Exploring longitudinal relationships between fitness tracking and disordered eating outcomes in college-aged women.

OBJECTIVE: A growing body of research, primarily cross-sectional, suggests a relationship between the practice of tracking one's food intake and exercise behaviors using fitness-tracking smartphone applications ("apps") or wearable devices ("wearables") and disordered eating symptomatology. The aim of the present study was to explore longitudinal relationships between fitness tracking and disordered eating outcomes among college-aged women, as well as to determine whether the individual-level risk factors of pre-existing eating concerns, perfectionism, and rumination about food moderated the relationship. METHOD: N = 68 female undergraduates used the MyFitnessPal app for 8 weeks while completing a series of self-report measures. RESULTS: At the trait level, fitness tracking frequency was positively associated with weight/shape concerns, but not with the other outcome measures. Daily levels of fitness tracking did not predict next-day levels for any of the outcome measures. Within-day fitness tracking at one timepoint was associated with lower reports of dietary restraint efforts at the next timepoint. None of the proposed moderators significantly interacted with the relationships over time. DISCUSSION: These results suggest that while those who engage in fitness tracking may experience higher weight/shape concerns as a trait, over time fitness tracking was not associated with an increase in concerns. Further work exploring whether fitness tracking may affect particular subgroups in different ways is warranted.

Strike a pose: Immediate effects of a model-created social media literacy video on body image and mood.

Exposure to idealized social media imagery has been shown to be detrimental to body image among young women, and social media literacy may be protective. This mixed methods study aimed to evaluate the effects of an online video narrated by a high-profile, plus-size model on the body image and negative mood of young women and predictors of the effects. A sample of 304 young women, average age 20.95 (SD = 2.09) years, completed an online survey including pre- and post-exposure measures of state body image and negative mood, and trait measures of upward social media appearance comparison, thin-ideal internalization, and selfie-investment. A subset (n = 148) responded to open-ended questions to obtain feedback on the video coded categorically and through thematic analysis. Findings revealed immediate improvements in state body satisfaction and negative mood, with higher levels of trait appearance comparison and selfie investment associated with smaller effects of the video. Participants endorsed the video as raising awareness of unrealistic images but limited in terms of mitigating appearance comparison and selfie-investment. Furthermore, participants described that Iskra's status as a professional model also influenced their reactions. These findings highlight the importance of assessing for unintended paradoxical effects of social media literacy efforts and ensuring that such interventions are empirically based.

Types, predictors, and consequences of medicines related problems (MRPs) in frail older adults admitted to hospital from primary care - A retrospective cohort study.

Introduction: Medicines related problems (MRPs) can be common in frail older people due to age-compromised body systems and a propensity to be on multiple drugs concurrently. This group of people can also succumb to a rapid deterioration in health. Thus, it is important to investigate MRPs in frail older people. The objectives of the study were to evaluate prevalence of MRPs, types of MRPs, risk factors and deterioration that can be associated with MRPs in frail older people admitted to an English teaching hospital from primary care. Methods: Included in the sample were frail older adults, aged 65 years and over, admitted from primary care. Data was retrieved from the hospital's electronic patient record system, anonymised, and reviewed for MRPs. MRPs which were retrospectively identified at admission were coded with the WHO-ICD10,2016 (World Health Organisation-International Classification of Diseases version 10, 2016). Descriptive and inferential statistics were performed on the data using SPSS Version 25. Primary outcome was the prevalence of MRPs in frail older patients. Secondary outcome was the association of deterioration indicated as fall, delirium, or NEWs ≥3 with presence of MRPs. Results: Among the 507 frail older people (≥4 on Rockwood scale) that met criteria for inclusion, 262 (51.8%) were patients with MRPs and 244 (48.2%) without. The Median age of sample as a whole was 85 years (IQR = 80-89). Prevalence of MRPs was 33.28%. Types of MRPs were adverse drug reaction (ADR-20%), non-compliance (9.1%), unintentional poisoning (3.3%) and inappropriate polypharmacy (0.8%). In logistic regression, potentially inappropriate medicines (PIM), social support, number of comorbidities and winter were significant predictors of MRPs. Risk of deteriorating with delirium was two times higher in patients with MRPs than in patients without MRPs, RR 2.613 (95% CI, 1.049 to 6.510). Conclusion: MRPs and risks of deterioration associated with MRPs in frail older people can be reduced. This is because factors associated with MRPs can be modified.

Holistic Hypertension Management.

Hypertension (HTN) is a major health care problem affecting nearly half of American's adult population. HTN is one of the costliest diagnoses among cardiovascular disease and leads to other major cardiovascular complications, which increase overall morbidity and mortality. Of those diagnosed with HTN in America, only one-fourth of patients are living with well-controlled HTN. This evidenced-based HTN management practice innovation was conducted to explore evidenced-based, holistic nursing practice of a low-sodium dietary approach to stop hypertension (DASH) diet, and exercise alongside antihypertensive medication management in decreasing systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adult patients diagnosed with HTN. This community-based holistic care initiative supports data previously published, which suggests a low-sodium DASH diet, exercise, and antihypertensive medication management are effective in decreasing SBP and DBP. This project supported clinicians seeking to integrate a complementary holistic and traditional approach to HTN management in patients diagnosed with HTN.

A Systematic Review of Post-Work Core Temperature Cooling Rates Conferred by Passive Rest.

Physical work increases energy expenditure, requiring a considerable elevation of metabolic rate, which causes body heat production that can cause heat stress, heat strain, and hyperthermia in the absence of adequate cooling. Given that passive rest is often used for cooling, a systematic search of literature databases was conducted to identify studies that reported post-work core temperature cooling rates conferred by passive rest, across a range of environmental conditions. Data regarding cooling rates and environmental conditions were extracted, and the validity of key measures was assessed for each study. Forty-four eligible studies were included, providing 50 datasets. Eight datasets indicated a stable or rising core temperature in participants (range 0.000 to +0.028 °C min-1), and forty-two datasets reported reducing core temperature (-0.002 to -0.070 °C min-1) during passive rest, across a range of Wet-Bulb Globe Temperatures (WBGT). For 13 datasets where occupational or similarly insulative clothing was worn, passive rest resulted in a mean core temperature decrease of -0.004 °C min-1 (-0.032 to +0.013 °C min-1). These findings indicate passive rest does not reverse the elevated core temperatures of heat-exposed workers in a timely manner. Climate projections of higher WBGT are anticipated to further marginalise the passive rest cooling rates of heat-exposed workers, particularly when undertaken in occupational attire.

Positive body image, intuitive eating, and psychosocial functioning among older women: Testing an integrated model.

BACKGROUND: Research on the body image and eating behaviors of older women is scarce. Moreover, the scant existing research has lacked a focus on positive dimensions, such as positive reappraisal and acceptance, body appreciation, appearance satisfaction, and intuitive eating among older women. Therefore, the aim of the present study was to examine a model of the relationships among these positive dimensions and psychological functioning in older women. METHODS: A sample of 171 women aged 60-75 years were recruited through social media to respond to a survey assessing body image, eating behaviors, and psychological wellbeing. RESULTS: The final model was a good fit to the data. In this model, positive reappraisal and acceptance of age-related appearance changes was associated with higher body appreciation, in turn associated with higher body image related quality of life, higher levels of intuitive eating, and lower levels of depressive symptoms. CONCLUSION: Positive body image and positive reappraisal of aging-related changes in appearance are associated with psychological wellbeing among older women. Longitudinal data are needed to clarify the direction of these relationships and inform interventions. Body image remains an important dimension among older women and should be accounted for in broader health promotion efforts among this group.

Body image concerns and disordered eating among older women: Identifying variables of interest for integrated models.

OBJECTIVE: Research focused on developing risk and protective models of body image concerns and disordered eating among older women is scant. Models including biological, psychological, and sociocultural elements may be useful explanatory frameworks in this group. Thus, the aim of this study was to conduct formative research exploring the constructs that form part of biopsychosocial models of body image concerns and disordered eating among older women. METHOD: A sample of 184 women aged 60-75 years completed an online survey assessing media pressures, thin-ideal internalization, depression symptoms, weight and shape concerns, and disordered eating as well as positive reappraisal and acceptance of aging-related changes to appearance. RESULTS: After the addition of two supplemental pathways, the model revealed good fit to the data. In the final model, age, depression, and media pressure were associated with media internalization, that was in turn associated with weight and shape concerns, and then disordered eating. Depression was also directly associated with both weight and shape concerns and disordered eating. The model varied across older women with high versus low levels of positive reappraisal and acceptance of aging-related changes to appearance. Specifically, among those high on this trait, the pathways between depression and thin-ideal internalization, and between weight and shape concerns and disordered eating were significantly weaker. DISCUSSION: These findings support the usefulness of biopsychosocial models for grounding research on body image concerns and disordered eating among older women, and suggest positive reappraisal and acceptance of aging-related changes to appearance as a useful dimension to focus on.

Bactericidal effects of high-energy visible light on common otitis media pathogens.

AIMS: This study assessed the use of high-energy, visible light on the survival rates of three bacteria commonly found in middle ear infections (i.e. otitis media; Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae). METHOD AND RESULTS: Bacteria were cultured and then subjected to a single, 4-h treatment of 405 nm wavelength light at two different intensities. All three bacteria species were susceptible to the light at clinically significant rates (>99.9% reduction). Bacteria were susceptible to the high-energy visible (HEV) light in a dose-dependent manner (lower survival rates with increased intensity and duration of exposure). CONCLUSIONS: The results suggest that HEV light may provide a non-surgical, non-pharmaceutical approach to the therapeutic treatment of otitis media. SIGNIFICANCE AN IMPACT OF THE STUDY: Given the growing concerns surrounding antibiotic resistance, this study demonstrates a rapid, alternative method for effective inactivation of bacterial pathogens partly responsible for instances of otitis media.

Anticholinergic burden in older adult inpatients: patterns from admission to discharge and associations with hospital outcomes.

BACKGROUND: Anticholinergic medications are associated with adverse outcomes in older adults and should be prescribed cautiously. We describe the Anticholinergic Risk Scale (ARS) scores of older inpatients and associations with outcomes. METHODS: We included all emergency, first admissions of adults ⩾65 years old admitted to one hospital over 4 years. Demographics, discharge specialty, dementia/history of cognitive concern, illness acuity and medications were retrieved from electronic records. ARS scores were calculated as the sum of anticholinergic potential for each medication (0 = limited/none; 1 = moderate; 2 = strong and 3 = very strong). We categorised patients based on admission ARS score [ARS = 0 (reference); ARS = 1; ARS = 2; ARS ⩾ 3] and change in ARS score from admission to discharge [admission and discharge ARS = 0 (reference); same; decreased; increased]. We described anticholinergic prescribing patterns by discharge specialty and explored multivariable associations between ARS score categories and mortality using logistic regression [odds ratios (ORs), 95% confidence intervals (CIs)]. RESULTS: From 33,360 patients, 10,183 (31%) were prescribed an anticholinergic medication on admission. Mean admission ARS scores were: Cardiology and Stroke = 0.56; General Medicine = 0.78; Geriatric Medicine = 0.83; Other medicine = 0.81; Trauma and Orthopaedics = 0.66; Other Surgery = 0.65. Mean ARS did not increase from admission to discharge in any specialty but reductions varied significantly, from 4.6% (Other Surgery) to 27.7% (Geriatric Medicine) (p < 0.001). The odds of both 30-day inpatient and 30-day post-discharge mortality increased with admission ARS = 1 (OR = 1.21, 95% CI 1.01-1.44 and OR = 1.44, 1.18-1.74) but not with ARS = 2 or ARS ⩾ 3. The odds of 30-day post-discharge mortality were higher in all ARS change categories, relative to no anticholinergic exposure (same: OR = 1.45, 1.21-1.74, decreased: OR = 1.27, 1.01-1.57, increased: OR = 2.48, 1.98-3.08). CONCLUSION: The inconsistent dose-response associations with mortality may be due to confounding and measurement error which may be addressed by a prospective trial. Definitive evidence for this prevalent modifiable risk factor is required to support clinician behaviour-change, thus reducing variation in anticholinergic deprescribing by inpatient speciality. PLAIN LANGUAGE SUMMARY: We describe how commonly medicines which block the chemical acetylcholine are prescribed to older adults admitted to hospital as an emergency and explore links between these medicines and death during or soon after hospital admission Backgroud: Medicines which block the chemical acetylcholine are commonly prescribed to treat symptoms such as itch and difficulty sleeping or to treat medical conditions such as depression. However, some studies in older adults have found potential links between these medicines and confusion and falls. Therefore, doctors are recommended to prescribe these drugs cautiously in adults aged 65 years and over.Methods: In our paper we use data collected as part of routine medical care at one university hospital to describe how often these medicines are prescribed in a large sample of older adults admitted to hospital as an emergency. We look at the medicines patients are prescribed on admission to the hospital and also when they are later discharged.Results: We find that these medicines are frequently prescribed. We also find that, in general, patients are prescribed fewer of these potentially harmful medicines on hospital discharge compared with hospital admission. This suggests that clinicians are aware of advice to prescribe acetylcholine blocking medicines cautiously and they are more often stopped in hospital than started. However, we find a lot of variation in practice depending on which hospital specialty was caring for the patient during their inpatient stay. We also find potential links with these medicines and death during the admission or soon after hospital discharge, but these potential links are not always consistent.Conclusion: Further study is needed to fully understand links between medicines that block acetylcholine and late life health. This will be important to reduce variation in prescribing practices.

Orthorexia nervosa, intuitive eating, and eating competence in female and male college students.

Orthorexia nervosa (ON) has emerged as a new pattern of disordered eating behaviors characterized by preoccupations related to diet quality and health concerns, rather than driven by weight and shape concerns. A growing body of cross-sectional empirical data has documented associations between orthorexia nervosa symptoms and other indicators of disordered eating. However, little attention has been paid to the potential relationship between ON symptoms and indicators of healthy eating or positive eating behaviors. The aim of the present study was therefore to evaluate the relationships between ON symptomatology and the different facets of intuitive eating and eating competence. A sample of n = 605, 19% male, college students from the USA completed an online survey assessing orthorexia nervosa behaviors, the four facets of intuitive eating, and eating competence. Overall, orthorexia nervosa behaviors were found to be associated with lower levels of positive eating attitudes and behaviors. However, among men, curvilinear convex relationships emerged for two facets of intuitive eating, Body-Food Choice Congruence and Reliance on Hunger and Satiety Cues, such that the highest levels of intuitive eating were reported by those with mid-range levels of orthorexia nervosa behaviors. Taken together, these findings suggest that broadly, patterns of eating characterized by restriction, albeit for health reasons, are associated with less positive eating behaviors particularly among women. Further work focused on evaluating how drive for a healthy diet can be associated with flexible and positive eating patterns is warranted.Level of evidence Level V descriptive cross-sectional study.

A qualitative investigation of Orthorexia Nervosa among U.S. college students: Characteristics and sociocultural influences.

BACKGROUND: Current studies on Orthorexia Nervosa (ON) are predominantly correlational and have largely been conducted outside of the U.S. with little attention to cultural aspects. This study aimed to qualitatively examine ON-related attitudes and behaviors among U.S. college students, with a particular focus on exploring concerns related to healthy eating and diet quality as defined by proposed diagnostic criteria, body image concerns and disordered eating, and sociocultural influences. METHOD: Eighteen women and 3 men, aged 18-23 years (M = 19.5, SD = 1.6), who had reported high levels of ON symptoms participated in individual interviews. Interviews were transcribed verbatim and examined for evidence of the proposed diagnostic criteria of ON. In addition, thematic analysis was conducted to examine concurrent body image and eating concerns, as well as sociocultural influences. RESULTS: The patterns of the presence of diagnostic criteria varied, with the importance of food quality, and associated severely restricted eating patterns emerging as some of the most common elements. Six themes emerged from the thematic analysis: healthy eating concerns and diet quality, frequency and nature of food-related thoughts, definitions of healthy eating and healthy foods, disordered eating and body image, interpersonal social influence, and media and other influence from the broader social context. DISCUSSION: The findings suggest that ON symptoms may be concurrent with, or an evolution of other eating disorder presentations. In addition, our results highlight the role of family and sociocultural factors in ON, pointing to the usefulness of examining these behaviors within sociocultural frameworks that have been successfully applied to other types of disordered eating.

Quantifying human post-mortem movement resultant from decomposition processes.

BACKGROUND: Post-mortem movement is highly significant in unexplained death investigations, as body position or the position of remains helps to determine cause and manner of death, as well as potentially the circumstances surrounding death. Therefore, understanding post-mortem movement is of forensic relevance in death scene assessments. PURPOSE: The aim of this study was to quantify post-mortem movement in anatomical structures of a human donor during decomposition in an Australian environment, an evaluation that has not previously been undertaken. METHODS: The aim was achieved using time-lapse images of a human donor decomposing in order to capture the post-mortem movement over a 16-month period. Megyesi et al.'s [1] total body score system was used to quantify the decomposition of the donor in each image to determine the decomposition stage. ImageJ software was used to determine the distance from static landmarks to anatomical structures of interest in each image to allow for quantification. RESULTS: Early decomposition progressed rapidly, and advanced decomposition plateaued at 41 post-mortem interval days with a total body score of 24. The results support the conclusion that post-mortem movement does occur in all limbs of the donor. The anatomical structure that produced the most movement was the right styloid process of the radius, moving a total distance of 51.65 cm. A surprising finding of the study was that most post-mortem movement occurs in the advanced decomposition stage, with the lower limbs being the most active. CONCLUSION: This study supports that post-mortem movement can be quantified using time-lapse imagery, with results supporting movement in all limbs, a process that was active for the entire study period. An interesting finding was that the decomposition plateaued in the advanced stage with the donor remaining in mummification, and not reaching skeletonization after 16 months in situ. These findings are of significant importance to police in death scene assessments and forensic investigations.

An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England.

BACKGROUND: Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends - particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England. METHODS: Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014-2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity. RESULTS: Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU - a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences - with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU). CONCLUSION: Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England - with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.

Body image and body change behaviors associated with orthorexia symptoms in males.

In recent years, Orthorexia Nervosa has received increasing attention as a form of restrictive disordered eating driven by concerns related to "healthy eating" as opposed to weight and shape concerns. To date, however, data on the correlates of orthorexia in men are lacking, particularly pertaining to the relationship between orthorexia and muscularity-related dimensions. A sample of 103 (Mage = 19.84) male college students completed an online questionnaire reporting on orthorexia symptoms, eating pathology, drive for muscularity, exercise dependence, and internalization of the thin and athletic ideals. Correlational analyses and linear regression models were used to explore relationships between orthorexia and variables of interest. Findings revealed positive relationships between high levels of orthorexia symptoms and eating pathology, exercise dependence, thin and athletic internalization, and behavioral dimensions of drive for muscularity. The results of this study extend our understanding of the correlates of orthorexia symptoms among young men and highlight their association with other dimensions of eating pathology as well as dysfunctional exercise. In addition, concerns related to healthiness may overlap with muscularity-related concerns, perhaps due to the conflation between health and muscular appearance in social constructions of male body ideals.

Food Composition at Present: New Challenges.

Food composition data is important for stakeholders and users active in the areas of food, nutrition and health. New challenges related to the quality of food composition data reflect the dynamic changes in these areas while the emerging technologies create new opportunities. These challenges and the impact on food composition data for the Mediterranean region were reviewed during the NUTRIMAD 2018 congress of the Spanish Society for Community Nutrition. Data harmonization and standardization, data compilation and use, thesauri, food classification and description, and data exchange are some of the areas that require new approaches. Consistency in documentation, linking of information between datasets, food matching and capturing portion size information suggest the need for new automated tools. Research Infrastructures bring together key data and services. The delivery of sustainable networks and Research Infrastructures in food, nutrition and health will help to increase access to and effective use of food composition data. EuroFIR AISBL coordinates experts and national compilers and contributes to worldwide efforts aiming to produce and maintain high quality data and tools. A Mediterranean Network that shares high quality food composition data is vital for the development of ambitious common research and policy initiatives in support of the Mediterranean Diet.

Evaluating the utility of time-lapse imaging in the estimation of post-mortem interval: An Australian case study.

Estimating post-mortem interval is an important aspect in forensic investigations. The aim of this study was to investigate if time-lapse imaging can be used to improve estimates of post-mortem interval using Megyesi et al.'s [1] method for a human donor decomposing in an Australian environment. To achieve this, time-lapse images were taken every 30 min over a 6-month period. The Megyesi et al. [1] total body score (TBS) system was used to quantify the level of decomposition of the donor for each image. Linear regression was performed to determine if observing decomposition more than once a day leads to increased accuracy in predicting PMI (post-mortem interval). Decomposition initially progressed quickly and then plateaued at 1004 hours PMI, with a TBS of 24. Individual timestamps were created from the time-lapse images taken each day at 08:00 hrs, 11:00 hrs, 14:00 hrs, 15:00 hrs, and 17:00 hrs. All timestamps produced R2 values > 0.80, indicating that the Megyesi et al. [1] method accurately predicts PMI for this donor. The 08:00 hrs timestamp had the highest value R2 = 0.886, whilst the combined timestamp (which included the scores from all five images for each 24-hour period) R2 = 0.823 was the lowest. This study supports the validity of Megyesi et al.'s [1] TBS model to estimate PMI. Two other interesting findings were that the results suggest that scoring TBS multiple times per day does not improve estimates of PMI, however scoring TBS at daybreak produces more accurate results than scoring TBS later in the day. This may be an important consideration in forensic scenarios.

Eating Disorders in Ethnic Minorities: an Update.

PURPOSE OF REVIEW: Eating disorders are recognized to occur across ethnic and racial groups. The aim of the present review was to examine recent advances in the understanding of the development, presentation, and intervention approaches specific to eating disorders among ethnic and racial minority groups. RECENT FINDINGS: An increasing number of measures have been found to be useful tools for assessing eating disorder risk and symptoms among ethnic and racial minority populations. In addition, further evidence has emerged supporting the relationship between higher levels of eating disorder symptoms and acculturation stress, as well as investment in appearance ideals. In contrast, the relationship between ethnic identity and eating disorder symptoms is less consistent, although several studies suggest that positive ethnic identity may be protective. Finally, increasing efforts have been made to develop and implement culturally sensitive interventions by tailoring evidence-supported treatments. Our understanding of and capacity to treat eating disorders among ethnic and racial minority groups continues to improve. However, further research is needed, particularly among neglected groups, such a smaller ethnic and racial groups, males, and intersecting minority statuses.

Identification of Requirements for Computer-Supported Matching of Food Consumption Data with Food Composition Data.

This paper identifies the requirements for computer-supported food matching, in order to address not only national and European but also international current related needs and represents an integrated research contribution of the FP7 EuroDISH project. The available classification and coding systems and the specific problems of food matching are summarized and a new concept for food matching based on optimization methods and machine-based learning is proposed. To illustrate and test this concept, a study has been conducted in four European countries (i.e., Germany, The Netherlands, Italy and the UK) using different classification and coding systems. This real case study enabled us to evaluate the new food matching concept and provide further recommendations for future work. In the first stage of the study, we prepared subsets of food consumption data described and classified using different systems, that had already been manually matched with national food composition data. Once the food matching algorithm was trained using this data, testing was performed on another subset of food consumption data. Experts from different countries validated food matching between consumption and composition data by selecting best matches from the options given by the matching algorithm without seeing the result of the previously made manual match. The evaluation of study results stressed the importance of the role and quality of the food composition database as compared to the selected classification and/or coding systems and the need to continue compiling national food composition data as eating habits and national dishes still vary between countries. Although some countries managed to collect extensive sets of food consumption data, these cannot be easily matched with food composition data if either food consumption or food composition data are not properly classified and described using any classification and coding systems. The study also showed that the level of human expertise played an important role, at least in the training stage. Both sets of data require continuous development to improve their quality in dietary assessment.

Comparing Diet and Exercise Monitoring Using Smartphone App and Paper Diary: A Two-Phase Intervention Study.

BACKGROUND: There is increasing recognition that personalized approaches may be more effective in helping people establish healthier eating patterns and exercise more, and that this approach may be particularly effective in adolescents. OBJECTIVE: The objective of this study was to investigate the use of a smartphone app (FoodWiz2) in supporting healthy lifestyle choices in adolescence. METHODS: Participants (N=34: 11 male, 23 female) aged 16-19 years in full- or part-time education were recruited from sixth form colleges, schools, and other further education establishments in Norfolk and Suffolk, United Kingdom, between February and May 2015. Participants recorded food intake and exercise using a paper diary for 4-5 weeks and then used the app for the same duration. Initial nutrition education and general support were provided during the paper diary use, but the app included personalized messages sent in response to app activity. At the end of each study phase, participants completed an online questionnaire to describe their experience of using the paper diary and app. RESULTS: Record completion declined throughout the study, possibly affected by examination pressure. Food intake data showed increased fruit consumption and significantly reduced consumption of chocolate snacks (P=.01) and fizzy drinks (P=.002) among participants using the app. Questionnaire responses indicated that the app was generally preferred to the paper diary, in particular, the app was seen as less boring to use (P=.03) and more acceptable in social settings (P<.001). CONCLUSIONS: This app-based approach has shown the potential for a more effective approach to improving adolescent diet and exercise levels.

Modeling tool for calculating dietary iron bioavailability in iron-sufficient adults.

Background: Values for dietary iron bioavailability are required for setting dietary reference values. These are estimated from predictive algorithms, nonheme iron absorption from meals, and models of iron intake, serum ferritin concentration, and iron requirements.Objective: We developed a new interactive tool to predict dietary iron bioavailability.Design: Iron intake and serum ferritin, a quantitative marker of body iron stores, from 2 nationally representative studies of adults in the United Kingdom and Ireland and a trial in elderly people in Norfolk, United Kingdom, were used to develop a model to predict dietary iron absorption at different serum ferritin concentrations. Individuals who had raised inflammatory markers or were taking iron-containing supplements were excluded.Results: Mean iron intakes were 13.6, 10.3, and 10.9 mg/d and mean serum ferritin concentrations were 140.7, 49.4, and 96.7 mg/L in men, premenopausal women, and postmenopausal women, respectively. The model predicted that at serum ferritin concentrations of 15, 30, and 60 mg/L, mean dietary iron absorption would be 22.3%, 16.3%, and 11.6%, respectively, in men; 27.2%, 17.2%, and 10.6%, respectively, in premenopausal women; and 18.4%, 12.7%, and 10.5%, respectively, in postmenopausal women.Conclusions: An interactive program for calculating dietary iron absorption at any concentration of serum ferritin is presented. Differences in iron status are partly explained by age but also by diet, with meat being a key determinant. The effect of the diet is more marked at lower serum ferritin concentrations. The model can be applied to any adult population in whom representative, good-quality data on iron intake and iron status have been collected. Values for dietary iron bioavailability can be derived for any target concentration of serum ferritin, thereby giving risk managers and public health professionals a flexible and transparent basis on which to base their dietary recommendations. This trial was registered at clinicaltrials.gov as NCT01754012.