Supporting the nutrition-related health and well-being of people experiencing socio-economic disadvantage: Findings from a national survey.

BACKGROUND: People experiencing socio-economic disadvantage face significantly higher rates of diet-related health inequities. This study aimed to explore barriers, opportunities and potential solutions in providing food and nutrition services to people experiencing socio-economic disadvantage from the perspective of services providers. The present study is part of a broad co-design model to improve service provision for people experiencing socio-economic disadvantage. METHODS: A cross-sectional online survey involving 33 open and closed-ended questions was distributed to Australian governmental and non-governmental organisations providing nutrition-related support to people experiencing socio-economic disadvantage aged 16 years and over. Data were analysed using frequency distributions and conceptual content analyses. RESULTS: Sixty-eight responses were analysed. Services are predominantly offered by charitable organisations (90%), funded through private donations (66%) and reliant on volunteers (100%). Barriers to supporting clients' nutrition needs include financial constraints, limited community engagement, understaffing, insufficient resources and knowledge gaps. Opportunities and solutions for enhancing support include increasing government funding, advocacy initiatives, stronger community collaboration and more holistic, customised services. Proposed recommendations include establishing purpose-built facilities or wrap-around services to expand access to health services, life skills, training and educational programs. CONCLUSIONS: Services face challenges including volunteer reliance, limited resources and inadequate government support, hindering food provision. Client barriers include transportation costs and lack of social support. With dedicated financial support, services can offer comprehensive assistance, including community spaces, staffing, health and social services and training. Community partnerships can maximise funding impact. Solutions must address overall well-being and broader social determinants such as income inequality and housing.

Association between plant-based diet quality and chronic kidney disease in Australian adults.

OBJECTIVE: To examine associations between three different plant-based diet quality indices, chronic kidney disease (CKD) prevalence and related risk factors in a nationally representative sample of the Australian population. DESIGN: Cross-sectional analysis. Three plant-based diet scores were calculated using data from two 24-h recalls: an overall plant-based diet index (PDI), a healthy PDI (hPDI) and an unhealthy PDI (uPDI). Consumption of plant and animal ingredients from 'core' and 'discretionary' products was also differentiated. Associations between the three PDI scores and CKD prevalence, BMI, waist circumference (WC), blood pressure (BP) measures, blood cholesterol, apo B, fasting TAG, blood glucose levels (BGL) and HbA1c were examined. SETTING: Australian Health Survey 2011-2013. PARTICIPANTS: n 2060 adults aged ≥ 18 years (males: n 928; females: n 1132). RESULTS: A higher uPDI score was associated with a 3·7 % higher odds of moderate-severe CKD (OR: 1·037 (1·0057-1·0697); P = 0·021)). A higher uPDI score was also associated with increased TAG (P = 0·032) and BGL (P < 0·001), but lower total- and LDL-cholesterol (P = 0·035 and P = 0·009, respectively). In contrast, a higher overall PDI score was inversely associated with WC (P < 0·001) and systolic BP (P = 0·044), while higher scores for both the overall PDI and hPDI were inversely associated with BMI (P < 0·001 and P = 0·019, respectively). CONCLUSIONS: A higher uPDI score reflecting greater intakes of refined grains, salty plant-based foods and added sugars were associated with increased CKD prevalence, TAG and BGL. In the Australian population, attention to diet quality remains paramount, even in those with higher intakes of plant foods and who wish to reduce the risk of CKD.

Higher anthocyanin intake is associated with lower depressive symptoms in adults with and without major depressive disorder.

Background: Major depressive disorder (MDD) is a significant cause of disability globally and an emerging body of evidence suggests that dietary components, including flavonoids, may impact depression-related biochemical pathways. Further research that characterizes dietary intake of flavonoids in diverse population groups, including people with MDD and explores the relationship between flavonoid intake and depression is needed. This study aimed to determine dietary flavonoid and subclass intake and assess the association with depressive symptomatology in a sample of adults with and without MDD. Methodology: Participants with and without MDD (determined using DSM 5) completed the Depression, Anxiety, and Stress Scale-21 (DASS-21). Diet history interviews were analyzed using PhenolExplorer to quantify flavonoid subclasses (flavan-3-ols, flavonols, anthocyanins, flavones, flavanones, isoflavones), and total flavonoid intake. Independent t-tests and linear regression, adjusting for age, sex, and BMI were performed. Results: Participants (n = 93; 75% female) had a mean age of 26.0 ± 8.2 years. Participants with MDD had significantly higher DASS-depression scores (n = 44; DASS-depression 27.3 ± 9.8) compared to participants without MDD (n = 49; DASS-depression 3.1 ± 4.4; p < .001). Intakes of total flavonoids and subclasses were similar between groups, except for anthocyanins where participants with MDD reported lower intakes of anthocyanins compared to participants without MDD (median intake: 0.08 mg/day and 11.6 mg/day, respectively; p = .02). In the total sample, higher anthocyanin intake was associated with lower DASS-depression score (B = -4.1; SE = 1.8; 95% CI [-7.7, -0.4]; p = .029). Conclusion: Intake of total flavonoids and most subclasses were similar between people with and without MDD. However, a dietary deficit of anthocyanins (found in purple/red fruits and vegetables) was evident in participants with MDD, and higher anthocyanin intake was associated with lower depressive symptomatology in the total sample. Further research in larger samples is warranted to explore if the documented association is independent of MDD status.

The effect of oral synbiotics on the gut microbiota and inflammatory biomarkers in healthy adults: a systematic review and meta-analysis.

CONTEXT: Prior research has explored the effect of synbiotics, the combination of probiotics and prebiotics, on the gut microbiota in clinical populations. However, evidence related to the effect of synbiotics on the gut microbiota in healthy adults has not been reviewed to date. OBJECTIVE: A systematic review and meta-analysis was conducted to comprehensively investigate the effect of synbiotics on the gut microbiota and inflammatory markers in populations of healthy adults. DATA SOURCES: Scopus, PubMed, Web of Science, ScienceDirect, MEDLINE, CINAHL, and The Cochrane Library were systematically searched to retrieve randomized controlled trials examining the primary outcome of gut microbiota or intestinal permeability changes after synbiotic consumption in healthy adults. Secondary outcomes of interest were short-chain fatty acids, inflammatory biomarkers, and gut microbiota diversity. DATA EXTRACTION: Weighted (WMD) or standardized mean difference (SMD) outcome data were pooled in restricted maximum likelihood models using random effects. Twenty-seven articles reporting on 26 studies met the eligibility criteria (n = 1319). DATA ANALYSIS: Meta-analyses of 16 studies showed synbiotics resulted in a significant increase in Lactobacillus cell count (SMD, 0.74; 95% confidence interval [CI], 0.15, 1.33; P = 0.01) and propionate concentration (SMD, 0.22; 95% CI, 0.02, 0.43; P = 0.03) compared with controls. A trend for an increase in Bifidobacterium relative abundance (WMD, 0.97; 95% CI, 0.42, 2.52; P = 0.10) and cell count (SMD, 0.82; 95% CI, 0.13, 1.88; P = 0.06) was seen. No significant differences in α-diversity, acetate, butyrate, zonulin, IL-6, CRP, or endotoxins were observed. CONCLUSION: This review demonstrates that synbiotics modulate the gut microbiota by increasing Lactobacillus and propionate across various healthy adult populations, and may result in increased Bifidobacterium. Significant variations in synbiotic type, dose, and duration should be considered as limitations when applying findings to clinical practice. SYSTEMATIC REVIEW REGISTRATION: PROSPERO no. CRD42021284033.

The INHABIT (synergIstic effect of aNtHocyAnin and proBIoTics in) Inflammatory Bowel Disease trial: a study protocol for a double-blind, randomised, controlled, multi-arm trial.

Ulcerative Colitis (UC), a type of Inflammatory Bowel Disease (IBD), is a chronic, relapsing gastrointestinal condition with increasing global prevalence. The gut microbiome profile of people living with UC differs from healthy controls and this may play a role in the pathogenesis and clinical management of UC. Probiotics have been shown to induce remission in UC; however, their impact on the gut microbiome and inflammation is less clear. Anthocyanins, a flavonoid subclass, have shown anti-inflammatory and microbiota-modulating properties; however, this evidence is largely preclinical. To explore the combined effect and clinical significance of anthocyanins and a multi-strain probiotic, a 3-month randomised controlled trial will be conducted in 100 adults with UC. Participants will be randomly assigned to one of four groups: anthocyanins (blackcurrant powder) + placebo probiotic, probiotic + placebo fruit powder, anthocyanin + probiotic, or double placebo. The primary outcome is a clinically significant change in the health-related quality-of-life measured with the Inflammatory Bowel Disease Questionnaire-32. Secondary outcomes include shotgun metagenomic sequencing of the faecal microbiota, faecal calprotectin, symptom severity, and mood and cognitive tests. This research will identify the role of adjuvant anti-inflammatory dietary treatments in adults with UC and elucidate the relationship between the gut microbiome and inflammatory biomarkers in this disease, to help identify targeted individualised microbial therapies. ANZCTR registration ACTRN12623000630617.

Does vitamin D play a role in the management of Covid-19 in Brazil?

ABSTRACT The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.