Association of fructose consumption with prevalence of functional gastrointestinal disorders manifestations: results from Hellenic National Nutrition and Health Survey (HNNHS).

The study aimed to assess the total prevalence of functional gastrointestinal disorders (FGID), and separately, irritable bowel syndrome (IBS) among adults and to determine their potential association with fructose consumption. Data from the Hellenic National Nutrition and Health Survey were included (3798 adults; 58·9 % females). Information regarding FGID symptomatology was assessed using self-reported physician diagnosis questionnaires the reliability of which were screened using the ROME III, in a sample of the population. Fructose intake was estimated from 24 h recalls, and the MedDiet score was used to assess adherence to the Mediterranean diet. The prevalence of FGID symptomatology was 20·2 %, while 8·2 % had IBS (representing 40·2 % of total FGID). The likelihood of FGID was 28 % higher (95 %CI: 1·03-1·6) and of IBS 49 % (95 %CI: 1·08-2·05) in individuals with higher fructose intake than with lower intake (3rd tertile compared with 1st). When area of residence was accounted for, individuals residing in the Greek islands had a significantly lower probability of FGID and IBS compared with those residing in Mainland and the main Metropolitan areas, with Islanders also achieving a higher MedDiet score and lower added sugar intake, comparatively to inhabitants of the main metropolitan areas. FGID and IBS symptomatology was most prominent among individuals with higher fructose consumption, and this was most conspicuous in areas with a lower Mediterranean diet adherence, suggesting that the dietary source of fructose rather than total fructose should be examined in relation to FGID.

Assessing Health Care Providers' Knowledge and Practices of Nutrition during Pregnancy in Lebanon: A Cross-Sectional Study.

Background and objectives: Health care professionals (HCPs) are well-positioned to discuss healthy behaviors during pregnancy, but the published research of prenatal healthcare providers' knowledge about the significance of nutrition during pregnancy in Lebanon is scarce. The purpose of this study was to explore the knowledge, attitudes, and practices of Lebanese prenatal healthcare providers towards nutrition during pregnancy. Materials and Methods: A cross-sectional study using an online questionnaire was conducted. Health care providers were contacted by phone and email to participate in the online survey. A list of all clinics providing antenatal health services was obtained from the Order of Physicians and the Order of Midwives. A multistage random sample was selected. In the first stage, it was stratified per region (Beirut center or suburbs, and the southern region). In the second phase, it was stratified per clinic type (private, primary healthcare center, or hospital). Gynecologists and midwives who are members of the Order of Physicians and the Order of Midwives (n = 1333), were included. Results: Two-hundred and six responses (55% males) were obtained. Approximately 44% of the HCP were aged 50 and older, and 68.4% had more than 10 years of work experience. HCPs from Beirut represented 41.3% of the respondents. Eighty-eight percent of the HCPs were physicians, and 11% were midwives. The majority of the participants considered nutrition during pregnancy to be very important. Furthermore, half of these participants considered their position in delivering nutrition information as very significant. Most of the respondents reported that they provide nutrition advice to pregnant women, and they also received nutrition education during their profession. However, they perceived their nutrition knowledge as inadequate. Conclusion: Health care providers' attitude towards the importance of maternal nutrition and their confidence in talking about nutrition-related topics with pregnant women were positive despite the lack of knowledge in several areas related to nutrition during pregnancy. Therefore, there is a need for continuing nutrition education for health care providers and the implementation of nutrition education programs to achieve better health outcomes.

Assessment of eating habits and lifestyle during the coronavirus 2019 pandemic in the Middle East and North Africa region: a cross-sectional study.

Coronavirus disease 2019 (COVID-19) has rapidly spread globally, forcing countries to apply lockdowns and strict social distancing measures. The aim of this study was to assess eating habits and lifestyle behaviours among residents of the Middle East and North Africa (MENA) region during the lockdown. A cross-sectional study among adult residents of the MENA region was conducted using an online questionnaire designed on Google Forms during April 2020. A total of 2970 participants from eighteen countries participated in the present study. During the pandemic, over 30 % reported weight gain, 6·2 % consumed five or more meals per d compared with 2·2 % before the pandemic (P < 0·001) and 48·8 % did not consume fruits on a daily basis. Moreover, 39·1 % did not engage in physical activity, and over 35 % spent more than 5 h/d on screens. A significant association between the frequency of training during the pandemic and the reported change in weight was found (P < 0·001). A significantly higher percentage of participants reported physical and emotional exhaustion, irritability and tension either all the time or a large part of the time during the pandemic (P < 0·001). Although a high percentage of participants reported sleeping more hours per night during the pandemic, 63 % had sleep disturbances. The study highlights that the lockdown due to the COVID-19 pandemic caused a variety of lifestyle changes, physical inactivity and psychological problems among adults in the MENA region.

Micronutrient dietary intakes and their food sources in adults: the Hellenic National Nutrition and Health Survey (HNNHS).

BACKGROUND: The present study aimed to assess micronutrient intake among Greek adults and to identify the main food sources that contribute to it. METHODS: Food consumption data from 2389 participants in the Hellenic National Nutrition and Health Survey (HNNHS), collected with 24-h recalls, was used to calculate micronutrient intakes. Usual nutrient intake was estimated according to the National Cancer Institute method. Nutrient adequacy was estimated using the estimated average requirement (EAR) cut-point method, when available, or adequate intake otherwise. The probability approach was used to determine iron intake adequacy in females of reproductive age. Food group contribution for each nutrient assessed was derived to identify their main food sources. RESULTS: Almost all individuals had vitamin D intake below EAR, whereas vitamins A, E, K and C, as well as potassium intake, were also insufficient in a considerable percentage of the population (>70% in most age groups). Calcium intake was substantially below the EAR for females aged >50 years and males >70 years; the same for magnesium in males >70 years. Furthermore, 50% of females, including those of reproductive age, had intake of folate below EAR. More than 50% of the population (to 79%) exceeded the upper tolerable limit for sodium (2300 mg day-1 ). Food contribution analysis revealed that most vitamins were derived from low-quality foods (i.e. fast-food). CONCLUSIONS: A significant proportion of adults residing in Greece have low nutrient intake and poor food selections. These results provide guidance to public health policy makers for developing strategies to improve the dietary quality in Greece.

Dietary patterns and cardiovascular disease in Greek adults: The Hellenic National Nutrition and Health Survey (HNNHS).

BACKGROUND AND AIMS: Empirically-derived dietary patterns have been shown to have both positive and adverse associations with cardiovascular disease (CVD). Yet, such associations remain unclear in the Greek population. The aim of this study was to investigate the association between empirically-derived dietary patterns and the presence of CVD and CVD-related medical conditions in a nationally representative sample of Greek adults. METHODS AND RESULTS: Adult participants (≥20 years old) of the Hellenic National Nutrition and Health Survey (HNNHS) were included (N = 3552; 41.2% men; 43.7 years, SD: 18.1). Dietary patterns were derived by principal component analysis using 24-h recall data. The presence of dyslipidemia (elevated cholesterol and/or triglycerides), hypertension, coronary heart disease, and total CVD, was defined according to the International Clinical Diagnosis (ICD)-10 codes. Odds ratios of CVD outcomes were estimated across dietary patterns using multivariable logistic regression analysis. Three dietary patterns -Traditional (proxy Mediterranean), Western, and Prudent-were identified explaining 16.5% of the total variance in consumption. Logistic regression analysis, adjusted for age, sex, total caloric intake, sociodemographic characteristics, and other CVD risk factors, showed an inverse association between the Traditional dietary pattern and CVD presence (OR: 0.53; 95% CI: 0.30-0.95), and a positive association between the Western pattern and dyslipidemia (1.52; 1.02-2.26). No association was found between the Prudent pattern and CVD outcomes. CONCLUSION: The variability of food intake combinations in the Greek population seem to be associated with the presence of CVD and CVD related conditions. Such findings are imperative for national monitoring and informed priority setting.

Micronutrient intakes and their food sources among Greek children and adolescents.

OBJECTIVE: To assess the usual dietary intake of twenty micronutrients and to identify their food sources in a representative sample of Greek children and adolescents. DESIGN: Cross-sectional data from the Hellenic National Nutrition and Health Survey (HNNHS). Vitamin and mineral intakes were estimated from two 24 h dietary recalls by sex and age groups. Estimates were calculated using the National Research Council method and the statistical software package Stata13 to account for within- and between-person variations. The prevalence of nutrients' inadequacy among sample was estimated using the estimated average requirement (EAR) cut-point method. The contribution of food groups to nutrient intake was estimated to identify micronutrients food sources. SETTING: Greece. PARTICIPANTS: Children and adolescents aged 1-19 years (n 577) who provided sufficient and plausible 24-h recalls. RESULTS: A substantial percentage of children and adolescents had insufficient intakes of numerous micronutrients. Usual intake of vitamins D, K and potassium was inadequate in practically all individuals. Vitamin A, folate, Ca and Mg were also insufficient to a considerable percentage, especially in girls aged 14-18 years. Pantothenic acid was highlighted as nutrient of interest since only one out of ten boys 9-13 years and girls 14-19 years had intake above the EAR. Data demonstrated that food groups highly ranked in energy contribution were not necessarily important sources of micronutrients. CONCLUSIONS: Results suggest that micronutrient density of Greek children and adolescents' diet should be improved. These findings might be used by public health policy-makers to help young people optimise their food choices in Greece.

Aims, design and preliminary findings of the Hellenic National Nutrition and Health Survey (HNNHS).

BACKGROUND: The aim of the Hellenic National Nutrition and Health Survey was to assess nutritional intake, health status and various behaviors in a representative sample of the Greek population. METHODS: Data collection took place from 01.09.2013 to 31.05.2015. Random stratified sampling was performed by (a) geographical density criteria of Greece (7 regions), (b) age group of the reference population (< 19, 20-64 and > 65 years) and (c) gender distribution. The final population enrolled included (throughout Greece), 4574 individuals (42.5% men; 57.5% women of who 47.2% were from Athens metropolitan area, 18.5% from Central Macedonia, and the remaining 34% almost equally scattered throughout the country (p for the comparisons with official statistics by region, age group and sex > 0.7). Questionnaires developed were based on extensive review of the literature, following a validation procedure when necessary. RESULTS: Preliminary analyses revealed that 32% of the adult population were overweight and 15.5% were obese, with significant gender differences in total and per age group (p < 0.001, for all). The majority of the adult population reported being active smokers (50.4%) or regular alcohol consumers (72.4%); with significant gender differences (p < 0.001, for all). Prevalence of hyperlipidemia was 16.7%, cardiovascular disease 13.9%, hypertension 13.3%, thyroid disease 13.8%, and Diabetes Mellitus 3.6%. Significant gender and age group differences were found in various diseases. CONCLUSIONS: Study's preliminary results provide valuable information about the Hellenic population's health. Findings from this survey could be used to detect disease risk factors for public health prevention policies and programs.

Acute effects of coffee consumption on self-reported gastrointestinal symptoms, blood pressure and stress indices in healthy individuals.

BACKGROUND: It has been suggested that coffee may affect the gut-brain axis with conflicting outcomes. Moreover, there is insufficient evidence to determine whether the type or temperature of coffee consumed will have a different impact on the gut-brain axis. The purpose of this study was to investigate the effects of acute coffee consumption on the following: 1. self-reported GI symptoms and salivary gastrin, 2. stress indices [salivary cortisol and alpha-amylase (sAA)] and psychometric measures, and 3. blood pressure (BP), in healthy, daily coffee consuming individuals in non-stressful conditions. METHODS: This was a randomized, double blind, crossover clinical trial, in which 40 healthy individuals (20 men, 20 women), 20-55 years of age, randomly consumed four 200 ml coffee beverages containing 160 mg caffeine (hot and cold instant coffee, cold espresso, hot filtered coffee), 1 week apart. Salivary samples and psychometric questionnaires were collected at baseline and post-coffee consumption at 15,30, and 60 min for salivary gastrin and sAA measurements and at 60,120, and 180 min for cortisol measurements. BP was measured at beginning and end of each intervention. ClinicalTrials.gov ID: NCT02253628 RESULTS: Coffee consumption significantly increased sAA activity (P = 0.041), with significant differences only between cold instant and filter coffee at 15 and 30 min post-consumption (P < 0.05). Coffee temporarily increased salivary gastrin, without differences between coffee types. Coffee did not affect salivary cortisol or self-reported anxiety levels. Coffee consumption significantly increased BP, within the healthy physiological levels, in a gender specific manner at the end of the experimental periods, without differences between coffee types. CONCLUSION: Acute coffee consumption in non-stressful conditions activated sAA and BP but not salivary cortisol, indicating activation of the sympathetic nervous system. Post-coffee sAA increase without a concomitant cortisol increase may also indicate that coffee may have some anti-stress properties.

Food sources of free sugars in children's diet and identification of lifestyle patterns associated with free sugars intake: the GRECO (Greek Childhood Obesity) study.

OBJECTIVE: Excessive free sugars consumption has a possible role in health issues, diet quality and obesity development. The present cross-sectional study aimed to identify the major food sources of free sugars in Greek children's diet and investigate possible associations of dietary patterns with free sugars intake. DESIGN: Anthropometric measurements and information on dietary and physical activity habits were obtained. Energy and free sugars intake coming from foods were estimated and principal components analysis was applied to identify dietary patterns. SETTING: The GRECO (Greek Childhood Obesity) study. SUBJECTS: Nationwide sample of 3089 children (aged 10-12 years). RESULTS: Adopting WHO criteria, 44·2 % of participants were categorized as having free sugars intake above 10 % of total energy intake. Mean contribution of free sugars to energy intake was 11·2 %, and the major food sources of free sugars differed from those of other childhood populations. Free sugars intake was not associated with overweight/obesity. Multiple linear regression analysis revealed that two lifestyle and dietary patterns, characterized by higher consumption of sweets, fast foods, fries, sugared drinks, frequently ordering/eating outside home and having meals in front of a screen (pattern 1) and higher consumption of whole fruits, 100 % fruit juices, vegetables, legumes and honey/jam (pattern 2), were positively associated with free sugars intake. CONCLUSIONS: A large proportion of children exceeded the recommended cut-off and free sugars intake was associated with lifestyle patterns rather than single foods. Public health programmes aiming to reduce free sugars consumption should be tailored on promoting the correct dietary habits of specific childhood populations.

Anthropometric, lifestyle and parental characteristics associated with the prevalence of energy intake misreporting in children: the GRECO (Greek Childhood Obesity) study.

The objectives of the present study were to identify childhood energy misreporting, and evaluate characteristics that are associated with its prevalence in a nationwide cross-sectional sample of Greek schoolchildren. Under the context of the GRECO (Greek Childhood Obesity) study, data from a total of 4547 children aged 10-12 years and 2318 parents were included in the analysis. Anthropometric, lifestyle and parental characteristics plus psychological concerns were investigated in relation to the prevalence of energy misreporting. Of the included children, 36 % were classified as energy under-reporters and 16 % as over-reporters. Multinomial logistic regression analysis revealed that the most important predictors of energy under-reporting (URP) were children's BMI (OR 1·11, 95 % CI 1·09, 1·14) and weight satisfaction (OR 0·87, 95 % CI 0·78, 0·97). In the case of energy over-reporting (ORP), children's BMI (OR 0·87, 95 % CI 0·84, 0·90), meal and snack consumption frequency (OR 1·52, 95 % CI 1·32, 1·75), female sex (OR 0·65, 95 % CI 0·45, 0·90), and maternal education (OR 0·95, 95 % CI 0·91, 0·99) remained as significant predictors. Additionally, parental perception that the body weight of their children was normal reduced the odds of URP (OR 0·69, 95 % CI 0·48, 0·99) and ORP (OR 0·53, 95 % CI 0·31, 0·93). In conclusion, the present study confirms that the issue of URP and ORP in childhood populations is evident and quite serious. Although there are no definite guidelines on how to use data obtained from misreporters in an epidemiological dataset, validity of reported energy intake seems to be influenced by children's BMI and weight satisfaction, as well as by parental perceptions regarding their children's weight.

Effect of green tea on postprandial antioxidant capacity, serum lipids, C-reactive protein and glucose levels in patients with coronary artery disease.

PURPOSE: Cardiovascular risk factors have been identified in the postprandial state, particularly in patients with coronary artery disease (CAD). Tea consumption has been linked to cardiovascular risk reduction, but the beneficial effect of tea has not been investigated under postprandial conditions. The objective was to examine the effect of green tea on postprandial levels of plasma total antioxidant capacity (TAC), serum lipids, C-reactive protein (CRP) and glucose in patients with CAD. METHODS: In a randomized controlled, parallel design with 2 arms, 43 patients with CAD were assigned to consume breakfast consisting of bread, butter and 330 ml water or tea (4.5 g green tea/330 ml, providing approximately 400 mg catechins). Blood samples were drawn immediately before and 1.5, 3 and 5 h after breakfast. TAC was measured in plasma with the ferric reducing antioxidant power of plasma and oxygen radical absorbance capacity assays. Total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides, glucose, CRP, uric acid and pancreatic lipase levels were measured in serum. RESULTS: Tested biomarkers did not differ between tea and water group at baseline, 1.5, 3 and 5 h (P > 0.05) postprandially. However, TAC increased 1.5 and 3 h after consumption of breakfast with tea (P < 0.005), but no change was observed after consumption of breakfast with water. Serum triglycerides levels significantly increased 3 h after breakfast with water (P = 0.031), but not after breakfast with tea. Serum uric acid decreased 1.5 h after breakfast with tea (P = 0.038). Pancreatic lipase, CRP, total cholesterol, HDL-C, LDL-C and glucose levels remained unchanged after breakfast with tea at any time point (P > 0.05). CONCLUSIONS: Tea consumption did not affect selected biomarkers at any postprandial time point in patients with CAD.

Estimations of water balance after validating and administering the water balance questionnaire in pregnant women.

Dehydration during pregnancy may be harmful for the mother and fetus; thus our objective was to understand whether pregnant women balance water intake and loss. The Water Balance Questionnaire (WBQ) was modified to reflect pregnancy (WBQ-P). Validation was performed using 3-day diaries (n = 60) and hydration indices in urine (osmolality, specific gravity, pH and color, n = 40). The WBQ-P was found valid according to Kedhal τ-b coefficient agreement. The WBQ-P was administered to 95, 100 and 97 women per trimester, in Greece. Median (IQR) water balance, intake and loss were, respectively, 203 (-577, 971), 2917 (2187, 3544) and 2658 (2078, 3391) ml/day; these did not differ among the trimesters or between pregnant and non-pregnant women. However, more pregnant women were falling in the higher quartiles of water balance distribution. No differences in sources of water intake were identified except that women in the third trimester had lower water intake from beverages.

The Relation between Consumer Perception and Objective Understanding of Front-of-Package Nutrition Labels (FOPNLs); Results from an Online Representative Survey.

BACKGROUND: This study investigates the efficacy of Front-of-Pack Nutrition Labels (FOPNLs) as a cost-effective tool for improving dietary choices among Greek consumers. The purpose of the study was to investigate Greek customers' preferences and comprehension of commonly used European FOPNL schemes. METHODS: The Hellenic Food Authority and the Agricultural University of Athens performed a representative online survey in March 2022, titled "The Role of Nutritional Labelling in Public Perception and Food Procurement." Consumers responded to a questionnaire separated into two parts. Part one included (i) personal, sociodemographic information, and (ii) subjective opinions on the FOPNL schemes, and part two comprised (iii) an objective understanding of NutriScore and NutrInform Battery, using 15 different foods. Participants were randomly allocated to these groups, and general mixed models were used for analysis. RESULTS: A total of 1389 adults completed the first part of the survey, and 74.8% completed the second part. The Multiple Traffic Lights scheme was the preferred FOPNL, chosen by 48.4% of respondents, compared to 19.7% for NutrInform Battery and 12.3% for NutriScore. However, the mean objective assessment score was highest for NutriScore (5.8 ± 2.3) compared to NutrInform Battery (5.4 ± 1.9). CONCLUSION: The results highlight the necessity for comprehensive nutrition education programs by showing a considerable gap between subjective preferences and an objective understanding of nutrition labels.

Adolescents' use of online food delivery applications and perceptions of healthy food options and food safety: a cross-sectional study in the United Arab Emirates.

Introduction: This cross-sectional study aimed to assess Online food delivery applications (OFDA) usage trends among adolescent users in the United Arab Emirates (UAE), focusing on their perceptions of healthy food options and food safety (n = 532). Methods: Sociodemographic information, frequency of OFDA use, factors affecting food choices, and perceptions of healthy food and food safety were investigated. A total perception score was calculated for each participant. Results: Most participants used OFDAs weekly (65.4%), favoring fast food (85.7%). Factors like appearance and price drove food choices (65.0%), while taste and cost hindered healthy food orders (29.7 and 28.2%). Younger and frequent users had lower scores for perceiving healthy food, while seeking healthy options was associated with higher scores (p < 0.05). Females and those seeking healthy food showed higher food safety scores (p < 0.05). Discussion: The study suggests tailored interventions to promote healthier choices and improve food safety perceptions among adolescents using OFDAs in the UAE.

Adherence to Mediterranean diet and close dietetic supervision increase total dietary antioxidant intake and plasma antioxidant capacity in subjects with abdominal obesity.

PURPOSE: To determine the effect of Mediterranean-type diet and close dietetic supervision on dietary antioxidant intake and plasma total antioxidant capacity (TAC) in patients with abdominal obesity. METHODS: Ninety subjects with abdominal obesity, 46 in intervention group, 44 in control group, participated in a 2-month, randomized, parallel dietary intervention. All participants were counseled on Greek Mediterranean diet. The intervention group was under close dietetic supervision, followed a specific relevant daily and weekly food plan consuming antioxidant-rich foods and food products. Total dietary antioxidant intake was calculated from the volunteers' food diaries, and plasma TAC using plasma ORAC assay and plasma ferric-reducing antioxidant power (FRAP) assay, both at baseline and at 2 months. RESULTS: Following the 2-month period, total dietary antioxidant intake was increased in the intervention group compared to the control group (P = 0.000). In addition, increased intake of total fat, due to higher consumption of monounsaturated fatty acids, as well as increased intakes of dietary fiber, vitamin C and alcohol was also observed in the intervention group compared to the control group (P < 0.05). Plasma TAC was increased in the intervention group compared to the control group (P = 0.039) using the ORAC assay, while there was a trend toward a TAC increase (P = 0.077) using the FRAP assay. CONCLUSION: Adherence to a Mediterranean-type diet, with emphasis on an increase in foods rich in antioxidants and close dietetic supervision, can increase total dietary antioxidant intake and plasma TAC in patients with abdominal obesity.

Socio-economic and demographic determinants of childhood obesity prevalence in Greece: the GRECO (Greek Childhood Obesity) study.

OBJECTIVE: Given the rapid increase in the prevalence of childhood obesity, identifying the sociodemographic influences on obesity status is important for planning and implementing effective prevention initiatives. However, this type of data is limited for Greek children. Therefore the aim of the present study was to identify possible sociodemographic factors associated with childhood obesity at the national level. DESIGN: Cross-sectional, population-based survey, carried out from October to May 2009. Setting Under the context of the GRECO (Greek Childhood Obesity) study, a nationwide sample of 2315 primary-school children. SUBJECTS: Children aged 10-12 years and their parents were voluntarily enrolled. Direct anthropometric measurements of the children were obtained and information on sociodemographic characteristics of the parents, as well as their self-reported values of body weight and height, were collected. RESULTS: Overweight and obesity prevalence was 29·5 % and 13·1 %, respectively, among boys; 29·5 % and 9·0 %, respectively, among girls. Multiple logistic regression analysis revealed that the most important sociodemographic predictors of childhood obesity were mother's age, parental BMI classification and father's type of occupation. More specifically, increased mother's age and normal BMI status of the parents seemed to have a protective effect on the likelihood of having an overweight/obese child. Additionally, the odds of a female child of being overweight/obese were reduced when the father's type of occupation tended to be less manual. CONCLUSIONS: Anti-obesity health policy interventions have to address to the parents and promote their active involvement, to effectively confront the alarming magnitude of the paediatric obesity problem in Greece.

Phytosterol supplementation does not affect plasma antioxidant capacity in patients with metabolic syndrome.

Several studies have observed decreased levels of lipophilic antioxidants after supplementation with phytosterols and stanols. The aim of this study was to examine the effect of phytosterol supplementation on plasma total antioxidant capacity in patients with metabolic syndrome. In a parallel arm, randomized placebo-controlled design, 108 patients with metabolic syndrome were assigned to consume yogurt beverage which provided 4 g of phytosterols per day or yogurt beverage without phytosterols. The duration of the study was 2 months and the patients in both groups followed their habitual westernized type diet. Blood samples were drawn at baseline and after 2 months, and the total antioxidant capacity of plasma was measured using the ferric reducing antioxidant power of plasma and oxygen radical absorbance capacity assays. After 2 months of intervention, plasma total antioxidant capacity did not differ between and within the intervention and the control groups. Phytosterol supplementation does not affect plasma antioxidant status.

Front-of-Pack Nutrition Labelling Schemes: Where Are We Now?

The development of nutritional policies plays a vital role in health promotion [...].

Nitrite and nitrate intake from processed meat is associated with elevated diastolic blood pressure (DBP).

BACKGROUND AND AIMS: Processed meat consumption has been linked to high blood pressure (BP), a key risk factor for cardiovascular disease (CVD), but gaps remain with regards to the ingredients which contribute to this association. This study, therefore, aimed to examine the association between nitrite and nitrate intake from processed meat with diastolic (DBP) and systolic (SBP) blood pressure, while accounting for sodium intake. METHODS: Dietary nitrite and nitrate intake from processed meat, assessed as total nitrite equivalent, was estimated for 1774 adult, processed meat consumers (≥18 years, 55.1% females) who had enrolled in the Hellenic National Nutrition and Health Survey (HNNHS). To avoid selection and reverse causality bias, associations with measured DBP and SBP were considered instead of self-reported data of hypertension presence. Participants were divided by tertile of dietary nitrite intake and by level of dietary guideline adherence for sodium (<1500; 1500-2300; ≥2300). Multiple regression models were used to examine associations with SBP and DBP, including an interaction term of nitrite with dietary sodium intake, for potential synergy. RESULTS: Overall, DBP increased by 3.05 mmHg (95% CI: 0, 6.06), per tertile increase in nitrite intake and 4.41 mmHg (95% CI: 0.17, 8.64) per level increase in sodium intake, when the interaction effect between nitrite and total sodium intakes was accounted for. By considering the significant synergistic effect of the two factors, DBP finally increased by 0.94 mgHg overall and 2.24 mgHg for subjects in the third tertile compared to those in the first. Also, a rise in total sodium intake of approximately 800 mg, above 1500 mg, caused a 2.30 mgHg increase in DBP. No significant correlations were found with SBP. CONCLUSIONS: Higher nitrite and nitrate intake from processed meats contributed to the increase of DBP, but the interaction effect with total sodium intake levels should be accounted for to properly interpret the findings.

The impact of ultra-processed foods on obesity and cardiometabolic comorbidities in children and adolescents: a systematic review.

CONTEXT: Over the past few decades, traditional foods have been displaced by ultra-processed foods (UPFs), with the latter being associated with health problems. OBJECTIVE: This scoping systematic review aimed to identify the relationship between UPF intake and overweight/obesity as well as other cardiometabolic risk factors during childhood and adolescence. DATA SOURCES: The guidance for this protocol is the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P). A systematic search was undertaken on PubMed, Scopus, and Cochrane Library electronic databases based on prespecified inclusion and exclusion criteria up to 6 February 2022. DATA EXTRACTION: A total of 17 observational studies-9 cross-sectional, 7 cohort-longitudinal, and 1 study reporting both cross-sectional and longitudinal outcomes-among children and adolescents aged ≤18 years were eligible for inclusion in this review. Fourteen studies evaluated the consumption of UPFs in association with overweight/obesity and 9 studies examined the association of UPF consumption and cardiometabolic-related risk factors. DATA ANALYSIS: Most studies (14/17) showed that an increase in UPFs was associated with a higher prevalence of overweight/obesity and cardiometabolic comorbidities among children and adolescents, whereas 4 of 17 studies (3 cross-sectional and 1 cohort) found no association. Most cohort and cross-sectional studies showed good quality according to the National Institutes of Health and Newcastle-Ottawa quality assessment, respectively. CONCLUSION: The positive association found between UPFs and overweight/obesity and cardiometabolic comorbidities among children and adolescents raises concerns for future health. Further investigation is recommended to explore the role of specific types of UPFs on cardiometabolic conditions and to identify the amount of daily intake that increase risk in order to shape appropriate public health policies. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022316432.