Toxic Metals and Metalloids in Food: Current Status, Health Risks, and Mitigation Strategies.

PURPOSE OF REVIEW: Exposure to toxic metals/metalloids, such as arsenic (As), cadmium (Cd), and lead (Pb), through food consumption is a global public health concern. This review examines the contamination status of these metals/metalloids in food, assesses dietary intake across different populations, and proposes strategies to reduce metal/metalloid exposures throughout the food chain. RECENT FINDINGS: For the general population, dietary intake of metals/metalloids is generally lower than health-based guidance values. However, for vulnerable populations, such as infants, children, and pregnant women, their dietary intake levels are close to or even higher than the guidance values. Among different food categories, seafood shows higher total As, but largely present as organic species. Rice accumulates higher As concentration than other cereals, with inorganic As (iAs) and dimethylarsinic acid (DMA) being the main As species. Methylated thioarsenate species, such as dimethylmonothioarsenate, have also been detected in rice. The distribution of iAs and DMA in rice shows geographical variation. Additionally, seafood and cocoa products generally contain more Cd than other food, but seafood consumption does not significantly increase in adverse health effects due to its high zinc and iron content. Compared to As and Cd, Pb concentrations in food are generally lower. To minimize the health risks of metal/metalloid exposure, several strategies are proposed. Food contamination with toxic metals/metalloids poses significant concerns for human health, particularly for vulnerable populations. This review provides scientific evidence and suggestions for policy makers to reduce human exposure of metals/metalloids via dietary intake.

Nutrient intake and food selectivity in children with Tourette syndrome.

Objectives: Children with Tourette syndrome (TS) have been shown to exhibit high levels of food selectivity; however, its association with nutritional status has yet to be explored. The current study explored macro and micronutrient intake and food selectivity among children with and without TS, using 24-hour dietary recall and the Child Eating Behaviour Questionnaire.Method: Parents of 43 children diagnosed with TS and 38 age-matched children without a clinical diagnosis completed an online 24-hour food diary.Results: Fifty-eight per cent of children with TS were identified as falling outside of the healthy BMI range (underweight = 24.2%; overweight = 27.3%; obese = 6.1%). Children with TS also consumed fewer portions of fruit and vegetables along with meeting the daily reference nutrient intake guidelines significantly less often for vitamins B3, B6 and C, selenium and phosphorus compared to children without TS.Conclusions: Understanding the nutritional risk of children with TS relative to other children is important to clinicians and health care professionals who oversee nutritional inspection in primary care, and caregivers who are worried about the impact of limited or restricted diets.

Plastics in human diets: development and evaluation of the 24-h Dietary Recall - Plastic Exposure and the Dietary Plastics Score.

Background: Humans are commonly exposed to plastic through their dietary intake and food consumption patterns. Plastic-associated chemicals (PAC), such as bisphenols and phthalates, are recognized as endocrine-disrupting and are associated with increased risk of cardiovascular disease and metabolic syndrome. However, accurate methods to assess dietary exposure to plastic products and PAC are inadequate, limiting interrogation of health impacts. Aim: To develop a tool that captures complete dietary exposure to plastics and establish a diet quality score to measure adherence to a low plastic dietary pattern. Methods: We developed the 24-h Dietary Recall - Plastic Exposure (24DR-PE) and administered it to healthy adults (n = 422). This computer-assisted, interviewer-administered tool systematically collects data on food volumes and types, packaging materials, storage, processing, cooking, and consumption methods to assess a food's exposure to plastic. Specifically, the 24DR-PE incorporates predefined criteria for identifying high-risk practices and food characteristics, such as individually packaged items or those microwaved in plastic, enabling the assignment of scores based on a theoretically derived Dietary Plastics Scoring Matrix. Conclusion: The 24DR-PE is the first tool specifically designed to capture detailed data on dietary exposures to plastic products. The next step is to validate the score using laboratory results of urine samples we collected contemporaneous to the dietary information. Once validated, the tool has potential for widespread distribution making it valuable for population monitoring, intervention guidance, and future research investigating the interplay between plastics, diet, and human health.

Ultraprocessed food intake and body mass index change among youths: a prospective cohort study.

BACKGROUND: Suboptimal diets may promote undesired weight gain in youths, with high ultraprocessed food (UPF) intake becoming a significant concern in the United States. OBJECTIVES: We evaluated the association between UPF intake and body mass index [BMI (in kg/m2)] change in large United States youth cohorts. METHODS: Participants included children and adolescents (7-17 y) from the Growing Up Today Study (GUTS1 and GUTS2) who completed baseline and ≥1 follow-up diet and anthropometrics assessment (GUTS1 1996-2001: N = 15,797; GUTS2 2004-2011: N = 9720). Follow-up years were based on diet assessment availability. UPFs were categorized using the Nova system, with intakes evaluated as the cumulative mean percent energy from UPFs and subgroups. BMI was assessed using self-reported body weight/height. Changes in BMI annually and over 2, 4-5, and 7 y in association with UPF intake were examined using multivariable repeated-measure linear mixed models. RESULTS: At baseline, the mean percentage of energy from UPFs was 49.9% in GUTS1 and 49.5% in GUTS2 participants; mean BMI was 18.7 and 19.8, respectively. After multivariable adjustments for sociodemographic and lifestyle factors, each 10% increment in UPF intake was associated with a 0.01 (95% confidence interval: 0.003, 0.03) increase annually and a 0.07 (0.01, 0.13) increase over 5 y in GUTS1 participants. In GUTS2, increases were 0.02 (0.003, 0.04) annually and 0.09 (0.01, 0.18) over 4 y. Among GUTS1, statistically significant annual BMI increases of 0.02-0.07 were associated with elevated intake of ultraprocessed breakfast cereals, savory snacks, and ready-to-eat/heat foods, especially pizza, burgers, and sandwiches. No association was found between UPF intake and overweight/obesity risk. CONCLUSIONS: A higher UPF intake was associated with a modest yet significant increase in BMI in large prospective cohorts of United States youths, calling for public health efforts to promote healthful food intake among youths to prevent excessive weight gain.

Traces of the past: assessing the impact of potentially toxic elements from an abandoned mine on groundwater and agricultural soil in San Luis Potosí, México.

The study was conducted in Cerritos, San Luis Potosí, México, near the Guaxcama mine, focused on environmental contamination (groundwater and agricultural soil) from antimony (Sb), arsenic (As), lead (Pb), cadmium (Cd), and mercury (Hg). In March 2022, 20 agricultural soil and 16 groundwater samples were collected near the historically cinnabar (HgS)- and arsenopyrite (FeAsS)-rich Guaxcama mine. Hydride generation atomic fluorescence spectrometry (HG-AFS) for As, cold vapor atomic fluorescence spectrometry (CV-AFS) for Hg, and inductively coupled plasma optical emission spectrometry (ICP-OES) for Cd, Pb, and Sb were used for the determinations of potentially toxic elements (PTEs). While concentrations of Cd, Hg, Pb, and Sb in groundwater were below detection limits, As levels exhibited a range from 40.9 ± 1.4 to 576.0 ± 1.0 µg/L, exceeding permissible limits for drinking water (10 µg/L). In agricultural soil, As was between 7.67 ± 0.16 and 24.1 ± 0.4 µg/g, Hg ranged from 0.203 ± 0.018 to 2.33 ± 0.19 µg/g, Cd from 2.53 ± 0.90 to 2.78 ± 0.01 µg/g, and Pb from 11.7 ± 1.2 to 34.3 ± 4.1 µg/g. Only one study area surpassed the Mexican As soil limit of 22 µg/g. Sequential extraction (four-step BCR procedure) indicated significant As bioavailability in soil (fractions 1 and 2) ranging from 3.66 to 10.36%, heightening the risk of crop transfer, in contrast to the low bioavailability of Hg, showing that fractions 1, 2, and 3 were below the limit of quantification (LOQ). Crucial physicochemical parameters in soil, including nitrate levels, pH, and organic matter, were pivotal in understanding contamination dynamics. Principal component analysis highlighted the influence of elements like Fe and Ca on phytoavailable As, while Pb and Cd likely originated from a common source. Ecological risk assessments underscored the significant impact of pollution, primarily due to the concentrations of Cd and Hg. Non-cancer and cancer risks to residents through As poisoning via contaminated water ingestion also were found. The hazard index (HI) values varied between 4.0 and 82.2 for adults and children. The total incremental lifetime cancer risk (TILCAR) values for adults ranged from 7.75E - 04 to 1.06E - 02, whereas for children, the values were from 2.47E - 04 to 3.17E - 03.

Causal relationship between dietary intake and IgA nephropathy: a Mendelian randomization study.

Objective: Previous studies have reported that dietary intake is associated with immunoglobulin A nephropathy (IgAN). However, the causal relationship remains unknown. Based on publicly available genome-wide association study (GWAS) data, we conducted a two-sample Mendelian randomization (MR) analysis to assess the causal association between 26 dietary exposures and IgAN. Methods: Five methods, including inverse variance weighting (IVW), MR-Egger regression, weighted median, simple mode, and weighted mode, were applied in the MR analysis. To identify the presence of horizontal pleiotropy, we used the MR-Egger intercept test and MR pleiotropy residual sum and outlier (MR-PRESSO) global test. Cochran's Q statistics were used to assess instrument heterogeneity. We conducted sensitivity analysis using the leave-one-out method. Results: Finally, the results indicated alcohol intake frequency (odds ratio [OR] (95% confidence interval [CI]) = 1.267 (1.100-1.460), p = 0.0010295) was a risk factor of IgAN, while cheese intake (OR (95% CI) = 0.626 (0.492-0.798), p = 0.0001559), cereal intake (OR (95% CI) = 0.652 (0.439-0.967), p = 0.0334126), and sushi intake (OR (95% CI) = 0.145 (0.021-0.997), p = 0.0497) were protective factors of IgAN. No causal relationship was found between IgAN and the rest of the dietary exposures. Conclusion: Our study provided genetic evidence that alcohol intake frequency was associated with an increased risk of IgAN, while cheese, cereal, and sushi intake were associated with a decreased risk of IgAN. Further investigation is required to confirm these results.

The carbon isotope ratio of breath is elevated by short-term and long-term added sugar and animal protein intake in a controlled feeding study.

BACKGROUND: The breath carbon isotope ratio (CIR) was recently identified as a noninvasive candidate biomarker of short-term added sugars (AS) intake. OBJECTIVES: This study aimed to better understand the potential of the breath CIR as a dietary biomarker. We evaluated the effects of short-term and long-term intakes of AS, animal protein (AP), and related variables on breath CIR, in the context of typical dietary intake patterns. METHODS: We conducted a 15-d controlled feeding study of 100 adults (age 18-70 y, 55% females) in Phoenix, AZ. Participants were provided individualized diets that approximated habitual food intakes and recorded the timing of food consumption. Three breath samples (fasting, midday, and evening) were collected on each of 3 nonconsecutive study days. We modeled the effects of dietary intake in each of 8 h preceding collection of the breath sample on breath CIR with a linear mixed model, which also included 15-d mean intakes, sex, age, and BMI. RESULTS: Median (IQR) intakes of AS and AP in our study were 65 (38) and 67 (33) g/d, respectively. Midday and evening breath CIRs correlated strongly with each other (0.80) and with fasting breath CIR (0.77 and 0.68, respectively). In our linear mixed models, breath CIR increased by AS consumed 1-4 h before sample collection, AP consumed 3-6 h before sample collection, and 15-d intakes of AS and AP, all with similar effect sizes. The breath CIR was also inversely associated with 15-d intakes of intrinsic sugars and plant protein; thus, associations with 15-d intakes were particularly strong when expressed proportionally as the AS ratio (added sugars/total sugars) and AP ratio (animal protein/total protein). CONCLUSIONS: The breath CIR is a promising measure of long-term intakes of AS and AP, especially as proportional intakes. Approaches to increase specificity would benefit the further development of this biomarker.

Association of Polyamine Intake, Other Dietary Components, and Fecal Content of N-acetyl Putrescine and Cadaverine with Patients' Colorectal Lesions.

Colorectal cancer (CRC) is the second leading cause of cancer death worldwide. Early detection and the modification of risk factors, such as diet, can reduce its incidence. Among food components, polyamines are important for maintaining gastrointestinal health and are metabolites of gut microbiota. Their disruption is linked to CRC, making polyamines a potential marker of the disease. This study analyzed the relationship between dietary components, including polyamines, and the presence of polyamines in feces to determine whether their presence could contribute to predicting the occurrence of colorectal lesions in patients. In total, 59 participants of both sexes (aged 50 to 70 years) who had undergone colonoscopy screening for CRC (18 without and 41 with colorectal lesions) participated in the study. A nutritional survey and determination of fecal polyamine content were performed. Specific dietary components and putrescine levels were higher in patients with colorectal lesions. The diet ratio of putrescine-spermidine and the fecal content of N-acetyl putrescine and cadaverine were elevated in patients with precancerous lesions and adenocarcinomas, showing a potential predictive value for the presence of colorectal lesions. These findings suggest that N-acetyl putrescine and cadaverine could be complementary markers for the diagnosis of suspected colorectal lesions.

Nutritional Assessment, Body Composition, and Low Energy Availability in Sport Climbing Athletes of Different Genders and Categories: A Cross-Sectional Study.

Climbing is an Olympic discipline in full development and multidisciplinary in nature, where the influences of body composition and nutritional status on performance have not yet been clarified despite the quest for a low weight in anti-gravity disciplines such as climbing. The present cross-sectional study aimed to conduct nutritional (3-day dietary diaries) and body composition (ISAK profile) assessments on sport climbing athletes by gender and climbing level during the months of February and March 2024. The t-test for independent samples and the Mann-Whitney U-test, as well as an ANOVA and the Kruskal-Wallis H-test, were used to compare the distributions of two or more groups, respectively, and Pearson's and Spearman's correlation coefficients were used to estimate the correlations between the different variables. The mean age of the 46 Spanish climbers (22 men and 24 women) was 30 years (SD: 9) with 7.66 years of experience (SD: 6.63). The mean somatotype of the athletes was classified as balanced mesomorph. Negative correlations were observed between fat mass variables and climbing level (p < 0.010), and positive correlations were observed with forearm circumference (p < 0.050). The mean energy availability (EA) was 33.01 kcal-kg FFM-1d-1 (SD: 9.02), with 55.6% of athletes having a suboptimal EA status and 35.6% having low energy availability (LEA). The carbohydrate and protein intakes were below the recommendations in 57.8% and 31.1% of athletes, respectively. There were deficient intakes of all micronutrients except phosphorus in males. These findings suggest that climbing athletes are at a high risk of developing low energy availability states and concomitant problems. Optimal nutritional monitoring may be advisable in this type of athlete to try to reduce the risk of LEA.

Stress levels and eating behavior among university students in Jordan: A cross-sectional study.

BACKGROUND: Increased body weight is common among university students; transitioning from high school to university may increase perceived stress levels, thus changing dietary habits and metabolism to promote overweight or obesity. The current study investigates the association between stress and dietary habits among university students in Jordan. MATERIALS AND METHODS: A cross-sectional study was conducted among 221 university students aged between 20 and 25 at Applied Science Private University [ASU]. A self-reported questionnaire was distributed to university students. The questionnaires were divided into three sections: the first was about general characteristics, body weight, change in body weight, and stress eating. RESULT: The survey of 208 participants showed that 64.3% were females, and 84.2% of students lived with their families. Results showed that more than half [51.1%] of the respondents were dissatisfied with their eating habits. Females [57.7%] monitored their food intake more than males did. However, most males [77.2%] reported less eating during stress compared to females. In addition, the data analysis revealed that those who ate more were less likely to monitor their food intake [χ 2 =9.734, df = 1, P = .002] or quantity [χ 2 =16.704, df = 1, P < .001]. Only 20.8% of the participants preferred sports or hobbies as a stress reduction activity; 29.4% took showers, while 51.1% ignored what made them stressed. Finally, 56.3% of participants reported increased weight after starting university, and it was significantly correlated with stress eating while studying for exams [χ 2 =8.762, df = 2, P = .013]. Stress affects university students and can lead to unhealthy eating habits and health issues like obesity. CONCLUSION: Many students face stress during their academic years, which affects their dietary choices. Policies promoting healthy eating habits and stress-reducing activities are important for university students.

Dietary sugar and saturated fat consumption associated with changes in the gastrointestinal microbiome during pregnancy.

BACKGROUND: Growing evidence supports changes in the gastrointestinal microbiome over the course of pregnancy may have an impact on the short and long-term health of both the mother and the child. OBJECTIVE: Our objective was to explore the association of diet quality, as measured by the Healthy Eating Index (HEI), with the composition and Gene Ontology (GO) representation of microbial function in the maternal gastrointestinal microbiome during pregnancy. METHODS: We conducted a retrospective, observational analysis of n=185 pregnant participants in the Pregnancy Eating Attributes Study (PEAS) study. Maternal dietary intake was assessed in the first trimester using the Automated Self-Administered 24-Hour Recall (ASA24) method, from which the Healthy Eating Index 2015 was calculated. Rectal swabs were obtained in the second trimester and sequenced using the NovaSeq 6000 system shotgun platform. We used unsupervised clustering to identify microbial enterotypes representative of maternal taxa and GO functional term composition. Multivariable linear models were used to identify associations between taxa, functional terms, and food components while controlling for relevant covariates. Multinomial regression was then used to predict enterotype membership based on a participant's HEI food component score. RESULTS: Those in the high diet quality tertile had a lower early pregnancy BMI (mean [M]=23.48 kg/m2, SD=3.38) compared to the middle (M=27.35, SD=6.01) and low (M=27.49, SD=6.99) diet quality tertiles (p<0.01). There were no statistically significant associations between the HEI components or the total HEI score and the four alpha diversity measures. Differences in taxa and GO term enterotypes were found in participants with, but not limited to, a higher saturated fat component score (ß=1.35, p=0.01), added sugar HEI component (ß=0.07, p<0.001), and higher total dairy score (ß=1.58, p=0.01). CONCLUSIONS: Specific dietary components are associated with microbial composition and function in the second trimester of pregnancy. These findings provide a foundation for future testable hypotheses.

Association between composite dietary antioxidant index and migraine in American young women: insights from NHANES 1999-2004 cross-sectional data.

Background: Excessive oxidative stress is one of the key pathophysiological mechanisms underlying migraine, and increasing antioxidant intake has proven to be an effective strategy for the prevention and improvement of migraine symptoms. To explore the relationship between the composite dietary antioxidant index (CDAI) and the occurrence of migraine attacks. Methods: Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2004 were utilized. Logistic regression, stratified analysis, and restricted cubic spline (RCS) models were employed to investigate the association between CDAI and migraine attacks. Results: A total of 8,137 adults aged ≥20 were enrolled, comprising 1,610 patients with migraine and 6,527 non-migraine individuals. After adjusting for all covariates, CDAI was negatively correlated with migraine. In the overall participants, compared with the CDAI Q1 (-5.83 to -2.14) group, the adjusted odds ratio (OR) for migraine in Q3 (-0.59 to 1.53) and Q4 (1.53-44.63) groups were 0.71 [95% confidence interval (95% CI): 0.54-0.92, p = 0.011] and 0.64 (95% CI: 0.47-0.87, p = 0.005), respectively. After stratifying by age and gender, the protective effect was more pronounced in females aged 20-50, with adjusted OR for Q3 (-0.59 to 1.53) and Q4 (1.53-44.63) groups of 0.60 (95% CI: 0.40-0.90, p = 0.013) and 0.48 (95% CI: 0.30-0.78, p = 0.003), respectively. The RCS curve indicated a nonlinear relationship between CDAI and migraine in females aged 20-50, with a threshold of 0.006. Conclusion: CDAI is negatively correlated with migraine attacks, and a higher CDAI may be an effective protective factor in preventing migraine attacks, especially in women aged 20-50.

Micronutrient intake inadequacies in Northwest Ethiopian children aged 6-23 months.

The early stages of childhood are a crucial period of life for health, with inadequate nutrition impacting physical growth, cognitive development, and the immune system. A considerable proportion of children are affected by micronutrient intake inadequacy and deficiency across the globe. Evidence on micronutrient intake among children aged 6-23 months is limited in Northwest Ethiopia, where there is a divergence between production and dietary consumption practices compared to other regions of the country. This study aimed to determine micronutrient inadequacy and associated factors among children aged 6-23 months. From February 1 to February 18, 2023, 435 children aged 6-23 months participated in a community-based cross-sectional study in the North Mecha District of the Amhara Region, Northwest Ethiopia. The study participants were selected using a multistage sampling technique. A multiphasic interactive 24-h dietary recall was used to collect dietary intake data via an interviewer-administered questionnaire. The interviews were conducted with the mothers of the selected children. Nutrient values for the selected 12 micronutrients were calculated using the NutriSurvey 2007 software and food composition tables from Ethiopia, Tanzania, and Kenya. SPSS version 25 was used for the remaining parts of the analysis. The Nutrient Adequacy Ratio and Mean Adequacy Ratio were calculated to evaluate the nutrient intakes. To identify the factors associated with overall micronutrient intake inadequacy, a binary logistic regression analysis was performed, with statistical significance determined at a p-value < 0.05. The overall prevalence of micronutrient intake inadequacy was 64.7% (95% CI 59.9, 69.2). The odds of inadequacy of micronutrient intake were 2.8 times higher among children aged 6-8 months than children aged 9-23 months (AOR = 2.80, 95% CI 1.71, 4.59). Children with paternal education unable to read and write and primary school incomplete were 3.1 (AOR = 3.12, 95% CI 1.26, 7.70) and 2.4 (AOR = 2.40, 95% CI 1.01, 5.73) times more likely to have micronutrient intake inadequacy, respectively, compared to children with paternal education of primary school completed and above. The likelihood of micronutrient intake inadequacy was 1.8 times higher among children from mothers who had an unfavorable nutrition-related attitude than those from mothers who had a favorable attitude (AOR = 1.76, 95% CI 1.02, 3.05). Inadequate intake of micronutrients was shown to be highly prevalent among children aged 6-23 months. Child age, paternal education, and maternal nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Integrating community-guided nutrition interventions targeting nutrition-related knowledge and attitudes of parents is critical in addressing the inadequate micronutrient intake of children in the study community, where production is not a major problem.

Association of ultra-processed food intake with severe non-alcoholic fatty liver disease: a prospective study of 143073 UK Biobank participants.

BACKGROUND: Previous studies indicate a link between non-alcoholic fatty liver disease (NAFLD) and unhealthy dietary patterns or nutrient intake. However, it remains unclear whether ultra-processed foods (UPF) contribute to an increased risk of NAFLD. This study aimed to explore how ultra-processed food consumption correlates with severe NAFLD using the UK Biobank data. METHODS: This prospective cohort study included 143,073 participants from the UK Biobank. UPF consumption levels were determined using the NOVA classification and quantified from 24-h dietary recall data. The association between UPF consumption and severe NAFLD (hospitalization or death) was initially examined using Cox proportional hazards models with intake quartiles. Nonlinear associations were investigated using penalized cubic splines fitted in the Cox proportional hazards models. Adjustments were made for general characteristics, sociodemographic factors, body mass index (BMI), and lifestyle. RESULTS: Throughout the median follow-up period of 10.5 years, 1,445 participants developed severe NAFLD. The adjusted models indicated a significant increase in severe NAFLD risk in higher UPF intake groups compared to the lowest quartile (HR: 1.26 [95% CI: 1.11-1.43]). Subgroup analysis revealed that individuals with a BMI of 25 or higher were at greater risk in the highest quartile of UPF consumption. Sensitivity analyses yielded results consistent with these findings. CONCLUSION: Higher consumption of UPF is associated with an increased risk of severe NAFLD. Reducing the intake of UPF can be a potential approach to lower the risk of NAFLD.

Socio-demographic differences in the dietary inflammatory index from National Health and Nutrition Examination Survey 2005-2018: a comparison of multiple imputation versus complete case analysis.

OBJECTIVE: Studies using the dietary inflammatory index often perform complete case analyses (CCA) to handle missing data, which may reduce the sample size and increase the risk of bias. Furthermore, population-level socio-economic differences in the energy-adjusted dietary inflammatory index (E-DII) have not been recently studied. Therefore, we aimed to describe socio-demographic differences in E-DII scores among American adults and compare the results using two statistical approaches for handling missing data, i.e. CCA and multiple imputation (MI). DESIGN: Cross-sectional analysis. E-DII scores were computed using a 24-hour dietary recall. Linear regression was used to compare the E-DII scores by age, sex, race/ethnicity, education and income using both CCA and MI. SETTING: USA. PARTICIPANTS: This study included 34 547 non-Hispanic White, non-Hispanic Black and Hispanic adults aged ≥ 20 years from the 2005-2018 National Health and Nutrition Examination Survey. RESULTS: The MI and CCA subpopulations comprised 34 547 and 23 955 participants, respectively. Overall, 57 % of the American adults reported 24-hour dietary intakes associated with inflammation. Both methods showed similar patterns wherein 24-hour dietary intakes associated with high inflammation were commonly reported among males, younger adults, non-Hispanic Black adults and those with lower education or income. Differences in point estimates between CCA and MI were mostly modest at ≤ 20 %. CONCLUSIONS: The two approaches for handling missing data produced comparable point estimates and 95 % CI. Differences in the E-DII scores by age, sex, race/ethnicity, education and income suggest that socio-economic disparities in health may be partially explained by the inflammatory potential of diet.

Cost of a Healthy Diet: A Population-Representative Comparison of 3 Diet Cost Methods in Canada.

BACKGROUND: Different food price sources and dietary assessment tools may impact the estimation of diet costs and hamper our understanding of the relationship between diet costs and dietary intakes. OBJECTIVES: We aimed to investigate the effect of 3 diet cost derivation methods, with increasing numbers of food prices and geographic specificity, holding consistent dietary assessment, on the estimation of diet costs overall and by food group. METHODS: We matched 24-h dietary recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS-N) to food price data from 3 Canadian Consumer Price Index (CPI) food price lists; national short list, national long list, and provincial long list. We compared the daily ($/day) and energy-adjusted ($/2000 kcal) diet costs overall and by food groups for the overall population (4+), children (4-18), and adults (19+). RESULTS: The proportion of dietary intakes (grams) that were covered by CPI prices significantly increased from the national short list to the national long list but did not significantly differ from the national long list to the provincial long list. The national short list resulted in the highest daily and energy-adjusted diet costs overall. No difference in diet costs was noted between the national and provincial long lists. Diet costs for 4 food groups-additions, sweets, fruits, and vegetables, which were poorly covered by the national short list-significantly differed using the national and provincial long lists. All 3 diet cost methods were significantly correlated with energy intakes; however, a strong/very strong correlation was detected for children, and a weak/moderate correlation for adults. CONCLUSIONS: The choice of food price data may introduce bias in the diet cost estimate, as well as limiting our understanding of how individuals allocate their diet costs. Refinement of diet cost estimation methodology and measures can strengthen future studies of how consumers allocate their purchases to their diets.

Analysis of the diet, weight-loss behavior, and nutritional knowledge of athletes and coaches in weightclass sports: influence of a coach's nutritional knowledge on athletes.

BACKGROUND: This study was conducted to investigate the nutritional knowledge of elite athletes undergoing weight loss and to identify differences in weight-loss strategies according to nutritional knowledge. METHODS: The participants included 22 coaches and 88 elite athletes registered under the same affiliation. The survey involved translating the General Nutrition Knowledge Questionnaire (GNKQ), and interviews were used to confirm the diet and weight loss patterns of the athletes. The coaches and athletes were divided into high-rank (12 coaches and 57 athletes) and low-rank (10 coaches and 31 athletes) groups based on GNKQ scores. Paired t-tests, correlation analysis, and logistic regression analysis were performed. RESULTS: GNKQ results showed significant differences between high-ranking and low-ranking coaches (p < 0.001). Furthermore, a significant difference in nutrition knowledge scores was also noticed between athletes with high-ranking and low-ranking coaches (p < 0.001). A strong correlation was observed between the GNKQ scores of coaches and athletes (r = 0.369; p < 0.001). The nutritional knowledge of coaches was also correlated with weight-loss strategies (weight loss attempt frequency; r = -0.235; p = 0.027; weight loss duration; r = -0.268; p = 0.012). Additionally, differences were observed in the intake of all nutrients (carbohydrates, proteins, and fat) in the diets of athletes (p < 0.001). CONCLUSION: Our study suggests that the nutritional knowledge of coaches indirectly affects athletes. Coaches have significant influence over athletes and possess experience with diet and weight-loss patterns. This insight should be effectively utilized to enhance the training and performance of athletes and coaches.

Flavonoid intakes, chronic obstructive pulmonary disease, adult asthma, and lung function: a cohort study in the UK Biobank.

BACKGROUND: Given their antioxidative stress, anti-allergic, anti-inflammatory, and immune-modulating effects, flavonoids are hypothesized to play a role in preventing chronic obstructive pulmonary disease (COPD) and asthma. OBJECTIVES: This cohort study aimed to examine associations between flavonoid intake and COPD, asthma, and lung function. METHODS: Among 119,466 participants of the UK Biobank, median [interquartile range] age of 60 [53, 65] y, we estimated intakes of flavonoids, flavonoid-rich foods, and a flavodiet score from 24-h diet assessments. Prospective associations with both incident COPD and asthma and cross-sectional associations with measures of lung function [%predicted forced expiratory volume in 1s (FEV1); and FEV1/forced vital capacity (FVC)] were examined using multivariable-adjusted Cox proportional hazards and linear regression models, respectively. We investigated mediation by inflammation--represented by the INFLA score--and stratified analyses by smoking status. RESULTS: Compared with low intakes, moderate intakes of total flavonoids, flavonols, theaflavins + thearubigins, and flavanones, and moderate-to-high intakes of flavanol monomers, proanthocyanidins, anthocyanins, flavones, and the flavodiet score were associated with up to an 18% lower risk of incident COPD {e.g., [hazard ratio (95% confidence interval) for total flavonoids: 0.83 (0.75, 0.92)]} but not incident asthma. Furthermore, compared with low intakes, higher intakes of all flavonoid subclasses (except theaflavins + thearubigins), and the flavodiet score were associated with better percent predicted FEV1 baseline. Associations were most apparent in ever (current or former) smokers. Flavonoid intakes were inversely associated with the INFLA score, which appeared to mediate 11%-14% of the association between intakes of proanthocyanidins and flavones and incident COPD. CONCLUSIONS: Moderate-to-high flavonoid intakes were associated with a lower risk of COPD and better lung function, particularly among ever smokers. Promoting intakes of healthy flavonoid-rich foods, namely, tea, apples, and berries, may improve respiratory health and lower COPD risk, particularly in individuals with a smoking history.

Oral Health Status, Dietary Intake, and Oral Health-related Quality of Life among Institutionalized Elderly in Bangalore.

Objective: The study aimed to evaluate the association between dietary intake and oral health status and how oral health-related quality of life (OHQoL) influences the institutionalized elderly population of Bangalore. Methods and Materials: A cross-sectional study was conducted to appraise the oral health and dietary intake of institutionalized elderly. Patients completed a validated questionnaire and a clinical evaluation. CPI index, loss of attachment (LoA), DMFT, prosthetic status, and prosthetic necessity were utilized to contrast OHQoL using the Chi-square test. The diet and OHQoL were compared using ANOVA. Results: This study surveyed 400 institutionalized elderly populations. The average age of the sample was 70.02 ± 8.149 years. LoA and DMFT were significantly associated with GOHAI's functional domain (P = 0.000). CPI (P = 0.049) and DMFT index (P = 0.003) were associated with GOHAI pain/discomfort and psycho-social domains. The psycho-social domain was associated with an upper arch prosthesis status (P = 0.010). Subjects with good OHQoL consumed 1961.19 ± 479.33 calories, while those with poor OHQoL consumed 1814 ± 432.41 calories (P = 0.002). Conclusion: According to the study findings, periodontal disease, decay, and missing teeth impaired OHQoL. The OHQoL was significantly declined with dietary intake.

Energy Deficit and Factors Associated with Energy Balance during a Combat Deployment in U.S. Army Special Operation Forces Soldiers.

The purpose of this study was to determine the difference between estimated energy expenditure (EE) and self-reported dietary intake (EI), and factors associated with energy balance in deployed U.S. Army Special Operations Forces (SOF) Soldiers. METHODS: Forty-six SOF Soldiers (age: 30.1 ± 3.5 yrs, body mass index: 27.7 ± 4.1 kg/m2) completed surveys on demographic data, mission activity characteristics, gastrointestinal issues, ration consumption, resilience, mood state, and dietary intake using a 127-question food frequency questionnaire at the end of a six-month deployment. EE was estimated using a SOF-specific prediction equation with a physical activity factor of 2.1. A paired t-test compared reported energy intake (EI) with estimated energy expenditure (EE). Pearson correlations identified significant variables associated with energy balance, which were then incorporated into a multiple linear regression model. The regression analysis included Profile of Mood States (POMS) anger and POMS depression as predictor variables to determine their influence on energy balance. RESULTS: Reported mean EI was 2512 ± 1059 kcal·d-1, while estimated mean EE was 5272 ± 525 kcal·d-1. The mean energy imbalance was -2854 kcal/d (95% CI: -2655 to -3055, p < 0.001), with all participants in negative energy balance (range: -492 to -3813 kcal/d). POMS depression (r = 0.517, p < 0.01) and POMS anger (r = 0.363, p = 0.020) were associated with energy balance. The regression model was significant (R2 = 0.23, F (2, 38) = 7.02, p < 0.01), with POMS depression significantly predicting energy balance (ß = 50.76, p = 0.011). CONCLUSIONS: Deployed SOF Soldiers reported high EE and limited EI, which may negatively impact performance. Higher POMS depression scores were associated with lower energy deficits. Future studies should investigate the relationship between mood and energy balance, using direct measures of EI and EE.