (ICE) and placebo- controlled design. Pulmonary gas exchange recording (oxygen uptake (VO 2 ), pulmonary ventilation (VE), respiratory exchange ratio (RER)) and analysis of blood lactate samples were obtained. Our findings indicate that the single dose of dietary amaranth (400 mg) significantly improved only the power of the test performance. Long-term (6 days) intake significantly increased the power of the test performance, the maximum oxygen consumption and the power of the test for the first ventilation threshold value (from 37.7±2.7 mL/kg/min during the first test to 41.2±5.4 mL/kg/min during the third test, p &lt;0.05).

The addition of flaxseed and amaranth on the physicochemical, functional and microstructural changes of instant-extruded cereals was evaluated. Six different mixtures were made with additions of amaranth (30%–50%) and flaxseed (10% and 15%) using maize grits and minor additives as supplementary ingredients and then extruded in a twin-screw extruder. The extrudates evaluated, had insoluble and soluble fiber contents increased with the proportion of amaranth and flaxseed. The mixture 4 (higher flaxseed content) presented highest soluble fiber percentage (1.9%). Extruded cereals had the lowest viscosity (<99.5 cp) and highest hardness values (5.2 N) whereas the dietary fiber content was highest. Fiber content increase, resulted in a higher water solubility index (WSI) (0.5) and decrease the water absorption index (WAI) (2.5). Amaranth and flaxseed incorporation increased crystallinity, resulting in a larger, and more compact laminar structure. Amaranth and flaxseed addition resulted in extruded cereals with acceptable physicochemical and functional properties.

There is a growing need to utilize community interventions to address modifiable behaviors that lead to poor health outcomes like obesity, diabetes, and heart disease. Poor health outcomes can be tied to community-level factors such as food deserts (identified areas with low access to fresh fruit, vegetables, and other healthful whole foods) and individual behaviors like sedentary lifestyles, consuming large portion sizes, and eating high-calorie fast food and processed foods. Through a social ecological approach with family, organization and community, the Faithful Families Cooking and Eating Smart (FFCES) intervention was created to address these concerns in a rural South Carolina community. FFCES used gatekeepers to identify 18 churches and 4 apartment complexes in low-income areas. 176 participants completed both pre- and post- survey measures. Student’s t-test measures found statistically significant change in participant perception of food security (0.39, p-value=0.005), self-efficacy with physical activity and healthy eating (0.26, p-value=000), and cooking confidence (0.17, p-value=.01). There was not significant change in cooking behaviors as assessed through the Cooking Behaviors Scale. FFCES shows that a social ecological approach can be effective at increasing and improving individual healthy behaviors and addressing community-level factors in low-income rural communities.

Microbiota plays a key role in various body’s functions, physiological, metabolic and immunological processes, through different mechanisms such as the regulation of the development and/or functions of different types of immune cells in the intestines. Several evidences indicate that alteration in the gut microbiota can influence infectious and non-infectious diseases. Bacteria that resides on the mucosal surface or within the mucus layer participate in interactions with the host immune system, and a healthy gut microbiota is essential for the development of mucosal immunity. The immunomodulatory activity of probiotics has been proposed in several bowel disorders or in aging-related dysfunctions. In HIV infected patients, the intestinal immune system is affected and inflammation persists during ART therapy too. Several studies are in progress to investigate the ability of probiotics to modulate epithelial barrier functions, microbiota composition and microbial translocation in HIV infection. This mini-review aims to suggest how the use of probiotics is beneficial not only in maintaining a healthy status but also to improve conditions in HIV subjects.

Dietary patterns were recently applied to examine the relationship between eating habits and prostate cancer (PC) risk. While the associations between PC risk with glycemic index and Mediterranean score have been reviewed, no meta-analysis is currently available on dietary patterns defined by “a posteriori” methods. Search was carried out (PubMed, Web of Science) to identify studies reporting the relationship between dietary patterns and PC risk. Relevant dietary patterns were selected and the risk estimated were calculated by a random-effect model. Multivariable-adjusted odds ratios (ORs) for a 1st-percentile increase in dietary pattern score were combined by a dose response meta-analysis. 12 observational studies were included in the meta-analysis which identified “Healthy pattern” and “Western pattern”. The Healthy pattern was not related to PC risk (OR=0.96; 95% CI: 0.88-1.04) while the Western pattern significantly increased it (OR=1.34; 95% CI: 1.08-1.65). In addition, a “Carbohydrate pattern”, identified in four articles, was positively associated with a higher PC risk (OR=1.64; 95% CI: 1.35-2.00). A significant linear trend between the Western (p=0.011) and the Carbohydrate (p=0.005) pattern and the increment of PC risk was observed. The small numbers of studies included suggest that further investigations are necessary to support these findings.

Metabolic and bariatric surgery (MBS) is the most effective long-term treatment for Class III obesity. Reduced dietary intake is considered a behavioral driver of post-surgical weight loss, but limited data have examined this association. Therefore, this study examined prospective, longitudinal relationships between dietary intake and weight loss over 24 months following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. Relationships between weight loss and dietary intake were examined using a validated 24-hour dietary recall method. Associations between total energy/macronutrient intake and weight loss outcomes were assessed at 12-, 18-, and 24-months following MBS, defining patients as “responders” and “suboptimal responders” according to the Reinhold criteria of 50% excess weight loss. Consistent with previous literature, 12-month responders and suboptimal responders showed significant associations between weight loss and dietary intake. Unlike previous work, this study revealed that many of these associations are no longer significant 24 months post-MBS, despite consistent weight loss trends. This study suggests a short-term signal between these dietary factors and weight loss outcomes 12 months post-MBS, consistent with previous observations. However, this signal does not persist beyond 12 months. These results are essential for interpreting and designing clinical studies measuring long-term post-surgical weight loss outcomes.

The goal of our study was to examine the effect of regional characteristics of living environment on individual a priori and a posteriori dietary patterns of the Russian population. For the analysis, we used cross-sectional data from the Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation study of 2013-2014. The sample included 18,054 men and women 25-64 years of age from 12 regions. Based on the frequency of consumption of basic foods, four a posteriori empirical dietary patterns (EDPs), along with an a priori cardioprotective dietary pattern (CPDP) were identified. To describe the regional living environment, 5 regional indices were used. The adherence to the meat-based EDP was directly associated with deterioration of social living conditions and the more northerly location of the region of residence. The probability of CPDP increased with deterioration of social living conditions, an aggravation of demographic crisis, higher industrial development of the region, as well as with a decline in the economic development of the region, income and economic inequality of the population. We detected some gender-dependent differences in associations. The revealed patterns reflect the national dietary preferences of Russians, and regional indices characterize the effect of living environment.

(1) Background: Loss of weight is one of the practices which have been identified as key in reducing the risk of various forms of cancer. Therefore, this study is a systematic review and meta-analysis of studies related to the topic of loss of weight and risk of cancer and addresses the question, ‘does losing weight reduce the risk of cancer?’ Its purpose is to identify current high-quality evidence on such a question and synthesize such evidence before summarizing it given specific data attributes to improve decision-making processes on cancer management. (2) Methods: Research studies were identified from four main databases: PubMed, Science Direct, Google scholar, and Medline. A systematic review and meta-analysis of such studies were then conducted to reveal the most current evidence on the research topic. (3) Results: The studies showed that losing weight reduces cancer risk. Nonetheless, such intervention is not necessarily effective, especially in cases where patients may be at risk of developing cancer due to other risk factors. (4) Conclusions: The current study concludes that there is a need to implement effective interventions such as physical exercise, dietary restrictions, or both that can be effective in reducing weight to reduce the risk of cancer.

The wheat aleurone layer is, according to millers, the main bran fraction. It is a source of nutritionally valuable compounds, such as dietary fibres, proteins, minerals and vitamins, that may exhibit health benefits. Despite these advantages, the aleurone layer is scarce on the market, probably due to issues related to its extraction. Many processes exist with some patents, but a choice must be made between the quality and quantity of the resulting product. Nonetheless, its potential has been studied mainly in bread and pasta. While the nutritional benefits of aleurone-rich flour addition to bread agree, opposite results have been obtained concerning its effects on end-product characteristics (namely loaf volume and sensory characteristics), thus ensuing different acceptability responses from consumers. However, the observed negative effects of aleurone-rich flour on bread dough could be reduced by subjecting it to pre- or post-extracting treatments meant to either reduce the particle size of the aleurone’s fibres or to change the conformation of its components.

Alzheimer’s disease is one of the neurodegenerative diseases, characterized by the accumulation of abnormal protein deposits, which disrupt the signal transduction in neurons and other glia cells. The pathological protein Tau and amyloid-β contributes to the disrupted microglial signaling pathways, actin cytoskeleton, and cellular receptor expression. The important secondary messenger lipids i.e., phosphatidylinositols are largely affected by protein deposits of amyloid-beta in Alzheimer’s disease. Phosphatidylinositols are the product of different phosphatidylinositol kinases and the state of phosphorylation at D3, D4, and D5 positions of inositol ring. PI 3, 4, 5-P3 involves in phagocytic cup formation and relates actin remodeling whereas PI 4, 5-P2-mediates the process of phagosomes formation and further fusion with early endosome. The necessary activation of actin-binding proteins such as Rac, WAVE complex, and ARP2/3 complex for the actin polymerization in the process of phagocytosis, migration is regulated and maintained by PI 3, 4, 5-P3 and PI 4, 5-P2. Dietary fatty acids depending on their ratio and types of intake influence secondary lipid messenger along with the cellular content of phaphatidylcholine and phosphatidylethanolamine. The deposited Aβ deposits and extracellular Tau seed disrupt levels of phosphatidylinositol and actin cytoskeletal changes that hamper microglia signaling pathways in AD. We hypothesize that being a lipid species intracellular levels of phosphatidylinositol would be regulated by dietary fatty acids. We keen to understand different types of phosphatidylinositol species levels in signaling events such as phagocytosis and actin remodeling owing to the exposure of various types of dietary fatty acids.

Background: The nutritional status of women during pregnancy can have a considerable effect on maternal and fetal health, and on perinatal outcome. The aim was to assess the changes occurring in dietary iodine intake, KI supplementation, and smoking habit, and the impact of these changes on the urinary iodine concentration (UIC) during pregnancy in a population of women in Catalonia (Spain). Methods: Between 2009-2011 an observational study including a cohort of women whose pregnancy was monitored in the publically-funded health system in a central region of Catalonia. Women received individual educational counseling imparted, a dietary questionnaire was completed, and a urine sample collected for iodine determination at each trimester visit. Results: 633 (67.9%) women answered the questionnaire at all 3 visits. The percentage of women with a desirable UIC (≥150μg/L) increased from the first to the second trimester and remained stable in the third (p<0.001). Analysis of the relationship between UIC≥150 μg/L and the women’s dietary habits showed that the percentage with UIC≥150 μg/L increased with greater consumption of milk, fresh vegetables, and fruit in the first trimester, and the same was true for iodized salt use in all three trimesters and iodine supplementation in all three. Conclusion: During pregnancy increased intake of milk, iodized salt, and iodine supplements was associated with an increase in the UIC.

Obesity has been identified as an emerging health concern for Chinese American children; however, very little is known about diets in Asian American children. The objective of our paper was to describe the dietary intakes of urban Chinese American schoolchildren using a state-of-the-art approach for dietary assessment. Data for this analysis come from the Food Journal Project 2017, a pilot and feasibility study conducted by a multi-sector collaboration. Children aged 8-12 (n=83) completed two dietary assessments using a food diary from January-June 2017. Children were then interviewed using the food diary as a guide and dietary data were entered into the online ASA24 system by study staff. Chinese American children were identified using surname, and were compared to non-Chinese peers with respect to nutrient intake and the Healthy Eating Index 2010 (HEI-2010). Chinese American children consumed more sodium dense diets, more protein, and less sugar compared to non-Chinese children. With regards to the HEI-2010, Chinese American children had less favorable whole grains and sodium scores; and more favorable seafood protein and empty calories scores compared to non-Chinese children. Sodium reduction and increasing whole grain intakes may be warranted in this group, but should be verified with additional studies.

Obesity and metabolic disorders can be risk factors for the onset and development of neurodegenerative diseases. The aim of the present study was to investigate the protective effects on dysmetabolism and neurodegeneration of a natural dietary supplement (NDS), containing Curcuma longa, silymarin, guggul, chlorogenic acid and inulin, on the brains of high fat diet (HFD)-fed mice. A decreased expression of FACL-4, CerS-1 and CerS-4, reduced cholesterol concentration, increased IR expression and insulin signaling activation, were found in brains of NDS-treated HFD mice, suggesting that NDS is able to prevent brain lipid accumulation and central insulin resistance. In the brains of NDS-treated HFD mice, the levels of RNS, ROS and lipid peroxidation, the expression of p-ERK, H-Oxy, i-NOS, HSP60, NF-kB, GFAP, IL-1β, IL-6, and CD4 positive cell infiltration were lower than in untreated HFD mice, suggesting antioxidant and anti-inflammatory effects of NDS. The decreased expression of p-ERK and GFAP in NDS-treated HFD mice was confirmed by immunofluorescence. Lastly, a lower number of apoptotic nuclei was found in cortical sections of NDS-treated HFD. All these data indicate that NDS exerts neuroprotective effects in HFD mice by reducing brain fat accumulation, oxidative stress and inflammation and improving brain insulin resistance.

This literature review was aimed to identifying the opportunistic bacterial pathogens that can be transmitted by contaminated food and represent a current threat for patients particularly suscep-tible to infections because of underlying conditions or predisposing factors. The analysis was focused on recent case or outbreak reports, and systematic reviews published in years 2019 - 2023 and resulted in sorting 24 bacterial groups comprising genera or species able to cause a variety of systemic or invasive infections if ingested with food or drinking water. These included both bacteria known to cause mild infections in immunocompetent persons and bacteria considered innocuous that are used in food fermentation or as probiotics. No recent cases from dietary routes were reported for bacteria of critical importance as nosocomial pathogens and widely occurring in food products, primarily, Acinetobacter baumanii and Klebsiella pneumoniae. However, the very first sources of their introduction in the clinical environment still need to be estab-lished. In many instances, risky dietary habits such as eating raw fish, seafood, raw meat, unpasteurized milk and derived products or the lack of control on fermentation processes led to the reported illnesses, pointing out to the necessity to improve the hygiene of production and consumer’s awareness of risks.

Dietary guidance to recommend food patterns to deliver nutrients has been well accepted for the past century. Foods to deliver essential nutrients and energy are needed across the life cycle and are dependent upon local industries and accepted cultural practices to deliver essential nutrients to prevent nutrient deficiency diseases. Since the 1980s, dietary guidelines to prevent chronic diseases have relied on epidemiological research to predict what dietary patterns are linked to reduced risk of chronic disease or links to health outcomes. Dietary guidelines have been broad, typically recommending avoiding “too much sugar”, “too much saturated fat”, and “too much sodium”. Efforts to fine tune these recommendations have met with limited scientific data to support more specific recommendations across the life cycle. Consumers have become skeptical of dietary guidelines as media coverage of new studies is often in conflict with accepted nutrition dogma. We discuss whether we really have a science-based databank to support dietary guidelines, based on a scientific session at the 10th International Conference on Nutrition and Growth.

Coronavirus Disease 2019 (COVID-19) exhibits a significant variation in presentation of symptoms ranging from mild to severe life-threatening symptoms, including death. COVID-19 infection susceptibility has been linked with various covariates, but studies in Qatar are limited. Data from Qatar Biobank (QBB) (n = 10,000; 18- to 79-year-old adults) were analyzed for associations between sociodemographic and lifestyle factors and susceptibility to COVID-19. Logistic regression was used to assess the associations between COVID-19 and age, gender, body mass index (BMI), smoking status, education level, dietary patterns, supplement use, physical activity, history of bariatric surgery, diabetes, and hypertension. In total, 10.5% (n = 1045) of the participants had COVID-19. Compared to non-smokers, current and ex-smokers had lower odds of having COVID-19 (odds ratio [OR]= 0.55; 95% CI: 0.44-0.68 and OR= 0.70; 95% CI: 0.57-0.86, respectively). Vitamin D supplement use was associated with an 18% reduction of the likelihood of contracting COVID-19 (OR = 0.82; 95% CI: 0.69-0.97). Obesity (BMI ≥30 kg/m2), history of bariatric surgery and higher adherence to the modern dietary pattern– characterized by consumption of foods high in saturated fat and refined carbohydrates– were positively associated with COVID-19. Our findings indicate that adopting a healthy lifestyle may be helpful in the prevention of COVID-19 infection.

To determine the impacts of metabolizable energy levels on the performance indices of geese and to forecast the ideal range of dietary metabolizable energy levels, this study was carried out. Literature on the effects of dietary metabolized energy level on the performance of geese was searched from CNKI, Wanfang, VIP, PubMed, Web of Science, and ScienceDirect databases from January 1, 2000, to December 31, 2022. A dose-response meta-analysis was performed by STATA (14.0), data were calculated by the robust error meta-regression model (REMR), and nonlinear dose-effect curves were plotted by the restricted cubic spline method (RCS). 29 papers were chosen from the 1,475 literatures that fit the criteria and were included in the dose-response meta-analysis. There were 6,079 geese included in the sample. The following production performance indices included average daily gain (ADG), average daily feed intake (ADFI), feed-to-gain ratio (F/G), dressed percentage, percentage of half-eviscerated yield, percentage of eviscerated yield, percentage of breast muscle, percentage of leg muscle and percentage of abdominal fat. The Egger test assessed publication bias, while sensitivity analysis was used to examine the heterogeneity. The verified results are consistent and reliable. The results indicated that for each group, the optimal dietary metabolizable energy level was about 13 to 13.5MJ/kg for medium-sized geese aged 0 to 4 weeks, 12 to 13MJ/kg for medium-sized geese aged above 5 weeks, 12.5 to 13MJ/kg for small-sized geese aged 0 to 4 weeks, and 13 to 13.5MJ/kg for mall-sized geese over 5 weeks of age. Future research should be conducted on related diets of large-sized geese, small-sized geese, and higher metabolizable energy levels.

Diabetes mellitus, a metabolic disorder that is persistent in nature, is identified by an elevated concentration of glucose in the bloodstream. The disease has become a major public health problem, affecting millions of people globally, and is associated with significant morbidity and mortality. The increasing prevalence of diabetes and the lack of effective therapeutic interventions have led to the exploration of alternative and complementary forms of therapy, including ethnomedicine. Ethnomedicine is the study of traditional medical systems and the medicinal plants used by Indigenous communities. In other words, Ethnomedicine refers to the traditional medical practices and beliefs of a particular cultural or ethnic group. The most popular example of traditional medicine is the use of Aloe vera for the treatment of various diseases such as sunburn, cuts, burns, hypertension, diabetes, and jaundice for thousands of years [1]. In recent years, there has been increasing interest in the potential role of ethnomedicine in the management of diabetes, given its widespread use in many communities and its potential to offer cost-effective and culturally acceptable treatment options. It encompasses a range of traditional healing practices, including herbalism, acupuncture, and massage therapy. Despite the inconsistencies, there is growing evidence to suggest that certain ethnomedical practices may be effective in the management of diabetes [2,3]. For example, several studies have shown that certain herbal remedies, such as cinnamon, ginseng, and bitter melon, may have potential benefits in terms of improving glucose control and reducing the risk of complications associated with diabetes. Evidence-based ethnomedicine is an approach that applies scientific principles and methods to evaluate the efficacy and safety of traditional medical practices. This approach is crucial in the development of effective and safe ways to treat diabetes. To date, there have been numerous studies conducted to examine the efficacy and safety of various ethnomedical interventions for diabetes, including herbal remedies, dietary changes, and physical activity [4]. However, it is important to note that not all ethnomedical interventions for diabetes have been thoroughly evaluated, and many remain unproven. Furthermore, some interventions may be associated with significant risks, particularly in terms of drug interactions and adverse effects. As such, it is crucial that any ethnomedical interventions for diabetes be carefully evaluated using rigorous scientific methods and that patients be advised to consult with their healthcare provider before using any such interventions. It is important to note that the results of these studies have been mixed, with some showing promising results, while others have failed to demonstrate significant benefits. In this chapter, the evidence-based current state of ethnomedicine for diabetes was reviewed. We first provide an overview of diabetes and its pathophysiology, followed by a discussion of traditional medicinal practices used to treat the disease. We then present a systematic review of the scientific literature on the use of ethnomedicine for diabetes, focusing on herbal remedies and dietary interventions. Our review found that several medicinal plants offered promising results to treat all types of diabetes. For example, Gymnema sylvestre, a traditional Indian herb, has been shown to reduce blood glucose levels and improve insulin sensitivity [5]. Additionally, the use of bitter melon (Momordica charantia) has been shown to reduce fasting blood glucose levels and improve glucose tolerance in individuals with type 2 diabetes [6]. Another important aspect of ethnomedicine for diabetes is the use of dietary interventions [7]. Traditional diets, such as the Mediterranean diet, have been shown to have beneficial particularly in terms of improving glycaemic control, reducing the risk of cardiovascular disease, and insulin sensitivity [8]. Additionally, the use of low-carbohydrate diets, such as the ketogenic diet, has been shown to improve glycaemic control in individuals with type 2 diabetes [9]. Traditional medicine has a long history of treating the symptoms and managing the condition. However, the efficacy and safety of these traditional practices have not always been scientifically tested, and there is a lack of standardization and regulation in the production and use of traditional remedies for diabetes. This creates a challenge for healthcare providers and patients, who need to ensure that the treatments they use are safe and effective. Additionally, there is a need for further research to understand the mechanisms by which traditional remedies may be effective in managing diabetes and to determine the optimal dosage and administration methods [9]. Finally, it is also important to understand that the use of traditional remedies may interact with conventional medications, leading to adverse effects; for example, the use of Chinese traditional medicine, known as “herb ginseng,” for the treatment of various health conditions, including diabetes sometimes cause the side effect such as dizziness, confusion, and fainting while interacting with the anti-diabetic medications [10]. Therefore, it is important to approach the use of ethnomedicine for diabetes with caution and under the guidance of a qualified healthcare professional. In conclusion, evidence-based ethnomedicine offers a promising approach to the treatment of diabetes. While further research is needed to fully understand the mechanisms and safety of these interventions, the results to date suggest that traditional remedies and dietary interventions have the potential to be effective in the management of this disease. However, it is important to approach the use of ethnomedicine for diabetes with caution and under the guidance of a qualified healthcare professional and to continue to conduct rigorous scientific research to fully understand the benefits and risks associated with these interventions.

It is estimated that about 50% of geriatric rehabilitation patients suffer from sarcopenia. Thereby, malnutrition is frequently associated with sarcopenia and dietary intake is the main modifiable risk factor. During hospitalization, older adults are recommended to consume more dietary protein than the current recommended dietary allowance of 0.8 g/kg body weight per day to optimize the recovery of muscular strength and physical function. This prospective study examined the effect of a short-term protein supplementation with protein-enriched foods and drinks on hand-grip strength, nutritional status and physical function in older patients at risk of malnutrition during a three week inpatient orthopedic rehabilitation stay. The Mini Nutritional Assessment (MNA) was used to assess malnutrition. Patients with a MNA score ≤ 23.5 points were randomly assigned to an intervention group (goal: to consume 1.2–1.5 g protein/kg body weight per day) or a control group (standard care). Both groups carried out the same rehabilitation program. Physical recovery parameters were determined at admission and discharge. There was a trend for participants in the intervention group to consume more protein than the control group (P = 0.058): 95.3 (SD 13.2) g/day as compared to 77.2 (SD 24.2) g/day, which corresponds to a mean protein intake of 1.6 (SD 0.3) g/kg/day vs. 1.3 (SD 0.5) g/kg/day. Dietary protein supplementation increased body weight by an average of 0.9 (SD 1.1) kg and fat mass by an average of 0.9 (SD 1.2) kg as compared with baseline (P = 0.039 and P = 0.050, respectively). There was no significant change in hand-grip strength, body composition and physical function. In conclusion, a short-term intervention with protein-enriched foods and drinks enabled older patients at risk of malnutrition to increase their protein intake to levels that are higher than their required intake. In these older individuals with appropriate protein intake, dietary protein supplementation did not result in a greater improvement in physical recovery outcomes during short-term inpatient rehabilitation. The intervention improved dietary protein intake, but further research (e.g., a full-scale randomized controlled trial with sufficient power) is required to determine the effects on physical function outcomes.

The gut microbiota plays a crucial role in childhood obesity, and diet is a dominating driver. The effects of fructo-oligosaccharides (FOS), as a dietary fiber, on the composition and metabolism of gut microbiota in healthy children was investigated by vitro fermentation system with a reformative YCFA medium (rich in tryptic hydrolysates of meat). The 16S rRNA sequencing technology was utilized to analyze the varieties of gut microbiota. Measurement of short chain fatty acids (SCFAs) and gases were used by the gas chromatograph. Majorbio Cloud Platform and MetOrigin, as the interactive cloud server, perform the microbiota analysis, the metabolic pathway enrichment analysis, the statistical correlations, and biological relationships using network visualization. We found that the FOS group significantly regulated the composition and metabolism of gut microbiota. The co-metabolism network showed that 3 metabolites were related to 6 differential bacteria and 8 metabolism pathways. These findings suggest that dietary fiber could regulate the composition of gut microbiota and its metabolites in a better direction, but when dietary fiber participates in precision nutrition formula, it may be relevant for precision obesity, may help identify windows of opportunity for the dietary intervention of childhood obesity.

Cholesterol-derived bile acids (BAs) affect numerous physiological functions such as glucose homeostasis, lipid metabolism and absorption, intestinal inflammation and immunity, as well as intestinal microbiota diversity. Diet influences the composition of the BA pool. The present study analyzes the impact of a dietary supplementation with a freeze-dried blueberry powder (BBP) on the fecal BA pool composition. The diet of 11 men and 13 women at risk for metabolic syndrome was supplemented with 50g/day of BBP for 8 weeks, and feces were harvested before (pre) and after (post) BBP consumption. BAs were profiled using liquid chromatography coupled to tandem mass spectrometry. No significant changes in total BAs were detected when comparing pre- vs post-BBP consumption samples. However, post-BBP consumption samples exhibited significant accumulations of glycine-conjugated BAs (p=0.04), glycochenodeoxycholic (p=0.01) and glycoursodeoxycholic (p=0.01) acids, as well as a significant reduction (p=0.03) of the secondary BA levels, when compared to pre-BBP feces (p=0.03). In conclusion, the fecal bileacidome is significantly altered after the consumption of BBP for 8 weeks. While additional studies are needed to fully understand the underlying mechanisms and physiological implications of these changes, our data suggest that the consumption of blueberries can modulate toxic BAs elimination.

The Mediterranean diet represents one of the most studied dietary patterns, however, there is no single tool for measuring the grade of adherence and no single criteria to adapting these indices to pregnant women. We characterized the adherence to the Mediterranean diet (MDA) of pregnant women participating in the NELA cohort and identified the sociodemographic determinants and lifestyle habits associated with a higher risk of a low MDA. Maternal diet during gestation was assessed by a validated Food Frequency Questionnaire (FFQ) (n=665). We estimated Relative Mediterranean Diet score (rMED), Alternative Mediterranean Diet score (aMED) and Alternate Healthy Index-2010 (AHEI-2010). Multivariate regression models were performed to identify the sociodemographic and lifestyle factors associated to each index. Mothers with lower age and more previous deliveries had a greater probability of low MDA (P &lt;0.05). Only, for aMED index, mothers with university education and / or who practiced 2 or more hours per week sport activities had a lower probability of a low MDA (P &lt;0.01). These results may be useful in order to design intervention strategies and dietary recommendation for pregnant women.

The recently defined and yet rather new topic of Healthy aging is gathering more attention on the global stage. With world’s population getting older - it is rapidly becoming very important to develop and maintain functional abilities in older age and develop mechanisms to protect senior population from chronic diseases. One of the most effective components, as well as, one may call - process involved in, and strongly associated with aging is recently discovered and Nobel prize awarded - nitric oxide as a signaling molecule, which followed by later discoveries showed to have a positive metabolic, immune and anti-inflammatory effects. One of the most debated topics of the last decade in the scientific community is nitrates, one of the pathways involved in nitric oxide production. Thus, the objective of this study was to evaluate effect of different potassium nitrate concentrate supplementation on Drosophila melanogaster longevity. 0,5-3% potassium nitrate medium was analyzed on the life span and motor function in different groups consisting of 100 females fruit flies each. In this assay, female fly species supplemented with potassium nitrate diet showed life span increase by 18.6% and 5.1% with 1% and 2% KNO3- respectively with a positive impact on locomotor function. In conclusion, we found that low concentration of potassium nitrate medium increased lifespan and locomotor function in Drosophila melanogaster.

The purpose of this study was to select target nutrients to be included in the nutritional standards of school lunches in Korea. The dietary intake data of children and adolescents aged 6-17 years old from the Korea National Health and Nutrition Examination Survey Ⅵ were analyzed for eight groups based on gender and age (6-8, 9-11, 12-14, and 15-17 years old). First, the usual intake of the 3,091 subjects was estimated and assessed to identify nutrients with insufficient or excessive intake prevalence. Along with the nutrients identified by the assessment, the energy and nutrients prioritized in the meal planning procedure of the 2015 Dietary Reference Intakes for Koreans were the initial candidates: energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, phosphorus, sodium, and iron. Phosphorus was excluded due to little evidence of clinical symptoms caused by insufficient intake. Sodium was excluded because reliable data on added salt were not available among the school lunch recipes in Korea. Therefore, energy, the percentages of energy from carbohydrates, protein, and fat, vitamin A, riboflavin, niacin, vitamin C, calcium, and iron were selected to be included in the nutritional standards of school lunches in Korea.

Dietary guidelines emphasizes the importance of a varied diet to provide an adequate nutrient intake. However, the aging is often associated with consumption of monotonous diets that can be nutritionally inadequate, increasing the risk for the development or progression of diet-related chronic diseases such as the metabolic syndrome (MetS). To assess the relationship between dietary diversity (DD) and nutrient adequacy and to identify associated demographic variables related with DD. We analysed cross-sectional baseline data from the PREDIMED-Plus study: 6587 Spanish adults, aged 55–75 years, with overweight/obesity and MetS. Using a 143-item validated semi-quantitative food frequency questionnaire (FFQ), we calculated an energy-adjusted score of DD (DDS). Nutrient inadequacy was defined as an intake below 2/3 of the recommended dietary intake at least of ≥4 of 17 nutrients. Logistic regression models were used to evaluate the relationship between nutritional inadequate intakes and DDS. In the higher DDS quartile there were more women and less current smokers. Compared with subjects in the highest DDS quartile, those in the lowest DDS quartile had a higher risk of inadequate nutrient intake OR=28.56 (95% C.I. 20.80-39.21). When we estimated diversity for each one of the food groups, participants in the first quartile of diversity had a higher risk of nutrient deficiency: for vegetables, OR= 14.03 (IC 95% 10.55-18.65), fruits OR=11.62 (IC 95% 6.81-19.81), dairy products OR= 6.54 (IC 95% 4.64-9.22) and protein foods OR=6.60 (IC 95% 1.96-22.24). As DDS decreases, the risk of inadequate nutrients intake rises. Given the impact of nutrient intake adequacy on the prevention of non-communicable diseases, health policies should focus on the promotion of a healthy varied diet, specifically promoting the intake of vegetables and fruit among population groups with lower DDS such as men, smokers or widow people.

The geographical environment, food culture, and dietary habits are substantially different between the southern and northern regions in China. We investigated the associations with dietary patterns and metabolic syndrome between Chinese adult from the southern and northern regions (North: 1249; South: 1849) using data from the Chinese Health and Nutrition 2009 survey. Respectively, four dietary patterns were identified by factor analysis in the two regions. Each dietary pattern of factor score was calculated for three groups by tertile (T1<T2<T3). In the northern region, the association between the Alcohol and Western pattern and the risk of abdominal obesity (OR: 1.31; 95%:1.01, 1.68), hypertriglyceridemia (OR: 1.35; 95%:1.05, 1.74), high fasting blood glucose (OR: 1.37; 95%: 1.05, 1.80), and hypertension (OR: 1.55; 95%: 1.45, 1.99) was increased. In the southern region, the Convenience Food pattern was positively associated with hypertriglyceridemia (OR: 1.53; 95%: 1.03, 2.26), low HDL-cholesterol (OR: 1.96; 95%: 1.12, 3.43), and metabolic syndrome (OR: 1.79; 95%: 1.03, 3.11). The Alcohol dietary pattern was positively associated with high fasting blood glucose (OR: 1.83, 95%: 1.13, 2.97). There are some dietary pattern differences in the two regions. It is necessary to consider the factors of food culture and food intake habits in order to provide nutrition education to Chinese individuals from different regions in the future.

This study investigates the impact of the economic downturn induced by the COVID-19 pandemic on nutritional health disparities among women. The research aimed to understand how economic challenges have influenced dietary choices, access to nutritious food, and overall nutritional well-being in different socioeconomic groups of women.Utilizing a mixed-methods approach, the study combined quantitative data from national health and economic databases with qualitative insights from interviews conducted with a diverse group of women. The quantitative analysis focused on trends in nutritional health indicators and economic variables pre- and post-pandemic. Simultaneously, the qualitative component explored personal experiences and perceptions related to nutrition and economic hardships during the pandemic.The findings revealed a significant correlation between the economic downturn and worsening nutritional health among women, especially in low-income and marginalized communities. Women in these groups reported reduced access to healthy food options, increased reliance on less nutritious food due to budget constraints, and a general decline in dietary quality. This decline was less pronounced in higher-income groups, highlighting a clear disparity.Moreover, the study observed that the pandemic exacerbated pre-existing nutritional inequalities, with vulnerable groups experiencing a more pronounced impact. The research also noted that community support systems and public health interventions played a crucial role in mitigating some of these effects.In conclusion, the COVID-19 pandemic has not only posed a direct health challenge but has also indirectly affected women's nutritional health through economic strain. The study underscores the need for targeted nutritional support and economic policies that prioritize the health of women, particularly those from socioeconomically disadvantaged backgrounds.

With rising rates of human obesity, the study aimed to determine the relationship between maternal diet-induced obesity and offspring morphometrics and behaviour in mice. Pregnant and lactating female mice fed a diet high in fat and sugar (HFHS) commonly consumed by human populations showed decreased food, calorie, and protein intake but increased adiposity at the expense of lean mass. The pre-weaning body weight of HFHS offspring was reduced for the first postnatal week but not thereafter with HFHS female offspring having higher body weights by weaning, due to continuing higher fractional growth rates. Post-weaning, there were minor differences in offspring food and protein intake. Maternal diet, however, affected fractional growth rate and total body fat content of male but not female HFHS offspring. Maternal diet did not affect offspring locomotor activity or social behaviour in either sex. Both male and female HFHS offspring displayed reduced anxiety-related behaviours with sex differences in particular aspects of the elevated plus maze task. In the novel object recognition task, performance was impaired in male but not female HFHS offspring. Collectively, the findings demonstrate that maternal obesity alters the growth, adiposity, and behaviour of male and female offspring, with sex-specific differences.

This paper provides a comprehensive review of the current understanding of non-alcoholic fatty liver disease (NAFLD) and its progression to non-alcoholic steatohepatitis (NASH), focusing on key factors influencing its pathogenesis and emerging therapeutic strategies. The background highlights the growing prevalence of NAFLD and NASH, emphasizing their multifactorial nature. The methods section outlines the various contributors to NAFLD development, including genetic, dietary, and environmental factors. The results highlight the intricate interplay between these factors and their impact on hepatic lipid metabolism, inflammation, and insulin resistance. Genetic predisposition, dietary fat intake, and excessive fructose consumption are discussed as significant contributors to NAFLD progression. The conclusions emphasize the lack of a single therapeutic approach and underscore the need for combination strategies. Lifestyle interventions, particularly weight loss through diet and exercise, remain crucial, while pharmacological options like GLP-1 receptor agonists, obeticholic acid, lanifibranor, and resmetirom show promise but require further validation. Bariatric surgery and emerging endoscopic procedures offer potential in eligible patients. In sum, this review underscores the complexity of NAFLD and NASH, advocating for a multifaceted approach to address this increasingly prevalent and clinically relevant condition.

The study's objective was to assess the impact of Mediterranean diet/lifestyle interventions for weight loss on Positive airway pressure (PAP) adherence, Body mass index (ΒΜΙ), sleepiness, and blood pressure measurements (BP) in patients with obstructive sleep apnea (OSA). We designed a randomized, controlled trial, including overweight and obese patients with moderate-to-severe OSA, randomized to standard care (SCG, n=37) and Mediterranean diet group (MDG, n=37). SCG received healthy lifestyle advice, while MDG underwent a 6-month behavioral intervention aiming to enhance weight loss and adherence to Mediterranean diet. PAP adherence, BMI, Epworth Sleepiness Scale (ESS) and BP measurements were evaluated pre- and post-intervention. Post-intervention PAP use was higher in MDG compared to SCG (6.1 vs 5.4, p=0.02). Diet/lifestyle intervention was one of the most significant predictive factors for PAP adherence (OR = 5.458, 95% CI = 1.144-26.036, p=0.03). The SCG demonstrated a rise in BMI, while the MDG displayed a decline (0.41 vs -0.75, p=0.02). The MDG also demonstrated a substantial reduction in adjusted SBP (-5.5 vs 2.8, p=0.014) and DBP (-4.0 vs 2.5, p=0.01). Ultimately, incorporating a dietary/lifestyle intervention with standard care yields superior PAP adherence, BMI, and BP measurements in contrast to standard care alone, underscoring the potential benefits of allocating increased time and support within the MDG group. Trial registry: ClinicalTrials.gov; No.: NCT05881824; URL: www.clinicaltrials.gov.

Hypertension and arterial stiffness are the main factors contributing to cardiovascular disease. L-citrulline, a nitric oxide precursor, has been proposed as a blood pressure-lowering intervention. This study aimed to investigate the impact of L-citrulline on central and peripheral blood pressure, arterial stiffness, and muscle oxygenation at rest and during an isometric knee extension exercise protocol. Twelve older males received 6 g of L-citrulline or a placebo for six days using a double-blind crossover design. Blood hemodynamics parameters (i.e., arterial and brachial systolic and diastolic blood pressure, mean arterial pressure, pulse pressure, heart rate), arterial stiffness (i.e., augmented pressure, augmentation index, forward, backward wave pressure and carotid-femoral pulse wave velocity) and muscle oxygenation [i.e., oxyhemoglobin (Δ[O2Hb]) and deoxyhemoglobin (Δ[HHb]), total hemoglobin concentration (Δ[tHb]) and tissue saturation index (TSI%)], were measured at baseline, post-supplementation and during isometric exercise. No significant effects of L-citrulline supplementation were observed at rest or during exercise on blood pressure, arterial stiffness, and muscle blood flow. Both central and peripheral blood pressure were increased during the exercise, which is consistent with isometric contractions. The results of the present study question the efficacy of short-term L-citrulline in decreasing blood pressure at rest or attenuating blood pressure increases during isometric exercise.

This study empirically investigates the effect of productive safety net programme (PSNP) on household food consumption and dietary diversity in Ethiopia. The study applied random effects with instrumental variable to estimate the effect of PSNP membership. The result of the study indicates that though PSNP membership improves household food consumption, it reduces household dietary diversity score. Household food consumption and dietary diversity are also significantly influenced by sex, age, education status of household head, household size, livestock ownership, distance to the nearest market and participation in non-farm activities. The findings of this study suggest that PSNP membership should be reinforced by building household awareness of the benefits of consuming a variety of foods. In addition, PSNP membership should be designed to endow the households to accumulate essential assets, especially livestock.

Understanding potential uptake and biodistribution of engineered nanoparticles in soil-grown plants is imperative for toxicity and risk assessment considering the oral exposure of edibles by humans. Herein, we assessed potential influence of particle size (25, 50, and 250 nm) and concentration (0, 50, 100, 200, and 500 mg/kg-soil) of Copper oxide nanoparticles (CuONPs) on: (1) the root system architecture, and the physicochemical attributes of soil at the soil-root interface, (2) leading to Cu transport and accumulation in root, stem, leaf and seed in soybean (Glycine max cv Kowsar) grown for entire lifecycle of 120 days, and compared with soluble Cu²⁺ ions and water-only controls, and (3) performed a comparative assessment of total seed Cu levels in soybean with other valuable food sources for Cu intake and discussed its human health implications. Our findings showed particle size- and concentration-dependent influence of CuONPs on Cu uptake and tissue distribution in root, stem, leaf and seed in soybean. Alterations in root architecture (root dry weight, root length, root volume, and root area) were dependent on the Cu compound type, Cu concentrations, and their interactions (p<0.05), except for root density. Concentration-response relationships for all three sized CuONPs, and Cu²⁺ ions, were linear. CuONPs and Cu²⁺ ions had inhibitory effects on root growth and development. Overall, soybean responses to smallest size CuONPs-25 nm were higher for all parameters investigated compared to two larger sized CuONPs (50 nm, 250 nm) or Cu²⁺ ions. Cu uptake/bioaccumulation differed among soybean tissues in the order: root > leaf > stem > seed. Despite reduced root architecture and seed yield, our smallest size CuONPs-25 nm led to increased total seed Cu uptake compared to the larger sized CuONPs and Cu²⁺ ions tested. Our findings also suggest that soil amendment by CuONPs, more so by the smallest size CuONPs-25 nm, could significantly improve nutritional Cu value in soybean seed as reflected by % Daily Values (DV), and are rated “Good” to “Very Good” according to the “World’s Healthiest Foods” rating. However, until the potential toxicity and risk from consumption of soybean seed is characterized in humans, caution should be exercised when the Cu fortified seeds are used for daily human consumption when addressing Cu deficiency and associated illnesses, globally.

Food exchange lists have been widely used in dietary practice in health and disease situations, but there are still no exchange lists for sports foods. The aim of this study was to develop a sports foods exchange list based on previously published statistical criteria. A cross-sectional study of the nutritional composition of sports foods, regarding macronutrients and energy, was carried out. A total of 323 sports foods from 18 companies were selected and divided into seven groups: sports drinks; sports gels; sports bars; sports confectionery; protein powders; protein bars; and liquid meals. A sports foods composition database based on portion size was created. Food exchange groups, with the definition of the amounts - in grams - of each sports foods within each group, were designed using the same methodology and statistical criteria as previously published. The nutritional composition of the portions usually consumed by athletes and/or recommended in commercial packaging was used to calculate the mean energy and macronutrient values for each group. Within each sports foods group, different subgroups were defined due to differences in the main and/or secondary macronutrient. The mean nutrient values of each exchange group and the subgroups were determined according to previously established rounding criteria. This sports foods exchange list, made up of commercial sports products, is a novel tool for dietetic practice. Its management will allow dietitians to adapt dietary plans more precisely to the training and/or competition of the athlete.

Socioeconomically disadvantaged people are disproportionally more likely to develop obesity and obesity-related diseases. However, it remains unclear to what extent diet quality contributes to socioeconomic inequalities in obesity. We aimed to assess the role of diet quality in the association between socioeconomic status (SES) and obesity. Data originated from the national nutrition survey, a cross-sectional sample of the adult Swiss population (N=1860). We used education and income as proxies for SES; calculated the Alternate Healthy Eating Index (AHEI) as measure of diet quality; and used body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) as obesity markers. We applied counterfactual mediation modelling to generate odds ratios, 95% confidence intervals, and the proportion mediated by diet quality. Individuals with less than a tertiary education were two to three times more likely to be obese, regardless of the marker (OR; 95% CI: 3.36 (2.01, 5.66) using BMI; 2.44 (1.58, 3.75) using WC; 2.48 (1.63, 3.78) using WHR; and 2.04 (1.43, 2.96) using WHtR). The proportion of the association between educational level and obesity that was mediated by diet quality was 22.1% using BMI, 26.6% using WC, 31.4% using WHtR, and 35.8% using WHR. Similar findings were observed for income. Our findings suggest that diet quality substantially contributes to socioeconomic inequalities in obesity while it does not fully explain them. Focusing efforts on improving the diet quality of disadvantaged groups could help reduce social inequalities in obesity.

myfood24 is a comprehensive self-completed online 24-hour dietary recall tool currently used for nutritional assessments in epidemiological research. However, its clinical application has been unexplored. This mixed methods prospective observational study explores the acceptability and usability of myfood24 in a clinical population, women with gestational diabetes (GDM). Women were recruited at their first diabetes antenatal clinic appointment. To assess acceptability and usability, they were asked to complete five 24-hour dietary recalls using myfood24 over two weeks and a user experience questionnaire; with a subset invited to participate in a one-to-one semi-structured interview. Of the 199 participants, mean maternal age was 33 years, mean booking BMI 29.7kg/m2, 36% primiparous, 57% White, 33% Asian. Of these 121 (61%) completed myfood24 at least once and 73 (37%) completed the user questionnaire; 15 were interviewed. Usability of myfood24 was measured using the System Usability Scale (SUS) and found to be good (mean 70.9, 95%CI 67.1, 74.6). Interviews identified several areas for improvement, including optimising its use for mobile devices. myfood24 appears to be acceptable and have potential to support self-management and behaviour change for women with GDM but requires adaptation to record blood glucose results alongside real-time tracking of diet.

Thyroid nodules (TNs) are common thyroid lesions in older population. Few studies focused on the prevalence of TNs and its relationship to lifestyle characteristics and dietary habits in centenarians. The current study aimed to determine the prevalence of TNs in Chinese centenarians using high-resolution ultrasound equipment and investigate its relationship to lifestyles and dietary habits. The current study was part of China Hainan Centenarian Cohort Study (CHCCS) which conducted in Hainan, an iodine sufficient region in China. A total of 874 permanent residents aged 100 years or older (mean age, 102.8 ± 2.8 years) without any missing data were included in the analysis. Among the participants, 649 of them were detected at least one thyroid nodule under the ultrasound examinations. The overall prevalence rate of TNs was 74.3%. The prevalence of TNs was higher in participants who were females, hypertension, diabetes, and underweight than their counterparts. Multivariate logistic regression analyses showed that being female, hypertension, diabetes, betel quid consumption, red meat consumption were independent risk factors, while being underweight, and nut consumption were independent protective factors for TNs. Our findings indicate that the presence of thyroid nodules was highly prevalent in Chinese centenarians, particularly in females. In addition to gender, hypertension, diabetes, and underweight, the presence of TNs was independently associated with betel quid, red meat, and nut consumptions. Further prospective studies are warranted to verify these associations in population from different age strata, races, cultures, and iodine backgrounds.

.Celiac disease (CeD) is a chronic, autoimmune disorder triggered by the ingestion of gluten, affecting around 1% of the global population. It is a multifactorial disease involving both genetics and environ-mental factors. Nowadays, the only available treatment for CeD is a life-long gluten-free diet (GFD), which can cause a significant burden for patients, since symptoms and mucosal injury can persist de-spite apparent compliance with a GFD. That could also lead to psychological consequences and affect the quality of life of these patients. Thankfully, recent advances in understanding the pathogenesis of CeD and the availability of various targets have made it feasible to explore pharmaceutical treatments specific to CeD. Recently, the FDA has highlighted the unmet needs of adult patients on GFD who expe-rience ongoing symptoms attributed to CeD and also show persistent duodenal villous atrophy. This re-view will outline the limitations of a GFD, describe the targets of potential novel treatment of CeD and provide an overview of the primary clinical trials involving oral and injectable agents for a non-dietary treatment of CeD.

Veganism and the interest towards a plant-based diet are experiencing exponential growth worldwide, and in Italy more and more individuals and families are adopting this lifestyle and diet, too.Such a change in eating habits also imperatively implies the support and expertise of medical and health care professionals, who to date are still often unprepared and skeptical about this dietary pattern, despite scientific evidence.

Dietary habits, including meal frequency, meal timing, and skipping meals, have been extensively studied due to their association with the development of non-communicable diseases (NCDs). This study describes dietary habits, meal timing, meal frequency, skipping meals, and late-night eating in Kuwaiti adults. The Kuwait National Nutrition Surveillance System data was utilized to reach the objectives of this study. The findings reveal that approximately 50% of the adults in Kuwait eat after 10 p.m., 29% skip breakfast, and 9.8% skip dinner. Furthermore, adults in Kuwait consume 4.4 meals per day on average. Women skip breakfast more often and have extended night fasting than men (p&lt;0.001). Married adults skip breakfast and dinner less than unmarried adults (p&lt;0.001). In conclusion, this descriptive study provides valuable insights into the dietary habits of Kuwaiti adults, emphasizing the importance of further investigating the association between meal timing, meal frequency, and the prevalence of NCDs in Kuwait.

We investigated whether cigarette smoking and dietary acid load (DAL) are associated with the risk of chronic obstructive pulmonary disease (COPD) in middle-aged healthy Korean men. Healthy men without diagnosed chronic disease (40-64 yrs) from the KNHANES-VI (2013–2015) included in the analysis (n=774) were subdivided by smoking status and DAL levels as estimated by the net endogenous acid production (NEAP) quartile. Current smokers tended to have a higher risk of COPD than non-smokers before and after the adjustment. When divided by the DAL quartile, the Q4 tended to have a higher risk of COPD than the Q1. Additionally, current smokers with lower (Q2), modest (Q3), and highest NEAP scores (Q4) showed more than 4-fold higher risks of COPD than the non-smokers with the lowest NEAP scores (Q1). Ex–smokers with higher NEAP scores (Q3 and Q4) showed more than 4-fold higher risks of COPD than the Q1. Interestingly, the risk of COPD was also more than 6-fold higher in non-smokers with the highest NEAP scores compared to the Q1. NEAP scores and smoking status synergistically increased the risk of COPD in middle-aged healthy Korean men. It suggests that DAL levels are an important factor for the prevention and management of COPD.