Experienced and internalized weight stigma among Spanish adolescents.

BACKGROUND AND OBJECTIVE: Weight stigma has negative consequences for both physiological and psychological health. Studies on weight stigma in adolescence, particularly from general populations, are scarce in the Mediterranean area. The main aim of this study is to describe the prevalence of experienced and internalized weight stigma among a representative sample of adolescents from the Spanish city of Terrassa, and to determine its association with sociodemographic variables and weight status. METHODS: Drawing on data from the initial assessment of a longitudinally funded project on weight stigma in adolescents, a cross-sectional survey-based study was conducted using random multistage cluster sampling. Weight stigma experiences, their frequency and sources, and weight bias internalization with the Modified Weight Bias Internalization Scale (WBISM) were assessed in a sample of 1016 adolescents. Adjusted odds ratios (AOR) between sociodemographic variables, weight status and having experienced weight stigma, and having reported high scores of WBISM (WBISM ≥ 4) were estimated by multiple logistic regression models. RESULTS: The prevalence of weight-related stigma experiences was 43.2% in the sample (81.8 in adolescents with obesity) and the prevalence of high levels of weight bias internalization was 19.4% (50.7 in adolescents with obesity). Other kids and school were the most prevalent sources of weight stigma, with society and family being other significant sources of stigma reported by girls. A significantly higher risk of having experienced weight stigma was observed in girls (AOR = 2.6) and in older adolescents (AOR = 1.9). Compared to normal weight adolescents, all weight statuses showed higher risk, being 3.4 times higher in adolescents with underweight and reaching 11.4 times higher risk in those with obesity. Regarding high levels of weight bias internalization, girls had a risk 6.6 times higher than boys. Once again, a "J-shaped" pattern was observed, with a higher risk at the lowest and highest weight statuses. The risk was 6.3 times higher in adolescents with underweight, and 13.1 times higher in adolescents with obesity compared to those with normal weight. CONCLUSIONS: Considering the high prevalence of experienced and internalized weight stigma among adolescents in Spain, especially in adolescents with obesity and girls, it seems important to implement preventive strategies in different settings and address all sources of stigma.

Barriers to home food preparation and healthy eating among university students in Catalonia.

Despite college being a critical life stage for developing enduring healthy dietary behaviours, Spanish university students show poor adherence to a healthy diet. Since research has shown an association between home cooking and healthy eating, the aim of this study was to analyse the main barriers that influence home food preparation and healthy eating among students at three Catalan universities. Focus groups, the photovoice technique and a validated questionnaire were used. Six focus groups (10 female; 14 male; aged 18-22) were conducted. NVivo9, was used to analyse the transcripts using an inductive thematic analysis. In two focus groups, the photovoice technique was used to further explore their perceptions about a healthy diet and their barriers for home cooking and healthy eating. The validated questionnaire was sent out to obtain data on students' diet quality, food environment and cooking self-efficacy for the focus group's design. We found that lack of motivation was the main barrier to healthy eating and home cooking, which was further influenced by the lack of cooking self-efficacy. Young adults lacked the knowledge and skills to prepare quick, affordable, and nutritious meals. Hence, even lack of time was cited as a primary barrier, time constraints seemed to be related to personal priorities. Students did not feel motivated to eat healthy and adopt time-deepening behaviours that influence food-choices. Thus, further research is required to develop context-specific culinary interventions that enhance students' cooking self-efficacy and identify strategies for encouraging students to adopt healthier eating habits.

Family meals and food insecurity in Spanish adolescents.

The world is not on track to achieve the goal of food security for the global population by 2030. New approaches to understand individuals' food insecurity are needed, especially insecurity related to children and adolescents, since it is associated with health and psychosocial problems. The study aimed to characterise the family dinners among a representative cohort of schooled adolescents (n = 1017) and their parents (n = 261) in Terrassa (Catalonia, Spain) and how family dinners could be related to household food insecurity. The survey findings revealed that in 2022, 19.2% of the adolescents were experiencing household food insecurity. Adolescents with a lower socioeconomic status and of foreign origin showed the highest likelihood of experiencing household food insecurity. Household food security was also associated with some characteristics of family dinners, such as better quality and a higher frequency (seven or more dinners eaten together per week). Based on this finding, possible ways in which family dinners could offer a beneficial effect, alleviating the consequences of food insecurity in adolescents, are discussed. In line with the 2030 Agenda and the Sustainable Development Goal of guaranteeing food security, the promotion of family dinners and their quality, frequency, and duration to leverage the beneficial effect in states of household food insecurity in Spanish adolescents should be taken into account to design actions and public campaigns in Spain.

Plant-derived nootropics and human cognition: A systematic review.

Substances with modulatory capabilities on certain aspects of human cognition have been revered as nootropics from the dawn of time. The plant kingdom provides most of the currently available nootropics of natural origin. Here, in this systematic review, we aim to provide state-of-the-art information regarding proven and unproven effects of plant-derived nootropics (PDNs) on human cognition in conditions of health and disease. Six independent searches, one for each neurocognitive domain (NCD), were performed in parallel using three independent scientific library databases: PubMed, Cochrane and Scopus. Only scientific studies and systematic reviews with humans published between January 2000 and November 2021 were reviewed, and 256 papers were included. Ginkgo biloba was the most relevant nootropic regarding perceptual and motor functions. Bacopa monnieri improves language, learning and memory. Withania somnifera (Ashwagandha) modulates anxiety and social-related cognitions. Caffeine enhances attention and executive functions. Together, the results from the compiled studies highlight the nootropic effects and the inconsistencies regarding PDNs that require further research.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2021137.

Beetroot juice ingestion does not improve neuromuscular performance and match-play demands in elite female hockey players: a randomized, double-blind, placebo-controlled study.

PURPOSE: Beetroot juice is a dietary supplement that contains high levels of inorganic nitrate (NO3-) and that its intake has proven effective at increasing blood nitric oxide (NO) concentrations improving endurance performance. However, the effect of this supplement in team sport performance, especially in female athletes, has been barely studied. This study aimed to compare the acute effects of beetroot juice supplementation on neuromuscular performance and match-play demands in elite female field hockey players. METHODS: Eleven elite female hockey players (22.8 ± 5.1 years) belonging to a bronze team medal in Eurohockey Club Champions Cup participated in this study. Participants were randomly divided into two groups undergoing a test battery with beetroot juice (70 mL, 6.4 mmol NO3-) or placebo (70 mL, 0.04 mmol NO3-) in two different days with one week between protocols. The neuromuscular test battery consisted of a countermovement jump, isometric handgrip strength (i.e., dominant hand), 20 m-sprint and repeated sprint ability test (RSA). Afterward, a simulated hockey match play (2 × 12.5 min) was performed and recorded by Global Positioning System (GPS). RESULTS: No statistically significant improvements were observed in any physical parameters analysed comparing beetroot juice compared to placebo ingestion, countermovement jump (p = 0.776, ES = 0.16), isometric handgrip strength (p = 0.829; ES = - 0.08), 20 m sprint test (p = 0.227; ES = - 0.23), mean repeated sprint ability (p = 0.955, ES = 0.03) and in any physical match demands measured by GPS (p = 0.243-1.000; ES = 0.02-0.47). CONCLUSION: Acute beetroot juice supplementation did not produce any statistically significant improvement in neuromuscular performance or match-play demands in elite female field hockey players. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov with the following ID: NCT05209139. The study was retrospectively registered by 26 January 2022.

Consensus-building around the conceptualisation and implementation of sustainable healthy diets: a foundation for policymakers.

BACKGROUND: Healthy and sustainable diets need to be adopted to reduce the negative impact of food consumption on human and planetary health. Food systems account for a third of greenhouse gas emissions. "Dietary Patterns for Health and Sustainability" is a World Health Organization (WHO) project that aims to build consensus among international food, health, and sustainability experts and policymakers on how to conceptualise healthy and sustainable diets and on the actions and policies that could be implemented in the WHO European Region to promote these diets. METHODS: A qualitative study among European food, health, and sustainability experts and policymakers to elicit their views on multiple dimensions of food sustainability and health was carried out using a three-phase process, including semi-structured interviews, a Nominal Group Technique, and focus groups during a participatory WHO workshop held in Copenhagen. Thematic analysis was used to analyse the three data sources. RESULTS: The workshop resulted in a shared understanding of the interconnected components of sustainable healthy eating habits. As a result of this understanding, a variety of potential solutions were identified, including actions across different policy domains, tools, strategic guidelines, needs, and pathways for sustainable healthy diets. The pathways included the need for a multi-stakeholder approach, as well as the simultaneous execution of an aligned and coherent mix of policies at the local and national levels. CONCLUSIONS: The prioritised actions should be aimed at helping government policymakers promote sustainable healthy diets and make decisions on improving dietary patterns for citizens' health and wellbeing in line with the United Nations Sustainable Development Goals in the European Region.

Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents.

PURPOSE: Weight Bias Internalization (WBI) is pervasive and potentially damaging for health. Little is known about WBI in youth. As negative effects of WBI have been observed when controlling for BMI, measures that allow WBI to be assessed across different weight categories are needed. The Modified Weight Bias Internalization Scale (WBIS-M) is one of the most frequently used scales in this field. Our purpose was to obtain a Spanish validated version of the WBIS-M for adolescents across different weight statuses. METHODS: The data were collected from 298 secondary students (mean age 14.31; 48.32% girls; 18.8% were overweight and 6.4% had obesity). Internal structure was examined by a cross-validation analysis, using both exploratory and confirmatory factor analyses in different subsamples. RESULTS: Item 1 showed a psychometric anomalous functioning and was deleted. The one-factor structure of the 10-item version was confirmed with adequate fit ([EFA (KMO = 0.915, χ2(55) = 1075.633, p < 0.0001)]; [CFA (χ2(35) = 200.515; GFI = 0.995; PGFI = 0.992; NFI = 0.991; SRMR = 0.060)]). Internal consistency was high [Formula: see text] ω = 0.93). Significant correlations with the same set of external variables assessed in the original version (anti-fat bias, self-esteem, mood, body dissatisfaction, drive for thinness, binge eating), all of them correlates of WBI in adolescents, were found. Girls and participants with obesity obtained higher scores. CONCLUSION: The results provide support for the validity and reliability of our WBIS-M version for use with adolescents across weight categories in Spain. LEVEL OF EVIDENCE: Level III, evidence obtained from well-designed cohort studies.

Which diet has the lower water footprint in Mediterranean countries?

The Mediterranean region is increasingly water scarce, with the food system being the largest driver of water use. We calculate the water resources related to food consumption in nine major Mediterranean countries, by means of the water footprint (WF), for the existing situation (period 2011-2013) as well as the Mediterranean and EAT-Lancet diets. We account for different food intake requirements according to gender and six age groups. These nine countries - Spain, France, Italy, Greece, Turkey, Egypt, Tunisia, Algeria and Morocco - represent 88% of the population of all countries bordering the Mediterranean. As first major observation, we find that the EAT-Lancet diet, a scientifically optimised diet for both nutrition and certain environmental indicators, requires less water resources than the Mediterranean diet, a culturally accepted diet within the region. In terms of water resources use, adherence to the former is thus more beneficial than adherence to the latter. As second major observation, we find that the EAT-Lancet diet reduces the current WF for all nations consistently, within the range -17% to -48%, whereas the Mediterranean diet reduces the WF of the European countries, Turkey, Egypt and Morocco within the range of -4% to -35%. For the Maghreb countries Tunisia and Algeria, the Mediterranean diet WF is slightly higher compared to the current WF and the proportions of food product groups differ. Such dietary shifts would be important parts of the solution to obtain the sustainable use of water resources in Mediterranean countries.

Screen Time Use and Ultra-Processed Food Consumption in Adolescents: A Focus Group Qualitative Study.

BACKGROUND: Sedentary lifestyles and ultra-processed food (UPF) consumption contribute to a high prevalence of overweight and obesity among adolescents. Screen time may be associated with higher UPF consumption and affect eating behaviors substantially. OBJECTIVE: The aim of this study was to explore adolescents' perceptions, attitudes, and motivations concerning the consumption of UPF when using screens; investigate their perceived educational needs regarding nutrition; and explore their knowledge about UPF. DESIGN: This was a qualitative study using focus groups. PARTICIPANTS/SETTING: Four focus groups with 30 adolescents aged 12 to 16 years at a Spanish high school were recruited in May 2022. Participants were chosen using purposive sampling based on a theoretical saturation criterion. ANALYSES: Focus group discussions were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis. RESULTS: Three themes emerged from the thematic analysis. Participants explained that most of their meals were eaten in front of screens. They confirmed more consumption of UPF at breakfast, as mid-afternoon snacks, on weekends, and during their main meals when alone. Participants reported that the high consumption of UPF during social gatherings was related to its easy availability, convenience, and palatability. Adolescents expressed that eating in front of screens and exposure to UPF advertising led to compulsive and impulsive consumption of these products. They described UPF as addictive and unhealthy. Although participants had little awareness of UPF health effects, they expressed interest in learning about healthy eating habits. Parental attitudes toward food were considered by the participants as relevant in establishing their eating behaviors. CONCLUSIONS: Loneliness, social gatherings, and parental attitudes toward UPF consumption emerged as important influences on adolescents' dietary behaviors in front of screens. In addition, availability, palatability, and exposure to advertising were key factors reported to influence adolescents' UPF consumption in front of screens. Addressing these influences through nutritional and educational interventions, as well as regulating the adolescent obesogenic environment and managing screen time could help modulate these effects.

Nutritional Quality of the Mid-Afternoon Snack of Schooled Children between the Ages of 3 and 12 Years in Three Areas in Spain.

BACKGROUND: The aim of this study was to analyze the nutritional quality of mid-afternoon snacks for schooled children aged 3 to 12 years in three areas of Catalonia (Spain). METHODS: A descriptive observational study collected information on habits and the mid-afternoon snack of 782 schooled children aged 3 to 12 years in three cities, Barcelona, Girona, and Lleida, located in Catalonia (Spain). The children's families voluntarily agreed to complete an online questionnaire that collected information about demographic data and snacking habits in the afternoon, as well as a record of mid-afternoon snack intake over three school days. RESULTS: A total of 2163 mid-afternoon snacks were analyzed from a sample of 764 families with 3 to 12 year-old children. Sandwiches emerged as the most prevalent choice, accounting for 41.89%, followed by pastries at 23.86%, fruit at 14.38%, and a combination of fruit and pastries at 6.29%. Of the mid-afternoon snacks recorded, 22.19% were healthy, 20.90% were quite healthy, 12.85% were quite unhealthy, and 44.06% were unhealthy. CONCLUSIONS: The nutritional quality of mid-afternoon snacks for a large majority of schooled children should be improved. It is essential to develop food education programs to improve the quality of this intake from early childhood and to consider it as an opportunity to adjust the daily dietary requirements of Spanish children.

Environmental footprints of Mediterranean versus Western dietary patterns: beyond the health benefits of the Mediterranean diet.

BACKGROUND: Dietary patterns can substantially vary the resource consumption and environmental impact of a given population. Dietary changes such as the increased consumption of vegetables and reduced consumption of animal products reduce the environmental footprint and thus the use of natural resources. The adherence of a given population to the Mediterranean Dietary Pattern (MDP) through the consumption of the food proportions and composition defined in the new Mediterranean Diet pyramid can thus not only influence human health but also the environment. The aim of the study was to analyze the sustainability of the MDP in the context of the Spanish population in terms of greenhouse gas emissions, agricultural land use, energy consumption and water consumption. Furthermore, we aimed to compare the current Spanish diet with the Mediterranean Diet and in comparison with the western dietary pattern, exemplified by the U.S.A. food pattern, in terms of their corresponding environmental footprints. METHODS: The environmental footprints of the dietary patterns studied were calculated from the dietary make-up of each dietary pattern, and specific environmental footprints of each food group. The dietary compositions were obtained from different sources, including food balance sheets and household consumption surveys. The specific environmental footprints of food groups were obtained from different available life-cycle assessments. RESULTS: The adherence of the Spanish population to the MDP has a marked impact on all the environmental footprints studied. Increasing adherence to the MDP pattern in Spain will reduce greenhouse gas emissions (72%), land use (58%) and energy consumption (52%), and to a lower extent water consumption (33%). On the other hand, the adherence to a western dietary pattern implies an increase in all these descriptors of between 12% and 72%. CONCLUSIONS: The MDP is presented as not only a cultural model but also as a healthy and environmentally-friendly model, adherence to which, in Spain would have, a significant contribution to increasing the sustainability of food production and consumption systems in addition to the well-known benefits on public health.

Food Sustainability Knowledge, Attitudes, and Dietary Habits among Students and Professionals of the Health Sciences.

The importance of a sustainable diet is an emerging concept within sustainable food systems. Food systems emit 30% of greenhouse gases, which needs to change. A cross-sectional study was carried out to determine the knowledge, attitudes, and habits of students and professionals in the health sciences regarding a sustainable diet, comparing these to the Spanish population. We further aimed to analyse the consistency between the knowledge and attitudes of these individuals and their dietary habits and analyse the consumption of different food groups that are typical of a sustainable diet. A survey was completed by a total of 415 participants, both university students in the health sciences and health professionals. These two groups were more knowledgeable of sustainable diets than the general population, although certain concepts are unfamiliar to both populations. A positive attitude towards sustainable food habits was also observed among the population studied. The health sector reported having better eating habits than the overall population. A significant positive correlation was observed between higher fruit and vegetable consumption and deeper knowledge and more favourable attitudes. People with less knowledge and worse attitudes reported consuming more red and processed meat. The findings of this study could inform targeted interventions for health professionals given the need to promote a healthy diet but also a healthy and sustainable diet for planetary health.

[Immunonutrition and (its impact on) health. Micronutrients and debilitating factors]. / Inmunonutrición y (su impacto en la) salud. Micronutrientes y factores debilitantes.

Introduction: Introduction: the interaction between immunity and nutrition is complex and multifaceted. Micronutrients, including vitamins and minerals, are essential for immune function. In turn, immune function and lifestyle habits can affect nutritional needs and micronutrient utilization, creating an interdependence between nutrition and immunity that can be modulated by both external and internal factors. Objectives: to examine the relationship between micronutrient intake and immune function, and how debilitating factors such as aging, disease, and stress can impact this relationship. Methods: a review of scientific evidence and recommendations from major international scientific societies was conducted to identify the importance of micronutrients in immune function and how debilitating factors can alter their impact. Results: the effect of different micronutrients on immune function is described. Debilitating factors like aging, stress, and chronic diseases can compromise the immune system and make the body more susceptible to infections. However, adequate intake of micronutrients and healthy habits can help to strengthen immunity and mitigate the effects of these debilitating factors. Conclusion: immunonutrition is a critical component for maintaining a strong and healthy immune system. Sufficient intake of micronutrients and healthy lifestyle habits can help improve immunity, especially in the presence of debilitating factors.

Introducción: Introducción: la interacción entre la inmunidad y la nutrición es compleja y multifacética. Los micronutrientes, incluidos las vitaminas y los minerales, son esenciales para la función inmunológica. A su vez, la función inmunológica y los hábitos de vida pueden afectar las necesidades nutricionales y la utilización de micronutrientes, creando una interdependencia entre la nutrición y la inmunidad que puede ser modulada por factores externos e internos. Objetivos: examinar la relación entre la ingesta de micronutrientes y la función inmunológica y cómo factores debilitantes, como el envejecimiento, la enfermedad y el estrés, pueden afectar esta relación. Métodos: se realizó una revisión de la evidencia científica y de las recomendaciones de las principales sociedades científicas internacionales para identificar la importancia de los micronutrientes en la función inmunológica y cómo los factores debilitantes pueden alterar su impacto. Resultados: se describe el efecto de diferentes micronutrientes sobre la función inmunológica. Los factores debilitantes como el envejecimiento, el estrés y las enfermedades crónicas pueden comprometer el sistema inmunológico y hacer que el cuerpo sea más susceptible a las infecciones. Sin embargo, una ingesta adecuada de micronutrientes y unos hábitos saludables pueden ayudar a fortalecer la inmunidad y mitigar los efectos de estos factores debilitantes. Conclusión: la nutrición inmunológica es un componente crítico para mantener un sistema inmunológico fuerte y saludable. Una ingesta suficiente de micronutrientes y unos hábitos de vida saludables pueden ayudar a mejorar la inmunidad, especialmente en presencia de factores debilitantes.

EU-27 ecological footprint was primarily driven by food consumption and exceeded regional biocapacity from 2004 to 2014.

The European Union (EU) plans to decarbonize the region by 2050. As highlighted by the Green Deal and Farm to Fork Strategy, food systems are essential for this transition. Here we investigate the resource dependence and carbon emissions of the EU-27's food systems from 2004 to 2014 via an ecological footprint (EF)-extended multi-regional input-output approach, accounting for demand and supply (including trade), and considering multiple externalities. Food contributes towards almost a third of the region's EF, and appropriates over half of its biocapacity. Average reliance on biocapacity within national borders decreased, while reliance on intra-EU biocapacity increased; yet a quarter of the biocapacity for food consumption originates from non-EU countries. Despite a reduction in both total EF and food EF over the study period, EU-27 residents demand more from nature than the region's ecosystems can regenerate-highlighting the need for new or strengthened food and trade policies to enable a transformation to sustainable EU food systems.

Vital role for primary healthcare providers: urgent need to educate the community about daily nutritional self-care to support immune function and maintain health.

The importance of self-care to improve health and social well-being is well recognised. Nevertheless, there remains a need to encourage people to better understand how their body works, and how to keep it healthy. Because of its important role, part of this understanding should be based on why the immune system must be supported. This highly complex system is essential for defending against pathogens, but also for maintaining health throughout the body by preserving homeostasis and integrity. Accordingly, the immune system requires active management for optimal functioning and to reduce the risk of chronic diseases. In addition to regular exercise, healthy sleeping patterns, cultivating mental resilience, adequate nutrition through healthy and diverse dietary habits is key to the daily support of immune function. Diet and the immune system are closely intertwined, and a poor diet will impair immunity and increase the risk of acute and chronic diseases. To help elucidate the roles of primary healthcare providers in supporting individuals to engage in self-care, an international group of experts reviewed the evidence for the roles of the immune system in maintaining health and for nutrition in daily immune support, and discussed implications for population health and clinical practice.

Nutritional and cultural aspects of the Mediterranean diet.

The recent recognition by United Nations Educational, Scientific and Cultural Organization (UNESCO) of the Mediterranean diet as an Intangible Cultural Heritage of Humanity reinforces, together with the scientific evidence, the Mediterranean diet as a cultural and health model. The Mediterranean diet has numerous beneficial effects on among others the immune system, against allergies, on the psyche, or even on quality of life, topics that are currently fields of research. The Mediterranean diet has an international projection; it is regarded as the healthiest and the most sustainable eating pattern on the planet and is a key player in the public health nutrition field globally, but especially in the Mediterranean area. Moreover, this ancient cultural heritage should be preserved and promoted from different areas: public health, agriculture, culture, politics, and economic development.

Consumers' Acceptability and Perception of Edible Insects as an Emerging Protein Source.

In recent years in Western Europe, studies on entomophagy have drawn the attention of many researchers interested in identifying parameters that could improve the acceptability of insect consumption in order to introduce insects as a sustainable source of protein into the future diet. Analysing the factors involved in consumer acceptability in the Mediterranean area could help to improve their future acceptance. A cross-sectional study was conducted using an ad-hoc questionnaire in which 1034 consumers participated. The questionnaire responses allowed us to study the areas relevant to acceptance: neophobia, social norms, familiarity, experiences of consumption and knowledge of benefits. Only 13.15% of participants had tried insects. Disgust, lack of custom and food safety were the main reasons for avoiding insect consumption. Consequently, preparations with an appetising appearance need to be offered, with flours being the most accepted format. The 40-59-year-old age group was the one most willing to consume them. To introduce edible insects as food in the future, it is important to inform people about their health, environmental and economic benefits because that could increase their willingness to include them in their diet.

Effect of supplementation with leucine alone, with other nutrients or with physical exercise in older people with sarcopenia: a systematic review.

BACKGROUND: Older adults are at a greater risk of developing sarcopenia as a result of reduced mobility, malnutrition, dietary changes and certain diseases. There are no systematic reviews in the literature analysing the effects of supplementation with leucine alone or as part of a supplement, and with or without physical exercise in older people with sarcopenia. We aimed to systematically review the evidence in intervention studies on the effects of supplementation with leucine, either alone, combined with other supplements, or combined with other supplements and physical exercise in older people with sarcopenia. MATERIALS AND METHODS: Literature searches related to the topic were conducted in three databases (Pubmed/Medline, Cochrane and SciELO) looking for articles published prior to December 2020. This review includes intervention studies in older adults over 60 years of age with a history of sarcopenia where researchers reported on the effects of leucine supplementation, with or without physical exercise, related to the disease's treatments or outcomes. RESULTS: The systematic review identified three intervention studies examining the effect of leucine without physical exercise, one on leucine with physical exercise, seven on leucine paired with another nutrient and without physical exercise, and twelve on leucine paired with another nutrient and physical exercise. The results revealed that leucine supplementation alone and without physical exercise did not improve markers of sarcopenia, whereas interventions pairing leucine with supplements, particularly leucine-enriched protein supplements, are a promising treatment for the improvement of sarcopenic markers, whether with or without physical exercise. CONCLUSIONS: Leucine supplementation, specifically paired with protein supplements, both with and without physical exercise, was found to be an effective dietary intervention for the improvement of sarcopenia. Further dietary interventions are necessary to calculate effective dosage quantities for both leucine and nutrient supplementation as an integral part of the treatment.

Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa.

Eat Better South Africa (EBSA) is an organization that provides low-carbohydrate, high-fat (LCHF) nutrition and health education programs for women from under-resourced South African communities. Community assessments are essential to explore participants' potential facilitators and challenges of adhering to new dietary behaviours and should be implemented before any dietary interventions. This study is a qualitative community assessment to enable the EBSA program to better meet potential participants' needs and explore their willingness to enrol in the EBSA program. Sixty women from two communities in the Western Cape were interviewed through six focus group discussions. A thematic analysis was conducted using NVivo 12 software, and four themes were developed around the women's (1) role within the households; (2) dietary behaviour; (3) health perceptions; and (4) willingness to participate in an LCHF program. Women mentioned that they were responsible for cooking and shopping for their households. They expressed their understanding of healthy and unhealthy behaviours and their dietary patterns. Some women showed concerns about LCHF diets, but others wanted to learn more due to their knowledge of other people's positive experiences with the diet. There was a general desire to become healthy. However, the women anticipated dietary behaviour change to be challenging. Those challenges mostly revolved around their socioeconomic environments. The findings are intended to inform EBSA (or other nutrition interventions) on what to consider when implementing their interventions in these communities.