[Diet guidelines in adult and pediatric patient after allogeneic stem cell transplantation (SFGM-TC)]. / Consignes alimentaires pour les patients adultes et pédiatriques en sortie d'hospitalisation post-allogreffe de cellules souches hématopoïétiques (SFGM-TC).

The nutritional status after bone marrow transplant plays an important role in the outcome of patients. Post-allograft dietary instructions are therefore essential to ensure quality nutrition while minimizing the risk of infection. For patients, this is one of their main concerns on discharge from hospital. With the aim of harmonizing post-allograft dietary instructions, a multidisciplinary working group has been set up within a number of French centers performing hematopoietic stem cell allogenic transplantation. The dietary guidelines have been updated by this working group, through videoconference meetings, an online questionnaire, a review of the literature and deliberations at harmonization days. These instructions will be incorporated into the next update of the adult and pediatric post-transplant follow-up booklet.

Identification of Intervention Characteristics Within Diabetes Prevention Programs Using the Template for Intervention Description and Replication: A Scoping Review.

OBJECTIVES: Diabetes prevention programs (DPPs) targeting dietary and physical activity behaviour change have been shown to decrease the incidence of type 2 diabetes; however, a more thorough reporting of intervention characteristics is needed to expedite the translation of such programs into different communities. In this scoping review, we aim to synthesize how DPPs are being reported and implemented. METHODS: A scoping review using Arkey and O'Malley methods was conducted in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis. MEDLINE, CINAHL, PsycINFO, EMBASE, and SPORTDiscus were searched for studies relating to diabetes prevention and diet/exercise interventions. Only studies delivering a diet/exercise intervention for adults identified as "at risk" for developing type 2 diabetes were included. The Template for Intervention Description and Replication (TIDieR) was used to guide data extraction, and each DPP was scored on a scale from 0 to 2 for how thoroughly it reported each of the items (0 = did not report, 2 = reported in full; total score out of 26). RESULTS: Of the 25,110 publications screened, 351 (based on 220 programs) met the inclusion criteria and were included for data extraction. No studies comprehensively reported on all TIDieR domains (mean TIDieR score: 15.7 of 26; range 7 to 25). Reporting was particularly poor among domains related to "modifications," "tailoring," and "how well (planned/actual)." "How well (planned)" assesses the intended delivery of an intervention, detailing the initial strategies and components as per the original design, whereas "how well (actual)" evaluates the extent to which the intervention was executed as planned during the study, including any deviations or modifications made in practice. CONCLUSIONS: Although there is evidence to suggest that DPPs are efficacious, a more thorough reporting of program content and delivery is needed to improve the ability for effective programs to be implemented or translated into different communities.

Postsecondary Students' Knowledge of and Adherence to the 2019 Canada's Food Guide: A Cross-sectional Pilot Survey.

Purpose: We conducted a pilot survey among young adults attending a suburban Canadian university to understand: (1) knowledge of the 2019 Canada's Food Guide (CFG); (2) self-reported food choices and eating habits; (3) perceived influence of the CFG on food choices and eating habits; and (4) suggestions to improve engagement with CFG.Methods: Students were recruited, through posts on social media platforms, to complete an online questionnaire between 7 March and 6 April 2020.Results: One-hundred and twenty-one (70% women) students responded. One-third (33%) of women and 8% of men reported consuming the recommended proportion of vegetables and fruits (i.e., 40%-60% of the plate) at their most recent meal (P = 0.001). Men were more likely to report overconsuming protein foods than women (58% vs 32%, P = 0.005). The perceived influence of the CFG on food choices and eating habits was low, with a mean score 2.2 ± 1.4 out of 7, with 7 indicating "highly influential." Over 92% of participants believed awareness of the CFG could be improved through social media platforms.Conclusions: Although half of the participants correctly answered all 8 questions that assessed knowledge of the CFG, there is an opportunity for dietitians and related health professionals to improve engagement with CFG.

Particle size distribution in commercial pig compound feeds in Switzerland: survey and methodological considerations.

INTRODUCTION: The grinding intensity of pig feed is considered one potential predisposing factor for gastric ulcers, and a variety of particle size recommendations have been published for pig feeds. We subjected 51 different commercial compound feeds for pigs (38 meals, 13 pellets/granulates) to dry and/or wet sieve analysis. The amount of particles passing the finest sieve (or being soluble) was estimated by the difference to the total dry matter weighed prior to sieving. Mean particle size was calculated based on the weighted average of the material retained on the sieves (MPSsieves), and additionally with accounting for this lost material (MPStotal). Dry sieve analysis of the meals yielded MPSsieves of 0,58-2,90 mm and MPStotal of 0,58-2,89 mm; only 0,02 to 2,71 % of the dry matter passed all sieves. Wet sieve analysis of all meals and pellets yielded similar MPSsieves of 0,63-1,66 mm, but dramatically lower MPStotal of 0,26-1,04 mm; between 35 and 66 % of the dry matter was not retained on the sieves. Pellets had smaller MPS, and a higher proportion of particles passing all sieves than meals. Depending on the reference used, a maximum of 26 % of meals conformed to recommendations for pig feed particle size. None of the pelleted feeds met these criteria, irrespective of the source consulted for the recommendation. Wet sieving should be considered the standard analysis, because in dry sieving, very fine particles adhering to larger particles may not be registered separately but contribute erroneously to larger particle weight. In addition, the MPS calculation should account for material lost through the finest sieve. Reasons why Swiss pig feed does not meet particle size recommendations should be further investigated.

INTRODUCTION: L'intensité de broyage des aliments pour porcs est considérée comme un facteur potentiel de prédisposition aux ulcères gastriques et diverses recommandations sur la taille des particules ont été publiées pour les aliments pour porcs. Nous avons soumis 51 différents aliments composés commerciaux pour porcs (38 farines, 13 pellets/granulés) à une analyse par tamisage à sec et/ou humide. La quantité de particules passant le tamis le plus fin (ou étant solubles) a été estimée par la différence avec la matière sèche totale pesée avant le tamisage. La taille moyenne des particules a été calculée sur la base des moyennes pondérées du matériel retenu sur les tamis (MPSsieves) en tenant compte en plus du matériel perdu (MPStotal). L'analyse des mélanges par tamisage à sec a donné des MPSsieves de 0,58­2,90 mm et des MPStotal de 0,58­2,89 mm ; seule 0,02 à 2,71 % de la matière sèche a passé tous les tamis. L'analyse par tamisage humide de toutes les farines et des granulés a donné des MPSsieves similaires de 0,63­1,66 mm, mais des MPStotal nettement inférieurs de 0,26­1,04 mm ; entre 35 et 66 % de la matière sèche n'a pas été retenue sur les tamis. Les granulés présentaient des MPS plus faibles et une proportion plus élevée de particules passant par tous les tamis que les farines. Selon la référence utilisée, un maximum de 26 % des farines étaient conformes aux recommandations relatives à la taille des particules des aliments pour porcs. Aucun des aliments granulés ne répondait à ces critères, quelle que soit la source consultée pour la recommandation. Le tamisage humide devrait être considéré comme l'analyse standard car, dans le tamisage sec, les particules très fines adhérant à des particules plus grosses peuvent ne pas être enregistrées séparément mais contribuer de manière erronée au poids des particules plus grosses. En outre, le calcul du MPS devrait tenir compte de la matière perdue par le tamis le plus fin. Les raisons pour lesquelles les aliments pour porcs suisses ne répondent pas aux recommandations sur la taille des particules devraient être étudiées plus en détail.

Association between adherence to plant-based dietary patterns and obesity risk: a systematic review of prospective cohort studies.

The worldwide prevalence of obesity and its comorbidities is staggering, and elevated body mass index represents a leading risk factor of death globally. Consistent evidence demonstrates a high-quality plant-based diet as an effective intervention for weight management, although it may be particularly challenging to adopt in its entirety for habitual meat consumers or individuals with especially poor-quality diets. Plant-based diets are increasingly studied using indices such as the overall plant-based diet index (PDI), healthful PDI, and unhealthful PDI, which offer more flexibility than a binary classification of vegetarianism and better facilitate translation into dietary recommendations. We summarized these recently accumulated studies to comprehensively evaluate plant-based diets in relation to obesity risk. We searched Medline, Embase, and CINAHL databases through January 2022 and identified 9 prospective adult cohorts. Reporting of results was consistent with Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and certainty of the evidence was assessed using domains from GRADE. The PDI had a protective association with body weight gain and adiposity. Emphasis of healthful plant foods strengthened this association and emphasis of unhealthful plant foods demonstrated either a positive or null association. The certainty of the evidence was considered moderate. These findings have wide application to inform dietary interventions and sustainable policy recommendations. (Prospero ID: CRD42020198143).

Effectiveness and Acceptability of a Nutrition Intervention Targeting Chinese Adult Immigrants With Type 2 Diabetes in Canada: A Study Using Mixed Methods Analysis.

OBJECTIVES: Although culturally tailored diabetes treatment is recommended, there is a lack of relevant dietary resources for the Chinese population in Canada. In this study we assessed the feasibility and efficacy of a culturally tailored menu plan combined with nutrition education on clinical outcomes, diet quality and qualitative outcomes among Chinese immigrants with type 2 diabetes. METHODS: Participants were 17 Chinese immigrants living with type 2 diabetes in Edmonton, Alberta, Canada. The design was a 12-week, single-arm intervention that included weekly nutrition education supported by a culturally tailored menu plan with mixed methods evaluation. Diet quality, clinical and other outcomes were assessed pre- and postintervention. One-on-one interviews were conducted postintervention to identify program feasibility and obstacles to adherence. RESULTS: Waist circumference (mean ± standard deviation: -2.0±2.5 cm; p=0.004), total cholesterol (-21.4±28.2 mg/dL; p=0.007) and low-density lipoprotein cholesterol (-18.4±24.6 mg/dL; p=0.007) were decreased when compared with baseline. No significant change was detected in glycated hemoglobin. Postintervention, the Healthy Eating Index (p=0.01) and diabetes knowledge score (p=0.009) also increased. Participants reported that the program was culturally acceptable, easily understood and feasible to implement. Participants indicated the program helped them to improve their diabetes knowledge, adhere to the dietary guidelines, choose low glycemic index food and read food labels when shopping. CONCLUSIONS: A flexible, culturally tailored menu plan was a feasible and effective tool for improving diabetes knowledge, diet quality and metabolic outcomes among Chinese immigrants with type 2 diabetes.

Diet, Lifestyle Behaviours and Other Risk Factors Associated With Type 2 Diabetes Beyond Body Mass Index: A Mendelian Randomization Study.

OBJECTIVES: Our aim in this study was to identify promising targets for the prevention of type 2 diabetes in addition to weight loss. We conducted a Mendelian randomization (MR) study to investigate the body mass index (BMI)-independent associations of 16 risk factors, including diet, lifestyle behaviours and others, with type 2 diabetes. METHODS: We selected genetic variants as instrumental variables for diet, sleep traits, smoking, physical activity, education and blood pressure (BP) from European-descent genome-wide association studies (GWASs). Summary statistics for type 2 diabetes were derived from a recent GWAS with 74,124 European cases and 824,006 European controls. The inverse-variance weighted MR method was used to assess the associations of the risk factors with type 2 diabetes, followed by validation of robustness using different MR methods in sensitivity analyses. RESULTS: Genetically predicted insomnia (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.06 to 1.15), smoking initiation (OR, 1.14; 95% CI, 1.06 to 1.21), educational level (OR, 0.69; 95% CI, 0.65 to 0.74), hypertension (OR, 6.50; 95% CI, 3.13 to 13.50), systolic BP (OR, 1.02; 95% CI, 1.02 to 1.03) and diastolic BP (OR, 1.03; 95% CI, 1.02 to 1.03) had BMI-independent effects on type 2 diabetes risk. In addition, alcohol dependence (OR, 1.10; 95% CI, 1.05 to 1.16; BMI-adjusted OR, 1.04; 95% CI, 0.98 to 1.09) and vegetarian diet (OR, 0.50; 95% CI, 0.33 to 0.74; BMI-adjusted OR, 0.78; 95% CI, 0.57 to 1.06) appeared to be correlated with type 2 diabetes via a BMI-mediated pathway. Sensitivity analyses further confirmed the relationship between these factors and type 2 diabetes. CONCLUSIONS: In this systematic MR study, insomnia, smoking, education and BP had BMI-independent causal effects on the risk of type 2 diabetes, whereas alcohol dependence and vegetarian diet were associated with type 2 diabetes through BMI.

Identifiable Dietary Patterns of Pregnant Women: A Canadian Sample.

Purpose: To estimate the percentage of a sample of pregnant women in Canada following a vegetarian, vegan, low-carbohydrate, gluten-free, Mediterranean, or well-balanced diet, before and during pregnancy and to explore if pregnant women received and were satisfied with nutrition information received from health care providers (HCPs).Methods: Participants were conveniently sampled through Facebook and Twitter. An online survey collected data on sociodemographic characteristics, maternal diet, and whether women received and were satisfied with nutrition information from their HCPs. The McNemar test assessed changes in the proportion of diets followed before and during pregnancy.Results: Of 226 women, most followed a well-balanced diet before (76.9%) and during (72.9%) pregnancy (p = 0.26). Vegetarian, gluten-free, vegan, and low-carbohydrate diets were the least followed diets before and during pregnancy (vegetarian: 7.6% vs 5.3%; gluten-free: 4.9% vs 4.0%; vegan: 2.7% vs 2.2%; low-carbohydrate:4.0% vs 0.4%). Overall, the number of women following restrictive diets before pregnancy was significantly reduced throughout pregnancy (19.1% vs 12.0%, p < 0.001). Only 52.0% of women received nutrition information from their primary HCP, and 35.6% were satisfied with the nutrition information received.Conclusions: Most women followed a well-balanced diet before and during pregnancy and approximately one-third were satisfied with the information received from HCPs.

Facile synthesis of bromelain copper nanoparticles to improve the primordial therapeutic potential of copper against acute myocardial infarction in diabetic rats.

Our current investigation comprises the synthesis and pharmacological impact of bromelain copper nanoparticles (BrCuNP) against diabetes mellitus (DM) and associated ischemia/reperfusion (I/R) - induced myocardial infarction. Bromelain is a proteolytic enzyme obtained from Ananas comosus L. Merr., which has blood platelet aggregation inhibiting and arterial thrombolytic potential. Moreover, copper is well-known to facilitate glucose metabolism and strengthen cardiac muscle and antioxidant activity; although, chronic or long-term exposure to high doses of copper may lead to copperiedus. To restrict these potential hazards, we synthesized herbal nano-formulation which convincingly indicated the improved primordial therapeutic potential of copper by reformulating the treatment carrier with bromelain, resulting in facile synthesis of BrCuNP. DM was induced by administration of double cycle repetitive dose of low dose streptozotocin (20 mg/kg, i.p.) in high-fat diet- fed animals. DM and associated myocardial I/R injury were estimated by increased serum levels of total cholesterol, low-density lipoprotein, very low-density lipoprotein, lactate dehydrogenase, creatine kinase myocardial band, cardiac troponin, thiobarbituric acid reactive substances, tumor necrosis factor α, interleukin 6, and reduced serum level of high-density lipoprotein and nitrite/nitrate concentration. However, treatment with BrCuNP ameliorates various serum biomarkers by approving cardioprotective potential against DM- and I/R-associated injury. Furthermore, upturn of histopathological changes were observed in cardiac tissue of BrCuNP-treated rats in comparison to disease models.

Changes in Adolescents' Dietary Intake Following the Initiation of an 8-Week Exercise Program.

Purpose: To assess changes in dietary intake of adolescents following an 8-week aerobic exercise program.Methods: Twenty-six adolescents (14-18 years) participated in an 8-week aerobic exercise program on cycle ergometer at their high school in Quebec, Canada. Twenty-four hour recalls were collected pre- and post-intervention. A two-way repeated measures ANOVA and paired sample t-tests were used to assess differences in energy and dietary intake parameters (food quantity, diet quality, eating patterns) between pre- and postintervention.Results: A decrease in total daily energy intake (-287.8 kcal, P = 0.007), in meal size at lunch (-110.1 g, P = 0.02) and dinner (-143.7 g, P = 0.03), in food density at breakfast (-1.8 kcal/g, P = 0.04), in daily carbohydrate intake (-56.1 g, P = 0.005), and in percentage of energy intake consumed at school (-5.1%, P = 0.04) were observed following initiation of an aerobic exercise program. No change in healthy eating index scores or percentage of energy from processed foods was observed.Conclusions: Changes in energy intake, food quantity, and eating pattern but not diet quality (Healthy Eating Index or food processing scores) were observed following the initiation of an aerobic exercise program. Nutrition interventions may be needed, in addition to an exercise program, to target diet quality and promote healthy eating habits in adolescents.

Longitudinal changes in circulating concentrations of inflammatory markers throughout pregnancy: are there associations with diet and weight status?

The natural inflammation occurring during pregnancy can, under certain conditions, be associated with adverse pregnancy outcomes. This study aimed to (1) quantify changes in circulating concentrations of leptin, adiponectin, interleukin-6 (IL-6) and C-reactive protein (CRP) across trimesters of pregnancy, according to pre-pregnancy body mass index (ppBMI); and (2) examine the trimester-specific associations between the inflammatory markers' concentrations, a Mediterranean diet score (MDS) and the dietary inflammatory index (DII). We measured leptin, adiponectin and IL-6 by ELISA and CRP by high-sensitivity immunonephelometry, in blood samples from 79 pregnant women (age: 32.1 ± 3.7 years; ppBMI: 25.7 ± 5.8 kg/m2). Three Web-based 24-h recalls were completed at each trimester and used to compute the MDS and the DII. CRP concentrations remained stable across trimesters, whereas concentrations of leptin and IL-6 increased, and adiponectin concentrations decreased (p < 0.001). Changes in leptin and adiponectin concentrations also differed according to ppBMI categories (p < 0.05). As for the dietary scores, the only significant association was observed in the second trimester between leptin concentrations and the MDS (r = -0.26, p < 0.05). In conclusion, ppBMI and the progression of pregnancy itself probably supplant the potential associations between diet and the inflammation occurring during that period. Novelty: Circulating leptin and IL-6 concentrations increased across trimesters whereas CRP was stable, and adiponectin decreased. Variations in circulating leptin and adiponectin concentrations differed by ppBMI categories. Very few associations were observed between dietary scores and inflammatory markers.

The effects of short-term low energy availability, achieved through diet or exercise, on cognitive function in oral contraceptive users and eumenorrheic women.

To date, no research has explored the effects of low energy availability on cognitive performance using dietary and exercise regimens relevant to athletes. Twenty female participants (10 eumenorrheic, 10 oral contraceptive [OC] users) completed three 3-day conditions: 1) controlled-balanced energy availability without exercise (BAL; 45 kcal·kg lean body mass [LBM]-1·day-1); 2) diet-induced low energy availability without exercise (DIET; 15 kcal·kg LBM-1·day-1); and 3) exercise-induced low energy availability (EX; 15 kcal·kg LBM-1·day-1, including 30 kcal·kg LBM-1·day-1 treadmill running at 70% maximal oxygen uptake). A cognitive test battery was completed before and after each 3-day condition. Mental rotation test accuracy improved in the BAL condition, but there was a decline in accuracy in the EX condition (BAL, +2.5%; EX, -1.4%; P = 0.042, d = 0.85). DIET (+1.3%) was not different to BAL or EX (P > 0.05). All other measures of cognitive performance were not affected by condition (P > 0.05) and OC use did not affect cognitive responses (P > 0.05). Accuracy in the mental rotation test was impaired when low energy availability was induced through increased exercise energy expenditure. All other aspects of cognition were unaffected by 3 days of low energy availability through diet or exercise. OC use did not mediate the effect of low energy availability on cognition. Novelty: Cognitive function was not affected by 3 days of diet-induced low energy availability. Only spatial awareness was impaired during 3 days of exercise-induced low energy availability. Reproductive hormones affected spatial awareness independent of energy availability.

The effect of maternal protein restriction during perinatal life on the inflammatory response in pediatric rats.

Fetal growth restriction can affect health outcomes in postnatal life. This study tested the hypothesis that the response to an inflammatory pulmonary insult is altered in pediatric fetal growth restricted rats. Using a low-protein diet during gestation and postnatal life, growth-restricted male and female rats and healthy control rats were exposed to an inflammatory insult via the intratracheal instillation of heat-killed bacteria. After 6 h, animal lungs were examined for lung inflammation and status of the surfactant system. The results showed that in response to an inflammatory insult, neutrophil infiltration was decreased in both male and female rats in the growth-restricted animals compared with the control rats. The amount of surfactant was increased in the growth-restricted animals compared with the control rats, regardless of the inflammatory insult. It is concluded that fetal growth restriction results in increased surfactant and altered neutrophil responses following pulmonary insult.

Effect of high-fat diet on mechanosensitive transient receptor potential channel activation in vagal afferent neurons.

Mechanical stimulation of the gastrointestinal tract is an important stimulus of satiety and can be transduced by transient receptor potential (TRP) channels. Several studies have revealed attenuated vagally-mediated satiety responses including mechanosensitivity in diet-induced obesity; however, ion channels underlying this hyposensitivity have not been fully understood. This study aimed to examine the effect of chronic high-fat diet on activation of selected mechanosensitive TRP channels in vagal afferents. C57/BL6 mice were fed on either a high-fat or low-fat diet for 6-8 weeks. An increase in the intracellular calcium to hypotonic solution and activators of TRPV1, TRPV4, and TRPA1 was measured in nodose neurons using Ca2+-imaging techniques. Jejunal afferent nerve firing induced by mechanical stimulation and TRP channel agonists was measured using in vitro extracellular multiunit afferent recording. In high-fat diet-fed mice, we observed reduced calcium influx and jejunal afferent response induced by mechanical stimuli and agonists of TRPV4 and TRPA1, but not TRPV1. Our data show diet-induced obesity disrupts the activation of TRPV4 and TRPA1, at both the cellular level and the level of nerve terminals in the small intestine, which may partly explain reduced mechanosensitivity of vagal afferents and may contribute to decreased gut-brain satiety signaling in obesity.

Epidemiological characteristics and therapeutic management of patients with chronic heart failure who use smartphones: Potential impact of a dedicated smartphone application (report from the OFICSel study).

BACKGROUND: The effectiveness of transitional care services for patients discharged from hospital after acute heart failure is challenging, especially in terms of reducing subsequent heart failure hospitalizations. The increased adoption of smartphone applications in society offers a new opportunity to interact with patients to avoid rehospitalization. Thus, electronic health (e-health) can enhance the impact of existing therapeutic education programmes. AIMS: To determine the prevalence of smartphone use among patients with chronic heart failure, and to assess the epidemiological characteristics and therapeutic management of these patients, with a broader aim of developing smartphone-based therapeutic education programmes for patients. METHODS: The French Observatoire français de l'insuffisance cardiaque et du sel (OFICSel) registry was conducted in 2017 by 300 cardiologists, and included both inpatients and outpatients who had been hospitalized for heart failure at least once in the previous 5 years. Data collection included demographic and heart failure-related variables, which were provided by the cardiologist and by the patient via a questionnaire. RESULTS: Among the 2822 patients included, 2517 completed the questionnaire. Of this total, 907 patients (36%) were smartphone users. Compared with non-users, smartphone users were younger, were more frequently men, more frequently lived in cities, had a higher educational level and were more frequently professionally active. Smartphone users less frequently had diabetes, hypertension, atrial fibrillation or ischaemic cardiopathy. Only 22% of patients were actively participating in a therapeutic education programme. CONCLUSION: Smartphones were used by more than one-third of patients with heart failure in France in 2017, underscoring the feasibility of developing a smartphone application to deliver therapeutic education to the population with chronic heart failure.

Greater Nutritional Risk Scores in 2-Year-Old Children Exposed to Gestational Diabetes Mellitus In Utero and Their Relationship to Homeostasis Model Assessment for Insulin Resistance at Age 5 Years.

OBJECTIVES: Exposure to gestational diabetes mellitus (GDM) in utero may impact nutritional intake and lifestyle habits in early childhood. However, it is unclear whether nutritional status predicts greater risk for metabolic disturbances, such as insulin resistance (IR). The primary objectives were: 1) to determine parent-reported nutritional risk scores in 2-year-old children born to women with and without GDM and 2) to assess whether these scores predict IR in 5-year-old children. METHODS: Children exposed (n=34) and unexposed (n=46) to GDM were screened at 2 years of age using the Toddler version of the Nutrition Screening Tool for Every Preschooler (NutriSTEP). At a 5-year follow up, IR was assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). RESULTS: Total NutriSTEP scores ranged from 6 to 33, with higher scores indicating greater risk. After controlling for infant birthweight, sex of the child, child ethnicity, maternal age at time of pregnancy, breastfeeding status and maternal prepregnancy body mass index, average NutriSTEP scores were higher in children exposed to GDM compared with those unexposed (13.8±1.1 vs 11.2±1.1, p=0.03). NutriSTEP scores at 2 years emerged as a positive independent predictor of HOMA-IR at 5 years. For each unit increase in NutriSTEP score, suggesting greater nutritional risk, we saw a 0.48 (95% confidence interval, 0.17 to 0.80; p=0.003) increase in score on the HOMA-IR. CONCLUSIONS: Parent-reported nutritional risk is greater in GDM-exposed children, and these nutritional behaviours developed during the first years of life may predispose to metabolic disturbance in early childhood.

Comparative protective effects of N-acetylcysteine and melatonin against obesity-induced testicular dysfunction in rats.

N-acetylcysteine (NAC) and melatonin were reported to exert protective effects on testicular tissues. Thus, this study aimed to determine which of these is more efficient against obesity-induced testicular dysfunction in albino rats. A total of 32 adult male rats (195 ± 10 g) were divided into four groups: control, obese rats fed a high-fat diet (HFD), HFD+NAC (150 mg/kg per day, i.p.) and HFD+melatonin (10 mg/kg per day, i.p.), for 5 weeks. Testes and epididymis were weighed. Lipid profile, pituitary-testicular hormones, tumor necrosis factor α (TNFα), epididymal sperm parameters, testicular oxidant-antioxidant system, testicular and the epididymal histopathology and immunohistochemical localization for androgen receptors (AR) and Bax reaction were analyzed. Administration of NAC or melatonin significantly improved the lipid parameters, gonadal hormones, TNFα level, sperm count and abnormal morphology, oxidant-antioxidant system and the absolute testicular and epididymal mass with an enhancement of testicular architecture, AR expression and apoptosis as compared with that in the obese group. Additionally, as compared with the NAC group, the melatonin group had significantly reduced body mass index, total cholesterol, triglyceride, and TNFα and increased testosterone, sperm count, motility, superoxide dismutase activity, mitigated histomorphometrical changes, Bax expression, and increased testicular AR expression. Therefore, melatonin was more efficient than NAC in affording fortification against HFD-induced testicular dysfunction.

Identifying Behaviour Change Techniques and Motivational Interviewing Techniques in Small Steps for Big Changes: A Community-Based Program for Adults at Risk for Type 2 Diabetes.

BACKGROUND: The risk of developing type 2 diabetes (T2D) can be reduced through diet and exercise changes. Given the rapidly increasing prevalence of T2D and the associated burden on the health-care system, there is a need for affordable and scalable diet and exercise programs to be delivered in communities. Small Steps for Big Changes (SSBC) is an evidence-based diabetes prevention program for improving diet and exercise adherence in individuals at risk for developing T2D. Detailed reporting of intervention components as SSBC transitions from laboratory to communities is an essential step to understand its effectiveness and subsequent uptake. METHODS: The aim of this study was to identify comprehensively the behaviour change techniques (BCTs) and motivational interviewing techniques used within the community-based SSBC. Intervention components were extracted from the SSBC session protocols using the Behaviour Change Technique Taxonomy v1 and the Table of Motivational Interviewing Techniques. RESULTS: Forty-three BCTs (interrater reliability [kappa]=0.77; prevalence and bias-adjusted kappa=0.78) and 20 MI techniques (kappa=0.63; prevalence and bias-adjusted kappa=0.64) were identified within SSBC session protocols (mean BCTs per session=30, mean MI techniques per session=16). CONCLUSIONS: Consistent and thorough reporting of intervention components as seen in the current analysis is crucial for future meta-analyses to accurately test which intervention components are eliciting change in desired outcomes and can inform which components should be adapted to different settings. SSBC sessions had an emphasis on BCT categories, including "Goals and Planning," "Feedback and Monitoring" and "Repetition and Substitution," and MI technique processes, including "Engaging" and "Evoking." Use of these categories and processes can inform development of future effective diabetes prevention programs.

Nutrition and Exercise Performance in Adults With Type 1 Diabetes.

The best nutritional practices for exercise and sports performance are largely activity specific. The presence of type 1 diabetes undeniably bestows additional factors to consider to manage exercise and ensure adequate nutrients and fuels are available for optimal performance. Whether participating in sports or physical activity on a recreational basis or striving to achieve a high level of athletic performance, individuals with type 1 diabetes must pay attention to their nutritional and dietary patterns, including intake of macronutrients, micronutrients, fluids and supplements, such as caffeine to maintain metabolic and glycemic balance. Performance aside, nutritional recommendations may also differ on an individual basis relative to exercise, glycemic management and body weight goals. Balancing all these dietary factors can be challenging for individuals with type 1 diabetes, and many related aspects have yet to be fully researched in this population.

Dietary nitrate does not alter cardiac function, calcium handling proteins, or SERCA activity in the left ventricle of healthy rats.

Dietary nitrate has been shown to increase cytosolic calcium concentrations within the heart, which would necessitate greater calcium sequestration for relaxation. In the present study we demonstrate that while nitrate supplementation reduced blood pressure, calcium-handling protein content, sarco(endo)plasmic reticulum Ca-ATPase 2a (SERCA) enzymatic properties, and left ventricular function were not altered. In addition, nitrite did not alter in vitro SERCA activity. Combined, these data suggest that in healthy rats, dietary nitrate does not increase left ventricle SERCA-related calcium-handling properties. Novelty Dietary nitrate decreases blood pressure but does not alter left ventricular calcium-handling protein content or SERCA activity in healthy rats.