RESUMO
INTRODUCTION: In 2014, the Navajo Nation Healthy Diné Nation Act (HDNA) was passed, combining a 2% tax on foods of 'minimal-to-no-nutritional value' and waiver of 5% sales tax on healthy foods, the first-ever such tax in the U.S. and globally among a sovereign tribal nation. The aim of this study was to measure changes in pricing and food availability in stores on the Navajo Nation following the implementation of the HDNA. METHODS: Store observations were conducted in 2013 and 2019 using the Nutrition Environment Measurement Survey-Stores (NEMS-S) adapted for the Navajo Nation. Observations included store location, type, whether healthy foods or HDNA were promoted, and availability and pricing of fresh fruits and vegetables, canned items, beverages, water, snacks and traditional foods. Differences between 2013 and 2019 and by store type and location were tested. RESULTS: The matched sample included 71 stores (51 in the Navajo Nation and 20 in border towns). In 2019, fresh produce was available in the majority of Navajo stores, with 71% selling at least 3 types of fruit and 65% selling at least 3 types of vegetables. Compared with border town convenience stores, Navajo convenience stores had greater availability of fresh vegetables and comparable availability of fresh fruit in 2019. The average cost per item of fresh fruit decreased by 13% in Navajo stores (from $0.88 to $0.76) and increased in border stores (from $0.63 to $0.73), resulting in comparable prices in Navajo and border stores in 2019. While more Navajo stores offered mutton, blue corn and wild plants in 2019 compared to 2013, these changes were not statistically significant. DISCUSSION: The findings suggest modest improvements in the Navajo store environment and high availability of fruits and vegetables. Navajo stores play an important role in the local food system and provide access to local, healthy foods for individuals living in this rural, tribal community.
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Indígena Americano ou Nativo do Alasca , Frutas/economia , Necessidades Nutricionais/fisiologia , Valor Nutritivo/fisiologia , Verduras/provisão & distribuição , Bebidas/economia , Bebidas/estatística & dados numéricos , Bebidas/provisão & distribuição , Custos e Análise de Custo/estatística & dados numéricos , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/estatística & dados numéricos , Frutas/provisão & distribuição , Regulamentação Governamental , Humanos , Inquéritos Nutricionais , Lanches/fisiologia , Estados Unidos , Verduras/economiaRESUMO
BACKGROUND & AIMS: Approximately 55% of neurological and neurosurgical early rehabilitation (NNER) patients are in need of enteral nutrition, but long-term nutritional assessment of these critically ill patients is suboptimal. Therefore, this study analyzed the effect of an individual nutritional assessment on weight changes during rehabilitation and impact on complications and functional outcome. METHODS: 170 NNER patients on enteral nutrition were enrolled in the study. According to the initial ward, patients were assigned to receive standardized enteral nutrition (n = 107, control group) or an individual nutritional assessment (n = 63, intervention group). Weight changes, complications, assessment of the functional outcome (Early Rehabilitation Index, Barthel Index, Early Rehabilitation Barthel Index) and the length of stay were recorded and compared between groups using non-parametric tests for non-paired samples (Mann-Whitney U test for metric data or the χ2 test for categorical data) or paired samples (Wilcoxon test). In addition, daily energy requirement was calculated and compared with daily intake. Correlation analysis by Spearman was performed to investigate linear relationship between weight changes and the difference of administered and calculated calories in both study groups. RESULTS: A weight loss was observed in the control group, whereas the weight of the intervention group remained stable over time. The difference between calculated and administered calories correlated with weight changes in the control group. Regarding complications during rehabilitation, control patients showed more frequently impaired diuresis. In addition, control patients were suffering longer from diarrhea than patients of the intervention group. Both groups improved in functional status to a comparable degree. Relationships between these improvements and weight changes or administered calories could not be found. CONCLUSIONS: Individual nutritional assessment had not an additional affect for the improvement of functional outcome or the prevention of complications. However, weight turned out to be more stable and signs of nutritional incompatibilities are less frequent among patients being treated with an individualized nutritional assessment.
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Peso Corporal/fisiologia , Cuidados Críticos/métodos , Nutrição Enteral/métodos , Doenças do Sistema Nervoso/reabilitação , Avaliação Nutricional , Necessidades Nutricionais/fisiologia , Adulto , Estado Terminal , Feminino , Alemanha , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Tempo , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Though infant and young children should be fed according to a minimum acceptable diet to ensure appropriate growth and development, only 7% of Ethiopian 6-23 months age children meet the minimum acceptable dietary standards, which is lower than the national target of 11% set for 2016. Therefore, this study aims to assess the individual and community level factors affecting feeding according to minimum acceptable diet among 6-23 months age children in Ethiopia. METHODS: This study analyzed retrospectively a cross-sectional data on a weighted sample of 2919 children aged 6-23 months nested within 617 clusters after extracting from Ethiopian Demographic and Health Survey 2016 via the link www.measuredhs.com. By employing bi-variate multilevel logistic regression model, variables which were significant at the p-value < 0.25 were included in multivariable multilevel logistic regression analysis. Finally, variables with a p-value < 0.05 were considered as significant predictors of minimum acceptable diet. RESULTS: Only 6.1% of 6-23 months age children feed minimum acceptable diet in Ethiopia. Children 18-23 months age (AOR = 3.7, 95%CI 1.9, 7.2), father's with secondary or higher education (AOR = 2.1, 95%CI 1.2, 3.6), Employed mothers (AOR = 1.7, 95%CI 1.2, 2.5), mothers have access to drinking water (AOR = 1.9, 95%CI 1.2, 2.9), mothers with media exposure (AOR = 2.1 95%CI 1.1, 2.7) were positive individual level predictors. Urban mothers (AOR = 4.8, 95%CI 1.7, 13.2)) and agrarian dominant region (AOR = 5.6, 95%CI 2.2, 14.5) were community level factors that significantly associated with a minimum acceptable diet of 6-23 months age children. CONCLUSION: Both individual and community level factors were significantly associated with a minimum acceptable diet of 6-23 months age children in Ethiopia, suggesting that nutritional interventions designed to improve child health should not only be implemented at the individual level but tailored to community context as well.
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Comportamento Alimentar/psicologia , Recomendações Nutricionais/economia , Fatores Socioeconômicos , Estudos Transversais , Demografia , Dieta , Etiópia , Pai , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Modelos Logísticos , Masculino , Mães , Análise Multinível , Necessidades Nutricionais/fisiologia , Razão de Chances , Estudos RetrospectivosRESUMO
Sustainably feeding the next generation is often described as one of the most pressing "grand challenges" facing the 21st century. Generally, scholars propose addressing this problem by increasing agricultural production, investing in technology to boost yields, changing diets, or reducing food waste. In this paper, we explore whether global food production is nutritionally balanced by comparing the diet that nutritionists recommend versus global agricultural production statistics. Results show that the global agricultural system currently overproduces grains, fats, and sugars while production of fruits and vegetables and protein is not sufficient to meet the nutritional needs of the current population. Correcting this imbalance could reduce the amount of arable land used by agriculture by 51 million ha globally but would increase total land used for agriculture by 407 million ha and increase greenhouse gas emissions. For a growing population, our calculations suggest that the only way to eat a nutritionally balanced diet, save land and reduce greenhouse gas emissions is to consume and produce more fruits and vegetables as well as transition to diets higher in plant-based protein. Such a move will help protect habitats and help meet the Sustainable Development Goals.
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Agricultura/estatística & dados numéricos , Produtos Agrícolas/provisão & distribuição , Comportamento Alimentar/fisiologia , Abastecimento de Alimentos/estatística & dados numéricos , Necessidades Nutricionais/fisiologia , Crescimento Demográfico , Agricultura/métodos , Conservação dos Recursos Naturais , Gases de Efeito Estufa/efeitos adversos , Humanos , Desenvolvimento SustentávelRESUMO
OBJECTIVE: To introduce the use of qualitative assessment in energy expenditure (EE) equation research to improve the understanding of performance of the equations in the clinical setting. PATIENTS AND METHODS: Hospitalized individuals who had an indirect calorimetry (IC) measurement during their hospital stay from 2010 to 2012 were included in the study (n = 59). An additional 1000 patients hospitalized during this time were used to limit the IC cohort to a more "clinically relevant" BMI range (n = 46). The following estimation equations were assessed: Harris-Benedict, 25 kcal/kg using actual body weight, Mifflin St. Jeor, Ireton-Jones, Penn State, and Owen. Bland-Altman plots with Loess curves were generated to compare estimated basal caloric needs between EE equations and IC values. RESULTS: This study found a large amount of variability with all EE equations. As the mean calorie level increased, the Harris Benedict, Mifflin St. Jeor, Penn State, and Owen equations all tended to increasingly under-predict caloric need. CONCLUSION: In a research setting a qualitative assessment of EE equations can provide a more comprehensive understanding of equation performance by complementing traditional quantitative methods. The addition of a Loess curve to the Bland-Altman plot further enhances qualitative assessment.
Assuntos
Metabolismo Basal/fisiologia , Metabolismo Energético/fisiologia , Hospitalização , Necessidades Nutricionais/fisiologia , Adulto , Idoso , Índice de Massa Corporal , Calorimetria Indireta , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Pesquisa Qualitativa , Reprodutibilidade dos Testes , DescansoRESUMO
BACKGROUND: Increasing population lifespan necessitates a greater understanding of nutritional needs in older adults (65 year and over). A synthesis of total energy expenditure in the older population has not been undertaken and is needed to inform nutritional requirements. We aimed to establish the extent of the international evidence for total energy expenditure (TEE) using doubly-labelled water (DLW) in older adults (65 years and over), report challenges in obtaining primary data, and make recommendations for future data sharing. METHODS: Four databases were searched to identify eligible studies; original research of any study design where participant level TEE was measured using DLW in participants aged ≥65 years. Once studies were identified for inclusion, authors were contacted where data were not publicly available. RESULTS: Screening was undertaken of 1223 records; the review of 317 full text papers excluded 170 records. Corresponding or first authors of 147 eligible studies were contacted electronically. Participant level data were publicly available or provided by authors for 45 publications (890 participants aged ≥65 years, with 248 aged ≥80 years). Sixty-seven percent of the DLW data in this population were unavailable due to authors unable to be contacted or declining to participate, or data being irretrievable. CONCLUSIONS: The lack of data access limits the value of the original research and its contribution to nutrition science. Openly accessible DLW data available through publications or a new international data repository would facilitate greater integration of current research with previous findings and ensure evidence is available to support the needs of the ageing population. TRIAL REGISTRATION: The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016047549 .
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Óxido de Deutério , Metabolismo Energético/fisiologia , Necessidades Nutricionais/fisiologia , Isótopos de Oxigênio , Idoso , Idoso de 80 Anos ou mais , Humanos , Marcação por Isótopo , Sensibilidade e Especificidade , ÁguaRESUMO
As a major contributor to agricultural greenhouse gas (GHG) emissions, it has been suggested that reducing animal agriculture or consumption of animal-derived foods may reduce GHGs and enhance food security. Because the total removal of animals provides the extreme boundary to potential mitigation options and requires the fewest assumptions to model, the yearly nutritional and GHG impacts of eliminating animals from US agriculture were quantified. Animal-derived foods currently provide energy (24% of total), protein (48%), essential fatty acids (23-100%), and essential amino acids (34-67%) available for human consumption in the United States. The US livestock industry employs 1.6 × 106 people and accounts for $31.8 billion in exports. Livestock recycle more than 43.2 × 109 kg of human-inedible food and fiber processing byproducts, converting them into human-edible food, pet food, industrial products, and 4 × 109 kg of N fertilizer. Although modeled plants-only agriculture produced 23% more food, it met fewer of the US population's requirements for essential nutrients. When nutritional adequacy was evaluated by using least-cost diets produced from foods available, more nutrient deficiencies, a greater excess of energy, and a need to consume a greater amount of food solids were encountered in plants-only diets. In the simulated system with no animals, estimated agricultural GHG decreased (28%), but did not fully counterbalance the animal contribution of GHG (49% in this model). This assessment suggests that removing animals from US agriculture would reduce agricultural GHG emissions, but would also create a food supply incapable of supporting the US population's nutritional requirements.
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Criação de Animais Domésticos/estatística & dados numéricos , Produção Agrícola/estatística & dados numéricos , Abastecimento de Alimentos/métodos , Gases de Efeito Estufa/análise , Modelos Estatísticos , Necessidades Nutricionais/fisiologia , Criação de Animais Domésticos/economia , Animais , Produção Agrícola/economia , Dieta/economia , Dieta/métodos , Fertilizantes/provisão & distribuição , Abastecimento de Alimentos/economia , Gases de Efeito Estufa/economia , Humanos , Gado/fisiologia , Estados UnidosRESUMO
Appropriate nutritional therapy has not been established for patients with amyotrophic lateral sclerosis (ALS). Our objective was to measure the total energy expenditure (TEE) and determine an equation to estimate the energy requirements for Japanese patients with ALS. Twenty-six Japanese patients with ALS participated in the study. The TEE was measured using the doubly labelled water (DLW) method for a 14-day period. Using a range of clinical parameters and multiple regression analyses, we determined an adequate equation to calculate TEE. Results showed that the median value of total energy intake (TEI) was 1581 (interquartile 1278-1782) kcal/d. TEE and TEE/body weight were 1628 kcal/d (1352-1865) and 31.3 kcal/kg (29.2-34.4), respectively. The ratio of TEE/estimated TEE by the Harris-Benedict equation was 1.14 (1.09-1.26). The difference between TEI and TEE was -63 kcal (-221 - 122), and 15 patients (57.7%) showed a negative balance. From regression analyses, we determined an equation to estimate TEE using the resting metabolic rate estimated by the Harris-Benedict equation (RMR-HB) and scores of the revised ALS Functional Rating Scale (ALSFRS-R): TEE = (1.67 × RMR-HB) + (11.8 × ALSFRS-R) - 680 (p < 0.0001). In conclusion, energy expenditure of Japanese patients with ALS was higher than expected, and we proposed a preliminary equation to estimate TEE for future nutritional intervention.
Assuntos
Esclerose Lateral Amiotrófica/fisiopatologia , Metabolismo Energético/fisiologia , Necessidades Nutricionais/fisiologia , Idoso , Esclerose Lateral Amiotrófica/epidemiologia , Ingestão de Energia/fisiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Índice de Gravidade de Doença , Fatores Sexuais , Capacidade Vital , ÁguaRESUMO
BACKGROUND: Intense debate exists regarding the optimal energy and protein intake for intensive care unit (ICU) patients. However, most studies use predictive equations, demonstrated to be inaccurate to target energy intake. We sought to examine the outcome of a large cohort of ICU patients in relation to the percent of administered calories divided by resting energy expenditure (% AdCal/REE) obtained by indirect calorimetry (IC) and to protein intake. METHODS: Included patients were hospitalized from 2003 to 2015 at a 16-bed ICU at a university affiliated, tertiary care hospital, and had IC measurement to assess caloric targets. Data were drawn from a computerized system and included the % AdCal/REE and protein intake and other variables. A Cox proportional hazards model for 60-day mortality was used, with the % AdCal/REE modeled to accommodate non-linearity. Length of stay (LOS) and length of ventilation (LOV) were also assessed. RESULTS: A total of 1171 patients were included. The % AdCal/REE had a significant non-linear (p < 0.01) association with mortality after adjusting for other variables (p < 0.01). Increasing the percentage from zero to 70 % resulted in a hazard ratio (HR) of 0.98 (CI 0.97-0.99) pointing to reduced mortality, while increases above 70 % suggested an increase in mortality with a HR of 1.01 (CI 1.01-1.02). Increasing protein intake was also associated with decreased mortality (HR 0.99, CI 0.98-0.99, p = 0.02). An AdCal/REE >70 % was associated with an increased LOS and LOV. CONCLUSIONS: The findings of this study suggest that both underfeeding and overfeeding appear to be harmful to critically ill patients, such that achieving an Adcal/REE of 70 % had a survival advantage. A higher caloric intake may also be associated with harm in the form of increased LOS and LOV. The optimal way to define caloric goals therefore requires an exact estimate, which is ideally performed using indirect calorimetry. These findings may provide a basis for future randomized controlled trials comparing specific nutritional regimens based on indirect calorimetry measurements.
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Estado Terminal/terapia , Proteínas Alimentares/administração & dosagem , Ingestão de Energia/fisiologia , Metabolismo Energético/fisiologia , Unidades de Terapia Intensiva , Necessidades Nutricionais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estado Terminal/mortalidade , Proteínas Alimentares/efeitos adversos , Feminino , Humanos , Unidades de Terapia Intensiva/normas , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
This is a clinical validation study of the nursing diagnosis of imbalanced nutrition: less than body requirements based on the diagnostic accuracy measures. Measures of sensitivity and specificity were calculated based on the latent class analysis method using a random effects model in a sample of 123 children between 0 and 6 years old. The prevalence of the diagnosis was estimated to be 27.6% using the latent class model. Indicators that exhibited the best measures of diagnostic accuracy included insufficient interest in food and satiety immediately upon ingesting food. A total of seven clinical indicators were validated clinically.
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Indicadores Básicos de Saúde , Diagnóstico de Enfermagem/métodos , Distúrbios Nutricionais/diagnóstico , Necessidades Nutricionais/fisiologia , Fatores Etários , Brasil , Pré-Escolar , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Distúrbios Nutricionais/enfermagem , Curva ROC , Medição de Risco , Fatores SexuaisRESUMO
BACKGROUND: Short bowel syndrome (SBS) is a serious malabsorption disorder, and dietetic management of patients with SBS is extremely challenging. Once the degree of undernutrition has been assessed, successful dietary intervention is contingent on an accurate estimation and provision of energy needs. OBJECTIVE: We quantified total energy expenditure (TEE) in patients with SBS by using the doubly labeled water (DLW) method to inform energy needs and nutritional therapy goals. DESIGN: In this observational study, TEE was measured in 22 participants, 11 with SBS and 11 sex-, age-, and body mass index (BMI)-matched controls (non-SBS), for 14 d with the DLW method. Predicted energy requirements were determined by using the Escott-Stump equation and compared with TEE determined with DLW. Resting energy expenditure was measured by using indirect calorimetry, and an accelerometer was also used to determine physical activity level. RESULTS: Participants were aged (mean ± SD) 53 ± 8 y. Measured TEE was significantly higher than predicted TEE for the SBS group (1875 ± 276 compared with 1517 ± 175 kcal/d, P = 0.001) and also for the non-SBS group (2393 ± 445 compared with 1532 ± 178 kcal/d, P < 0.01). Measured TEE was significantly lower in the SBS group than in the non-SBS group (P < 0.01); however, predicted TEE did not differ significantly between the groups (P = 0.84). No significant differences were seen between measured and predicted resting energy expenditure either within or between groups. CONCLUSIONS: Measured TEE in patients with SBS was significantly higher than predicted by using standard equations but also lower than values for age-, BMI-, and sex-matched non-SBS controls. Currently used formulas in clinical practice appear to underestimate energy requirements of patients with SBS, and revision is needed to prevent underfeeding and improve long-term prognosis. This trial was registered at clinicaltrials.gov as NCT02113228.
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Metabolismo Energético , Desnutrição/prevenção & controle , Necessidades Nutricionais , Síndrome do Intestino Curto/terapia , Acelerometria , Adulto , Idoso , Metabolismo Basal , Índice de Massa Corporal , Calorimetria Indireta/métodos , Gerenciamento Clínico , Ingestão de Energia , Metabolismo Energético/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Atividade Motora , Necessidades Nutricionais/fisiologia , Esforço Físico , ÁguaRESUMO
OBJECTIVE: The study aimed to examine secular trends and determinants of changes in complementary feeding indicators in Nigeria. DESIGN, SETTING AND PARTICIPANTS: Data on 79â 953 children aged 6-23â months were obtained from the Nigeria Demographic and Health Surveys (NDHS) for the period spanning 2003-2013. The surveys used a stratified two-stage cluster sample of eligible mothers aged 15-49â years from the six geopolitical zones of Nigeria. Trends in complementary feeding indicators and socioeconomic, health service and individual characteristics including factors associated with complementary feeding indicators were examined using multilevel logistic regression analyses. RESULTS: Minimum dietary diversity for children aged 6-23â months worsened from 26% in 2003 to 16% in 2013. Minimum meal frequency improved from 43% in 2003 to 56% in 2013 and minimum acceptable diet worsened from 11% to 9%. Among educated mothers, there was a decreasing prevalence of the introduction of solid, semisolid and soft foods in infants aged 6-8â months (67% in 2003 to 57% in 2013); minimum dietary diversity (33% in 2003 to 24% in 2013) and minimum acceptable diet (13% in 2003 to 8% in 2013). Mothers with a higher education level and mothers who reported more health service contacts were more likely to meet the minimum dietary diversity. Similarly, the odds for minimum acceptable diet were higher among mothers from higher socioeconomic status groups and mothers who reported frequent health services use. CONCLUSIONS: Complementary feeding practices in Nigeria declined over the study period and are below the expected levels required to ensure adequate growth and development of Nigerian children. National policies and programmes that ensure sustainability of projects post-MDGs and higher health service coverage for mothers, including community-based education initiatives, are proposed to improve complementary feeding practices among Nigerian mothers.
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Comportamento Alimentar , Educação em Saúde/métodos , Inquéritos Epidemiológicos , Alimentos Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , Mães/educação , Necessidades Nutricionais/fisiologia , Adolescente , Adulto , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Nigéria , Estudos Retrospectivos , Fatores Socioeconômicos , Adulto JovemRESUMO
Determination of appropriate nutritional requirements is essential to optimize the productivity and longevity of lactating sows. The current recommendations for requirements do not consider the large variation between animals. Therefore, the aim of this study was to determine the amino acid recommendations for lactating sows using a stochastic modeling approach that integrates population variation and uncertainty of key parameters into establishing nutritional recommendations for lactating sows. The requirement for individual sows was calculated using a factorial approach by adding the requirement for maintenance and milk. The energy balance of the sows was either negative or zero depending on feed intake being a limiting factor. Some parameters in the model were sow-specific and others were population-specific, depending on state of knowledge. Each simulation was for 1000 sows repeated 100 times using Monte Carlo simulation techniques. BW, back fat thickness of the sow, litter size (LS), average litter gain (LG), dietary energy density and feed intake were inputs to the model. The model was tested using results from the literature, and the values were all within ±1 s.d. of the estimated requirements. Simulations were made for a group of low- (LS=10 (s.d.=1), LG=2 kg/day (s.d.=0.6)), medium- (LS=12 (s.d.=1), LG=2.5 kg/day (s.d.=0.6)) and high-producing (LS=14 (s.d.=1), LG=3.5 kg/day (s.d.=0.6)) sows, where the average requirement was the result. In another simulation, the requirements were estimated for each week of lactation. The results were given as the median and s.d. The average daily standardized ileal digestible (SID) protein and lysine requirements for low-, medium- and high-producing sows were 623 (CV=2.5%) and 45.1 (CV=4.8%); 765 (CV=4.9%) and 54.7 (CV=7.0%); and 996 (CV=8.5%) and 70.8 g/day (CV=9.6%), respectively. The SID protein and lysine requirements were lowest at week 1, intermediate at week 2 and 4 and the highest at week 3 of lactation. The model is a valuable tool to develop new feeding strategies by taking into account the variable requirement between groups of sows and changes during lactation. The inclusion of between-sow variation gives information on safety margins when developing new dietary recommendations of amino acids and protein for lactating sows.
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Fenômenos Fisiológicos da Nutrição Animal , Dieta/veterinária , Lactação/fisiologia , Modelos Biológicos , Suínos/fisiologia , Adiposidade/fisiologia , Aminoácidos/metabolismo , Animais , Simulação por Computador , Metabolismo Energético/fisiologia , Feminino , Tamanho da Ninhada de Vivíparos/fisiologia , Lisina/metabolismo , Leite/química , Método de Monte Carlo , Necessidades Nutricionais/fisiologiaRESUMO
INTRODUCTION: Adequate, balanced nutrition is a precondition for the formation of health of the younger generation. The study of the dietary intake and peculiarities of the chemical composition offood is needed to substantiate measures aimed at the correction of the ration of adolescents. PURPOSE: Hygienic evaluation of the content of water soluble vitamins in foods and the ration of teenage population of the Omsk region. TASKS OF THE STUDY: 1. To determine levels of water-soluble vitamins content in foods forming the basis of the ration of the population the Omsk region. 2. On the base of a study of the actual nutrition of adolescents to determine the levels of water-soluble vitamins consumption. 3. To give a hygienic assessment of adolescent nutrition in the Omsk region in terms of provision with water-soluble vitamins, and to identify priority directions of the alimentary correction of the revealed disorders. METHODS: The analysis of 389 food samples for the content of water-soluble vitamins (B1, B2, B6, PP C, folic acid) was performed with the use of reversed-phase HPLC high pressure on the Shimadzu LC-20 Prominence detector. The hygienic assessment of the actual nutrition of adolescents aged 13-17 years (sample survey; n = 250; 2012-2014) in the Omsk region was performed by the method of the analysis of food consumption frequency. RESULTS: There were noted significantly lower concentrations of vitamin B1 and B2 in the studied samples of cereals, bread and vegetables in comparison with reference data. Consumption levels of vitamins B1, B2, PP folic acid in the diet of adolescents in the Omsk region are lower than recommended values. In the structure of nutrition there is not enough milk dairy products--in 82.4 ± 2.4%, fish and sea products in 90.8 ± 1.8% of adolescents. CONCLUSION: The actual nutrition of the adolescent population of the Omsk region is irrational, unbalanced in quantitative and qualitative terms, and does not provide the necessary level of consumption of most important water-soluble vitamins. Priority for the correction nutrients there are B1, B2, folic acid (B0).
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Comportamento Alimentar , Análise de Alimentos/métodos , Alimentos/normas , Higiene , Necessidades Nutricionais/fisiologia , Estado Nutricional , Vitaminas/química , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Feminino , Humanos , Masculino , SibériaRESUMO
BACKGROUND: Hispanics in the US have a higher prevalence of neural tube defect (NTD) -affected pregnancies than non-Hispanic whites, and lower median total folic acid (FA) intake. FA fortification of corn masa flour (CMF) is a policy-level intervention for NTD prevention; however, the impact on NTD prevalence has not been estimated. METHODS: We developed a model to estimate the percentage reduction in prevalence of spina bifida and anencephaly (NTDs) that could occur with FA fortification of CMF. Model inputs included estimates of the percentage reduction in United States NTD prevalence attributed to FA fortification of enriched cereal grain products (1995-1996 vs. 1998-2002), the increase in median FA intake after enriched cereal grain product fortification, and the estimated increase in median FA intake that could occur with CMF fortification at the same level as enriched cereal grain products (140 µg/100 g). We used Monte Carlo simulation to quantify uncertainty. We stratified analyses by racial/ethnic group and rounded results to the nearest 10. RESULTS: We estimated CMF fortification could prevent 30 Hispanic infants from having spina bifida (95% uncertainty interval: 0, 80) and 10 infants from having anencephaly (95% uncertainty interval: 0, 40) annually. The estimated impact among non-Hispanic whites and blacks was smaller. CONCLUSION: CMF fortification with FA could prevent from 0 to 120 infants, with the most likely value of approximately 40, from having spina bifida or anencephaly among Hispanics, the population most likely to benefit from the proposed intervention. While this estimated reduction is unlikely to be discernible using current birth defect surveillance methods, it still suggests an important benefit to the target population.
Assuntos
Anencefalia/prevenção & controle , Ácido Fólico/administração & dosagem , Alimentos Fortificados , Hispânico ou Latino , Modelos Estatísticos , Disrafismo Espinal/prevenção & controle , Negro ou Afro-Americano , Anencefalia/epidemiologia , Anencefalia/etnologia , Farinha/análise , Humanos , Lactente , Método de Monte Carlo , Necessidades Nutricionais/fisiologia , Prevalência , Disrafismo Espinal/epidemiologia , Disrafismo Espinal/etnologia , Estados Unidos/epidemiologia , População Branca , Zea mays/químicaRESUMO
BACKGROUND: Problems related to food security in Russian Arctic (dietary imbalance, predominance of carbohydrates, shortage of milk products, vegetables and fruits, deficit of vitamins and microelements, chemical, infectious and parasitic food contamination) have been defined in the literature. But no standard protocol of food security assessment has been used in the majority of studies. OBJECTIVES: Our aim was to obtain food security indicators, identified within an Arctic collaboration, for selected regions of the Russian Arctic, Siberia and the Far East, and to compare food safety in these territories. STUDY DESIGN AND METHODS: In 18 regions of the Russian Arctic, Siberia and the Far East, the following indicators of food security were analyzed: food costs, food consumption, and chemical and biological food contamination for the period 2000-2011. RESULTS: Food costs in the regions are high, comprising 23-43% of household income. Only 4 out of 10 food groups (fish products, cereals, sugar, plant oil) are consumed in sufficient amounts. The consumption of milk products, eggs, vegetables, potatoes, fruits (and berries) is severely low in a majority of the selected regions. There are high levels of biological contamination of food in many regions. The biological and chemical contamination situation is alarming, especially in Chukotka. Only 7 food pollutants are under regular control; among pesticides, only DDT. Evenki AO and Magadan Oblast have reached peak values in food contaminants compared with other regions. Mercury in local fish has not been analyzed in the majority of the regions. In 3 regions, no monitoring of DDT occurs. Aflatoxins have not been analyzed in 5 regions. Nitrates had the highest percentage in excess of the hygienic threshold in all regions. Excesses of other pollutants in different regions were episodic and as a rule not high. CONCLUSION: Improvement of the food supply and food accessibility in the regions of the Russian Arctic, Siberia and the Far East is of utmost importance. Both quantitative and qualitative control of chemical and biological contaminants in food is insufficient and demands radical enhancement aimed at improving food security.