Effects of finisher diet nutrients density and slaughter age on energy and protein efficiency, productive and economic performance and meat quality of broilers.

BACKGROUND: The current broilers have been greatly optimized for weight gain and breast yield, which necessitates the provision of nutrients-dense diets for maximum potential. OBJECTIVES: The current study aimed to evaluate the effect of finisher diet nutrients density (ND) on energy and protein efficiency, productive and economic performance and breast meat quality of broilers raised until different slaughter age. METHODS: A total of 600 23-day-old broiler male chicks (Cobb-500) were assigned to 10 treatments with six replicates and 10 birds each. Experimental treatments were included factorial arrangement of five increment (2.5%) levels of finisher diet ND (92.5%, 95%, 97.5%, 100% and 102.5% as strain recommendation) and slaughtered at 38 or 46 days of age. The relative difference in the energy level of experimental diets was used to increase ND levels at the same ratio. RESULTS: Feed intake (FI) and breast meat quality traits exception water holding capacity (WHC) were not affected by finisher diet ND. In response to increasing finisher diet ND, energy and protein efficiency, productive traits, bio-economic index (BEI) and breast relative weight (BRW) linearly improved. However, residual feed intake and breast meat WHC improved with a quadratic trend. By using broken-line regression analysis, the optimum dietary ND was obtained at 97.5%-102% of strain recommendation. Energy and protein efficiency, feed conversion ratio and BEI deteriorated by prolonging rearing period. The BRW, meat lightness (L*), redness (a*), hue angle (h*) and WHC values for the birds slaughtered at 46 days of age were significantly higher, and cooking loss was lower than those slaughtered at 38 days old. CONCLUSIONS: Broilers during the finisher period are not able to regulate their FIs with diet ND. The energy and protein efficiency, productive and economic performance were reduced when broilers were fed diluted diet or the rearing period was prolonged.

Acid accumulation is associated with metabolic alterations; higher energy, fat, and protein intake; and energy expenditure.

OBJECTIVE: The objective of this study was to study how acid accumulation (lower plasma bicarbonate and higher anion gap [AG] and corrected anion gap [CAG]) correlates with metabolic parameters, food intake, and 24-h energy expenditure (EE). METHODS: Acid accumulation was measured in 286 healthy adults with estimated glomerular filtration rate > 60 mL/min/1.73 m2. Measurements included body composition by dual-energy x-ray absorptiometry scan, ad libitum energy intake by a vending machine paradigm over 3 days, and 24-h EE in a whole-room indirect calorimeter. RESULTS: Lower bicarbonate, higher AG, and higher CAG were correlated with higher waist and thigh circumferences, body fat (percentage), fat mass, triglycerides, and lower high-density lipoprotein cholesterol. Acid accumulation markers were correlated with higher total energy (CAG partial r = 0.17; p = 0.02), fat (CAG partial r = 0.17; p = 0.02), protein intake (CAG partial r = 0.20; p = 0.006), and 24-h EE (CAG partial r = 0.24; p = 0.0007). A mediation analysis of CAG and total energy intake found that 24-h EE was a partial mediator (40%), but the association remained significant (ß = 0.15; p < 0.0001). CONCLUSIONS: In healthy individuals, acid accumulation was associated with an unfavorable metabolic phenotype; higher 24-h EE; and increased total energy, fat, and protein intake. Acid accumulation markers, as putative markers of higher dietary acid load (e.g., from protein), may affect energy balance physiology promoting weight gain.

Allergenicity assessment of new or modified protein-containing food sources and ingredients.

The growing world population, changing dietary habits, and increasing pressure on agricultural resources are drivers for the development of novel foods (including new protein sources as well as existing protein sources that are produced or used in an alternative way or in a different concentration). These changes, coupled with consumer inclination to adopt new dietary trends, may heighten the intake of unfamiliar proteins, or escalate consumption of specific ones, potentially amplifying the prevalence of known and undiscovered food allergies. Assessing the allergenicity of novel or modified protein-based foods encounters several challenges, including uncertainty surrounding acceptable risks and assessment criteria for determining safety. Moreover, the available methodological tools for gathering supportive data exhibit significant gaps. This paper synthesises these challenges, addressing the varied interpretations of "safe" across jurisdictions and societal attitudes towards allergenic risk. It proposes a comprehensive two-part framework for allergenicity assessment: the first part emphasises systematic consideration of knowledge and data requirements, while the second part proposes the application of a generic assessment approach, integrating a Threshold of Allergological Concern. This combined framework highlights areas that require attention to bridge knowledge and data gaps, and it delineates research priorities for its development and implementation.

The effects of dietary macronutrient composition on resting energy expenditure following active weight loss: A systematic review and meta-analysis.

A systematic review and meta-analysis was conducted to evaluate the relative effectiveness of different dietary macronutrient patterns on changes in resting energy expenditure (REE) in relation to weight loss, categorized as minimal (<5%) and moderate to high (>5%). Changes in REE were assessed using a DerSimonian and Laird random-effects meta-analysis. A diet lower in carbohydrates (CHO) or higher in fat and protein was associated with smaller reductions in REE, with these trends being more pronounced among participants who experienced moderate to high weight loss. Adjusted meta-regression analysis indicated that, within the participants who experienced moderate to high weight loss, each 1% increase in CHO intake was associated with a reduction of 2.30 kcal/day in REE (95% CI: -4.11 to -0.47, p = 0.013). In contrast, a 1% increase in protein and fat intake was correlated with an increase in REE by 3.00 (95% confidence interval [CI] [1.02, 5.07], p = 0.003) and 0.5 (95% CI [-2.43, 3.41], p = 0.740) kcal/day, respectively. No significant associations were found among participants who experienced minimal weight loss. These findings indicate that, under a caloric deficit, the impact of dietary macronutrient composition on REE may vary depending on the degree of weight loss and individual metabolic responses.

Targeting strategies of antenatal balanced energy and protein supplementation in Addis Ababa, Ethiopia: study protocol for a randomized effectiveness study.

BACKGROUND: Antenatal balanced energy and protein (BEP) supplements have well-documented benefits for pregnancy outcomes. However, considerable practical gaps remain in the effective and cost-effective delivery of antenatal BEP supplements at scale in low- and middle-income countries. METHODS: A randomized effectiveness study will be conducted in two sub-cities of Addis Ababa, Ethiopia, to evaluate the effectiveness, cost-effectiveness, and implementation of different targeting strategies of antenatal BEP supplements. Pregnant women aged 18 to 49, with a gestational age of 24 weeks or less, and attending antenatal visits in one of the nine study health facilities are eligible for enrollment. In six of the health facilities, participants will be randomized to one of three study arms: control (Arm 1), targeted BEP provision based on baseline nutritional status (Arm 2), and targeted BEP supplementation based on baseline nutritional status and monthly gestational weight gain (GWG) monitoring (Arm 3). In the remaining three facilities, participants will be assigned to universal BEP provision (Arm 4). Participants in Arms 2 and 3 will receive BEP supplements if they have undernutrition at enrollment, as defined by a baseline body mass index less than 18.5 kg/m2 or mid-upper arm circumference less than 23 cm. In Arm 3, in addition to targeting based on baseline undernutrition, regular weight measurements will be used to identify insufficient GWG and inform the initiation of additional BEP supplements. Participants in Arm 4 will receive BEP supplements until the end of pregnancy, regardless of baseline nutritional status or GWG. All participants will receive standard antenatal care, including iron and folic acid supplementation. A total of 5400 pregnant women will be enrolled, with 1350 participants in each arm. Participants will be followed up monthly during their visits to the antenatal facilities until delivery. Maternal and infant health status will be evaluated within 72 h after delivery and at 6 weeks postpartum. The effectiveness and cost-effectiveness of the different BEP targeting strategies in preventing adverse pregnancy outcomes will be compared across arms. Qualitative data will be analyzed to assess the feasibility, acceptability, and implementation of different supplementation strategies. DISCUSSION: This study will inform global recommendations and operational guidelines for the effective and cost-effective delivery of antenatal BEP supplements. The targeted approaches have the potential for broader scale-up in Ethiopia and other low-resource settings with a high burden of undernutrition among pregnant women. TRIAL REGISTRATION: ClinicalTrials.gov registration number: NCT06125860. Registered November 9, 2023.

Validating nutrient selection for product-group-specific nutrient indices for use as functional units in life cycle assessment of foods.

The ability to provide adequate nutrition is considered a key factor in evaluating the sustainability of foods and diets. Nutrient indices are used as functional units (FU) in life cycle assessment of foods to include nutritional performance in the environmental assessment of a product. Several general and food-group-specific nutrient indices exist but many lack validation, particularly when used as FU. In addition, the nutrient selection strategies and reference units for nutrient intake can vary considerably among studies. To validate intake-based product-group-specific nutrient indices previously developed for protein (NR-FIprot) and carbohydrate (NR-FIcarb) foods and for fruits and vegetables (NR-FIveg), we applied principal component analysis to investigate correlations between nutrients in foods and dishes representing a typical Finnish diet. The reference amounts for meal components were based on a plate model that reflected Finnish dietary recommendations. The portion sizes for the different food groups were anchored at 100 g, 135 g and 350 g for proteins, carbohydrates and fruits/vegetables, respectively. Statistical modelling largely validated the NR-FI indices, highlighting protein foods as sources of niacin, vitamin B12 and Se, carbohydrate foods as sources of Mg, Fe and phosphorous, and fruits/vegetables as sources of potassium, vitamin K, vitamin C, fibre and thiamine. However, in contrast to the intake-based approach applied in NR-FIprot, the dietary recommendation-based validation process suggested that fruits and vegetables should be favoured as sources of riboflavin and vitamin B6.

Energy expenditure and dietary intake in professional female football players in the Dutch Women's League: Implications for nutritional counselling.

In contrast to male football players, research on the nutritional requirements of female football players is limited. This study aimed to assess total daily energy expenditure (TDEE) in professional female football players, along with body composition, physical activity and dietary intake. This observational study included 15 professional football players playing in the highest Dutch Women's League. TDEE was assessed by doubly labelled water over 14 days, along with resting metabolic rate (RMR; ventilated hood), fat-free mass (FFM; dual-energy x-ray absorptiometry), and dietary intake (24-h recalls). Physical activity energy expenditure (PAEE) was derived from subtracting RMR and estimated diet-induced thermogenesis (10%) from TDEE. TDEE was 2882 ± 278 kcal/day (58 ± 5 kcal/kg FFM) and significantly (p < 0.05) correlated with FFM (r = 0.62). PAEE was 1207 ± 213 kcal/d. Weighted energy intake was 2344 kcal [2023-2589]. Carbohydrate intakes were 3.2 ± 0.7, 4.4 ± 1.1 and 5.3 ± 1.9 g/kg body mass for rest, training and match days, respectively, while weighted mean protein intake was 1.9 ± 0.4 g/kg body mass. In conclusion, the energy requirements of professional female football players are moderate to high and can be explained by the substantial PAEE. To fuel these requirements, sports nutritionists should consider shifting the players' focus towards prioritizing adequate carbohydrate intakes, rather than emphasizing high protein consumption.

Perspective: The Place of Pork Meat in Sustainable Healthy Diets.

The food systems sustainability framework has 4 domains: nutrition, economics, environment, and society. To qualify as sustainable, individual foods and total diets need to be nutrient-rich, affordable, environmentally friendly, and socially acceptable. Pork is the most consumed meat globally, providing high-quality protein and several priority micronutrients. With research attention focused on plant-based diets, it is time to assess the place of pork meat protein in the global sustainability framework. First, not all proteins are equal. The United States Department of Agriculture category of protein foods includes meat, poultry and fish, eggs, beans and legumes, and nuts and seeds. These protein sources have different protein digestibility profiles, different per-calorie prices, and different environmental footprints, measured in terms of greenhouse gas emissions. Second, most analyses of animal-source proteins combine beef, pork, and lamb into a single category of red meat. Beef, pork, and lamb have different nutrient profiles, different protein costs, and different impacts on the environment. Future analyses of nutrient density and monetary and carbon costs of alternative diets would do well to separate pork from beef, lamb, and chicken. There are also different profiles of global food demand. Prior analyses of global Food and Agriculture Organization Statistical Database food balance sheets joined with World Bank country incomes have consistently shown that rising incomes across lower- and middle-income countries (LMIC) create a growing demand for meat to replace traditional plant proteins. Most of the observed increase has been for pork and chicken rather than beef. This ongoing LMIC protein transition toward more animal proteins may be irreversible as long as incomes grow. The present analyses explore the place of pork in sustainable healthy diets worldwide, given the need for high-quality protein and the predictable patterns of global food demand.

Techno-Economic Analysis of Gas Fermentation for the Production of Single Cell Protein.

Despite the large carbon footprint of livestock production, animal protein consumption has grown over the past several decades, necessitating new approaches to sustainable animal protein production. In this techno-economic analysis, single cell protein (SCP) produced via gas fermentation of carbon dioxide, oxygen, and hydrogen is studied as an animal feed source to replace fishmeal or soybean meal. Using wind-powered water electrolysis to produce hydrogen and oxygen with carbon dioxide captured from corn ethanol, the minimum selling price (MSP) of SCP is determined to be $2070 per metric ton. An emissions comparison between SCP, fishmeal, and soybean meal shows that SCP has a carbon intensity as low as 0.73 kg CO2-equiv/kg protein, while fishmeal and soybean meal have an average carbon intensity of 2.72 kg CO2-equiv/kg protein and 0.85 kg CO2-equiv/kg protein, respectively. Moreover, SCP production would occupy 0.4% of the land per ton of protein produced compared to soybean meal and would disturb less than 0.1% of the marine ecosystem currently disturbed by fishmeal harvesting practices. These results show promise for the future economic viability of SCP as a protein source in animal feed and indicate significant environmental benefits compared to other animal feed protein sources.

Life-History Trade-Offs in Drosophila: Flies Select a Diet to Maximize Reproduction at the Expense of Lifespan.

Macronutrient intake impacts physiology, behavior, and gene expression in a wide range of organisms. We used the response surface methodology to compare how life history traits, lifespan, and reproduction differ as a function of protein and carbohydrate intakes under choice and no-choice feeding regimens in the fruit fly, Drosophila melanogaster. We found that when offered a choice of nutritionally complementary foods mated female flies regulated toward a protein to carbohydrate ratio (P:C) that was associated with shortened lifespan and maximal egg production when compared to response surfaces derived from flies fed 1 of a range of fixed diets differing in P:C (no-choice regimen). This difference in lifespan between choice and no-choice feeding was not seen in males or virgin flies, reflecting the fact that increased protein intake is triggered by mating to support egg production. However, whereas in mated females a higher P:C intake was associated with greater egg production under both choice and no-choice feeding, contrary to expectations, choice-fed mated flies laid fewer eggs than no-choice flies on equivalent macronutrient intakes, perhaps reflecting that they had to ingest twice the volume of food to attain an equivalent intake of nutrients than no-choice flies on a diet of equivalent P:C ratio.

Evaluation of a mechanistic model that estimates feed intake, growth and body composition, nutrient requirements, and optimum economic response of broilers.

Efficient meat production is crucial in addressing global market demands and sustainability goals. Modeling production systems has gained worldwide attention, offering valuable insights for predicting outcomes and optimizing economic returns. In the poultry industry, researchers have developed mathematical models to predict animal performance and maximize profits. These models incorporate theories to explain real-world processes and enable future event predictions. One such model is the Broiler Growth Model (BGM), which serves as a predictive tool for estimating feed intake, growth, and body composition of broilers. The BGM takes into account the genetic potential of the broilers, the feed they are provided, and several constraining factors that may prevent the animal from achieving their genetic potential. To evaluate the BGM, a series of simulations were performed: (i) model behavior was evaluated by simulating the response of males and females from 22 to 35 d to feeds differing in dietary protein content and nutrient density; (ii) model prediction was evaluated using the results of a protein response trial conducted at UNESP in which six dietary protein levels were fed to male and female broilers over a 56 d period; and (iii) model optimization was used to maximize economic returns in the above trial. The model behaved as expected when feeds differing in protein content were fed, with feed intake per kg of BW increasing as protein level was decreased, resulting in lower gains and higher body lipid contents. Increasing nutrient density resulted in higher feed intake in the second level, followed by a reduction in feed intake in the highest nutrient feed. The simulated response to nutrient density resulted in increasing body lipid deposition as the nutrient density increased. In comparing the simulated and actual results of the protein response trial, the overall error of prediction was up to 15% for feed intake, BW, and body protein. The optimization routine allows the simulation of different economic scenarios, helping in decision-making. The Broiler Growth Model emerges as a valuable tool for the poultry industry, offering predictive capabilities and economic optimization potential. While minor discrepancies between simulated and actual results exist, the BGM holds significant promise for enhancing efficiency and profitability in broiler production, contributing to the broader goals of sustainable broiler meat production.

Energy Expenditure, Dietary Energy Intake, and Nutritional Supplements in Adolescent Volleyball Athletes versus Nonathletic Controls.

Evidence suggests that athletes competing in team sports do not follow dietary recommendations. However, only few studies have investigated energy needs and supplement use in adolescent athletes, and whether they are meeting their energy requirements. This observational study examined energy expenditure, dietary energy intake, and use of nutritional supplements in 58 adolescent (14-17 years old) volleyball athletes (15 males, 43 females) and 58 age-matched nonathletic controls (13 males, 45 females). Participants completed an online survey including questions on demographic information, body mass, and a series of standardized questionnaires assessing energy expenditure, dietary energy, macronutrient, micronutrient, and supplement intake. Energy expenditure relative to body mass was higher in athletes than nonathletes by 13 kcal/kg/day (group effect, p < 0.001), and in males compared to females by 5.7 kcal/kg/day (sex effect, p = 0.004). Athletes had higher energy intake than nonathletes (+6.4 kcal/kg/day, p = 0.019) and greater consumption of fruits (p = 0.034), vegetables (p = 0.047), grains (p = 0.016), dairy (p = 0.038), meats and meat alternatives (p < 0.001), as well as higher intakes of fat (p < 0.001), carbohydrates, protein, sugar, fiber, vitamin C, calcium, and sodium (p = 0.05) compared to nonathletes. The average protein intakes exceeded the upper recommendations in all groups, suggesting that this is not a nutrient of concern for young volleyball athletes. However, athletes were only meeting 60% of the estimated energy requirements (EER) for their age, height, body mass, and physical activity score, (3322 ± 520 kcal/day), while nonathletes were meeting 74% of the EER (p < 0.001). The relative energy balance of male athletes was lower compared to both female athletes (p = 0.006) and male nonathletes (p = 0.004). Finally, more athletes reported using performance-related supplements than nonathletes, but there were no differences in the consumption of other dietary supplements. Overall, when compared to nonathletic controls, both male and female adolescent volleyball athletes were found to match their higher energy expenditure with a greater dietary energy intake; however, all adolescents were below the estimated energy requirements, a finding more profound among the volleyball athletes.

[Controversy 1: Assessing nutritional status and sarcopenia, and calculating protein requirements. Should these be specific?] / Controversia 1. ¿Cómo realizar la valoración nutricional y de la sarcopenia, y el cálculo de requerimientos de proteínas necesarias? ¿Deben ser específicas?

Introduction: Controversy 1: Assessing nutritional status and sarcopenia, and calculating protein requirements. Should these be specific?

Introducción: Controversia 1. ¿Cómo realizar la valoración nutricional y de la sarcopenia, y el cálculo de requerimientos de proteínas necesarias? ¿Deben ser específicas?

A Cell-Based Assessment of the Muscle Anabolic Potential of Blue Whiting (Micromesistius poutassou) Protein Hydrolysates.

Blue whiting (BW) represents an underutilised fish species containing a high-quality protein and amino acid (AA) profile with numerous potentially bioactive peptide sequences, making BW an economic and sustainable alternative source of protein. This study investigated the impact of three different BW protein hydrolysates (BWPH-X, Y and Z) on growth, proliferation and muscle protein synthesis (MPS) in skeletal muscle (C2C12) myotubes. BWPHs were hydrolysed using different enzymatic and heat exposures and underwent simulated gastrointestinal digestion (SGID), each resulting in a high degree of hydrolysis (33.41-37.29%) and high quantities of low molecular mass peptides (86.17-97.12% <1 kDa). C2C12 myotubes were treated with 1 mg protein equivalent/mL of SGID-BWPHs for 4 h. Muscle growth and myotube thickness were analysed using an xCelligence™ platform. Anabolic signalling (phosphorylation of mTOR, rpS6 and 4E-BP1) and MPS measured by puromycin incorporation were assessed using immunoblotting. BWPH-X significantly increased muscle growth (p < 0.01) and myotube thickness (p < 0.0001) compared to the negative control (amino acid and serum free media). Muscle protein synthesis (MPS), as measured by puromycin incorporation, was significantly higher after incubation with BWPH-X compared with the negative control, but did not significantly change in response to BWPH-Y and Z treatments. Taken together, these preliminary findings demonstrate the anabolic potential of some but not all BWPHs on muscle enhancement, thus providing justification for human dietary intervention studies to confirm and translate the results of such investigations to dietary recommendations and practices.

Multiomics assessment of dietary protein titration reveals altered hepatic glucose utilization.

Dietary protein restriction (PR) has rapid effects on metabolism including improved glucose and lipid homeostasis, via multiple mechanisms. Here, we investigate responses of fecal microbiome, hepatic transcriptome, and hepatic metabolome to six diets with protein from 18% to 0% of energy in mice. PR alters fecal microbial composition, but metabolic effects are not transferable via fecal transplantation. Hepatic transcriptome and metabolome are significantly altered in diets with lower than 10% energy from protein. Changes upon PR correlate with calorie restriction but with a larger magnitude and specific changes in amino acid (AA) metabolism. PR increases steady-state aspartate, serine, and glutamate and decreases glucose and gluconeogenic intermediates. 13C6 glucose and glycerol tracing reveal increased fractional enrichment in aspartate, serine, and glutamate. Changes remain intact in hepatic ATF4 knockout mice. Together, this demonstrates an ATF4-independent shift in gluconeogenic substrate utilization toward specific AAs, with compensation from glycerol to promote a protein-sparing response.

Determinants of active energy expenditure in haemodialysis patients.

BACKGROUND: Less active haemodialysis patients have an increased risk of mortality. We wished to determine which factors were associated with active energy expenditure (AEE). METHODS: We used the validated recent physical activity questionnaire to determine AEE and estimated dietary protein intake and creatinine generation rates. We measured extracellular and total body water ratio (ECW/TBW) and appendicular lean muscle with bioimpedance and arm strength by hand grip strength (HGS). Patients were graded using the Charlson co-morbidity and the Clinical Frailty Score (CFS). RESULTS: AEE was calculated in 98 patients (64 male), mean age 62.1 ± 15.5 years, and AEE was negatively associated with CFS (r = -0.48), ECW/TBW (r = -0.47) and age (r = -0.4), all p < 0.001, Charlson co-morbidity score (-0.27, p = 0.007), and positively with serum creatinine (r = 0.38, p < 0.010), and HGS (r = 0.25, p = 0.016). Although protein nitrogen accumulation and creatinine generation were associated with resting energy expenditure (r = 0.70 and r = 0.44 respectively, both p < 0.0001), neither were associated with AEE. On multivariable analysis only CFS remained independently associated with AEE (ß = -0.031, 95% limits: -0.057 to -0.004, p = 0.024), although both age (negative p = 0.07), and ALM (positive p = 0.081) were retained in the model. CONCLUSIONS: We found that AEE was lower with increasing frailty, age, loss of cell mass, co-morbidity and inflammation, and greater AEE in patients with higher serum creatinine and albumin, and greater muscle strength on univariate analysis, but only frailty remained independently associated on multivariable analysis. Whether exercise programmes designed to increase AEE in haemodialysis patients can improve frailty scores, and so reduce mortality risk reman to be determined.

Comparison of Energy and Macronutrients Between a Mobile Application and a Conventional Dietary Assessment Method in Korea.

BACKGROUND: The use of mobile apps for dietary evaluation avoids some of the disadvantages of costly and time-consuming traditional diet assessment. However, few studies have compared dietary intake data in smartphone apps with a conventional diet assessment. OBJECTIVE: This study aimed to compare the dietary data collected on energy and macronutrients (proteins, fats, and carbohydrates) consumed for 3 nonconsecutive days using both a mobile application (Noom) and a conventional dietary assessment tool (CAN Pro). DESIGN: This was a cross-sectional study. PARTICIPANTS/SETTING: A total of 119 healthy adults (68 males and 51 females) aged 19 to 65 years were recruited from the National Cancer Center in Korea between May and September 2019. MAIN OUTCOME MEASURES: The mean daily energy and macronutrient intake data were obtained for the dietary intakes consumed for 3 nonconsecutive days using Noom and CAN Pro. STATISTICAL ANALYSIS PERFORMED: The estimates of energy and macronutrient intake between the two tools were compared using correlation coefficients and cross-classification. RESULTS: Although mean daily fat intake and percent total energy from carbohydrate estimated by Noom were comparable with values provided by CAN Pro, mean daily estimated energy intake (kcal), protein (g, percent total energy), and carbohydrate (g) were significantly higher with Noom than with CAN Pro. The correlation coefficients ranged from 0.79 to 0.99 for crude intake and from 0.77 to 0.88 for energy-adjusted values of intake after adjustment for sex and age. The percentages of participants classified into quartiles of "exact agreement and plus adjacent" varied between 95% and 99% for crude intake and between 93% and 97% for energy-adjusted values of intake. CONCLUSIONS: The findings indicate that Noom may be useful for monitoring the dietary intake of energy and macronutrients and reducing workload compared with a traditional dietary assessment in Korea. However, further research is needed to assess the validity and usability of Noom for estimating intake of micronutrients and other dietary components.

Cost-effectiveness of antenatal multiple micronutrients and balanced energy protein supplementation compared to iron and folic acid supplementation in India, Pakistan, Mali, and Tanzania: A dynamic microsimulation study.

BACKGROUND: Malnutrition among women of childbearing age is especially prevalent in Asia and sub-Saharan Africa and can be harmful to the fetus during pregnancy. In the most recently available Demographic and Health Survey (DHS), approximately 10% to 20% of pregnant women in India, Pakistan, Mali, and Tanzania were undernourished (body mass index [BMI] <18.5 kg/m2), and according to the Global Burden of Disease (GBD) 2017 study, approximately 20% of babies were born with low birth weight (LBW; <2,500 g) in India, Pakistan, and Mali and 8% in Tanzania. Supplementing pregnant women with micro and macronutrients during the antenatal period can improve birth outcomes. Recently, the World Health Organization (WHO) recommended antenatal multiple micronutrient supplementation (MMS) that includes iron and folic acid (IFA) in the context of rigorous research. Additionally, WHO recommends balanced energy protein (BEP) for undernourished populations. However, few studies have compared the cost-effectiveness of different supplementation regimens. We compared the cost-effectiveness of MMS and BEP with IFA to quantify their benefits in 4 countries with considerable prevalence of maternal undernutrition. METHODS AND FINDINGS: Using nationally representative estimates from the 2017 GBD study, we conducted an individual-based dynamic microsimulation of population cohorts from birth to 2 years of age in India, Pakistan, Mali, and Tanzania. We modeled the effect of maternal nutritional supplementation on infant birth weight, stunting and wasting using effect sizes from Cochrane systematic reviews and published literature. We used a payer's perspective and obtained costs of supplementation per pregnancy from the published literature. We compared disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (ICERs) in a baseline scenario with existing antenatal IFA coverage with scenarios where 90% of antenatal care (ANC) attendees receive either universal MMS, universal BEP, or MMS + targeted BEP (women with prepregnancy BMI <18.5 kg/m2 receive BEP containing MMS while women with BMI ≥18.5 kg/m2 receive MMS). We obtained 95% uncertainty intervals (UIs) for all outputs to represent parameter and stochastic uncertainty across 100 iterations of model runs. ICERs for all scenarios were lowest in Pakistan and greatest in Tanzania, in line with the baseline trend in prevalence of and attributable burden to LBW. MMS + targeted BEP averts more DALYs than universal MMS alone while remaining cost-effective. ICERs for universal MMS compared to baseline IFA were $52 (95% UI: $28 to $78) for Pakistan, $72 (95% UI: $37 to $118) for Mali, $70 (95% UI: $43 to $104) for India, and $253 (95% UI: $112 to $481) for Tanzania. ICERs for MMS + targeted BEP compared to baseline IFA were $54 (95% UI: $32 to $77) for Pakistan, $73 (95% UI: $40 to $104) for Mali, $83 (95% UI: $58 to $111) for India, and $245 (95% UI: $127 to $405) for Tanzania. Study limitations include generalizing experimental findings from the literature to our populations of interest and using population-level input parameters that may not reflect the heterogeneity of subpopulations. Additionally, our microsimulation fuses multiple sources of data and may be limited by data quality and availability. CONCLUSIONS: In this study, we observed that MMS + targeted BEP averts more DALYs and remains cost-effective compared to universal MMS. As countries consider using MMS in alignment with recent WHO guidelines, offering targeted BEP is a cost-effective strategy that can be considered concurrently to maximize benefits and synergize program implementation.

Wool keratin - A novel dietary protein source: Nutritional value and toxicological assessment.

Keratin derived protein (KDP) was extracted from sheep wool using high pressure microwave technology and food acids and investigated for its potential as a novel dietary protein. The proximate composition, amino acid profile, element profile, in vitro cytotoxicity and digestibility of KDP were evaluated. Nutritive effects of KDP at 50% dietary supplementation were compared with a casein-based diet in a growing rat model for 95 days. Results indicate KDP to be rich in protein (86%), amino acid cysteine (8.8 g/100 g) and element selenium (0.29 µg/g). KDP was non-cytotoxic in vitro at ≤ 2 mg/mL concentration. There were no differences in the rat's weight gain compared to the control group (P > 0.05). Overall, the inclusion of the KDP in the diet was an effective substitute for casein protein at 50% and KDP has the potential to be used in the food industry as a novel dietary protein, free of fat and carbohydrate.

Impact of room service on nutritional intake, plate and production waste, meal quality and patient satisfaction and meal costs: A single site pre-post evaluation.

AIM: Room service is a patient-focused foodservice model gaining interest in Australian hospitals following demonstrated patient and organisational benefits. This study aimed to compare nutritional intake, waste, patient satisfaction, meal costs and meal quality between a bought-in, thaw-retherm foodservice model and a cook-fresh, on-demand room service model at a large tertiary public hospital. METHODS: A retrospective analysis of quality assurance data compared thaw-retherm to room service. Nutritional intake and plate waste were measured using a visual intake analysis tool; production waste was measured using weighted analysis methodology; patient satisfaction was measured using a validated patient satisfaction survey; meal quality was assessed using a validated meal quality audit tool, and meal costs were obtained from hospital finance reports. Independent sample t-tests or nonparametric equivalent (Mann-Whitney U-test) for continuous variables and Pearson's Chi-square for categorical data were applied for comparative purposes. RESULTS: Average energy and protein intake, as well as percentage requirements met, improved between thaw-retherm and room service (4320 kJ/day vs 7265 kJ/day; 42.4 g/day vs 82.5 g/day; and 46% vs 80.7%; 49.9% vs 98.4%; all P < .001. Reductions in plate waste (40% vs 15%) and production waste (15% vs 5.6%, P < .001) were observed and food costs decreased by 9% with room service. Meal quality audit results improved, and patient satisfaction increased with % respondents satisfied increasing from 75.0% to 89.8% (χ2 9.985[2]; P = .007) for room service. CONCLUSIONS: This research demonstrates significant improvements in patient and organisational outcomes with room service compared to a thaw-retherm model in a large public hospital.