Effectiveness and safety of vedolizumab and infliximab in biologic-naive patients with Crohn's disease: results from the EVOLVE study.

OBJECTIVES: This study compared the real-world effectiveness and safety of α 4 ß 7 -integrin inhibitor vedolizumab and anti-tumor necrosis factor alpha (anti-TNFα) inhibitor infliximab in biologic-naive patients with Crohn's disease (CD). METHODS: EVOLVE was a retrospective, multicenter, medical chart review of biologic-naive adults with inflammatory bowel disease receiving vedolizumab or anti-TNFα treatment as first-line biologics in Canada, Greece, and the USA. Twelve-month outcomes were analyzed in vedolizumab- or infliximab-treated patients with moderate-to-severe CD (and subgroups with complicated and noncomplicated CD) including cumulative rates of clinical response, clinical remission, and mucosal healing, and incidence rates of serious adverse events (SAEs) and serious infections (SIs). Inverse probability weighting (IPW) was used to account for baseline differences between treatment groups. RESULTS: Data were analyzed from 167 patients. In the IPW dataset (99 vedolizumab-treated and 63 infliximab-treated), adjusted 12-month clinical remission rates were 73.1% and 55.2%, respectively ( P  = 0.31). Overall, effectiveness rates were similar across treatment and complicated/noncomplicated disease subgroups. Adjusted 12-month incidence rates (first occurrence/1000 person-years) of SAEs for vedolizumab vs. infliximab: 43.6 vs. 200.9 [hazard ratio (HR) 0.36 (0.09-1.54)]; SIs: 10.8 vs. 96.0 [HR 0.08 (<0.01-2.64)]. AE incidence was significantly lower in vedolizumab- vs. infliximab-treated patients for complicated [131.6 vs. 732.2; HR 0.19 (0.05-0.65)] and noncomplicated [276.3 vs. 494.8; HR 0.59 (0.35-0.99)] disease subgroups. CONCLUSION: These real-world data on first-line biologics show no differences in 12-month effectiveness outcomes for vedolizumab- vs. infliximab-treated biologic-naive patients with CD. Vedolizumab may have a more favorable safety profile vs. infliximab in patients with complicated and noncomplicated disease.

INSPECT: A Retrospective Study to Evaluate Long-term Effectiveness and Safety of Darvadstrocel in Patients With Perianal Fistulizing Crohn's Disease Treated in the ADMIRE-CD Trial.

BACKGROUND: The efficacy of a single administration of darvadstrocel (expanded allogeneic adipose-derived mesenchymal stem cells) for treating complex perianal fistulas in patients with Crohn's disease was demonstrated in a randomized, double-blind trial (ADMIRE-CD [Adipose Derived Mesenchymal Stem Cells for Induction of Remission in Perianal Fistulizing Crohn\'s Disease] trial). The current chart review study (INSPECT [A retrospectIve chart review study evaluatINg the longer-term effectiveneSs of darvadstrocel in PatiEnts who CompleTed ADMIRE-CD]) evaluated the longer-term effectiveness and safety of darvadstrocel. METHODS: Eligible patients had completed at least 52 weeks in the ADMIRE-CD trial. Data on clinical remission and fistula relapse outcomes were collected retrospectively at 104 and 156 weeks after treatment. Adverse events of special interest (tumorigenicity and ectopic tissue formation) were collected up to 208 weeks after treatment. RESULTS: Eighty-nine patients were included (43 darvadstrocel patients, 46 control subjects). At 52, 104, and 156 weeks posttreatment, clinical remission was observed in 29 (67.4%) of 43, 23 (53.5%) of 43, and 23 (53.5%) of 43 darvadstrocel-treated patients, compared with 24 (52.2%) of 46, 20 (43.5%) of 46, and 21 (45.7%) of 46 control subjects, respectively. In patients with clinical remission at week 52, this remission was sustained at 104 and 156 weeks after treatment in 19 (65.5%) of 29 and 16 (55.2%) of 29 darvadstrocel-treated patients and in 17 (70.8%) of 24 and 13 (54.2%) of 24 control subjects, respectively. Time to fistula relapse and incidence of fistula relapse or new fistula occurrence were not significantly different between groups. Tumorigenicity was reported for 1 (2.2%) patient in the control group (malignant epidermoid carcinoma). No ectopic tissue formation was reported. CONCLUSIONS: Real-world follow-up of patients from the ADMIRE-CD trial indicates that clinical remission of complex perianal fistulas can be sustained in the long term irrespective of whether it is achieved through darvadstrocel administration or maintenance treatment regimens and confirms a favorable long-term safety profile of darvadstrocel.

This retrospective chart review of patients treated with darvadstrocel indicates sustained remission and confirms a favorable safety profile up to 156 weeks after a single administration of stem cells for treatment of complex perianal fistulas in patients with Crohn's disease.

Test-retest reliability and validity of body composition methods in adults.

Cost-effective and efficient body composition measurement devices that are reliable and valid are necessary for identifying health risk as well as for understanding the effectiveness of lifestyle interventions. The objective of this study was to evaluate the test-retest reliability and validity of three body composition measurement devices. Forty-nine adults (mean age (SD) = 31.5 (10.7) y; BMI = 23.5 (3.0) kg/m2 ) completed a reference air displacement plethysmography (ADP) measure, and duplicate measures using skinfold callipers (Lange), ultrasound (BodyMetrix A-mode) and a 3-dimensional photonic scanner (3DPS; Fit3D ProScanner). Skinfold thickness was measured at seven sites using callipers and ultrasound; percent body fat (%BF) was then estimated using population-specific algorithms. The 3DPS was used to measure body circumferences, and then %BF was estimated using its beta-software. While skinfold callipers showed poor absolute reliability (mean differences (Δ) [95% CI] = 0.54% [0.22, 0.87], standard error of measurement (SEM) = 0.63%), ultrasound and the 3DPS showed excellent absolute (Δ = 0.17% [-0.25, 0.58], SEM = 0.78%; and Δ = -0.01% [-0.43, 0.40], SEM = 0.67%, respectively) and relative reliability (ICC2,1  = 0.988 [0.979, 0.993]; and ICC2,1  = 0.983 [0.968, 0.991], respectively). Compared to ADP (n = 43), skinfold callipers underestimated %BF (Δ = -4.53 [-7.72, -1.34]; p = 0.003), while ultrasound (Δ = -0.32 [-3.51, 2.87]; p = 0.99) and the 3DPS (Δ = 1.06 [-2.12. 4.26]; p = 0.77) were not significantly different. Bland-Altman plots showed a minimal bias of ultrasound [95% limit of agreement (LOA) = -7.87, 7.23] and the 3DPS [95% LOA = -6.66, 8.79]. In conclusion, estimating %BF from subcutaneous fat measurements using ultrasound and body circumferences using a 3DPS may be reliable and valid methods that require minimal technician expertise.

Individual participant data (IPD)-level meta-analysis of randomised controlled trials with vitamin D-fortified foods to estimate Dietary Reference Values for vitamin D.

CONTEXT AND PURPOSE: Individual participant data-level meta-regression (IPD) analysis is superior to meta-regression based on aggregate data in determining Dietary Reference Values (DRV) for vitamin D. Using data from randomized controlled trials (RCTs) with vitamin D3-fortified foods, we undertook an IPD analysis of the response of winter serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among children and adults and derived DRV for vitamin D. METHODS: IPD analysis using data from 1429 participants (ages 2-89 years) in 11 RCTs with vitamin D-fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D DRV estimates across a range of serum 25(OH)D thresholds using unadjusted and adjusted models. RESULTS: Our IPD-derived estimates of vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25 and ≥ 30 nmol/L are 6 and 12 µg/day, respectively (unadjusted model). The intake estimates to maintain 90%, 95% and 97.5% of concentrations ≥ 50 nmol/L are 33.4, 57.5 and 92.3 µg/day, respectively (unadjusted) and 17.0, 28.1 and 43.6 µg/day, respectively (adjusted for mean values for baseline serum 25(OH)D, age and BMI). CONCLUSIONS: IPD-derived vitamin D intakes required to maintain 90%, 95% and 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L are much higher than those derived from standard meta-regression based on aggregate data, due to the inability of the latter to capture between person-variability. Our IPD provides further evidence that using food-based approaches to achieve an intake of 12 µg/day could prevent vitamin D deficiency (i.e., serum 25(OH)D < 30 nmol/L) in the general population.

Effects of a high-intensity interval training session and chocolate milk on appetite and cognitive performance in youth aged 9-13 years.

BACKGROUND/OBJECTIVES: To investigate the separate and combined effects of a single session of high intensity interval training (HIIT) and chocolate milk on appetite and cognitive performance in youth aged 9-13 years. Blood glucose, salivary cortisol, and subjective emotions were measured to evaluate potential underlying mechanisms contributing to changes in appetite and cognitive performance. SUBJECTS/METHODS: Using a 2 × 2 repeated measures design, 20 youth (n = 12 girls and n = 8 boys; age = 11.4 ± 0.3 years) performed HIIT on a cycle ergometer (7 × 60 s bouts, interspersed by 60 s active recovery) or sitting, followed by consumption of 163 kcal chocolate milk or water. Capillary blood glucose, salivary cortisol, cognitive performance, and subjective appetite and emotions were assessed at baseline and at several time points post-treatment. RESULTS: Subjective appetite decreased from baseline following chocolate milk consumption compared water (p = 0.04), and increased from baseline after HIIT compared to sitting (p = 0.01). Participants recalled more words during a short-term memory task and had faster reaction times during an attention task following HIIT compared to sitting (Δ = 1.1 ± 0.02 words, p = 0.03; and Δ = 117.9 ± 23.1 ms, p = 0.01, respectively). Blood glucose increased from baseline following chocolate milk consumption compared to water (at 10 min: Δ = 1.0 ± 0.33 vs. Δ = 0.29 ± 0.060 mmol/L; p < 0.0001). CONCLUSIONS: Our findings that HIIT may have a positive effect on aspects of cognitive performance suggest that youth should engage in HIIT-like exercise during recesses and lunch at school to attenuate declines in cognitive performance throughout the day. Registered at https://clinicaltrials.gov (NCT03305107).

Effect of Increasing the Dietary Protein Content of Breakfast on Subjective Appetite, Short-Term Food Intake and Diet-Induced Thermogenesis in Children.

Dietary protein affects energy balance by decreasing food intake (FI) and increasing energy expenditure through diet-induced thermogenesis (DIT) in adults. Our objective was to investigate the effects of increasing the dietary protein in an isocaloric breakfast on subjective appetite, FI, blood glucose, and DIT in 9-14 y children. Two randomized repeated measures designs were used. In experiment 1, 17 children (9 boys, 8 girls) consumed isocaloric meals (450 kcal) on four separate mornings containing: 7 g (control), 15 g (low protein, LP), 30 g (medium protein, MP) or 45 g (high protein, HP) of protein. Blood glucose and subjective appetite were measured at baseline and regular intervals for 4 h, and FI was measured at 4 h. In experiment 2, 9 children (6 boys, 3 girls) consumed the control or HP breakfast on two separate mornings, and both DIT and subjective appetite were determined over 5 h. In experiment 1, all dietary protein treatments suppressed subjective appetite compared to control (p < 0.001), and the HP breakfast suppressed FI compared with the LP breakfast and control (p < 0.05). In experiment 2, DIT was higher after HP than control (p < 0.05). In conclusion, increasing the dietary protein content of breakfast had favorable effects on satiety, FI, and DIT in children.

Effect of White Potatoes on Subjective Appetite, Food Intake, and Glycemic Response in Healthy Older Adults.

The objective of this study was to determine the effect of white potato cooking methods on subjective appetite, short-term food intake (FI), and glycemic response in healthy older adults. Using a within-subject, repeated-measures design, 20 participants (age: 70.4 ± 0.6 y) completed, in random order, five treatment conditions: three potato treatments (baked potatoes, mashed potatoes, and French fries), an isocaloric control treatment (white bread), or a fasting condition (meal skipping). Subjective appetite and glycemic response were measured for 120 min using visual analogue scales and capillary blood samples, respectively. Lunch FI was measured with an ad libitum pizza meal at 120 min. Change from baseline subjective appetite (p < 0.001) and lunch FI (p < 0.001) were lower after all test treatments compared with meal skipping (p < 0.001), but did not differ among test treatments. Cumulative FI (test treatment + lunch FI) did not differ among treatment conditions. Blood glucose concentrations were higher after all test treatments compared with meal skipping (p < 0.001), but were not different from each other. In healthy older adults, white potatoes suppressed subjective appetite and lunch FI compared with meal skipping, suggesting white potatoes do not bypass regulatory control mechanisms of FI.

The association of maternal plant-based diets and the growth of breastfed infants.

Background: Studies are needed to further understand how different plant-based dietary patterns of mothers relate to infant growth. Thus, we investigated the association between maternal plant-based diets and infant growth in breastfed infants during the first 4 months of life. Methods: This cross-sectional study included 290 Iranian mothers and infants. Maternal dietary intake was assessed using a 168-question validated semi-quantitative food frequency questionnaire (FFQ). Three plant-based diet indices (PDIs) were then created to evaluate dietary intakes. Eighteen food groups were classified in three main categories by scoring method: wholeplant diet, healthy plant diet, and animal and unhealthy plant diet. Results: Participants in the top tertile of unhealthy PDI (uPDI) had a lower intake of potassium,phosphorus, zinc, magnesium, calcium, folate and vitamin C, B1, B2, and B3. The upper tertileof uPDI was associated with stunting at 4-month in infants (uPDI: odds ratio [OR] = 3.27, 95%CI= 1.32, 8.10). There were no significant associations between plant-based diet scores and anthropometric indices, including weight, weight status and head circumference (P > 0.05). Conclusion: In conclusion, higher adherence to uPDI may be associated with stuntingamong Iranian infants. Other PDIs were not associated with anthropometric measures. Future studies are needed to further understand the association between plant-based diets and infant growth.

Effects of White Potatoes Consumed With Eggs on Satiety, Food Intake, and Glycemic Response in Children and Adolescents.

Objective: Short-term studies in adults have shown that white potatoes increase satiety and suppress food intake (FI) compared with several other carbohydrate-containing foods; however, studies are limited in children. The objective was to compare the effects of white potatoes in mixed meals on satiety, FI, and glycemic response in 9-14-year-old children and adolescents.Methods: Using a within-subject, repeated-measures design, 21 children completed five counter-balanced test sessions. After an overnight fast, children consumed one of four isocaloric treatment meals (450 kcal) of French fries, mashed potatoes, or white beans served with a fixed portion of egg omelet (30 g of protein), a control meal with cereal, milk, and bread, or continued to fast (i.e., meal skipping). Subjective appetite was measured using visual analogue scales. FI at an ad libitum pizza meal at 180 min and rest of day diet record were used to measure lunch FI and rest of day energy intake, respectively. Total daily energy intake was calculated by adding the energy intake from the treatment meal, the ad libitum pizza lunch, and rest of day food record. Capillary blood samples were collected to assess glycemic response over 180 min.Results: Change from baseline subjective average appetite scores were lower after mashed potatoes compared with all other treatment conditions (p < 0.001), and higher after French fries compared with white beans (p = 0.04). Lunch FI (kcal) was significantly lower (p < 0.001) after French fries (1010±73) and mashed potatoes (1039±74) compared with the control meal (1257±92) and meal skipping (1235±74). Total daily energy intake (kcal) was lower after French fries compared with the control meal (2228±141 vs. 2624±137; p = 0.04). Change from baseline blood glucose was lower after white beans and French fries compared with mashed potatoes (p < 0.05) and the control meal (p < 0.001).Conclusion: In conclusion, white potatoes with eggs increased satiety, decreased short-term FI, and resulted in similar energy intakes compared with meal skipping.

Association of low-carbohydrate diet score with overweight, obesity and cardiovascular disease risk factors: a cross-sectional study in Iranian women.

Introduction: This study aimed to determine the association of low-carbohydrate-diet score with overweight, obesity and cardiovascular risk factors among Iranian women. Methods: In healthy Iranian women 20-50 years, demographics, anthropometrics, physical activity, blood pressure, fasting blood glucose, blood lipids, and dietary intake (using a validated food frequency questionnaire) were assessed. Participants were divided into deciles of macronutrient intakes. Women in the lowest decile of carbohydrate intake received a score of 9 and women in the highest decile received a score of 0. For protein and fat intakes, women in the lowest decile received a score of 0 for that macronutrient and those in the highest decile received the score of 9. Macronutrient scores were summed to create the low-carbohydrate diet score and women were grouped into tertiles based on these scores. Continuous and qualitative variables were compared among the low-carbohydrate-diet score by one-way ANOVA and chi-square test, respectively. Logistic regression was used to determine the association of low-carbohydrate-diet score and cardiovascular risk factors. Results: A total of 209 women were included in the study. Socioeconomic status significantly increased from tertile 1 to 3 of the low-carbohydrate diet score (P = 0.02). Total dietary glycemic index (GI) significantly differed among tertiles (tertile 1 GI: 63.1 ±0.50, tertile 2 GI: 61.9 ± 0.5, tertile 3 GI: 59.5 ± 0.5; P < 0.001). The odds ratios for overweight, obesity and cardiovascular risk factors were not significantly different among the tertiles of low-carbohydrate diet score. Conclusion: In Iranian women, diets lower in carbohydrate and higher in protein and fat were not associated with overweight, obesity and cardiovascular risk factors.

The association between types of seafood intake and the risk of type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies.

Background: Seafood is the main source of long-chain n-3 polyunsaturated fatty acids (n-3PUFAs) with beneficial health effects; however, findings on the association between the consumption of different types of seafood and type 2 diabetes mellitus (T2DM) are conflicting. Our objective was to perform a systematic review and meta-analysis examining the relationship between different types of fish/seafood and the risk of T2DM in adult populations. Methods: A systematic search of PubMed/Medline, Scopus, and Web of Science (ISI) databases was performed for cohort studies, published in English, before 1 September 2017. Multivariate adjusted relative risk (RR) estimates with 95% confidence intervals (CIs) for each category of seafood were pooled to examine the association. Results: Comparing the highest vs. lowest fatty fish intake categories indicated that there was a significant inverse association between the consumption of fatty fish and onset of T2DM (RR:0.89; 95 % CI: 0.82, 0.98; I2: 0%, P=0.54). However, after performing sensitivity analysis, we found that eliminating one study resulted in a non-significant association (RR: 0.93; 95 % CI:0.80, 1.09). There were no significant associations between lean fish (RR: 1.03; 95% CI: 0.87,1.22, I2: 51.0%, P=0.08), seafood other than fish (RR: 0.95; 95% CI: 0.83, 1.10, I2: 71.2%,P=0.002), fish products (RR: 0.96; 95% CI: 0.82, 1.13, I2:0%, P=0.62), and fried fish (RR: 1.02;95% CI: 0.83, 1.26, I2:71.2%, P=0.06) and T2DM risk. Conclusion: The risk of T2DM was not associated with the intake of lean fish, seafood other than fish, and fish products. However, due to the low robustness of findings regarding protective roles of oily fish, more longitudinal studies are needed to clarify this association.

Effect of potatoes and other carbohydrate-containing foods on cognitive performance, glycemic response, and satiety in children.

Dietary carbohydrates have been shown to influence cognitive performance and satiety in children. However, it remains unclear whether the carbohydrate source is a primary determinant of cognitive performance and satiety. The objective was to compare the effects of white potatoes and other carbohydrate-containing foods on cognitive performance, glycemic response, and satiety in children. On 6 separate mornings, in random order, children (n = 22) consumed 50 g of available carbohydrates from microwaved mashed potatoes (prepared from fresh potatoes then frozen), deep-fried potato strips (French fries), hash browns, white rice, white beans, or skipped a meal. Cognitive performance, glycemic response, and satiety were measured over 180 min. Cognitive performance was measured using a battery of tests assessing verbal declarative memory, spatial memory, short-term memory, working memory, and information processing speed. Although cognitive performance after the treatment meals did not differ from meal skipping, children recalled more words after French fries (9.1 ± 0.4 words) compared with mashed potatoes (8.2 ± 0.3 words; p = 0.001) and white rice (8.4 ± 0.3 words; p = 0.04) on the verbal declarative memory test. Blood glucose concentrations were higher after white rice compared with white beans, mashed potatoes, and hash browns (p < 0.05). Change from baseline subjective average appetite (mm/kcal) was lower after mashed potatoes compared with all other treatment meals (p < 0.05). In conclusion, verbal declarative memory was higher after French fries and subjective average appetite was lower after mashed potatoes. Future longitudinal studies are needed to confirm these short-term findings and to elucidate the mechanism of action.

Developing and Assessing the Validity and Reliability of an Iranian Food Security Questionnaire.

BACKGROUND: Food insecurity has a considerable impact on the social, physical, and psychological well-being of people and there is no food security assessment tool specific for Iranians. This study aimed to develop and assess the validity and reliability of an Iranian-specific food security questionnaire. METHODS: The food security questionnaire was developed by five food security specialists by evaluating all available questionnaires (not specific to Iranians) in terms of applicability to Iranians. Furthermore, questions were developed from interviews conducted with ten families who were below the poverty threshold to understand how they described their food status. This questionnaire was administered to 200 households from different parts of Isfahan, Iran. Households were selected by multi-stage cluster randomized sampling. Households were categorized into 4 groups based on their score on the questionnaire; food secure (total score 0), mildly (total score 1-2), moderately (total score 3-7) and severely food insecure (total score 8-18). In the second stage of the study, 25 households were selected from each food security status group to evaluate the reliability and validity of the questionnaire by assessing sociodemographic, anthropometric, nutritional and biochemical parameters. RESULTS: The prevalence of food security and mildly, moderately and severely food insecure were 24%, 33%, 27% and 16%, respectively. Content and face validity of the questionnaire was evaluated by experts, and latent class analysis confirmed construct validity. The developed questionnaire had good internal consistency (Cronbach's α = 0.91) and showed significant differences in hypothesized directions in food security status for sociodemographic factors. The prevalence of mothers, but not fathers or children, who had hemoglobin, mean corpuscular volume (MCV) and hematocrit less than the normal ranges increased (P = 0.04, P = 0.02, P = 0.02; respectively) with food insecurity. CONCLUSION: Our findings indicated that the developed questionnaire was a valid and reliable instrument to measure household food insecurity of Iranian families.

Effect of Commercially Available Sugar-Sweetened Beverages on Subjective Appetite and Short-Term Food Intake in Boys.

It is unclear whether sugar sweetened beverages bypass regulatory controls of food intake (FI) in boys. The objective of the present study was to determine the effects of isovolumetric preloads (350 mL) of a fruit-flavoured drink (154 kcal), cola (158 kcal), 1% M.F. chocolate milk (224 kcal), and water (0 kcal) on subjective appetite and FI in boys aged 9⁻14 years. On four separate mornings, boys consumed one of the preloads in a random order; subjective appetite was measured at 15 min intervals, and FI was measured via an ad libitum pizza lunch at 60 min post-beverage consumption. In the 32 boys (age: 11.8 ± 0.3 years), FI was reduced (p < 0.001) after cola (940 ± 46 kcal) and chocolate milk (878 ± 41 kcal) compared with the water control (1048 ± 35 kcal) and after chocolate milk compared to the fruit drink (1005 ± 44 kcal). Cumulative FI after the fruit drink was greater than the water control (1159 ± 44 vs. 1048 ± 35 kcal; p = 0.03). Average appetite was not affected by the treatment, but the cola treatment resulted in greater fullness (p = 0.04) and lower prospective food consumption (p = 0.004) compared with the fruit drink. In conclusion, chocolate milk and cola suppressed next-meal FI at 60 min, while fruit drink increased cumulative FI (beverage + next meal) over 60 min in boys. Results from this study suggest that beverage composition is an important determinant of FI suppression in boys.

Association of a plant-based dietary pattern in relation to gestational diabetes mellitus.

AIM: The prevalence of gestational diabetes mellitus (GDM), which has adverse effects on mothers and their offspring, is increasing worldwide. The role of a plant-based dietary pattern as a determinant of GDM is not well understood. Therefore, we examined the association between plant-based dietary patterns and the risk of GDM. METHODS: We enrolled 460 pregnant women in this case-control study, of them 200 were cases and 260 were controls. Dietary intake of participants was evaluated using three 24-hour dietary records. Adherence to the plant-based dietary patterns was scored using three indices of the overall plant-based dietary index (PDI), healthy plant-based diet (hPDI) and unhealthy plant-based diet index (uPDI). The risk of GDM was compared across tertiles of PDI, hPDI and uPDI. RESULTS: After multivariable adjustment, we demonstrated that the high PDI score was inversely associated with risk of GDM (OR = 0.47; 95% CI: 0.28-0.78, P = 0.004), but there was no significant association between hPDI (OR = 1.03; 95% CI: 0.64-1.65, P = 0.884) or uPDI (OR = 1.65; 95% CI: 0.98-2.78, P = 0.06) and GDM risk. CONCLUSIONS: We found that following an overall plant-based diet was associated with lower risk of GDM. Future studies are warranted with longitudinal designs to confirm these findings.

Effect of video game playing and a glucose preload on subjective appetite, subjective emotions, and food intake in overweight and obese boys.

Video game playing (VGP) is associated with overweight/obesity (OW/OB). VGP and caloric preloads in the pre-meal environment influence short-term food intake (FI) in healthy-weight children. Therefore, the purpose of the present study was to examine the effect of pre-meal VGP and a glucose preload on subjective emotions, subjective appetite, and FI in boys with OW/OB. On 4 separate mornings, boys with OW/OB (n = 22; mean ± SD: age = 11.9 ± 1.6 years; body mass index percentile = 94.3 ± 3.9) participated in 4 test conditions. Two hours after a standardized breakfast, boys consumed equally sweetened preloads (250 mL) of sucralose (0 kcal) or glucose (200 kcal), with or without 30 min of subsequent VGP. Immediately after each test condition, FI was evaluated during an ad libitum pizza meal. Subjective appetite was measured at 0 (baseline), 15, and 30 min. Subjective emotions (aggression, anger, excitement, disappointment, happiness, upset, and frustration) were measured at 0 and 30 min. VGP did not affect FI, but the glucose preload decreased FI compared with the sucralose control (Δ = -103 ± 48 kcal, p < 0.01). However, cumulative FI (preload kcal + meal kcal) was 9% higher after the glucose preload (p < 0.01). Subjective appetite increased with time (p < 0.05) but was not influenced by preload or VGP. Frustration was the only subjective emotion that increased following VGP (p < 0.01). A glucose preload, but not VGP, suppressed FI in boys with OW/OB, suggesting a primary role of physiological factors in short-term FI regulation.

Effect of Vitamin D Supplementation, Food Fortification, or Bolus Injection on Vitamin D Status in Children Aged 2-18 Years: A Meta-Analysis.

Meta-analyses on the effect of vitamin D intake on status in children are lacking, especially those focused on vitamin D-fortified foods. The objective of this meta-analysis was to investigate the effect of vitamin D interventions (fortified foods, supplements, bolus injections) on vitamin D status in children 2-18 y of age. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, literature searches were conducted up to December 2016. Randomized placebo-controlled vitamin D interventions in healthy children aged 2-18 y were included. A random-effects model was used with I2 assessing heterogeneity. We included 26 trials (5403 children) with interventions (n = 9 fortified foods, n = 15 supplements, n = 2 bolus injections) from 100-4000 IU vitamin D/d over 4 wk to 2 y. The serum 25-hydroxyvitamin D [25(OH)D] weighted mean difference for all 26 trials (23.5 nmol/L; 95% CI: 20.7, 26.3 nmol/L; I2 = 99.9%) resulted in a mean increase of 1.0 nmol/L (95% CI: 0.3, 1.7 nmol/L) for each increase of 100 IU vitamin D/d (per 1 µg/d : 0.4 nmol/L; 95% CI: 0.1, 0.7 nmol/L). The response per 100 IU vitamin D/d was greater in trials with a mean baseline serum 25(OH)D <30 nmol/L, with the use of fortified foods and with baseline vitamin D intakes <100 IU/d. In conclusion, the serum 25(OH)D response to vitamin D intake differs on the basis of baseline status, intakes, and delivery mode, but not age, sex, or latitude.

Association between adherence to the Dietary Approaches to Stop Hypertension diet with food security and weight status in adult women.

AIM: To investigate the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet with food security and weight status in adult women. METHODS: This cross-sectional study was carried out in 227 women-20-50 years of age-who were referred from 10 health centres. Dietary intakes were assessed using validated food frequency questionnaires. The DASH score was calculated using the Fung method based on eight food and nutrient components (high intake of fruits, vegetables, whole grains, nuts and legumes, low-fat dairy, low intakes of red and processed meats, sweetened beverages and sodium). The United States Department of Agriculture (USDA) household food security questionnaire was used to assess food security status. RESULTS: The prevalence of food insecurity was 33.9%. A greater percentage of overweight and obese people were in the food insecure group (P = 0.006). In addition, the prevalence of overweight and obese people was lower with greater adherence to the DASH dietary pattern (P = 0.017). After controlling for age and energy intake, participants in the highest tertile of adherence to DASH diet had 66% lower odds of overweight and obesity than those in the lowest tertile (odds ratio (OR): 0.34; 95% confidence interval (CI): 0.15; 0.79). This relationship of DASH diet tertile and overweight and obesity was significant for both food secure women (OR: 0.54, 95% CI: 0.23; 0.97) and food insecure women (OR: 0.35, 95% CI: 0.06; 0.42). CONCLUSIONS: Adherence to the DASH diet is associated with a reduced risk of overweight and obesity, based on body mass index, in both food secure and insecure Iranian women.

Vitamin D Status and Immune Health Outcomes in a Cross-Sectional Study and a Randomized Trial of Healthy Young Children.

In young children, the relationship between vitamin D and biomarkers of immune function is not well elucidated. The objective was to investigate relationships between vitamin D and immune function in young children. Data were from a cross-sectional study (study 1) of healthy children 1.8⁻5.9 years (n = 457) and a 12 weeks trial using vitamin D fortified foods (study 2) in healthy 1.8⁻8.7 years old (n = 77) in Montreal, Canada. Vitamin D status and ex vivo immune function were assessed. In study 1 (male: n = 242; 53%), plasma IL-6, TNFα and CRP were significantly higher (p < 0.05) in children with 25-hydroxyvitamin D (25(OH)D) ≥ 75 nmol/L compared to.