Microbial foods for improving human and planetary health.

The current food production system is negatively impacting planetary and human health. A transition to a sustainable and fair food system is urgently needed. Microorganisms are likely enablers of this process, as they can produce delicious and healthy microbial foods with low environmental footprints. We review traditional and current approaches to microbial foods, such as fermented foods, microbial biomass, and food ingredients derived from microbial fermentations. We discuss how future advances in science-driven fermentation, synthetic biology, and sustainable feedstocks enable a new generation of microbial foods, potentially impacting the sustainability, resilience, and health effects of our food system.

Interspecies Competition Impacts Targeted Manipulation of Human Gut Bacteria by Fiber-Derived Glycans.

Development of microbiota-directed foods (MDFs) that selectively increase the abundance of beneficial human gut microbes, and their expressed functions, requires knowledge of both the bioactive components of MDFs and the mechanisms underlying microbe-microbe interactions. Here, gnotobiotic mice were colonized with a defined consortium of human-gut-derived bacterial strains and fed different combinations of 34 food-grade fibers added to a representative low-fiber diet consumed in the United States. Bioactive carbohydrates in fiber preparations targeting particular Bacteroides species were identified using community-wide quantitative proteomic analyses of bacterial gene expression coupled with forward genetic screens. Deliberate manipulation of community membership combined with administration of retrievable artificial food particles, consisting of paramagnetic microscopic beads coated with dietary polysaccharides, disclosed the contributions of targeted species to fiber degradation. Our approach, including the use of bead-based biosensors, defines nutrient-harvesting strategies that underlie, as well as alleviate, competition between Bacteroides and control the selectivity of MDF components.

Commercially traded fish portfolios mask household utilization of biodiversity in wild food systems.

The global biodiversity that underpins wild food systems-including fisheries-is rapidly declining. Yet, we often have only a limited understanding of how households use and benefit from biodiversity in the ecosystems surrounding them. Explicating these relationships is critical to forestall and mitigate the effects of biodiversity declines on food and nutrition security. Here, we quantify how biodiversity filters from ecosystems to household harvest, consumption, and sale, and how ecological traits and household characteristics shape these relationships. We used a unique, integrated ecological (40 sites, quarterly data collection) and household survey (n = 414, every 2 mo data collection) dataset collected over 3 y in rice field fisheries surrounding Cambodia's Tonlé Sap, one of Earth's most productive and diverse freshwater systems. While ecosystem biodiversity was positively associated with household catch, consumption, and sold biodiversity, households consumed an average of 43% of the species present in the ecosystem and sold only 9%. Larger, less nutritious, and more common species were disproportionally represented in portfolios of commercially traded species, while consumed species mirrored catches. The relationship between ecosystem and consumed biodiversity was remarkably consistent across variation in household fishing effort, demographics, and distance to nearest markets. Poorer households also consumed more species, underscoring how wild food systems may most benefit the vulnerable. Our findings amplify concerns about the impacts of biodiversity loss on our global food systems and highlight that utilization of biodiversity for consumption may far exceed what is commercially traded.

High fried food consumption impacts anxiety and depression due to lipid metabolism disturbance and neuroinflammation.

Western dietary patterns have been unfavorably linked with mental health. However, the long-term effects of habitual fried food consumption on anxiety and depression and underlying mechanisms remain unclear. Our population-based study with 140,728 people revealed that frequent fried food consumption, especially fried potato consumption, is strongly associated with 12% and 7% higher risk of anxiety and depression, respectively. The associations were more pronounced among male and younger consumers. Consistently, long-term exposure to acrylamide, a representative food processing contaminant in fried products, exacerbates scototaxis and thigmotaxis, and further impairs exploration ability and sociality of adult zebrafish, showing anxiety- and depressive-like behaviors. Moreover, treatment with acrylamide significantly down-regulates the gene expression of tjp2a related to the permeability of blood-brain barrier. Multiomics analysis showed that chronic exposure to acrylamide induces cerebral lipid metabolism disturbance and neuroinflammation. PPAR signaling pathway mediates acrylamide-induced lipid metabolism disorder in the brain of zebrafish. Especially, chronic exposure to acrylamide dysregulates sphingolipid and phospholipid metabolism, which plays important roles in the development of anxiety and depression symptoms. In addition, acrylamide promotes lipid peroxidation and oxidation stress, which participate in cerebral neuroinflammation. Acrylamide dramatically increases the markers of lipid peroxidation, including (±)5-HETE, 11(S)-HETE, 5-oxoETE, and up-regulates the expression of proinflammatory lipid mediators such as (±)12-HETE and 14(S)-HDHA, indicating elevated cerebral inflammatory status after chronic exposure to acrylamide. Together, these results both epidemiologically and mechanistically provide strong evidence to unravel the mechanism of acrylamide-triggered anxiety and depression, and highlight the significance of reducing fried food consumption for mental health.

Deforestation reduces fruit and vegetable consumption in rural Tanzania.

SignificanceTwo billion people across the planet suffer from nutrient deficiencies. Dietary diversification is key to solving this problem, yet many food and nutrition security policies, especially in low- and middle-income countries, still focus on increasing agricultural production and access to sufficient calories as the main solution. But calories are not all equal. Here, we show how deforestation in Tanzania caused a reduction in fruit and vegetable consumption (of 14 g per person per day) and thus vitamin A adequacy of diets. Using a combination of regression and weighting analyses to generate quasi-experimental quantitative estimates of the impacts of deforestation on people's food intake, our study establishes a causal link between deforestation and people's dietary quality.

Vaccination of household chickens results in a shift in young children's diet and improves child growth in rural Kenya.

Childhood growth faltering remains unacceptably high in sub-Saharan Africa. Rural communities dependent on household food production with limited off-farm income or liquid assets to bridge seasonal food availability are especially vulnerable. A cross-sectional survey in Siaya County, Kenya identified 23.5 and 4.8% of children under 5 y of age as stunted and wasted, respectively, using height-for-age Z (HAZ) scores to detect stunting and weight-for-height Z (WHZ) scores for wasting. Although these households are classified as living in poverty or extreme poverty with very limited off-farm income, households commonly have on-farm resources that could be developed to improve nutrition. While 95% of these households have chickens and consumption of eggs was shown to increase childhood growth by an average of 5%, the average flock size is small and constrained by high mortality due to infectious disease. We hypothesized that interventions to relieve this constraint would translate into household decisions influencing the diets and growth of children. Here, we show that vaccination of chickens against Newcastle disease has a causal impact on children's consumption of animal source foods rich in protein and micronutrients relative to a high-carbohydrate, grain-based diet. Children in treatment households (chicken vaccination) showed overall increases in scores for both HAZ and WHZ relative to control households, benefiting both girls and boys. The findings demonstrate the impact of directing interventions at common on-farm assets managed by women in rural communities and support programs to enhance productivity at the household level.

An approach for evaluating the effects of dietary fiber polysaccharides on the human gut microbiome and plasma proteome.

Increases in snack consumption associated with Westernized lifestyles provide an opportunity to introduce nutritious foods into poor diets. We describe two 10-wk-long open label, single group assignment human studies that measured the effects of two snack prototypes containing fiber preparations from two sustainable and scalable sources; the byproducts remaining after isolation of protein from the endosperm of peas and the vesicular pulp remaining after processing oranges for the manufacture of juices. The normal diets of study participants were supplemented with either a pea- or orange fiber-containing snack. We focused our analysis on quantifying the abundances of genes encoding carbohydrate-active enzymes (CAZymes) (glycoside hydrolases and polysaccharide lyases) in the fecal microbiome, mass spectrometric measurements of glycan structures (glycosidic linkages) in feces, plus aptamer-based assessment of levels of 1,300 plasma proteins reflecting a broad range of physiological functions. Computational methods for feature selection identified treatment-discriminatory changes in CAZyme genes that correlated with alterations in levels of fiber-associated glycosidic linkages; these changes in turn correlated with levels of plasma proteins representing diverse biological functions, including transforming growth factor type ß/bone morphogenetic protein-mediated fibrosis, vascular endothelial growth factor-related angiogenesis, P38/MAPK-associated immune cell signaling, and obesity-associated hormonal regulators. The approach used represents a way to connect changes in consumer microbiomes produced by specific fiber types with host responses in the context of varying background diets.

Revised Swedish infant feeding guidelines are associated with earlier introduction of allergenic foods.

BACKGROUND: Randomized controlled trials have demonstrated that early introduction of allergenic foods, such as peanut and egg, can reduce food allergy in high-risk children. Many international guidelines recommend introduction of allergenic foods in the first year of life, and accordingly, the Swedish National Food agency released updated guidelines in June 2019. OBJECTIVE: Our aim was to examine whether the age at introduction and consumption frequency of allergenic foods have changed since release of the revised national guidelines on the introduction of solid foods in Sweden. METHODS: Children born between June 2016 and December 2018 (n = 1925) were compared with children born between June 2019 and April 2021 (n = 1761) by using data from the NorthPop Birth Cohort study. Data on food introduction, eczema, and food allergy were prospectively collected until age 18 months by using web-based questionnaires. IgE sensitization was assessed at 18 age months. RESULTS: The proportion of participants who had been introduced to egg, legume, soy products, peanut, almond, and cashew nut during the first year of life increased after implementation of the revised national guidelines. The most significant changes were seen for legume (from 55.2% to 69.8% [adjusted odds ratio = 1.90 (95% CI = 1.62-2.24)]) and peanut (from 29.2% to 43.2% adjusted odds ratio = 1.87 (95% CI = 1.55-2.24)]); consumption frequency had also increased. No differences in the prevalence of eczema, food allergy, or sensitization to the foods of interest were found. CONCLUSION: Since release of the revised guidelines, infants in the general population are introduced to and consume a variety of allergenic foods earlier and more frequently; however, early manifestations of allergic disease have remained unchanged.

How dietary advanced glycation end products could facilitate the occurrence of food allergy.

BACKGROUND: Food allergy (FA) is one of the most common chronic conditions in children with an increasing prevalence facilitated by the exposure to environmental factors in predisposed individuals. It has been hypothesized that the increased consumption of ultra-processed foods, containing high levels of dietary advanced glycation end products (AGEs), could facilitate the occurrence of FA. OBJECTIVE: We sought to provide preclinical and clinical evidence on the potential role of AGEs in facilitating the occurrence of FA. METHODS: Human enterocytes, human small intestine organ culture, and PBMCs from children at risk for allergy were used to investigate the direct effect of AGEs on gut barrier, inflammation, TH2 cytokine response, and mitochondrial function. Intake of the 3 most common glycation products in Western diet foods, Nε-(carboxymethyl) lysine, Nε-(1-carboxyethyl) lysin, and Nδ-(5-hydro-5- methyl-4-imidazolone-2-yl)-ornithine (MG-H1), and the accumulation of AGEs in the skin were comparatively investigated in children with FA and in age-matched healthy controls. RESULTS: Human enterocytes exposed to AGEs showed alteration in gut barrier, AGE receptor expression, reactive oxygen species production, and autophagy, with increased transepithelial passage of food antigens. Small intestine organ cultures exposed to AGEs showed an increase of CD25+ cells and proliferating crypt enterocytes. PBMCs exposed to AGEs showed alteration in proliferation rate, AGE receptor activation, release of inflammatory and TH2 cytokines, and mitochondrial metabolism. Significant higher dietary AGE intake and skin accumulation were observed children with FA (n = 42) compared with age-matched healthy controls (n = 66). CONCLUSIONS: These data, supporting a potential role for dietary AGEs in facilitating the occurrence of FA, suggest the importance of limiting exposure to AGEs children as a potential preventive strategy against this common condition.

Microbial-Based Bioactive Compounds to Alleviate Inflammation in Obesity.

The increased prevalence of obesity with several other metabolic disorders, including diabetes and non-alcoholic fatty liver disease, has reached global pandemic proportions. Lifestyle changes may result in a persistent positive energy balance, hastening the onset of these age-related disorders and consequently leading to a diminished lifespan. Although suggestions have been raised on the possible link between obesity and the gut microbiota, progress has been hampered due to the extensive diversity and complexities of the gut microbiota. Being recognized as a potential biomarker owing to its pivotal role in metabolic activities, the dysregulation of the gut microbiota can give rise to a persistent low-grade inflammatory state associated with chronic diseases during aging. This chronic inflammatory state, also known as inflammaging, induced by the chronic activation of the innate immune system via the macrophage, is controlled by the gut microbiota, which links nutrition, metabolism, and the innate immune response. Here, we present the functional roles of prebiotics, probiotics, synbiotics, and postbiotics as bioactive compounds by underscoring their putative contributions to (1) the reduction in gut hyperpermeability due to lipopolysaccharide (LPS) inactivation, (2) increased intestinal barrier function as a consequence of the upregulation of tight junction proteins, and (3) inhibition of proinflammatory pathways, overall leading to the alleviation of chronic inflammation in the management of obesity.

Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire for Measuring Intakes of Foods and Food Groups.

We evaluated the validity and reproducibility of a semiquantitative food frequency questionnaire (FFQ) for measuring intakes of 149 foods and 25 food groups among 736 participants of the Women's Lifestyle Validation Study (WLVS, 2010-2012) and 649 participants of the Men's Lifestyle Validation Study (MLVS, 2011-2013). Validity of the FFQ compared with two 7-day dietary records measured 6 months apart and the reproducibility between 2 FFQs administered 1 year apart (FFQ1 and FFQ2) were assessed using Spearman correlations and intraclass correlation coefficients. The average 1-year reproducibility of FFQ-measured foods was 0.64 in both the WLVS and MLVS. Reproducibility of the food groups (mean = 0.71 among women and 0.72 among men) was generally higher than that for individual foods. Among women, the average validity correlation for individual foods was 0.59 when comparing FFQ2 with the 7-day dietary records. Among men, the corresponding average validity correlation was 0.61. Compared with individual foods, food groups had slightly higher validity correlations in both women (range, 0.45-0.92; mean = 0.61) and men (range, 0.46-0.88; mean = 0.65). This study reaffirms that the FFQ performs well in measuring most foods and food groups and provides data to adjust for measurement errors in epidemiologic studies of foods and food groups.

Trends in the healthiness and nutrient composition of packaged products sold by major food and beverage companies in New Zealand 2015 to 2019.

BACKGROUND: Dietary risk factors are the leading cause of death globally and in New Zealand (NZ). Processed packaged foods are prevalent in the food supply and contribute excess amounts of sodium, saturated fat, and sugar in diets. Improving the nutritional quality of these foods has the potential to reduce population chronic disease risk. We aimed to evaluate the healthiness using the Australasian Health Star Rating (HSR, from 0.5 to 5 stars, with 5 being the healthiest) and nutrient composition (sodium, saturated fat, and total sugar) of packaged products manufactured by the largest NZ-based food and beverage companies in NZ 2015-2019. This analysis relates to a larger study evaluating structured engagement with food companies to improve nutrition-related policies and actions. METHODS: Data was sourced from Nutritrack, a NZ-branded supermarket-sourced food composition database. The largest NZ-based companies from annual retail sales revenue (n = 35) were identified using 2019 Euromonitor data. All relevant products of the selected companies were extracted for analysis. Products included totalled 17,795 with a yearly range of 3462-3672 products. The primary outcome was a nutrient profile score estimated using HSR. Healthiness was defined as ≥ 3.5 stars. Secondary outcomes were sodium, total sugar, and saturated fat per 100 g/100 mL. All outcomes were assessed overall, by food company, and food category. Change over time was tested using linear mixed models, adjusting for major food categories and cluster effects of food companies controlling for multiple comparisons. Model-adjusted mean differences between years were estimated with 95% confidence intervals. RESULTS: There was a small statistically significant increase in mean HSR between 2015 and 2019 (0.08 [0.15,0.01], p = 0.024). Mean total sugar content decreased over the same period (0.78 g/100 g [0.08,1.47], p = 0.020), but there were no significant changes in mean sodium or saturated fat contents. Seven of the 13 categories showed small increases in mean HSR (0.1-0.2). Most categories (9/13) exhibited a reduction in mean total sugar content. CONCLUSIONS: Between 2015 and 2019, there were slight improvements in the nutritional quality of selected packaged foods and drinks in NZ. Much more substantive changes are needed to address the health-related burden of unhealthy diets, supported by stronger government action and less reliance on voluntary industry initiatives.

Food contamination from packaging material with special focus on the Bisphenol-A.

Additives, such as bisphenol A (BPA) that are added to packaging material to enhance functionality may migrate into food products creating a concern for food safety. BPA has been linked to various chronic diseases, such as: diabetes, obesity, prostate cancer, impaired thyroid function, and several other metabolic disorders. To safeguard consumers, BPA migration limits have been defined by regulatory bodies. However, it is important to address the underlying factors and mechanisms so that they can be optimized in order to minimize BPA migration. In this review, we determine the relative importance of the factors, i.e. temperature, contact time, pH, food composition, storage time and temperature, package type, cleaning, and aging, and packaging damage that promote BPA migration in foods. Packaging material seems to be the key source of BPA and the temperature (applied during food production, storage, can sterilization and cleaning processes) was the critical driver influencing BPA migration.

3D printing: trends and approaches toward achieving long-term sustainability in the food industry.

Global food security has recently been under serious threat from the rapid rise in the world's population, the problems brought on by climate change, and the appearance of new pandemics. As a result, the need for novel and innovative solutions to solve the existing problems and improve food sustainability has become crucial. 3D printing is expected to play a significant role in providing tangible contributions to the food industry in achieving sustainable development goals. The 3D food printing holds the potential to produce highly customized food in terms of shape, texture, flavor, structure and nutritional value and enable us to create new unique formulations and edible alternatives. The problem of whether the cost of the printed meal and 3D printing itself can be sustainably produced is becoming more and more important due to global concerns. This review intends to provide a comprehensive overview of 3D printed foods with an overview of the current printing methodologies, illustrating the technology's influencing factors, and its applications in personalized nutrition, packaging, value addition, and valorization aspects to fully integrate sustainability concerns thus exploring the potential of 3D food printing.

Socioeconomic Inequalities in Intakes of Ultraprocessed and Minimally Processed Foods in Nationally Representative Samples of Adults in Canada: An Analysis of Trends between 2004 and 2015.

BACKGROUND: Individuals with a lower socioeconomic position (SEP) often have higher intakes of ultraprocessed food (UPF) and lower intakes of minimally processed food (MPF); however, studies have not examined trends in absolute and relative gaps and gradients in UPF and MPF intake using multiple indicators of SEP. OBJECTIVES: We examined within-year absolute and relative gaps and gradients in UPF and MPF intake and trends between 2004 and 2015 according to 6 indicators of SEP among nationally representative samples of adults in Canada. METHODS: Adults (≥18 y) in the Canadian Community Health Survey-Nutrition 2004 (n = 20,880) or 2015 (n = 13,970) reported SEP (individual and household education, household income adequacy, household food insecurity, neighborhood material and social deprivation) and completed a 24-h dietary recall. Multivariable linear regression assessed within-year absolute and relative gaps and gradients in the proportion of energy from UPF and MPF and trends between 2004 and 2015. RESULTS: The largest and most consistent within-year inequities in UPF and MPF intake were for individual and household educational attainment. Overall and among males, higher SEP groups had more favorable intakes over time based on trends in absolute and relative gaps and gradients in UPF and MPF intake by household food insecurity [for example, the absolute gap in UPF intake declined from -1.2% (95% confidence interval: -5.3%, 2.9%) to -7.9% of energy (95% confidence interval: -11.2%, -4.5%) in the overall population]. Overall and among males, lower SEP groups had more favorable intakes over time based on trends in absolute and relative gaps in UPF and MPF intake by neighborhood material deprivation. CONCLUSIONS: Socioeconomic inequalities in UPF and MPF intake were most pronounced for individual and household education. Between 2004 and 2015, several inequalities in UPF and MPF intake emerged according to household food insecurity (favoring higher SEP groups) and neighborhood material deprivation (favoring lower SEP groups).

Association of ultra-processed foods intake with untargeted metabolomics profiles in adolescents and young adults in the DONALD cohort study.

BACKGROUND: High consumption of ultra-processed foods (UPF) continues to draw significant public health interest due to the associated negative health outcomes. Metabolomics can contribute to the understanding of the biological mechanisms through which UPFs may influence health. OBJECTIVES: To investigate urine and plasma metabolomic biomarkers of UPF intake in adolescents and young adults. METHODS: We used data from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study to investigate cross-sectional associations of UPF intake with concentrations of urine metabolites in adolescents using 3-d weighed dietary records (3d-WDR) and 24-h urine samples (n = 339), and associations of repeatedly assessed UPF intake with concentrations of circulating plasma metabolites in young adults with 3 to 6 3d-WDRs within 5 y preceding blood measurement (n = 195). Urine and plasma samples were analyzed using mass spectrometry-based metabolomics. Biosample-specific metabolite patterns were determined using robust sparse principal components analysis. Multivariable linear regression models were applied to assess the associations of UPF consumption (as a percentage of total food intake in g/d) with concentrations of individual metabolites and metabolite pattern scores. RESULTS: The median proportion of UPF intake was 22.0% (interquartile range, IQR: 12.3, 32.9) in adolescents and 23.2% (IQR: 16.0, 31.6) in young adults. We identified 42 and 6 UPF intake-associated metabolites in urine and plasma samples, respectively. One urinary metabolite pattern, "xenobiotics and amino acids" (ß = 0.042, 95% confidence interval, [CI]: 0.014, 0.070) and one plasma metabolite pattern, "lipids, xenobiotics, and amino acids" (ß = 0.074, 95% CI: 0.031, 0.117) showed positive association with UPF intake. Both patterns shared 29 metabolites, mostly of xenobiotic metabolism. CONCLUSIONS: We identified urine and plasma metabolites associated with UPF intake in adolescents and young adults, which may represent some of the biological mechanisms through which UPFs may influence metabolism and health.

Acute Microbial Protease Supplementation Increases Net Postprandial Plasma Amino Acid Concentrations After Pea Protein Ingestion in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Digestibility is a primary factor in determining the quality of dietary protein. Microbial protease supplementation may be a strategy for improving protein digestion and subsequent postprandial plasma amino acid availability. OBJECTIVES: To assess the effect of co-ingesting a microbial protease mixture with pea protein on postprandial plasma amino acid concentrations. DESIGN: A mixture of 3 microbial protease preparations (P3) was tested for proteolytic efficacy in an in vitro static simulation of gastrointestinal digestion. Subsequently, in a randomized, double-blind, placebo-controlled crossover trial, 24 healthy adults (27 ± 4 y; 12 females, 12 males) ingested 25 g pea protein isolate (20 g protein, 2.2 g fat) with either P3 or maltodextrin placebo (PLA). Blood samples were collected at baseline and throughout a 0‒5 h postprandial period and both the early (0-2 h) iAUC and total (0-5 h) iAUC were examined. RESULTS: Plasma glucose concentrations decreased in both conditions (P < 0.001), with higher concentrations after P3 ingestion compared with PLA (P < 0.001). Plasma insulin concentrations increased for both conditions (P < 0.001) with no difference between conditions (P = 0.331). Plasma total amino acid (TAA) concentrations increased over time (P < 0.001) with higher concentrations observed for P3 compared with PLA (P = 0.010) during the 0‒5 h period. There was a trend for elevated essential amino acid (EAA) concentrations for P3 compared with PLA (P = 0.099) during the 0‒5 h postprandial period but not for leucine (P = 0.282) or branched-chain amino acids (BCAA, P = 0.410). The early net exposure (0‒2 h iAUC) to amino acids (leucine, BCAA, EAA, and TAA) was higher for P3 compared with PLA (all, P < 0.05). CONCLUSIONS: Microbial protease co-ingestion increases plasma TAA concentrations (0-5 h) and leucine, BCAA, EAA, and TAA availability in the early postprandial period (0‒2 h) compared with ingesting pea protein with placebo in healthy adults.

An Egg Intervention Improves Ponderal But Not Linear Growth Among Infants 6-12 mo of Age in Rural Bangladesh.

BACKGROUND: Animal source foods are rich in multiple nutrients. Regular egg consumption may improve infant growth in low- and middle-income countries. OBJECTIVES: To assess the impact of daily egg consumption on linear growth among 6-12-mo olds in rural Bangladesh. METHODS: We conducted a 2 × 4 factorial cluster-randomized controlled trial allocating clusters (n = 566) to treatment for enteric pathogens or placebo and a daily egg, protein supplement, isocaloric supplement, or control. All arms received nutrition education. Here, we compare the effect of the egg intervention versus control on linear growth, a prespecified aim of the trial. Infants were enrolled at 3 mo. We measured length and weight at 6 and 12 mo and visited households weekly to distribute eggs and monitor compliance. We used linear regression models to compare 12-mo mean length, weight, and z-scores for length-for-age (LAZ), weight-for-length, and weight-for-age (WAZ), and log-binomial or robust Poisson regression to compare prevalence of stunting, wasting, and underweight between arms. We used generalized estimating equations to account for clustering and adjusted models for baseline measures of outcomes. RESULTS: We enrolled 3051 infants (n = 283 clusters) across arms, with complete 6 and 12 mo anthropometry data from 1228 infants (n = 142 clusters) in the egg arm and 1109 infants (n = 141 clusters) in the control. At baseline, 18.5%, 6.0%, and 16.4% were stunted, wasted, and underweight, respectively. The intervention did not have a statistically significant effect on mean LAZ (ß: 0.05, 95% confidence interval [CI]: -0.01, 0.10) or stunting prevalence (ß: 0.98, 95% CI: 0.89, 1.13) at 12 mo. Mean weight (ß: 0.07 kg, 95% CI: 0.02, 0.11) and WAZ (ß: 0.06, 95% CI: 0.02, 0.11) were significantly higher in the egg compared with control arms. CONCLUSIONS: Provision of a daily egg for 6 mo to infants in rural Bangladesh improved ponderal but not linear growth. TRIAL REGISTRATION NUMBER: NCT03683667, https://clinicaltrials.gov/ct2/show/NCT03683667.

Intake of Snacks and Sweets in a National Study of Built and Social Environments: the REasons for Geographic And Racial Differences in Stroke Study.

BACKGROUND: Few national studies across the United States' rural-urban continuum examine neighborhood effects on snacks and sweets intake among adults. OBJECTIVES: This study examines associations of urbanicity/rurality-tailored measures of food store availability and neighborhood socioeconomic status (NSES) with the intake of snacks and sweets in a national sample of middle and older age adults. METHODS: This cross-sectional study used food frequency questionnaire data collected in the REasons for Geographic And Racial Differences in Stroke study (N = 21,204). What We Eat in America food group categorizations guided outcome classification into 1 main category (total snacks and sweets) and 4 subcategories (savory snacks and crackers; sweet bakery products; candy and desserts; nutrition bars and low-fat snacks and sweets). NSES and food store availability were determined using geographic information systems. Food store availability was characterized as geographic access to primary food stores (e.g., supermarkets, supercenters, and select food retailers) in urbanicity/rurality-tailored neighborhood-based buffers. Multiple linear regression was used to predict each outcome. RESULTS: Living in neighborhoods with a high density of primary food stores was associated with 8.6%, 9.5%, and 5.8% lower intake of total snacks and sweets, sweet bakery products, and candy and desserts, respectively. Living in the highest NSES quartile was associated with 11.3%, 5.8%, and 18.9% lower intake of total snacks and sweets, savory snacks and crackers, and sweet bakery products, respectively. Depending on primary food store availability, higher household income was associated with significantly greater intake of nutrition bars and low-fat snacks and sweets. Living in a United States Department of Agriculture-defined food desert was not associated with intake. CONCLUSIONS: In a geographically diverse sample of middle and older age United States adults, living in neighborhoods with no primary food stores or neighborhoods of low-SES was associated with higher intake of total snacks and sweets and subgroups of snacks and sweets.

Protein Biomarkers of Ultra-Processed Food Consumption and Risk of Coronary Heart Disease, Chronic Kidney Disease, and All-Cause Mortality.

BACKGROUND: There is a need to understand the underlying biological mechanisms through which ultra-processed foods negatively affect health. Proteomics offers a valuable tool with which to examine different aspects of ultra-processed foods and their impact on health. OBJECTIVE: To identify protein biomarkers of usual ultra-processed food consumption, and assess their relation to incidence of coronary heart disease, chronic kidney disease, and all-cause mortality risk. METHODS: A total of 9,361 participants from the Atherosclerosis Risk in Communities (ARIC) visit 3 (1993-1995) were included. Dietary intake was assessed using a 66-item food frequency questionnaire and the processing levels were categorized based on Nova classification. Plasma proteins were detected using an aptamer-based proteomic assay. We used multivariable linear regressions to examine the association between ultra-processed food and proteins, and Cox proportional hazard models to identify associations between ultra-processed food-related proteins and health outcomes. Models extensively controlled for sociodemographic characteristics, health behaviors, and clinical factors. RESULTS: Identified were eight proteins (6 positive, 2 negative) significantly associated with ultra-processed food consumption. Over a median follow-up of 22 years, there were 1,276, 3,084, and 5,127 cases of coronary heart disease, chronic kidney disease, and death, respectively. Three, five, and three ultra-processed food-related proteins were associated with each outcome, respectively. One protein (ß-glucuronidase) was significantly associated with higher risk of all three outcomes, and three proteins (receptor-type tyrosine-protein phosphatase U, C-C motif chemokine 25, and twisted gastrulation protein homolog 1) were associated with higher risk of two outcomes. CONCLUSIONS: We identified a panel of protein biomarkers that were significantly associated with ultra-processed food consumption. These proteins may be considered potential biomarkers for ultra-processed food intake and elucidate the biological processes through which ultra-processed foods impact health outcomes.