Association between Food Insecurity and Vision Impairment among Older Adults: A Pooled Analysis of Data from Six Low- and Middle-Income Countries.

OBJECTIVES: Food insecurity has gained attention as a potential risk factor for vision impairment. However, research on this topic is limited. This objective of this study was to investigate the relationship between food insecurity and visual impairment among adults aged 50 years or older using data from six low-and middle-income countries (LMIC). DESIGN AND SETTING: Data from the longitudinal Study on global AGEing and adult health (SAGE) were analyzed in a community-based, cross-sectional, and nationally representative sample. PARTICIPANTS: Adults aged 50 years or older from six low- and middle-income countries (LMICs) including China, India, Mexico, Russia, South Africa, and Ghana. MEASUREMENTS: Food insecurity was evaluated using a questionnaire comprised of two questions that addressed the frequency of eating inadequately and hunger due to a lack of food in last 12 months. Distance and/or near vision impairment was considered as a visual acuity score of less than 6/18 in the eye with better vision. RESULTS: The analytical sample consisted of 29,804 adults (mean (SD) for age: 63.2 (9.54) years; 54.3% female). The prevalence of food insecurity, near vision and distance vision impairment in the sample was 16.4%, 36.7%, and 13.9%, respectively. Adjusted pooled analyses across countries revealed a significant association between food insecurity and distance (OR: 1.16; 95% CI: 1.01, 1.33; P=0.04, significant individually in India and South Africa) and near (OR: 1.12; 95% CI: 1.02, 1.22; P=0.01, significant individually in South Africa) vision impairment, and a between-country heterogeneity of 46.30% and 25.99%, respectively. CONCLUSION: Food insecurity was associated with both distance and near vision impairment in adults aged 50 years or older across six LMIC. Food policies and intervention programs targeted at decreasing food insecurity in vulnerable households are essential.

The effect of synbiotics pomegranate juice on cardiovascular risk factors in PCOS patients: a randomized, triple-blinded, controlled trial.

PURPOSE: Polycystic ovarian syndrome (PCOS) is one of the most common metabolic and endocrine disorders. Functional foods like pomegranate and probiotics are those that are considered to have beneficial effects on metabolic diseases beyond their basic nutritional value. So, we aimed to evaluate the effect of synbiotic pomegranate juice (SPJ) on cardiovascular risk factors on PCOS patients. METHODS: This was a randomized, triple-blinded, 8-week trial. Participants were randomly assigned to receive 300 mL/day of pomegranate juice (PJ), synbiotic beverage (SB), synbiotic pomegranate juice (SPJ), or placebo beverage (PB). Biochemical indices (lipid profile, Total Antioxidant Capacity (TAC), Malondialdehyde (MDA), high sensitive C-Reactive Protein (hs-CRP)) and blood pressure were assessed before and after the intervention. RESULTS: Participants in the PJ, SB, and SPJ groups experienced improvement in their lipid profile, oxidative stress, inflammation, and blood pressure during the time. Compared to placebo, Total Cholesterol (TC) was lower in the SB group (P < 0.01), LDL-c was lower in the SPJ and SB groups (P < 0.01), and HDL-c was higher in the SPJ and PJ groups (P < 0.01). With regards to oxidative stress and inflammation, when compared with placebo, MDA was lower in the SPJ, SB, and PJ groups (P < 0.001), TAC was increased in the SPJ and PJ groups (P[Formula: see text] 0.001), and hs-CRP was decreased in the PJ group (P = 0.02). Blood pressure (BP) was lower in the SPJ and PJ groups compared to placebo (P < 0.001; P < 0.01, respectively). CONCLUSIONS: Consuming daily SPJ for 8 weeks improved metabolic, oxidative, inflammatory, and BP outcomes in females with PCOS. This trial was registered in the Iranian Registry of Clinical Trials (IRCT20170207032439N2).

The effect of daily fortified yogurt consumption on weight loss in adults with metabolic syndrome: A 10-week randomized controlled trial.

BACKGROUND AND AIMS: Obesity is a complex and multifaceted condition. Thus, functional foods need investigation as novel adjunct treatments for obesity. The objective was to determine the effects of daily consumption of a fortified yogurt (FY) on weight loss in overweight and obese patients with metabolic syndrome on a caloric-restricted diet. METHODS AND RESULTS: This was a randomized, double-blind, 10-week study. Participants were randomly allocated to two groups receiving either two servings (2 × 250 g)/day of FY with whey protein, calcium, vitamin D, prebiotic fibre and probiotic cultures (n = 44) or a low-fat plain yogurt (PY) (n = 43). All participants were put on a calorie-restricted diet throughout the 10-week study. Body composition and biochemical indices were assessed before and after the intervention. Body mass decreased by 4.3 ± 1.9 kg and 5.1 ± 3.0 kg in the PY and FY groups, respectively, following the 10-week intervention. Compared to PY, consumption of FY resulted in a significant reduction in body fat mass (FM) (p = 0.023), body fat percentage (p = 0.028), waist circumference (p = 0.002), homoeostasis model of assessment-insulin resistance (HOMA-IR) (p = 0.025), triglyceride concentration (p = 0.003), and a significant increase in total 25-hydroxyvitamin D (25(OH)D) concentration (p < 0.001), high density lipoprotein-cholesterol (HDL-C) (p = 0.009) and quantitative insulin sensitivity check index (QUICKI) (0.022). Participants consuming the FY lost less fat-free mass (FFM) compared to the PY group (Δ = -0.9 ± 3.5 kg vs. Δ = -2.0 ± 2.7 kg; p = 0.025). CONCLUSIONS: Consuming FY for 10-weeks improved body composition and metabolic parameters, while on a caloric-restricted diet. Further research is needed to elucidate whether FY can be used as a preventative strategy for metabolic syndrome in obese persons. TRIAL REGISTRATION: www.irct.ir (IRCT2017050633836N1).

Association of eating while television viewing and overweight/obesity among children and adolescents: a systematic review and meta-analysis of observational studies.

The objective of this systematic review and meta-analysis was to examine the association between eating while television viewing (TVV) and overweight or obesity in children (<18 years). A systematic search of PubMed, Scopus, Web of science, PreQuest and Embase was conducted up to April 2017; pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using a random effects model. Of 4,357 articles identified, 20 observational studies met inclusion criteria (n = 84,825) and 8 of these 20 (n = 41,617) reported OR. Eating while TVV was positively associated with obesity-related anthropometric measurements in 15 studies (75%). The meta-analysis revealed that eating while TVV was positively associated with being overweight (OR = 1.28; 95% CI: 1.17, 1.39). Subgroup analyses showed similar positive associations in both girls and boys, as well as in children who ate dinner while TVV. There was no evidence of publication bias. The present systematic review and meta-analysis suggests that eating while TVV could be a risk factor for being overweight or obese in childhood and adolescents.

The effect of flaxseed supplementation on body weight and body composition: a systematic review and meta-analysis of 45 randomized placebo-controlled trials.

Flaxseed consumption may be inversely associated with obesity; however, findings of available randomized controlled trials (RCTs) are conflicting. The present study aimed to systematically review and analyse RCTs assessing the effects of flaxseed consumption on body weight and body composition. PubMed, Medline via Ovid, SCOPUS, EMBASE and ISI Web of Sciences databases were searched up to November 2016. Mean changes in body composition indices including body weight, body mass index (BMI) and waist circumference were extracted. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity between studies was assessed with the I2 test. Publication bias and subgroup analyses were also performed. The quality of articles was assessed via the Jadad scale. A total of 45 RCTs were included. Meta-analyses suggested a significant reduction in body weight (WMD: -0.99 kg, 95% CI: -1.67, -0.31, p = 0.004), BMI (WMD: -0.30 kg m-2 , 95% CI: -0.53, -0.08, p = 0.008) and waist circumference (WMD: -0.80 cm, 95% CI: -1.40, -0.20, p = 0.008) following flaxseed supplementation. Subgroup analyses showed that using whole flaxseed in doses ≥30 g d-1 , longer-term interventions (≥12 weeks) and studies including participants with higher BMI (≥ 27 kg m-2 ) had positive effects on body composition. Whole flaxseed is a good choice for weight management particularly for weight reduction in overweight and obese participants.

The Effect of n-3 Polyunsaturated Fatty Acid Supplementation on Androgen Status in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials.

The anti-androgenic role of n-3 polyunsaturated fatty acids (PUFAs) among patients with polycystic ovary syndrome (PCOS) has recently been proposed. The present study aimed to systematically review clinical trials assessing the effects of n-3 PUFAs consumption on androgen status among adult females with PCOS. PubMed, ISI Web of Science, Google Scholar, and Scopus were searched up to December 2015. Clinical investigations assessing the effect of n-3 PUFAs on adult females with PCOS were included. Mean±standard deviation of change in serum total testosterone, sex hormone binding globulin (SHBG), and dehydroepiandrostrone sulfate (DHEAS) were extracted. Eight clinical trials with 298 participants were eligible. Meta-analysis showed that n-3 PUFAs supplementation marginally reduces total testosterone (mean difference [MD]: - 0.19 nmol/l; 95% CI: - 0.39 to 0.00; p=0.054), but not SHBG (MD: 1.75 nmol/l; 95% CI: -0.51 to 4.01; p=0.129) or serum DHEAS levels (Hedes' g: -0.11 nmol/l; 95% CI: -0.29 to 0.06; p=0.19) among adult females with PCOS. Subgroup analyses showed that only before-after studies (Hedges' g: 0.15; 95% CI: -0.27 to -0.04; p=0.01) and long-term interventions (>6 weeks) (Hedges' g: -0.17; 95% CI, -0.29 to -0.05; p=0.004) had reducing effects on serum DHEAS levels. The majority of long-term trials utilized a single group design (no control group). It does not appear that n-3 PUFAs supplementation significantly affects the androgenic profile of females with PCOS; however, some before-after and long-term intervention studies show reduced DHEAS levels. Future studies incorporating double blinded placebo controlled clinical trials with long follow-up periods are warranted.

Dietary diversity score and obesity: a systematic review and meta-analysis of observational studies.

BACKGROUND/OBJECTIVES: Studies examining the association between dietary diversity score (DDS) and obesity have led to inconsistent findings. Therefore, the purpose of this review is to summarize and elucidate the source of heterogeneous results reported in different studies. METHODS: PubMed, ISI Web of Science, Scopus and Google Scholar were searched through December 2013 to identify all relevant articles. Sixteen publications met the inclusion criteria for the systematic review and 10 articles were entered into the meta-analysis. Eight studies had data on the odds ratio (OR) for overweight/obesity and eight compared the mean body mass index (BMI) among subjects with highest versus the lowest DDS. RESULTS: A meta-analysis on eligible studies failed to show a significant association on either overweight/obesity OR (OR: 0.72; 95% confidence interval (CI): 0.45-1.16; P=0.174) or mean differences (MD) in BMI (MD: 0.22; 95% CI: -0.70-1.14; P=0.643) comparing the highest and lowest diverse diets. Between-study heterogeneity was high, and subgroup analysis failed to identify the source of heterogeneity. CONCLUSIONS: Our systematic review and meta-analysis showed that there was no significant association between DDS and BMI status, which may be due to use of different methods for assessing dietary intake and determination of DDS. Thus, well-designed prospective studies with similar approaches to assess DDS are highly recommended.

Effect of sugars in solutions on subjective appetite and short-term food intake in 9- to 14-year-old normal weight boys.

BACKGROUND AND OBJECTIVE: The role of sugars in solutions on subjective appetite and food intake (FI) has received little investigation in children. Therefore, we examined the effect of isocaloric solutions (200 kcal/250 ml) of sugars including sucrose, high-fructose corn syrup-55 (HFCS) or glucose, compared with a non-caloric sucralose control, on subjective appetite and FI in 9- to 14-year-old normal weight (NW) boys. PARTICIPANTS AND METHODS: NW boys (n=15) received each of the test solutions, in random order, 60 min before an ad libitum pizza meal. Subjective appetite was measured at baseline (0 min), and 15, 30, 45 and 60 min. RESULTS: Only glucose (P=0.003), but neither sucrose nor HFCS, reduced FI compared with the sucralose control. This led to a higher cumulative energy intake, compared with sucralose, after sucrose (P=0.009) and HFCS (P=0.01), but not after glucose. In all treatment sessions, subjective average appetite increased from baseline to 60 min, but change from baseline average appetite was the highest after sucrose (P<0.005). Furthermore, sucrose (r=-0.59, P=0.02) and HFCS (r=-0.56, P=0.03), but not glucose, were inversely associated with test meal FI when the treatment dose (200 kcal) was expressed on a body weight (kg) basis. CONCLUSIONS: Change from baseline subjective average appetite was the highest after sucrose, but only the glucose solution suppressed FI at the test meal 60 min later in NW boys.

Prevalence of metabolic syndrome in pre- and postmenopausal Iranian women.

BACKGROUND AND AIMS: The metabolic syndrome (MetS) is a constellation of risk factors increasing the risk of developing cardiovascular disease and diabetes. Little information is available on the association between MetS and menopausal status in Iranian women. Therefore, the purpose of the current study was to examine the prevalence and severity of MetS in pre- and postmenopausal women based on two commonly employed assessment criteria. METHODS: A total of 490 premenopausal and 434 postmenopausal women from the Shiraz Women's Health Cohort Study were included in the study. MetS was defined according to the criteria of the National Cholesterol Education Program-Adult Panel Treatment III (NCEP-ATPIII) and the International Diabetes Federation (IDF). Clinical, biochemical and anthropometric measures were collected from all study participants for determination of MetS. RESULTS: The majority of participants had at least two components of MetS. Postmenopausal women, compared to premenopausal women, had a higher prevalence of MetS. The prevalences of MetS were 60.2% and 59.4% based on the NCEP-ATPIII and IDF definitions, respectively. Waist circumference, waist-to-hip ratio, blood pressure, and levels of fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, and triglycerides were higher in postmenopausal women compared to premenopausal women. CONCLUSIONS: MetS is a major threat to women's health and an aging population, and longitudinal studies to determine the mechanism of postmenopausal MetS are required.

A comparison of short-term appetite and energy intakes in normal weight and obese boys following glucose and whey-protein drinks.

OBJECTIVE: To compare the effect of glucose and whey-protein preloads on satiety and food intake (FI) as affected by time to the next meal and body composition in normal weight (NW) and obese (OB) boys. DESIGN: Cross-sectional clinical intervention study of the effect of caloric preloads on FI control in boys. SUBJECTS: Seventeen NW (body mass index (BMI)=18.9+/-0.5 kg/m(2); age=12.2+/-0.3 years) and 17 OB boys (BMI=25.8+/-0.9 kg/m(2); age=11.4+/-0.3 years) (Experiment 1) and 12 NW boys (BMI=18.6+/-0.6 kg/m(2); age=12.1+/-0.3 years) (Experiment 2). MEASUREMENTS: On three separate mornings and in random order each of the boys consumed a noncaloric sweetened preload, glucose (837 kJ) or whey protein (837 kJ) (Experiment 1) or noncaloric preload, glucose (1.0 g/kg) or whey protein (1.0 g/kg) (Experiment 2) made up to 250 ml with water 2 h after the consumption of a fixed breakfast. Food intake from a pizza meal was measured 30 min (Experiment 1) or 60 min (Experiment 2) later. RESULTS: In Experiment 1, glucose suppressed FI (mean kJ+/-s.e.m.) in NW (3126+/-304) and OB boys (3116+/-286) compared with the control (NW, 4015+/-337 and OB, 3791+/-255). Whey protein suppressed FI in NW, but not in OB boys. Body weight, fat-mass and fat-free mass were positively associated with FI after all treatments in NW, but was not related to FI in OB boys. In Experiment 2, FI was suppressed by whey protein (2683+/-367) more than by glucose (3107+/-294) or the control (3585+/-361). CONCLUSION: NW and OB boys respond differently to whey-protein preloads, with time to next meal a factor in the response to both glucose and protein preloads.