There is evidence that optimal nutrition is fundamental to human health and in the prevention of non-communicable diseases (NCDs) later in adult life. The identification, production and consumption of functional foods worldwide can increase health benefits for all who can access and afford such foods subject to advice from nutritionists. Recent meetings organized by the health agencies, give a crucial opportunity to make nutrition, a central part of the post-2015 sustainable human and agricultural development agenda. The aim of discussions in these meetings was to provide functional crops and foods to achieve optimal health by prevention of NCDs. It is possible that these efforts might ensure that the goals and targets set in the agenda are adequate to address the many challenges of global undernutrition as well as obesity which are major risk factors of NCDs. In many developing and middle income countries, food security provided by the governments, in one sense understandably, gave least consideration to functional foods supply and the prevention of obesity and metabolic syndrome, resulting in to emergence of NCDs. The Thailand Declaration reiterates that commitments to eradicate hunger and undernutrition as well as over-nutrition, and to increase investments in effective interventions; designers foods and designers crops. However, in planning coherent policies, our past experience on rapidly absorbed, energy-rich processed foods should be taken in to account while developing sustainable food systems. The food industry should be educated to exploit the expertise of food scientists and health professionals in designing functional foods taking cognizance of manufacturing and processing. Similarly, agriculture scientists may be actively involved in educating farmers so as to grow cash crops providing functional foods. The aim should be to achieve an increase in the availability of functional foods to an extent, or by a policy, by which such foods are available to poors, at affordable cost to prevent hunger and undernutrition and related diseases as well as NCDs. In addition our efforts might help in developing an international consensus on how to approach the development of new designer foods by farmers and food industry to produce low glycemic index foods. Such efforts may establish an international framework for the prevention of NCDs, so that human susceptibility to these diseases is substantially diminished.

A total of 473 metabolites were identified from 4 sour cherry genotypes using UPLC-TOF-MS. Untargeted metabolomics revealed the dominant chemical groups present in sour cherries. PCA showed that the diversity in sour-cherry metabolites was due to the genotype differences indicating iditol, malic acid, chlorobenzene, 2-mercaptobenzothiazole, and pyroglutamic acid as the predominant contributors. The variable importance in the projection (VIP > 1.0) in partial least-squares–discriminant analysis described 20 biomarker metabolites, representing the cherry metabolome profiles. A heatmap of Pearson’s correlation analysis between the 20 biomarker metabolites and antioxidant activities identified seven antioxidant determinants that displayed the highest correlations with different types of antioxidant activities. This study of correlating metabolomics and antioxidant activities elucidated that the higher nutritional value and biological functions of select sour cherry genotypes can be useful for the development of nutraceutical and functional foods.

Local food has continued to become more popular in both the home and as featured ingredients in all segments of food service. Numerous studies have explored the motivating factors for consumer purchasing motivators. However, no known study has explored if there is a correlation between ego and intent to buy local foods. This study adopted a modified version of the Theory of Trying and surveyed a sample of 237 food service buying agents in South Carolina to examine their perceptions of buying local. Results suggest that ego is a predictor of trying to purchase local foods for restaurants. It was also found that the modified model is an acceptable model for predicting buyer intent. These findings support the majority of the studies looking at ego-centric behaviors with green purchases and could potentially help local food suppliers to better market their products to foodservice establishments. This study could also act as the foundation for future studies to explore the full extent of ego’s motivational effect on purchasing intentions in the food service industry.

The ubiquitous presence of microplastics (MPs) in the environment poses a threat to ecosystems and increases concerns about their exposure to the human body. However, despite being consumed for health improvement, limited research has been conducted on MPs in functional foods. This study aimed to investigate the occurrence of MPs and the relation of the source of raw material or the manufacture in various omega-3 oil in the Korean market. MPs in omega-3 capsule and raw oil, sourced from both plant-based (PB) and animal-based (AB) sources, were investigated. We developed the method by direct filtration with acetone washing and analyzed MPs greater than 5 μm using microscope-Raman spectroscopy. The average number of MPs was found to be 1.2 ± 1.7 MPs/g for PB raw oil, 2.2 ± 1.7 MPs/g for AB raw oil, 3.5 ± 3.9 MPs/g for PB capsule oil, and 10.6 ± 8.9 MPs/g for AB capsule oil. Polypropylene and polyethylene terephthalate were major specious (83-95 %) found in omega-3 oil. The ratio of size range remained consistent across all groups, with a trend of higher detection rates as the size diminished. The results reveal that the main reason of MPs contamination is not the source of raw material but the manufacturing and packaging process for omega-3 oil.

Herbal Coffee is getting more popular due to its unique flavor and higher concentration of bioactive compounds, mainly polyphenols. Rosemary is a unique herb with potent antioxidant properties. A green technique called ultrasound aids in releasing bioactive substances from the plant cell wall. In this context, ultrasound-assisted herbal coffee prepared and their anti-diabetic, anti-Alzheimer, and antioxidant activities were measured while the LC/MS was used to determine the bioactive components from the herbal coffee infusion. A total of 95 secondary metabolites were putatively reported, including alkaloids, phenolic acids, and flavonoids, which we identified in the herbal coffee infusion. The total phenolic content (61.5 ± 5.1 mg GAE/g), total flavonoid content (19.3 ± 0.9 mg QE/g), and total condensed tannin (7.6 ± 0.7 mg CE/g) of herbal coffee infusion were observed to be highest of the two remaining samples. The herbal coffee extracts were used to determine all samples' antioxidant, anti-diabetic, and anti-Alzheimer activities. Using LC-MS/MS, we semi-quantified 19 phenolic metabolites. The results show numerous bioactive components in herbal coffee infusion with more potent antioxidant, antidiabetic, and anti-Alzheimer potential. Moreover, more studies must be conducted to confirm how the metabolomic profile of herbal coffee affects its flavor profile.

Pigmented corn is a gramineae food of great biological, cultural and nutritional importance for many Latin American countries, with more than 250 breeds in the American continent. It confers a large number of health benefits due to its diverse and abundant bioactive compounds. In this narrative review we decided to organize the information on the nutrients, bioactive compounds and phytochemicals present in pigmented corn, as well as their effects on human health. Phenolic compounds and anthocyanins are some of the most studied and representative compounds in these grasses, with a wide range of health properties, mainly the reduction of prooxidant molecules. Carotenoids are a group of molecules belonging to the terpenic compounds, present in a large number of pigmented corn breeds, mainly the yellow ones, whose biological activity incorporates a wide spectrum. Bioactive peptides can be found in abundance in corn, having very diverse biological effects that include analgesic, opioid, antihypertensive, etc. activity. Other compounds with biological activity found in pigmented corn are resistant starches, some fatty acids, phytosterols, policosanols, phospholipids, ferulic acid and phlobaphenes, as well as a great variety of vitamins, elements, and fibers. This review aims to disseminate and integrate the existing knowledge on compounds with biological activity in pigmented corn, in order to promote their research, interest and use by scientists, nutrition professionals, physicians, industries and the general population.

ABSTRACT After locavore was chosen as “the best word of the year” in 2007, its popularity increased gradually. Today great number of locavores consciously prefer locally produced food for the benefit of themselves and their community. Undoubtedly this conscious movement has its consequences in marketing discipline. Accordingly, this paper is purposed to examine the how locavore perceptions affect loyalty towards retailers that sell locally produced food. In this context, a survey was applied to people residing in Istanbul and Kocaeli districts to measure the robustness of these effects. Furthermore, attitude towards locavore is used as a control variable to reveal to what extend locavorism affects these proposed connections. According to results, for participants with low attitude, Social Responsibility and Health Consciousness variables have significant effect on local retailer shopping loyalty. However, for participants with high attitude, all independent variables proved to have substantial effect on local retailer shopping loyalty. As the first empirical study in Turkey on the subject, this paper will provide important insight to academia and practicioners due to today’s ever-increasing consciousness in green marketing.

Background: Vitamin D and calcium are important dietary compounds that affect bone mass, even if other minerals (potassium, zinc, etc.) and other vitamins (A, C and K) are also involved. Vitamin D and other minerals, in fact, play an important role in calcium homeostasis and calcium absorption. Hip fractures incidence is higher in western countries, where calcium is frequently included in human diet, while the occurrence of these fractures is lower in developing countries, where diets are often poor in calcium. This situation is known as the “calcium paradox”, and may be partially explained considering phosphate toxicity, that can induce a disorder of mineral metabolism. It is important to maintain adequate dietary calcium-phosphate balance in order to perform a healthy life, reducing the risk of osteoporotic fracture in older people. Vitamin D can also act as a hormone; vitamin D2 (ergocalciferol) is derived from the UV-B radiation of ergosterol, the vitamin D precursor naturally found in plants, fungi, and invertebrates. Vitamin D3 (cholecalciferol) is originated by sunlight exposure from 7-dehydrocholesterol, a precursor of cholesterol that can also act as a provitamin D3. Dietary intake of vitamin D3 is very important when skin is exposed for short times to ultraviolet B light (UV-B) one of the three kinds of invisible light rays together with UV-A and UV-C. This can be considered the usual situation in northern latitudes and in winter season, or the typical condition for older people and/or for people with very white delicate skin. Actually, the recommended daily intake of dietary vitamin D is strictly correlated with age, ranging from 5 μg for infants, children, teen-agers and adults, including women during pregnancy and lactation, to 15 μg for people over 65 years.

Oyster mushroom (Pleurotus ostreatus), nopal (Opuntia ficus-indica) and amaranth (Amaranthus spp.) are pre-hispanic foods widely consumed in Mexico. However, there are no standard products developed with these ingredients as functional cookies. This study evaluated the impact of partial replacement (50%) of whole-wheat flour (WWF) with three formulations of P. ostreatus, nopal and amaranth flours (POF, NF and AF, respectively) in the nutritional/antioxidant properties of fortified cookies. The proportion of flours´ ingredients (WWF:AF:NF:POF) were 100% WWF (traditional cookies), 50:35:10:5 (formulation 1), 50:30:15:5 (formulation 2) and 50:40:5:5 (formulation 3). Proximal composition, phenolic/flavonoid contents, and ABTS+ scavenging activity were determined in flours and cookies. POF, NF and AF possess a high nutritional value comprising polyphenols/flavonoids and a significant antioxidant potential. Total protein, ashes and flavonoids were higher in fortified cookies than controls. Cookies prepared with Formulation 2 -highest nopal level- contained 5.29% of dietary fiber and 5-times higher polyphenol content than control cookies. The ABTS+ scavenging ability was similar in the three enriched cookies (87.73-89.58%) but higher than traditional cookies (75.60%). Applicability of POF/NF/AF for replacing up to 50% of WWF in production of functional cookies was demonstrated. The research promotes renewable local bioresouces for a sustainable agri-food chain, especially edible mushrooms.

Inconsistent results published in previous studies make it difficult to determine the precise effect of consumer knowledge on their acceptance of functional foods, which were developed to improve consumers’ health status by providing adequate nutrition. We conducted a systematic review and meta-analysis by identifying and collecting relevant literature from three databases. Of the 1050 studies we reviewed, we included 40 in the systematic review and 18 in meta-analysis. Based on the focus of each included study, we operationally defined knowledge as knowledge of the functional food concept, nutritional-related knowledge, and knowledge of specific functional products. Results from the systematic review indicate that most participants from the included studies had a low level of knowledge, especially nutrition-related knowledge associated with consuming functional foods, and they were generally not familiar with the concept of functional foods. It is possible that participants’ level of knowledge was influenced by their demographic characteristics (e.g., age, gender, educational level, marital status, nationality). Results from the meta-analysis generated a summary effect size (r = 0.14, 95% CI [0.05; 0.23]), measured by the correlation coefficient r, which indicates that a small positive relationship exists between consumers’ level of functional foods knowledge and their acceptance of functional foods.

The microbioma is presently one of the hottest areas of scientific and medical research and exerts a marked influence on the host during homeostasis and disease. Fermented foods arise in the human relationship to the microbial environment. Further to the traditionally recognized effects of fermented foods and beverages on the digestive health and well-being there is now strong evidence on their general health benefits, namely the significance on the gut microbiota and brain functionality. We highlight the possibilities in this field, how little is still known, and call for a convergence of interdisciplinary research fields of One Health microbe-nutrition with fermented foods and gut-brain research. A consequence of civilisation, changes in present-day society in diets with more sugar, fat and salt, habits and lifestyle, contributes to the likelihood of an inflammatory microbiome, particularly the global epidemics of obesity and mental health. Although two recent papers claim that probiotics perturb rather than aid in microbiota recovery back to baseline after antibiotic administration in humans, consuming fermented foods has shown to reduce inflammation so improve gut health and the proper function of the body’s immune system.

Cholesterol is a lipid-derived substance found in lipoproteins and cell membranes. It is also one of the main sources for the production of bile acids, vitamin D, and steroid hormones. Today, foods are evaluated by consumers not only according to their taste and nutritional content but also according to their effects on consumer health. For example, many consumers choose foods according to their cholesterol level. The cholesterol in the food can directly affect the blood cholesterol level when consumed, which can lead to cardiovascular diseases. High levels of cholesterol can lead to diet-related human diseases such as cardiac arrest, paralysis, type II diabetes cerebral hemorrhage. In societies with high living standards, interest in and consumption of foods that lower or have low cholesterol levels have increased recently. Accordingly, efforts to increase the variety of foods with reduced cholesterol levels are on the rise. This has indirectly insulted in accurate measurement of cholesterol levels in blood and food being of great importance. Classical chemical, enzymatic, colorimetric, polarographic, chromatographic, spectrophotometric methods, and enzymatic, nonenzymatic, and electrochemical sensors and biosensors are used for the determination of cholesterol in foods. The purpose of this review is to reveal and explore current and future trends in cholesterol detection methods in foods. The review will summarize the most appropriate and standard methods for measuring cholesterol in biological components and foods.

Advanced food processing techniques have drastic effects on the food, mainly on the nutritional profile; furthermore, the sedentary lifestyle led by people makes the body starve for nutrients and has a negative impact on proper growth and health. Addressing those major issues, various organic and functional foods have been widely recognised in recent times. The current work intends to prepare and evaluate a functional food made out of Aloe Vera. The health claims of Aloe Vera were uncountable. From the organoleptic profiling of the milk shake up to the 5% addition of Aloe Vera, all the sensory parameters were more satisfying. Incorporating Aloe Vera in the milkshake will be an innovative novel food product while enhancing the functional properties of Aloe Vera.

Among young children, parents are a main factor of children's preferences for food served as they are responsible for purchasing and providing Functional Foods (FFs) and they are role models for them. This revies study conducted according PRISMA guidelines and aimed to review the recent data about the consumption of FC into families as part of a balanced diet. The literature search was conducted via online academic search engines PubMed, ResearchGate and Google Scholar. The search process was restricted to research papers published in English in reviewed journals from 2012 to 2023. Thirty six articles were ultimately included in the present review. The results showed that there is a correlation between several socio-demographic and a higher probability of buying FFs for children. There is a positive effect on purchasing frequencies of gender (female), higher household annual income and education level, together with higher levels of nutritional knowledge and trust in positive scientific evidence regarding FFs. Also, parents’ socio-demographic factors affect the children’s F/V consumption. The summary of evidence concludes on the point that parents are the role models about their children’s eating behavior and eating habits.

Fermented food products are widely consumed for their nutritional and health-promoting properties earning them a central place in diets around the globe. However, these foods can present a paradox, as they have the potential to harbor not only beneficial probiotics but also antibiotic-resistant (AR) microbes and genes. The impact of AR in fermented foods has far-reached implications, such as its potential effects on human health, repercussions in the food industry, and environmental consequences. An in-depth analysis of AR in fermented foods, including dairy products, fermented fruits and vegetables, meat products, and beverages, would provide insights into the extent and ramifications of the issue with these foods. Therefore, this review systematically presents the status of AR in fermented foods, with a particular focus on AR bacteria and genes within this category of food products. The review also highlights the complexities of AR in fermented foods, emphasizing the role of bacterial adaptation during the fermentation process and the dynamics of bacterial gene transfer. Various contributing factors to AR are brought into focus, including intrinsic resistance among bacteria in fermented foods and the potential risk of contamination with pathogenic bacteria. Moreover, this review presents a range of mitigation strategies, from the development of novel antimicrobials to advances in fermentation technology and regulatory control. This comprehensive perspective on the intricate interplay between AR and fermented food will potentially pave the way for more targeted research and mitigation strategies in this critical area.

Fructan, a fructose polymer, is used as carbohydrate reserve in many plants. The nutritional and therapeutic benefits of fructans have attracted increasing interest by consumers and food industry. In the course of evolution, many plants have developed the ability of regulating plant frunctan metabolism genes to produce different structures and chain length fructans, which are strongly correlated with their survival in harsh environments. De nevo domestication of fructan-rich plants based on genome editing is a viable and promising approach to improve human dietary quality and reduce the risk of chronic disease. These advances will greatly facilitate breeding and production of tailor-made fructans as a healthy food ingredient from wild plants such as polygonati rhizoma. The purpose of this review is to broaden our knowledge on plant fructan biosynthesis, evolution and beneficial applications for human health.

The changes in consumer preferences and the increasingly competitive global market have demanded that food entrepreneurs engage in innovative value-added activities. The date is a delicatessen fruit known by its content of active compounds (e.g., dietary fiber and antioxidants) and its biological activity which has a vast potential in the design of new products such as bioactive ingredients, sugar substitutes, dietary supplements, functional foods, among others. In the current paper, innovative approaches to the value addition to date fruits and their processing by-products have been reviewed from recent high-quality scientific works. New processes such as ultrafiltration and hydrothermal treatments are shown as a useful alternative to obtain differentiated date-based ingredients (e.g., fiber concentrates, sap syrups, and date powders). Moreover, the use of date fruits and their byproducts as natural sources of value-added active compounds in the preparation of dairy, meat, and bakery and cereal products is also presented.

Diabetes mellitus (DM) comprises a range of metabolic disorders characterized by high blood glucose levels caused by defects in insulin release, insulin action, or both. DM is a widespread condition that affects a substantial portion of the global population, causing high morbidity and mortality rates. The prevalence of this major public health crisis is predicted to increase in the forthcoming years. Although, several drugs are available to manage DM, these are associated with adverse side effects, which limits their use. In underdeveloped countries, where such drugs are often costly and not widely available, many people continue to rely on alternative traditional medicine, including medicinal plants. The latter serve as a source of primary healthcare and plant-based foods in many low and middle-income countries. Interestingly, many of the phytochemicals they contain have been demonstrated to possess antidiabetic activity such as lowering blood glucose levels, stimulating insulin secretion and alleviating diabetic complications. Therefore, such plants may provide protective effects that could be used in the management of DM. The purpose of this article was to review the medicinal plant-based foods traditionally used for the management of DM, including their therapeutic effects, pharmacologically-active phytoconstituents and antidiabetic mode of action at the molecular level. It also presents future avenues for research in this field.

Type 2 Diabetes (T2D) is a growing global health problem that requires new and effective prevention and management strategies. Recent research has highlighted the role of epigenetic changes in the development and progression of T2D, and the potential of functional foods as complementary therapy for the disease. This review aims to provide an overview of the current state of knowledge on the preventive epigenetic mechanisms of functional foods in T2D. We provide background information on T2D and its current treatment approaches, an explanation of the concept of epigenetics, and an overview of the different functional foods with demonstrated preventive epigenetic effects in T2D. We also discuss the epigenetic mechanisms by which these functional foods prevent or manage T2D and the studies that have investigated their preventive epigenetic effects. In addition, we revisit works on the beneficial influence of functional foods against the programming and complications of parentally-triggered offspring diabetes. We also postulate, albeit based on the scarce data, that epigenetic inheritance mechanistically mediates the impacts of functional nutrition against the metabolic risk of diabetes in the offspring. Finally, our review highlights the importance of considering the preventive epigenetic mechanisms of functional foods as a potential avenue for the development of new prevention and management strategies for T2D.

Bioactive compounds are the food constituents, providing beneficial health effects to functional foods and nutraceuticals. These compounds have antioxidants activity including anti-inflammatory, antifungal, and have additional preventative actions. Since these compounds are important constituents enhancing function of the foods, therefore, these constituents are necessary to be incorporated under the umbrella of functional foods. Functional foods provides health benefits though bioactive compounds, as these compounds target mechanisms that manage, prevent, and/or treat chronic or acute diseases. The bioactive compounds are quite essential for functional foods that are crucial for optimal health, thereby leading to the inclusion of these compounds in the most recent definition of functional foods. Some experts have defined that bioactive compounds are the chemical components that contributes and regulates in biological mechanisms. These bioactive compounds are more accurately defined by Dr. Martirosyan and Pisarski as the “primary and secondary metabolites of nutritive and non-nutritive natural components generating health benefits by preventing or managing chronic disease or its symptoms”. These compounds have potential antioxidant and anti-inflammatory activity, which provide benefits to health. Although they are a small proportion of a food source, these compounds can also trigger the mechanisms that will alter and can improve human health. Certain bioactive compounds present in foods are extremely beneficial, but if consumed in excess, they can cause toxicity. Therefore, each bioactive compound must be fully evaluated in order to establish a beneficial and a toxic threshold amount.

Chronic diseases (e.g., heart disease, cancer, diabetes) are of major public concern. Such chronic diseases are often caused by a dietary pattern characterized as relatively high in fat, refined sugar, salt, and cholesterol. Societal interest in consuming healthy foods and the demand for healthy food products has increased significantly. As a result, functional foods have gained significant research attention in the food health and technology innovations field. To date, many studies have investigated the factors that may predict consumer acceptance of functional foods, and a wide range of influential factors have been reported. However, studies conducted in different contexts pose challenges to gaining a clear understanding of the factors influencing consumer acceptance. This scoping review identified 75 articles published with varying populations around the globe that empirically investigated consumers’ acceptance of functional foods. We identified and categorized a wide range of determinants related to consumer acceptance of different types of functional foods. The five categories of determinants were product characteristics, socio-demographic characteristics, psychological characteristics, behavioral characteristics, and physical characteristics. Each of the determinants were more fully described by sub-determinants in our scoping review. These determinants should be considered and used by leaders and scientists in product development to aid decision making and, ultimately, the successful launch of novel functional foods.

The current performance indicator for universal salt iodization (USI) is the percent of households using adequately iodized salt. However, the proportion of dietary salt from household salt is decreasing with the increase in consumption of processed foods and condiments globally. This paper reports on case studies supported by the GAIN-UNICEF USI Partnership Project to investigate processed food industry use of adequately iodized salt in contrasting national contexts. Studies were conducted in Egypt, Indonesia, the Philippines, the Russian Federation, and Ukraine. In all cases, the potential iodine intake from iodized salt in selected food products was modelled according to the formula: Quantity of salt per unit of food product x minimum regulated iodine level of salt at production x average daily per capita consumption of the product. The percent of adult recommended nutrient intake for iodine potentially provided by the average daily intake of bread and frequently consumed foods and condiments was from 10% to 80% at the individual product level. The potential contribution to iodine intake from the use of iodized salt in the processed food industry is of growing significance. National USI strategies should encourage co-operative industry engagement and include regulatory monitoring of iodized salt use in the food industry in order to achieve optimal population iodine status.

Zn is an essential element for children related to optimal growth, development and nutritional metabolism. We measured Zn bioaccesibility (Zn-BA) levels of foods by Inductively coupled plasma mass spectrometry (ICP-MS) after in vitro digestion-fermentation method from children with gluten related disorders (GRD-CH), obesity (OB-CH) and allergy/intolerance to cow’s milk proteins (AICM-CH). Zn-BA levels in sick children (34.7 ± 28.8, 29.6 ± 30.1 and 26.7 ± 30.4%, respectively) were significantly lower (p < 0.05) than in healthy norm-weight children (HE-CH). For AICM-CH, Zn-BA in animal foods was significantly lower than in plant foods, and in both plant and animal foods from sick and healthy children (p < 0.05). In foods of animal origin in sick and healthy children, Zn-BA in foods heated in liquid media (frying and boiling) was significantly higher than in foods heated by hot air (roasting and grilling). In conclusion, in children the studied diseases diminished the Zn-BA, probably by the alteration of the gut microbiota which could negatively affect their appropriate long-term development. In AICM-CH, the allergy to cow's milk proteins could induce intestinal dysbiosis and inflammatory processes, leading to allergies to other animal food proteins, and to a more pronounced decrease of Zn-BA.

Lifestyle is the primary prevention of diabetes, especially type-2 diabetes (T2D). Nutritional intake of olive oil (OO), the key Mediterranean diet component has been associated with the prevention and management of many chronic diseases including T2D. Several OO bioactive compounds such as monounsaturated fatty acids, and key polyphenols including hydroxytyrosol and oleuropein, have been associated with preventing inflammation and cytokine-induced oxidative damage, glucose lowering, reducing carbohydrate absorption and increasing insulin sensitivity and related gene expression. However, research into the interaction of OO nutraceuticals with lifestyle components, especially physical activity is lacking. Promising postprandial effects have been reported when OO or other similar monounsaturated fatty acids was the main dietary fat compared with other diets. Animal studies have shown a potential anabolic effect of oleuropein. Such effects could be further potentiated via exercise, especially strength training, which is an essential exercise prescription for individuals with T2D. There is also an evidence from in vitro, animal and limited human studies for a dual preventative role of OO polyphenols in diabetes and cancer, especially that they share similar risk factors. Putative anti-oxidative and anti-inflammatory mechanisms and associated gene expressions resulting from OO phenolics, have produced paradoxical results making suggested inferences from dual prevention T2D and cancer outcomes difficult. Well-designed human interventions and clinical trials are needed to decipher such a potential dual anti-cancer and anti-diabetic effects of OO nutraceuticals. Exercise combined with OO consumption, individually or as part of a healthy diet is likely to induce reciprocal action for T2D prevention outcomes.

Nutraceuticals comprise dietary supplements, functional foods, medicinal foods, and pharmaceuticals. However, to date all these concepts are interpreted in different ways with the rapid increasing knowledge on nutrition, medicine, and plant biotechnology changing the concepts about food, health and agriculture. What matters are the bioactive elements conveyed by foodstuffs as nutrients or non-nutrients, which interfere with human metabolism and have impact on health, aging and well-being. Food, not nutrients, is the fundamental unit in nutrition and edible mushrooms, are fungi that supply unique biological compounds, different from plant or animal origin, which significantly impact on health status. Their influence on medicinal interventions has been known and studied for many years. The role on neurodegenerative disorders has been recently investigated and their significance on many other diseases has been well demonstrated. On this note it is synthesized the more recent knowledge of some edible mushrooms and preparations on Ménière’s disease, a lifelong condition it can develop at any age, but most commonly appearing between 40 and 60 years of age.

Background: Considering its deleterious effects on health, as well as the importance of information to support actions, strategies and public policies, this study was aimed to identify and classify the risk factors for consumption of ultra-processed foods among Brazilian adolescents. Data sources: targeting observational studies involving samples of Brazilian adolescents (11 to 19 years old), which evaluated possible associations between the consumption of ultra-processed foods and individual, interpersonal, environmental and public policies variables, in October 2022, a systematic review was conducted, consulting electronic databases (Lilacs, Pubmed, Scielo, Scopus and Web of Science), Google Scholar and the reference lists of included articles. Data synthesis: The descriptive synthesis consisted of 11 papers, representing nine original studies. In general, the consumption of ultra-processed foods was associated with different individual, interpersonal and environmental variables. More specifically, the following variables can be highlighted: sedentary behavior (specially screen time), studying at a private school, having a higher Body Mass Index and being female. Conclusions: Based on this evidence, it is important to direct actions, strategies and public policies aimed at confronting the consumption of ultra-processed foods for these groups.

The biogeography of inflammation in ulcerative colitis (UC) suggests a proximal to distal concentration gradient of a toxin. Hydrogen sulfide (H2S) has long been considered one such toxin candidate, and dietary sulfur along with the abundance of sulfate reducing bacteria (SRB) were considered the primary determinants of H2S production and clinical course of UC. The metabolic milieu in the lumen of the colon, however, is the result of a multitude of factors beyond dietary sulfur intake and SRB abundance. Here we present an updated formulation of the H2S toxin hypothesis for UC pathogenesis, which strives to incorporate the interdependency of diet composition and the metabolic activity of the entire colon microbial community. Specifically, we suggest that the increasing severity of inflammation along the proximal-to-distal axis in UC is due to dilution of beneficial factors, concentration of toxic factors, and changing detoxification capacity of the host, all of which are intimately linked to the nutrient flow from the diet.

Infant foods and formulae may contain toxic substances and elements which can be neo-formed contaminants or derived from raw materials or processing. The content of minerals, toxic elements and hydroxymethylfurfural in infant foods and formulae were evaluated. The effect of storage temperature on HMF formation in infant formulae and its potential as a quality parameter was also evaluated. Prune-based foods contained the highest HMF content. HMF significantly increased when storage temperature was elevated to 30 ℃ for 21 days. All trace elements were present in adequate amounts while the concentration of nickel was higher when compared to those of other studies. The study indicates that HMF can be used as quality indicator for product shelf-life and that the concentrations of minerals and toxic elements vary greatly due to the diverse compositions of foods and formulae. Such contaminants need to be monitored as infants represent a vulnerable group compared to adults.

Epidemiological studies indicate an increased risk of cancer from the consumption of very hot foods and beverages. The International Agency for Research on Cancer (IARC) has already recommended threshold values for the maximum drinking temperature of very hot beverages. The contact time and the contact temperature are decisive for the risk of injury when hot media come into contact with human skin. However, measuring the contact temperature is not easily possible in practice. In the present study, a numerical simulation based on the solution of the heat conduction equation was initially used to investigate whether and for what period of time a constant contact temperature is to be expected under oral conditions. For small circular 3-cm food samples (e.g., cooked potatoes) with 2.5 mm thickness in contact with the tongue, the simulation results in a constant contact temperature of 10 s before cooling. With a thickness of 0.5 mm, the contact temperature is only maintained 1 s. Hot beverages, which spread as a thin film and thereby increase their surface area, can therefore be consumed at higher temperatures than solid foods. Furthermore, a simple test technique with a "measuring spoon" was developed. A hot sample is placed on the tongue. Orientating measurements were used to determine which contact temperature was considered to be just comfortable for any period > 10 s and for which period of less than 10 s it was still just bearable. The contact temperature, which was still perceived as tolerable for periods > 10 s, was 46.5 °C. The time spans for the higher contact temperature 48 °C were between 2 and 4 s and for 49 °C between 1 and 2 s. The course of the contact temperatures determined in the experiment over time allows to calculate the corresponding threshold values of consumption temperatures for various foods. Consumption temperatures of about 56 °C for potatoes and 60 °C for cheese are still perceived as tolerable. In view of the fact that the contact temperature is obviously the determining factor for the risk of injury from burns in the oral cavity in addition to the contact time, it makes sense to reference threshold values to the contact temperature rather than to the surface or consumption temperature of a food product, which is current customary practice. If this contact temperature is defined as a threshold value, the surface or consumption temperature for any other food can be calculated.

The aim of this study was to gather preliminary data about the potential inhibitory effects and contributions of live foods used from 3 to 32 days after hatching (DAH) in routine feeding protocols on protease activities of meagre, Argyrosomus regius (Asso 1801) larvae, using in vitro techniques. Enriched rotifer, Artemia nauplii and Artemia metanauplii were tested in the present study. The highest values of protease activities of meagre larvae at 7 DAH in 2013 and 2014 years were established. The lowest values at 15 DAH in 2013 and at 20 DAH in 2014 were observed. Protease activities of enriched rotifer, Artemia nauplii, and Artemia metanauplii were 21.76±0.31, 36.00±1.48–29.33±0.93, and 416.44±19.7–403.53±11.85 U/mg protein, respectively (p< 0.05). The highest inhibitions of live foods were observed at 7 DAH. The positive contributions of live food Artemia metanauplii’s on protease activities of meagre larvae were significant (p< 0.05). The inhibitory effects and positive contributions of live foods on survival and growth rates of meagre larvae, should be taken into account in meagre and other marine fish larvae’s future studies. Cysteine protease activities of Artemia sp. should be investigated to provide the higher growth and survival ratio from the feeding protocols used in marine fish larvae.

Numerous studies have shown that quinolones residues in the foods exceeding the MRL is harmful to the human health. There are some limitations in the existing methods for the residues, so we developed a new limit test method (TLC-SERS) to rapidly determine following residues: enrofloxacin(A), ciprofloxacin (B), ofloxacin(C), fleroxacin(D), sparfloxacin(E), enoxacin(F), gatifloxacin(G) and nadifloxacin(H). The residues can be preliminarily separated by TLC. Labeling the tested compounds’ position on the thin layer plate by their relative Rf under 254nm ultraviolet, and an appropriate amount of nanometer silver solution should be added to the position. The silver on the plate should be irradiated with 532nm laser to obtain SERS of the compounds. The results showed a significant differences of the 8 quinolones’ SERS; the LOD of the H, A, D, E, C, G, F and B were orderly 9.0, 12.6, 8.0, 19.0, 8.0, 8.4, 9.0 and 12.6 ng/mL, and the RSD≤4.9% for SERS of each quinolones.The limit test results of the 20 samples was consistent with that determined by the UPLC–MS/MS. The above results indicate that the TLC-SERS is specific, sensitive, stable, and accurate, providing a new reference for the rapid limit test of harmful residues in foods.

Secondary metabolites from Hibiscus sabdariffa have been used to prevent different diseases. Roselle Hibiscus is known for being rich in phenolic bioactive compounds. The extraction conditions are directly related to the chemical composition and then to the overall bioactivity of the extract. In this study, a Box Behnken experimental design has been used to optimize the antioxidant activity, considering four variables: the ethanol:water ratio, the temperature, the extraction time, and the solvent:solid ratio. The experiment comprises 27 experiments and 3 repetitions at the central point. The results are described by surface response analysis and a second-degree polynomial equation. The model explains 87% of the variation in the response. The maximum antioxidant activity is yielded when 1% solids are extracted in 35.5% ethanol at 60°C for 33 min. Finally, a nutritional functional supplement of 495 µmol Trolox Equivalent (TE) antioxidant capacity was prepared with the optimized extract.

The aim of this study (first analytical approach) was to obtain data on the fatty acid composition of gluten-free foods (bakery products) for celiac people. The study included 35 different products (snacks, biscuits, bakery products, pasta, flours, etc.) from several manufacturers. After extraction and esterification, the fatty acid content was determined by GC-MS. The monounsaturated fatty acids (MUFAs) are the major constitutes (57%) of the fatty acids pool followed by saturated fatty acids (SFAs) (30%) and polyunsaturated fatty acid (13%). Only fifteen, of the thirty-five gluten free samples analyzed, provide adequate energy intake, while in eleven samples, saturated fatty acids take more energy than that recommended by EFSA. It has emerged that local producers generally use the finest raw materials (olive oil, etc.) compared to the industries which, as has been pointed out, in many cases use palm and palm kernel oils although gluten free commercial products are high added value foods, expensive and intended for a particularly sensitive public.

Excessive intake of fat and fatty acids is associated with major health hazards such as obesity or chronic diseases. The aim of this study was to provide the first data on total fat, saturated fatty acids (SFA) and trans fatty acids (TFA) intakes and their major food sources in Tunisian children. A total of 1200 children, aged 3 to 9 years old (yo), were randomly selected from primary schools and kindergarten under a cross-sectional design. The 24-hour 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, breakfast 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.

Meat-based diets are still the norm and vegans and vegetarians represent only a small minority of the population. A transition respectively behavioural change towards a diet with less meat can only occur with the adoption of a positive attitude towards dietary changes based on reasons and motivations. The main aim of this study is to validate the so-called meat attachment scale (MEAS) for Germany in order to analyse if this construct is a barrier towards a diet with less meat in this country. The findings show that the MEAS can be applied in Germany and a similar structure as reported for Spain and other countries could be found. Furthermore, a correlation analysis demonstrated that food neophobia and MEAS are not correlated with each other. That is, that meat attachment represents an independent and single predictor for trust in food (processing) technologies as e.g. plant-based proteins or cultured meat.

In recent years, organic agriculture has gained more popularity, yet its approach to food production and its potential impact on consumers’ health and various environmental aspects remain to be fully discovered. The goal of organic farming practices is to maintain soil health, sustain ecological systems, maintain fairness in its relationship with the environment and protect the environment in its entirety. Various health benefits have been associated with higher consumption of organic foods. This review identified some of these health benefits including a reduction in obesity and body mass index (BMI), improvements in blood nutrient composition as well as a reduction in maternal obesity and pregnancy-associated preeclampsia risk. Furthermore, organic food consumption can reduce the development of non-Hodgkin lymphoma and colorectal cancers. Upon reviewing existing literature regarding the nutritional value of organic foods, it was found that organic food contained higher levels of iron, magnesium, and vitamin C. However, the evidence available to draw definitive generalizations remains limited. In this review, we provided essential insights to support sustainable organic farming and highlighted the potential of organic food consumption that could play a pivotal role in positively impacting human health.

In the present study, we isolated and screened thirty strains of GABA-producing lactic acid bacteria (LAB) from Indonesian traditional fermented foods. Two strains were able to convert monosodium glutamate (MSG) to GABA after 24 h of cultivation at 37oC based on thin layer chromatography (TLC) screening. 16S rDNA sequencing and proteomic identification using MALDI-TOF MS identified these two strains as Lactobacillus plantarum designated as L. plantarum FNCC 260 and L. plantarum FNCC 343. The highest yield of GABA production obtained from the fermentation of L. plantarum FNCC 260 was 809.2 mg/l of culture medium after 60 h of cultivation. Supplementation of 0.6 mM pyridoxal 5’-phosphate (PLP) and 0.1 mM pyridoxine led to the increase in GABA production to 945.3 mg/l and 969.5 mg/l, respectively. The highest GABA production of 1226.5 mg/l of culture medium was obtained with 100 mM initial concentration of MSG added in the cultivation medium. The open reading frame (ORF) of 1410 bp of the gadB gene from L. plantarum FNCC 260 encodes 469 amino acids with a calculated molecular mass of 53.57 kDa. The production of GABA via enzymatic conversion of monosodium glutamate (MSG) using purified recombinant glutamate decarboxylase (GAD) from L. plantarum FNCC 260 expressed in Escherichia coli was found to be more efficient (5-fold higher within 6 h) than the production obtained from fermentation. L. plantarum FNCC 260 could be of interest for the synthesis of GABA.

Among the array of structurally and toxicologically diverse mycotoxins, aflatoxins have attracted the most interest of scientific research due to their high toxicity and incidence in foods and feeds. Despite the undeniable progress made in various aspects related to aflatoxins, the ultimate goal consisting of reducing the associated public health risks worldwide is far from being reached due to multiplicity of social, political, economic, geographic, climatic, and development factors. However, a reasonable degree of health protection is attained in industrialized countries owing to their scientific, administrative, and financial capacities allowing them to use high-tech agricultural management systems. Less fortunate situation exists in equatorial and sub-equatorial developing countries mainly practicing traditional agriculture managed by smallholders for subsistence, and where the climate is suitable for mould growth and aflatoxin production. A situation that worsens by the climatic change being increasingly suitable for aflatoxigenic mold growth and toxin production. Accordingly, it is difficult to harmonize the regulatory standards of aflatoxins worldwide, which prevents agri-foods of developing countries from access to the market of industrialized countries. To tackle the multi-facetted aflatoxin problems, actions should be taken collectively by the international community involving scientific research, technological and social development, environment protection, awareness promotion, etc. International cooperation should foster technology transfer and exchange of pertinent technical information. This review presents the main historical discoveries leading to our present knowledge on aflatoxins and the challenges that should be addressed presently and in the future at various levels to ensure higher health protection for everybody. In short, it aims to elucidate where we come from and where we should go in terms of aflatoxin research/development.

Seafood products are the main dietary source of n-3 polyunsaturated fatty acids (n-3 PUFA), which are essential for human health. However, due to the widespread use of processed fish products, the presence of these n-3 PUFAs may be subject to changes related to different processing methods. The aim of this study was to determine the fatty acid composition, with a focus on n-3 polyunsaturated fatty acids (n-3 PUFAs), in different processed fish and shellfish food of EU and non-EU origin purchased in supermarkets and ethnic food shops in Messina (Italy), using gas chromatography with flame-ionization detector (GC-FID). From the fatty acid profile, the atherogenic index (AI), thrombogenicity index (TI) and flesh-lipid quality index (FLQ) were determined: 0.13-1.04 (AI), 0.31-9.84 (TI) and 0.41-29.90 (FLQ). The percentages of saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids had the following ranges: 13.55-50.48%, 18.91-65.58%, 13.84-52.73%, respectively. All samples showed a good presence of PUFAs and, in particular, eicosapentaenoic (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3) were the main n-3 polyunsaturated fatty acids (n-3 PUFA).

Background: The level of food processing has gained interest for a potential determinant of human health. The aim of this study was to assess the relation between level of food processing and prostate cancer severity. Methods: A sample of 120 consecutive patients were examined for their dietary habits assessed through validated food frequency questionnaires, their dietary intake of food groups categorized according to the NOVA classification, and the severity of prostate cancer according to the European Association of Urology (EAU) guidelines groups risk. Uni- and multivariate logistic regression analyses were performed to test the association between the variables of interest. Results: Individuals reporting higher consumption of unprocessed/minimally processed foods were less likely to have worse prostate cancer severity than lower consumers in the energy-adjusted model [odds ratio (OR) = 0.38, 95% confidence interval (CI): 1.17-0.84, P = 0.017 and OR = 0.33, 95% CI: 0.12-0.91, P = 0.032 for medium/high vs. low grade and high vs. medium/low grade prostate cancers, respectively); however, after adjusted for potential confounding factors, the association was no more significant (Table 4). A borderline association was also found between higher consumption of UPF and worse prostate cancer severity in the energy-adjusted model (OR = 2.11, 95% CI: 0.998-4.44; P = 0.051), but again the association was no more significant after adjusting for the other covariates. Conclusions: The level of food processing seems not to be independently associated with prostate cancer severity, while potentially related to other factors that need further investigation.

Healthcare systems are mindful of the importance of proper diet and nutrition in reducing the risk of various chronic diseases resulting in hospitalizations. In this regard, they are focusing on promoting the intake of foods comprising various diets with health benefits, such as the ketogenic diet. In this meta-analysis, a total of 20 research studies on the effect of the ketogenic diet on the immune system were analyzed. The research studies were obtained from three databases: Google Scholar, PubMed, and Science Direct. From the meta-analysis, the odd ratio of a similar outcome of an improvement in the strength of immunity between the intervention and control group was 0.76. On the other hand, the p-value for the studies was 0.09, with 15 out of the 20 being considered statistically significant. The heterogeneity between the studies was I2 = 15%, signifying a low variability in the findings that is not by chance. The Ketogenic diet indeed has positive effects on immunity. Nonetheless, it can also result in negative effects that may harm human health.

In Sub-Saharan Africa, despite poverty, chronic hunger and food insecurity, traditional eating has been related to positive health outcomes and sustainability. There is little health research on diet quality based on what African people consume. The defining characteristics of the traditional African cuisine are the richness in herbs and spices, fermented foods and beverages, and healthy and whole ingredients used. However, as countries in this region become more economically developed, there is a shift to “modern” occidental foods rich in saturated fats, sugar and sweeteners. As a result, there are increased incidences of previously unreported ailments due to unbalanced diet. The regular practice of infinite international aid to the region to curb food insecurity has been unsustainable, ineffective and with no end in sight. Local increase in production and productivity is imperative. Protein rich foods in dietary guidelines enhance only those of animal or plant sources while rich protein sources such of mushroom, has been absent in these charts. This article considers the valorisation of traditional African foods and the importance of establishing an African Food-Based Dietary Guidelines (AFBDGs), an unprecedented Food Pyramid, along with the added emphasis on the potential of African mushrooms, which may play a role in shielding Sub-Saharan Africans against the side-effects of a western stylish diet and promote health. It enhances the preventive role of mushrooms in viral diseases and other disorders.

How a species is represented by marketers of animal-based products both reflects and shapes how consumers think about that animal. By examining the explicit statements, and implicit messages encoded in the imagery on supermarket egg boxes, this paper explores how hens are represented by whole egg retailers. Content analysis reveals two prominent messages purveyed through eggbox graphics, namely those pertaining to hen welfare and human health. The later disenfranchises hens from their products by focusing on the nutritional value of eggs, whereas the former reflects a public concern for the welfare of egg-laying hens. Although claims of improvements in welfare practices are undoubtedly exploited as marketing tools, they serve to raise awareness and drive competitors to adopt similar practices. Welfare claims are a direct response to public concerns about the plight of hens, and may positively influence industry welfare standards. However, idyllic depictions displayed on eggboxes also lull consumers into the belief that those eggs are an ethically sound food choice, regardless of the actual standard of living experienced by the hens.

The ANTIATERO-ALIM study was a randomized, parallel design nutritional trial testing functional food (FF) diets against the usual diet recommended in the metabolic syndrome. Functional meals included balsamic vinegar from apples and honey and grape juice enriched with polyphenols from seeds of red grapes. 300 patients with metabolic syndrome were randomized into 4 groups: gr.1: FF + Ω-3 supplements, gr.2: FF, gr.3: Ω-3 supplements, gr.4: control. IRHOMA insulin resistance, plasma lipids and oxidative stress were assessed at inclusion and at 6 months. After 6 months there was a very significant decrease of oxidative stress in group 3, followed by a significant decrease in groups 1 and 2.

The goal was to model the irrigated (IBY) and rainfed (RBY) bean yields, as a function of essential climatic variables (ECVs), in the center (Culiacán) and south (Rosario) from Sinaloa. In Sinaloa, and for the period 1982–2013 (October–March), the following were calculated: a) temperatures. b) average degree days for the bean, c) cumulative potential evapotranspiration and d) cumulative effective precipitation. For ECVs, from the European Space Agency, e) daily soil moisture. f) IBY and RBY, from the Agrifood and Fisheries Information Service. Multiple linear regressions were applied, which modeled IBY–RBY (dependent variables), as a function of ECVs (independent variables). Then, to establish each Pearson correlation (PC) as significantly different from zero, a hypothesis test was applied: PC vs Pearson's critical correlation (CPC). The four models obtained were significantly predictive: IBY–Culiacán (PC = 0.590 > CPC = |0.349|), RBY–Culiacán (PC = 0.734 > CPC = |0.349|), IBY–Rosario (PC = 0.621 > CPC = |0.355|) and RBY–Rosario (PC = 0.532 > CPC = |0.349|). This study is the first in Sinaloa to predict IBY and RBY based on ECVs, contributing to the production of sustainable food.

The potentiality of cv. Malbec grape pomace (GP) as a functional ingredient in the formulation of bakery foods (muffins, biscuits and cereal bars) was studied. The effect of GP addition on the phenolic compounds (PCs) composition, nutritional and sensory properties were evaluated. The addition of GP increased the content of dietary fiber, proteins, ash, total phenolic content (TPC), antioxidant activity (AA), anthocyanins and non-anthocyanins PCs while decreasing the carbohydrates content. The main PCs given by the GP to supplemented foods were (-)-gallocatechin, quercetin-3-O-glucoside, rutin, caffeic acid, syringic acid and (+)-catechin. For anthocyanins, the acylated derivatives were more stable to heat treatment (baking) in food processing which was evidenced by a higher proportion of these PCs compounds when compared to the same derivatives quantified in GP. In general, when the TPC or individual concentrations of PCs were analyzed in a nutritional or functional context, one portion of the supplemented foods showed levels high enough to satisfy the recommended dose per day of these bioactive compounds. Additionally, the foods were well received by consumers during the sensory evaluation and supplemented biscuits got the highest acceptability. This study demonstrated that GP could be a viable functional ingredient in bakery foods to give nutritionally enhanced properties like TPC, PCs, AA and dietary fiber in consumer’s diets.

In the food sector, packaging is one of the important steps that ensures the safe, unspoiled, min-imum cost of storing, transporting and delivering the food that goes into production to the con-sumer. Food spoilage caused by foodborne pathogens and microorganisms is a serious problem in the food chain, reducing the shelf life of foods. Therefore, consumers' demands for more natural, disposable, biodegradable and recyclable antibacterial food packaging materials have considera-bly increased. This review covers a comprehensive current literature review of antibacterial food packaging, which includes with titles antibacterial agents, organic acids and other compounds, enzymes, bacteriocins, natural extracts, essential oils, application of encapsulation and antimi-crobial packaging. Research findings on antimicrobial food packaging used to extend the shelf life of foods were collected from online databases such as PubMed/MedLine, Wiley Online Li-brary, Scopus, Web of Science, and Google Scholar. In this review, the activities of different bio-materials and compounds used to extend the shelf life of foods were compared

Children with severe acute malnutrition (SAM) are at high risk of impaired development. Contributing causes include inadequate intake of specific nutrients such as polyunsaturated fatty acids (PUFA) and lack of adequate stimulation. We conducted a pilot study assessing developmental and nutritional changes in children with SAM provided with a modified ready-to-use therapeutic food and a context-specific psychosocial intervention in Mwanza, Tanzania. We recruited 82 children with SAM (6-36 months) and 88 sex- and age-matched non-malnourished children. We measured child development, using the Malawi Development Assessment Tool (MDAT), measures of family and maternal care for children, and whole blood PUFA levels. At baseline, the mean total MDAT z-score of children with SAM was lower than non-malnourished children; -2.37 (95% confidence interval: -2.92; -1.82) as was their total n-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) levels. After 8 weeks’ intervention, MDAT z-scores improved in all domains, especially fine motor, among children with SAM. Total n-3, and EPA levels increased, total n-6 fatty acids decreased, and DHA remained unchanged. Family and maternal care also improved. The suggested benefits of the combined interventions on developmental and nutritional status of children with SAM will be tested in a future trial.

The increasing demand by consumers for popular healthy fruits, such as the watermelon (Citrullus lanatus), generate substantial bio-wastes, making it imperative to harness the value of these by-products. Watermelon has low-calorie content and several other nutritional benefits that make it suitable for weight management and heart-healthy diets. Within this article, the nutritional composition and bioactives of watermelon which are strongly linked to the prevention of cardiovascular disorders (CVD), cancer, and age-related conditions, will be thoroughly reviewed. In addition, the therapeutic potential effects of watermelon consumption, such as anti-inflammatory, cardio-protective and anti-cancer properties, are also examined, with emphasis to the importance of incorporating watermelon into regular diets for overall health improvement. Additionally, the study explores various applications of watermelon by-products in functional foods, contributing to meeting recommended daily nutrient allowances, as well as in other functional products like cosmetics, with health promoting properties. In conclusion, this comprehensive review underscores the role of watermelon and its by-products for the development of products that can contribute to the prevention of chronic diseases and promote overall well-being

(1) Background : Low dietary intake of calcium, vitamin D, vitamin C and magnesium has been associated with increased risk of osteoposrosis. The purpose was to evaluate changes in biomarkers of bone metabolism, and cardiometabolic health in postmenopausal women, with high risk of osteoporosis, followed by a nutritional intervention program. (2) Method: It was a prospective randomized controlled trial. A sample of 115 apparently healthy postmenopausal women(45 -75 years of age) randomized into four groups: (I) nutritional intervention group(n=40) received daily 1000mg vitamin C, 500mg vitamin D3, 500mg calcium(Ca) and 300mg magnesium (Mg); (II) control group(n=42) received daily 500mg vitamin D3, 500mg Ca and 300mg Mg; (III) nutritional intervention group (n=18) received daily 150mg bisphosphonates, 500mg vitamin D3, 500mg Ca and 300mg Mg; and (IV) nutritional intervention group (n=15) received daily about 364 mg polyphenols via an innovative functional food (50g olive paste enriched with mountain tea extract) along with 500mg vitamin D3, 500mg Ca and 300mg Mg. Groups I -III received supplementation for a year whereas group IV for 5 months. Changes in calciregulatory hormone parathormone (PTH) were evaluated at the beginning of the study as well as at 5 and 12 months intervals. Blood levels of vitamin D, vitamin C, Ca, Mg and the lipid profile were assessed at the beginning and at the end of the study. Anthropometric indices (weight, body fat(Kg), Body Mass Index(BMI) and bone mineral density(BMD) were evaluated at the beginning and at the end of the study. Statistical analysis was performed with IBM-SPSS Statistics-21. The level of statistical significance was set at p<0.05. (3) Results: 25(OH)D3 levels were improved, in groups II, III and IV (+3,71% and +1.45% and +5.62% respectively). PTH levels were increased at the end of the intervention period, for groups I and IV. Significant positive changes recorded, in total BMD, in all four study groups. Significant beneficial changes for total cholesterol was observed in group IV (-2.07%, P<0.05) and positive changes in group I for HDL biomarker (+61.62%, P<0.05) (4) Conclusions:. Additional larger-scale clinical trials and intervention studies are considered essential, in order to fully investigate and elucidate associations between dietary components and biochemical indices of bone metabolism.

The development of sarcopenia in the elderly is associated to many potential factors and/or processes, that impair the renovation and the maintenance of skeletal muscle mass and strength as ageing progresses. Among them, a defect by skeletal muscle to respond to anabolic stimuli is to be considered. Common anabolic stimuli/signals in skeletal muscle are hormones (insulin, growth hormones, IGF-1, androgens, β-agonists such epinephrine), substrates (amino acids as protein precursors on top, but also glucose and fat, as source of energy), metabolites (such as β-agonists and HMB), some cytokines, various biochemical/ intracellular mediators), physical exercise, neurogenic and immune-modulating factors, etc. Each of them may exhibit a reduced effect upon skeletal muscle as ageing progresses. In this review article, we will concisely overview the effects of anabolic signals on muscle metabolism, as well as currently available evidence of a resistance, at skeletal muscle level, to any of the above-mentioned anabolic factors, from both in vitro and in vivo studies.

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.

The official recommendations to manage COVID-19 in the outpatient setting focus on high-cost drugs (remdesivir, nirmatrelvir-ritonavir, molnupiravir), suffering from many problems. Therefore, one may consider also other treatments meeting these criteria: • promising effectiveness, based on favorable randomized controlled trials (RCTs) of sufficient validity. Even without definitive evidence, physicians and informed patients can consider them if they are also: • safe, to the state of knowledge • with a very favorable opportunity cost • biologically plausible/not implausible • accessible • without major commercial sponsors in the trials promoting them, and with researchers without major conflicts of interests. The main focus is on a limited group of functional foods and some their active ingredients, with further mention of other substances of different origin, yet fully meeting all the aforementioned criteria. The functional foods and substances described and discussed certainly do not cover all the known effective therapies for COVID-19 (in one case also for Long-COVID), but the only therapies proposed in this paper currently satisfy all the above criteria. The supporting scientific evidence will favor meta-analyses of RCTs that include the most definitive outcome: all-cause mortality, i.e. the outcome that most fully informed people tend to prioritize. Furthermore, the reported evidence favors clinical studies of the most valid design, i.e. RCTs.

Introduction: Child undernutrition remains a challenge globally and in the geographically diverse country of Ethiopia. Improving dietary diversity and consumption of animal source foods are important for improving child nutrition and corresponding health outcomes. Objective: The objective of the study was to identify household and community factors associated with consumption of animal source foods among 6 to 36-month-old children from four regions of Ethiopia. Methods: A cross-sectional survey using multistage probability sampling in eight geographic zones and four regions of Ethiopia took place in 2015 with parents/caretakers of 6 to 36-month-old children. Data was collected on demographic information, proxy indicators of socioeconomic status, and food consumed by the child the day before the survey. Results: Increased child age, pastoral livelihood, Muslim religion, and participation in the Productive Safety Net Program were associated with increased consumption of animal source foods. Odds of animal source foods consumption increased 8% with each 3-month age increase. Children from pastoralist households were the most likely to have consumed animal source foods in the preceding 24 hours as compared with those in agro-pastoralist households (0.21 times as likely) or those in agriculturalist/farming households (0.15 times as likely). The odds of consumption of animal source foods for families with food aid or safety net support was 1.7 times greater among those receiving traditional support from the Productive Safety Net Program and 4.5 times greater for those in the direct support arm of the program. Conclusions: The findings illustrate the importance of accounting for local context and community characteristics, such as livelihood and religion, when undertaking programming designed to improve diversity of children’s diets through increasing animal source foods. In addition, the Productive Safety Net program may be a critical determinant of dietary diversity for young children in these regions.

Obesity is a global public health problem and the environment as its major determinant. To identify interventions an evidence base is warranted. To this aim we investigate the relationship between the consumption of foods and eating locations (like home, school/work and others) in British adolescents, using data from the UK National Diet and Nutrition Survey Rolling Program (2008–2012 and 2013-2016). Cross-sectional analysis of 62,523 food diary entries from this nationally representative sample then focused on foods contributing up to 80% total energy to the daily adolescent´s diet. Correspondence Analysis (CA) was first used to generate food-location relationship hypotheses and Logistic Regression (LR) to quantify the evidence in terms of odds ratios and formally test those hypotheses. The less-healthy foods that emerged from CA were chips, soft drinks, chocolate and meat pies. Adjusted Odds Ratios (99% CI) for consuming specific foods at a location “Other” than home (H) or school/work (S) in the 2008-12 survey sample were: for soft drinks 2.8 (2.1 to 3.8) vs. H and 2.0 (1.4 to 2.8) vs. S; for chips 2.8 (2.2 to 3.7) vs. H and 3.4 (2.1 to 5.5) vs. S; for chocolates 2.6 (1.9 to 3.5) vs. H and 1.9 (1.2 to 2.9) vs. S; and for meat pies 2.7 (1.5 to 5.1) vs. H and 1.3 (0.5 to 3.1) vs. S. These trends were confirmed in the 2013-16 survey sample. Interactions between location and BMI were not significant in either sample. In conclusion, our study showed that adolescents are more likely to consume specific less-healthy foods at locations away from home and school/work, irrespective of BMI. Such locations include leisure places, food outlets and “on the go”, hence public health policies to discourage less-healthy food choices in these locations is warranted for all adolescents.

Glutamate decarboxylase (L-glutamate-1-carboxylase, GAD; EC 4.1.1.15) is a pyridoxal 5-phosphate-dependent enzyme, which catalyzes the irreversible α-decarboxylation of L-glutamic acid to γ-aminobutyric acid (GABA) and CO2. The enzyme is widely distributed in eukaryotes as well as prokaryotes, where it – together with its reaction product GABA - fulfils very different physiological functions. The occurrence of gad genes encoding GAD has been shown for many microorganisms, and GABA-producing lactic acid bacteria (LAB) have been a focus of research during recent years. A wide range of traditional foods produced by fermentation based on LAB offer the potential of providing new functional food products enriched with GABA that may offer certain health-benefits. Different GAD enzymes and genes from several strains of LAB have been isolated and characterized recently. GABA-producing LAB, biochemical properties of their GAD enzymes, and possible applications are reviewed here.

A variety of bioactive substances present in fruits and vegetables processed products have health-promoting properties. Consumption of nutrient-rich plant-based products is essential to address undernutrition and micronutrient deficiencies. Preservation is paramount in manufacturing plant-based non-solid foods such as juices, purees, and sauces. Thermal processing has been widely used to preserve fruit and vegetable-based products by reducing enzymatic and microbial activities, thereby ensuring safety and prolonged shelf life. However, the nutritional value of products is compromised due to the deleterious effects of thermal treatments on essential nutrients and bioactive compounds. To prevent the loss of nutrients associated with thermal treatment, alternative technologies are being researched extensively. In studies conducted on non-solid food, UV-C treatment has been proven to preserve quality and minimize nutrient degradation. This review compiles information on the use of UV-C technology in preserving the nutritional attributes of non-solid foods derived from fruit and vegetables. Legislation, market potential, consumer acceptance, and limitations of UV-C are reviewed.

Obesity in the United States continues to worsen. Anthocyanin-rich fruits and vegetables provide a pragmatic dietary approach to slow its metabolic complications. Given American diet patterns, foods with high anthocyanin content could address dose-response challenges. In a placebo-controlled, randomized, crossover pilot study, determine the effect of 100% elderberry juice on measures of indirect calorimetry (IC), and insulin sensitivity/glucose tolerance. Overweight and obese adults were randomized to a 5-week study which included two 1-week periods of twice-daily elderberry juice (EBJ), or sugar-matched placebo consumption separated by a 3-week washout period. Following each 1-week test period, IC and insulin sensitivity/glucose tolerance was measured with a 3-hour meal tolerance test (MTT). Treatment differences were tested with linear mixed modeling. 22 prospective study volunteers (18F/4M) attended recruitment meetings, 10 volunteers completed the protocol, and 9 were analyzed for treatment differences. EBJ was well tolerated and compliance was 99.6%. Six IC measures (intervals) were created which coincided with 10-20 minute gaseous samplings in-between MTT blood samplings. Average CHO oxidation was significantly higher during the MTT after 1-week EBJ consumption (3.38 vs. 2.88 grams per interval, EBJ vs. placebo, p = 0.0113). Conversely, average fat oxidation was significantly higher during the MTT after 1-week placebo consumption (1.17 vs 1.47 grams per interval, EBJ vs. placebo, p = 0.0189). This was in-line with a significantly lower average respiratory quotient after placebo treatment (0.87 vs. 0.84, EBJ vs. placebo, p = 0.0114). Energy expenditure was not different. There was no difference in serum glucose or insulin response between treatments. This pilot study of free-living volunteers describes significant change in IC but not insulin sensitivity with an EBJ intervention. Controlled feeding and increased sample size will help determine the utility of EBJ on these outcomes.

Staphylococcus aureus is a major food-borne pathogen. The ability of S. aureus to produce biofilm is a significant virulence factor triggering its persistence in hostile environments. In this study, we screened a total of 420 different food samples and human hand swabs to detect S. aureus and to determine their biofilm formation ability. Samples analyzed were meat, milk, egg, fish, fast foods, and hand swabs. S. aureus were detected by culturing, staining, biochemical, and PCR. Biofilm formation ability was determined by Congo Red Agar (CRA) plate and Crystal Violet Microtiter Plate (CVMP) tests. The icaA, icaB, icaC, icaD, and bap genes involved in the synthesis of bio-film-forming intracellular adhesion compounds were detected by PCR. About 23.81% (100/420; 95% CI: 14.17-29.98%) samples harbored S. aureus as revealed by detection of the nuc gene. CRA plate revealed 20% of S. aureus isolates as strong biofilm producers, while 69% and 11% as in-termediate and non-biofilm producers, respectively. By the CVMP staining method, 20%, 77%, and 3% of the isolates were found strong, intermediate, and non-biofilm producers. Furthermore, 21% of S. aureus isolates carried at least one biofilm-forming gene, where icaA, icaB, icaC, icaD, and bap genes were detected in 15%, 20%, 7%, 20%, and 10% of the S. aureus isolates, respectively. Bivariate analysis showed high significant correlations (p<0.001) between any of the two adhesion genes of S. aureus isolates. To the best of our knowledge, this is the first study in Bangladesh describing the detection of biofilm-forming S. aureus from foods and hand swabs with molecular-based evidence. Our findings suggest that food samples should be deemed a potential reservoir of biofilm-forming S. aureus that indicates a potential public health significance.

Exposure to bisphenol analogues can occur in several ways throughout the food production chain with their presence at higher concentrations representing a risk to human health. This study aimed to develop effective analytical methods to simultaneously quantify BPA and fifteen bisphenol analogues (i.e., bisphenol AF, bisphenol AP, bisphenol B, bisphenol BP, bisphenol C, bisphenol E, bisphenol F, bisphenol G, bisphenol M, bisphenol P, bisphenol PH, bisphenol S, bisphenol Z, bisphenol TMC and tetramethyl bisphenol F) present in canned foods and beverages. Samples of foods and beverages available in the Swiss and EU markets (n = 22) including canned pineapples, ravioli and beer were prepared and analyzed using QuEChERS GC-MS. The quantification method was compared to a QuEChERS LC-MS/MS analysis. This allowed for the selective and efficient quantitative simultaneous analysis of bisphenol analogues. Quantities of these analogues were present in 20 of the 22 samples tested with the most frequent analytes at higher concentrations; BPA and BPS being discovered in 78% and 48% of cases respectively. The study demonstrates the robustness of QuEChERS GC-MS for determining low quantities of bisphenol analogues in canned foods. However, further studies are necessary to achieve full knowledge of the extent of bisphenol contamination in the food production chain and its associated toxicity.

Trans fatty acids (TFA) are a concern for public health due to their negative impact on cardiovascular health. This study aimed to assess the levels of TFA and other fatty acids in popular edible oils and fried foods commonly consumed in Tanzania. A total of 57 samples from 38 brands of edible oils and 20 samples of fried street foods and fast foods were collected in Dar es Salaam, Tanzania. Capillary gas chromatography was used to determine TFA levels, while nutritional labeling and other fatty acid classes were also evaluated. Among the analyzed edible oils, 21% exceeded the recommended TFA levels, primarily found in popular brands of margarine, industrially refined sunflower oils, animal butter, and peanut butter. Only two food items surpassed the 2% TFA limit, but a majority of the foods had high levels of saturated fatty acids and a fatty acid profile similar to palm oil. Additionally, only 22% of the edible oils provided TFA content information. These findings indicate the persistence of TFA levels beyond recommended limits and inadequate TFA nutritional labeling in Tanzanian food products. Urgent interventions are necessary to reduce TFA levels and improve nutritional labeling practices to safeguard public health.

The prevalence and incidence of obesity and the comorbidities linked to it are increasing in the world population. Current therapies for obesity and associated pathologies have proven to cause a broad number of adverse effects and often, they are overpriced or not affordable for all patients. Among the alternatives currently available, natural bioactive compounds stand out. These are frequently contained in pharmaceutical presentations, nutraceutical products, supplements, or functional foods. The clinical evidence for these molecules is increasingly solid, among which epigallocatechin-3-gallate, ellagic acid, resveratrol, berberine, anthocyanins, probiotics, carotenoids, curcumin, silymarin, hydroxy citric acid, and α-lipoic acid stand out. The molecular mechanisms and signaling pathways of these molecules have been shown to interact with the endocrine, nervous, and gastroenteric systems, as well as regulate the expression of multiple genes and, therefore, proteins involved in starvation-satiety processes, activation of brown adipose tissue, increased lipolysis, decreased lipogenesis, and inflammation, beneficial changes in metabolism and improved insulin sensitivity. This review provides a comprehensive view of nature-based therapeutic options to address the increasing prevalence of obesity. It offers a valuable perspective for future research and subsequent clinical practice, addressing everything from the molecular, genetic, and physiological bases to the clinical study of the bioactive compound.

Tree nuts show nutritional properties and human health benefits. However, they contain allergenic proteins, which make them harmful to the sensitised population. The presence of tree nuts on food labelling is mandatory and, consequently, the development of suitable analytical methodologies to detect nuts in processed foods is advisable. Real-time PCR allowed a specific and accurate amplification of allergen sequences. Some food processing methods could induce structural and/or conformational changes in proteins by altering their allergenic capacity, as well as produce the fragmentation and/or degradation of genomic DNA. In this work, we analysed by means of Real-time PCR, the influence of pressure and thermal processing through Instant Controlled Pressure Drop (DIC) on the detectability of hazelnut,pistachio and cashew allergens have been tested. The detection of targets in hazelnut, pistachio and cashew (Cor a 9, Pis v 1 and Ana o 1, respectively) is affected by the treatment, in different extent depending on the tree nut. Results are compared to those previously obtained by our group in the analysis of different treatments on the amplificability of the same targets. Reduction in amplificability is similar to that reported for some autoclave conditions. Our assays might allow detecting up to 1000 mg/kg of hazelnut, pistachio and cashew flours after being submitted to DIC treatment in food matrices.

The global consumption of vegan foods is experiencing an expressive upward trend, underscoring the critical need for quality control measures based on nutritional and functional considerations. This study aimed to evaluate the functional quality of caviar and salmon analogs food inks, based on pulses combined with nano ingredients. The primary objective of this work was to determine the total antioxidant compounds contained in these samples using a voltammetric technique with a glassy carbon electrode. Approximately 100 mg of samples underwent ethanolic extraction (70%) with 1 hour of stirring. The voltammograms were acquired under specific conditions: 10 mL of phosphate buffer electrolyte with a pH of 3.0; an initial potential (Ei) of 0.0 V; a final potential (Ef) of 1.0 V; a pulse amplitude of 50 mV; and a scan rate of 50 mV s-1. The reference electrode used was Ag/AgCl (KCl 3 mol L-1), and the auxiliary electrode was a platinum wire. The voltammograms revealed prominent anodic current peaks at 0.76-0.78 V, which are attributed to isoflavones. Isoflavones, known secondary metabolites with substantial antioxidant potential commonly found in pulses, were identified. The total isoflavone concentrations obtained ranged from 31.5 to 64.3 mg Eq genistein 100 g-1. The results not only validated the efficacy of the electrochemical sensor for quantifying total antioxidant compounds in the samples but also demonstrated that the concentration of total isoflavones in caviar and salmon analogs fell within the expected limits.

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.

Abstract: The Mediterranean diet, a widely studied and highly beneficial diet, underpins my research. Initially, the Mediterranean diet included Wild Edible Plants (WEPs). According to numerous research reports, this diet 1) promotes health and longevity and 2) prevents various modern diseases, including coronary and Alzheimer’s disease. A vital component of this diet is consuming locally available green plants, which are rich in health-promoting substances. In Åhlberg (2021, 2022b), I presented evidence for 56 health-promoting substances that all green vascular WEPs contain. While reading research reports of these five species, I found eight more health-promoting substances that all green vascular wild edible plants have. This article adds eight new substances to the earlier 56, bringing the total to 64. This is a novel and groundbreaking finding for which I provide research evidence. Each WEP has 1) health-promoting substances that all green vascular plants share and 2) species-specific health-promoting substances. I present the latest research on five invasive wild edible plants (WEPs) species. Each contains at least 64 health-promoting substances and varying species-specific health-promoting substances. I also present the experimental research results showing how many of these substances prevent Alzheimer’s disease. Keywords: wild edible plants (WEPs); wild food plants; Mediterranean diet; functional foods; good health, longevity; Alzheimer’s disease; alimurgic plants; invasive species; sustainability

Background:Although highly strict social distancing and viral spread protection guidelines are in force, the reported numbers of COVID-19 cases across the world are still increasing. This indicates that we are still unable to completely understand the transmission routes of SARS-CoV-2. One of the possible routes that can play a significant role is the fecal-oral transmission since SARS-CoV-2 can replicate in the intestines as demonstrated by isolation of infectious virus from fecal samples of COVID-19 cases. Scope and approach:In this review, we compare the characteristics of SARS-CoV-2 with the distinctive characteristics of enteric foodborne viruses. We also discuss and respond to the arguments given in some reports that downplay the importance of foodborne transmission route of SARS-CoV-2. Key findings and conclusions:Enteric viruses such as human noroviruses (HuNoVs) and hepatitis A virus (HAV) are known to transmit through foods such as fresh produce and berries, leading to frequent multistate foodborne disease outbreaks all over the world. SARS-CoV-2 was found to share four distinctive characteristics of foodborne viruses that allow them to transmit through foods. This similarity in characteristics, recent report of detecting SARS-CoV-2 particles from frozen food packages in China, and recent suspected foodborne COVID-19 case in New Zealand, indicate that foodborne transmission of SARS-CoV-2 is more evident than previously thought possible. To support or deny this route of transmission, urgent research needs to be undertaken to answer two primary questions and many secondary ones as described in this review.