Effect of vitamin D supplementation or fortification on bone turnover markers in women: a systematic review and meta-analysis.

Vitamin D is a vital indicator of musculoskeletal health, as it plays an important role through the regulation of bone and mineral metabolism. This meta-analysis was performed to investigate the effects of vitamin D supplementation/fortification on bone turnover markers in women. All human randomised clinical trials reported changes in bone resorption markers (serum C-terminal telopeptide of type-I collagen (sCTX) and urinary type I collagen cross-linked N-telopeptide (uNTX)) or bone formation factors (osteocalcin (OC), bone alkaline phosphatase (BALP) and procollagen type-1 intact N-terminal propeptide (P1NP)) following vitamin D administration in women (aged ≥ 18 years) were considered. Mean differences (MD) and their respective 95 % CI were calculated based on fixed or random effects models according to the heterogeneity status. Subgroup analyses, meta-regression models, sensitivity analysis, risk of bias, publication bias and the quality of the included studies were also evaluated. We found that vitamin D supplementation had considerable effect on sCTX (MD: -0·038, n 22) and OC (MD: -0·610, n 24) with high heterogeneity and uNTX (MD: -8·188, n 6) without heterogeneity. Our results showed that age, sample size, dose, duration, baseline vitamin D level, study region and quality of studies might be sources of heterogeneity in this meta-analysis. Subgroup analysis also revealed significant reductions in P1NP level in dose less than 600 µg/d and larger study sample size (>100 participants). Moreover, no significant change was found in BALP level. Vitamin D supplementation/fortification significantly reduced bone resorption markers in women. However, results were inconsistent for bone formation markers.

What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails.

BACKGROUND: There is conflicting evidence on the effect of vitamin D on glycemic control. Therefore, in the current meta-analyses, we aimed to assess the effect of vitamin D supplementation on the glycemic control of type 2 diabetes (T2D) patients. METHODS: We conducted a comprehensive search in electronic databases including; PubMed/Medline, Web of Science, Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and NIH's Clinical Trials Registry, from the inception of each database up to January first, 2021. RESULTS: A total of 46 randomized controlled trials (RCTs) consisting of 2164 intervention subjects and 2149 placebo controls were included in this meta-analysis. Pooled analyses for HbA1c showed a significant change between the intervention and placebo group, the weighted mean difference (WMD)(95% confidence interval(CI)) was -0.20%(-0.29, -0.11) with P < 0.001. Analyses for assessing changes in FPG found a significant reduction in the intervention group after vitamin D supplementation, the WMD (95%CI) was -5.02 mg/dl (-6.75,-3.28) with P < 0.001. The result of pooled analyses for HOMA-IR revealed a significant change between the intervention and control group, the WMD (95%CI) was -0.42(-0.76, -0.07) with P = 0.019. The subgroup analyses showed the most efficacy in a higher dose and short intervention period and in subjects with deficient vitamin D status. CONCLUSION: Vitamin D supplementation might be beneficial for the reduction of FPG, HbA1c, and HOMA-IR in type 2 diabetes patients with deficient vitamin D status. This effect was especially prominent when vitamin D was given in large doses and for a short period of time albeit with substantial heterogeneity between studies and a probability of publication bias.

Associations between empirically derived dietary patterns and cardiovascular risk factors among older adult men.

Cardiovascular disease (CVD) remains the leading cause of death globally, and epidemiological studies have suggested a link between diet and cardiometabolic risk. Currently, the prevalence of CVD is rapidly increasing with an aging population and continues to contribute to the growing economic and public health burden. However, there is limited evidence available regarding dietary patterns and cardiometabolic risk factors in older adults. We conducted a cross-sectional study to assess dietary patterns and cardiometabolic risk factors in males ≥60 years. Factor analysis identified a "healthy" diet and an "unhealthy" diet as the two primary dietary patterns. Multivariable logistic regression was used for estimating the associations of identified dietary patterns and cardiometabolic risk factors including anthropometric measures, blood pressure, glycemic biomarkers, lipid profile, and inflammatory biomarkers. A healthy dietary pattern was significantly associated with decreased odds of high serum fasting blood sugar (FBS) (OR: 0.32; 95% CI: 0.15-0.67; Ptrend=0.002), but increased odds of high serum low-density lipoprotein cholesterol (LDL-C) (OR: 1.82; 95% CI: 1.02-3.24; Ptrend=0.04). In comparison, an unhealthy diet was associated with increased odds of obesity (OR: 2.33; 95% CI: 1.31-4.15; Ptrend=0.004) and high LDL-C (OR: 2.00; 95% CI: 1.10-2.61; Ptrend=0.02). Thus, in older adults, adherence to an unhealthy dietary pattern has a significant impact on clinically relevant risk factors for cardiometabolic risk.

Vegetarian diet and the risk of depression, anxiety, and stress symptoms: a systematic review and meta-analysis of observational studies.

Previous studies reported inconsistent findings regarding the consumption of a vegetarian diet with mental health outcomes, specifically depression, anxiety and stress. A systematic review was conducted to summarize the current state of literature regarding our understanding of the association between a vegetarian diet and depression, anxiety and stress. A literature search was completed using Scopus, PubMed, and the Web of Science for relevant articles published prior to July 2020. Prospective cohort and cross-sectional studies conducted on adults reporting risk estimates for the consumption of a vegetarian diet, depression, anxiety, and stress were selected. A fixed effects or a random effects model was performed to pool effect sizes. Results from 13 publications (four cohort studies and nine cross-sectional studies) assessing the relationship between the consumption of a vegetarian diet and depression, anxiety and stress were included. The pooled effect size from 10 studies indicated no association between the consumption of a vegetarian diet and depression (pooled effect size: 1.02, 95% CI: 0.84-1.25, p = 0.817). Further, the pooled effect size from four studies suggests that a vegetarian diet is not associated with anxiety (pooled effect size: 1.09, 95% CI: 0.71-1.68, p = 0.678). Due to insufficient data for stress, we were not able to pool the results. Together, no significant associations were observed between the consumption of a vegetarian diet and depression or anxiety. Future cohort studies are needed to further investigate the effects of a vegetarian diet on these mental health outcomes.

Association between Ultraprocessed Food Intake and Overweight, Obesity, and Malnutrition among Children in Tehran, Iran.

Childhood is a critical period for susceptibility to malnutrition. The consumption of ultraprocessed foods (UPFs) has been increasing among children. The objective of this study was to evaluate the relationship between UPF intake and overweight/obesity and malnutrition in children. 788 children aged 6 years were included in a population-based cross-sectional study in Tehran. A 168-item semiquantitative food frequency questionnaire was used to evaluate dietary intake. UPFs were detected using the NOVA classification system. Logistic regression analyses were used, and results were reported as odds ratios (ORs) and 95% confidence interval (CI) of obesity and malnutrition across the tertiles of UPFs adjusted for energy intake, socioeconomic status, and physical activity. The mean weight, height, BMI, and total energy intake of participants were 20.85 ± 2.35 kg, 113.75 ± 2.00 cm, 16.12 + 1.84 kg/m2, and 1014.74 ± 259.16 (kcal/d), respectively. There were no significant associations between UPF intake and obesity (OR = 0.97; 95% CI 0.31 to 3.01; P-trend = 0.98), wasting (OR = 0.94; 95% CI 0.30 to 2.87; P-trend = 0.87), overweight/obesity (OR = 0.86; 95% CI 0.59 to 1.25; P-trend = 0.45), underweight/wasting (OR = 0.69; 95% CI 0.40 to 1.17; P-trend = 0.17), marginal-stunting (OR = 1.16; 95% CI 0.71 to 1.89; P-trend = 0.53), or marginal-stunting/overweight/obesity (OR = 1.25; 95% CI 0.62 to 2.54; P-trend = 0.47). There was no evidence of an association between intake of UPFs and risk of overweight, obesity, and malnutrition in children.

Association between Different Types of Edible Oils and Anthropometric Indices Mood, and Appetite among Women.

Introduction: The objective of this study was to evaluate the relationship between consumption of dietary oils and anthropometric indices, mood, and appetite among women staff of Tehran University of Medical Sciences. Methods: A cross-sectional study design was used, and 245 women staff of Tehran University of Medical Sciences participated. A 168-item food frequency questionnaire was used to evaluate dietary and nutrient intake. The association between liquid vegetable oils, hydrogenated vegetable oil, and animal fat intake and anthropometric indices, appetite, and mood was evaluated. The Profile of Mood States (POMS) questionnaire was used to assess mood. A Visual Analogue Scale (VAS) was used to evaluate appetite status. The tape measure was used to measure the waist circumference and height. SPSS was used to compute body mass index (BMI) and waist-to-height ratio (WHtR). Results: In the present study, sunflower and frying oil were the most consumed liquid oils (n = 135/245 participants). Participants with a moderate intake of MUFA had greater odds ratio (OR: 3.47; 95% CI: 1.20-10.7; P trend = 0.025) of a high appetite compared to those with a low intake of MUFA. However, the study found no evidence of an association between consumption of edible oils (vegetable oils, animal fat oils, and other fatty acid sources) and mood, anthropometric indices, or appetite. Conclusions: In the current research, we noticed a significant connection between moderate intake of MUFA and a large appetite and no association between consumption of edible oils and other outcomes. In conclusion, a balanced diet low in fast meals, processed foods, cakes, cookies, and sweets is suggested to limit the consumption of artificial trans-fatty acids.

The associations between lifestyle factors and mental well-being in baccalaureate nursing students: An observational study.

Lifestyle factors are modifiable habits that shape the way in which individuals live their lives and can influence mental health. This study examined the associations between lifestyle factors and mental well-being among baccalaureate nursing students at one Canadian university. A cross-sectional, observational online survey was distributed at one urban university campus in Ontario, Canada. Baccalaureate nursing students (n = 147) completed the survey containing questions for demographic variables, sleep quality, dietary pattern, alcohol use, physical activity, sitting time, cigarette smoking, depression, anxiety and stress. Linear regression analysis revealed that more sitting time, poor sleep quality, and low dairy consumption were associated with higher scores in depression, anxiety, and psychological stress. In conclusion, poor lifestyle behaviors such as sedentary lifestyle, poor sleep, and low dairy consumption may reduce the mental well-being of baccalaureate nursing students. Future efforts should aim to establish a causal relationship between lifestyle and mental well-being, which would contribute to the development of lifestyle interventions to promote mental health.

Knowledge and Perceptions of Carbohydrates among Nutrition-Major and Nutrition-Elective Undergraduate Students in Canada.

Objective: The purpose of the study was to assess knowledge and perceptions related to carbohydrates, including sugars, among Canadian nutrition-major undergraduates compared to those enrolled in elective nutrition courses (i.e., "nutrition-elective students").Methods: Cross-sectional surveys were distributed during class time at eight Canadian universities, which included 32 questions on demographics, knowledge and perceptions of carbohydrates and sugars. Descriptive analyses were performed. Differences between groups were tested by Chi-squared statistics.Results: A total of 1207 students (60% nutrition-majors) participated in the survey (January 2016-February 2017). Internet-based sources accounted for one-third of the sources where students obtained nutrition information. About 61% of internet-bases sources were "online" or "website" with no qualifiers, and about a quarter was from social media. A higher percentage of nutrition-majors correctly answered knowledge questions of carbohydrates compared with nutrition-elective students (p < 0.01); no difference was observed for sugars-related knowledge questions. The perceptions of sugars were generally negative and did not differ between groups.Conclusions: Several knowledge gaps and common perceptions on topics related to carbohydrates and sugars were identified; nutrition-major students performed better than nutrition-elective students on carbohydrate knowledge questions, but not sugars. These results highlight the importance of identifying methods to help students bridge knowledge gaps and develop skills to critically evaluate nutrition information from various resources and challenge personal biases.

Associations between dietary intake of B vitamins and cardiovascular risk factors in elderly men: A cross-sectional study.

OBJECTIVE: Low intake of B vitamins can lead to hyperhomocysteinaemia, which is reported as a risk factor for cardiovascular disease (CVD). However, little is known about this relationship. Therefore, we decided to examine the association between dietary intake of B vitamins and cardiovascular risk factors in elderly men. METHODS: The present cross-sectional study consisted of 357 elderly men. Dietary intake was assessed using a validated and reliable food frequency questionnaire. All biochemical factors [fasting blood sugar (FBS), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α)], waist circumference (WC) and blood pressure (BP) were assessed using standard methods. RESULTS: A significant inverse association was observed between high dietary intake of total B vitamins (ORTotal B vitamins : 0.30; 95% CI: 0.10, 0.86; P = .01) and vitamin B9 (ORvitamin B9 : 0.20; 95% CI: 0.02, 0.52; P = .002) with high WC. Furthermore, an inverse association was observed between high dietary intake of vitamin B6 (ORvitamin B6 : 0.28; 95% CI: 0.08, 1.00; P = .05) and vitamin B9 (ORvitamin B9 : 0.20; 95% CI: 0.06, 0.70; P = .01) with hs-CRP level. CONCLUSIONS: In elderly men, a high dietary intake of total B vitamins and vitamin B9 was associated with lower odds of having a high WC. Similarly, high dietary intake of vitamin B6 and B9 was associated with lower odds of having a high hs-CRP level.

The association between dietary acid load with cardiometabolic risk factors and inflammatory markers amongst elderly men: A cross-sectional study.

BACKGROUND: Existing epidemiological data on dietary acid load and cardiovascular disease (CVD) are controversial. There is no literature evaluating the association between dietary acid load (DAL) with cardiometabolic risk factors and inflammatory markers in elderly. OBJECTIVE: To evaluate the association between DAL and cardiometabolic risk factors amongst Iranian elders. METHOD: A cross-sectional study was completed using 357 Iranian elders above >60 years of age. Anthropometric, clinical, and biochemical measurements were performed. Dietary intake was assessed using a validated and reliable food frequency questionnaire. DAL was estimated using the Potential Renal Acid Load (PRAL) score, Net Endogenous Acid Production (NEAP) and the Net Endogenous Acid Excretion (NAE) score. Metabolic syndrome (MetS) was defined according to the ATP-III criteria. Multivariable-adjusted odds ratios (ORs) of CVD risk factors were estimated using logistic regression. RESULTS: After adjustment for confounders, a higher PRAL score was associated with higher odds of hypertriglyceridemia (OR: 2.28, 95% CI: 1.15, 4.50). We also observed that the NEAP score was positively associated with MetS (OR: 17.2, 95% CI: 2.34, 127). Finally, there was a positive association between NAE and lipid accumulation product (LAP) (OR: 1.81, 95% CI: 1.04, 3.17) and hypertriglyceridemia (OR: 2.46 95% CI: 1.22, 4.95). CONCLUSION: Men with higher DAL scores had a higher risk of MetS, hypertriglyceridemia and LAP. Our findings suggest that further prospective studies are required to appraise DAL-CVD risk factors in populations with varying dietary patterns.

Food quality score and anthropometric status among 6-year-old children: A cross-sectional study.

OBJECTIVE: Weight status and growth during childhood are indicative of healthy development throughout the lifespan. It is well understood that dietary patterns and overall quality of diet can prevent disease, improve health status and optimise growth and development. The current study investigates the relationship between overall diet quality and measures of childhood development including body mass index and height-for-age in 6-year-old children. METHODS: This cross-sectional study was conducted across 788 6-year-old children from Tehran, Iran, in 2018. Food quality score (FQS) was used to assess overall diet quality, in addition to a modified food-based diet quality score specific to children (modified FQS) developed by our group. RESULTS: Participants in the highest tertile using the modified FQS had the highest height-for-age z-score (HAZ) (-0.509 ± 0.028 vs -0.605 ± 0.028; P = .048). In contrast, participants in the highest tertile assessed using the original FQS had a higher BMI for age z-score (BAZ) compared to participants in the first tertile (0.391 ± 0.072 vs 0.266 ± 0.072; P = .023). Children within the highest tertile, according to the original FQS, compared to those within the lowest tertile were 49% less likely to be categorised as severely underweight (OR: 0.51; 95% CI: 0.47-0.98). CONCLUSIONS: Findings presented in this study demonstrate that FQS was significantly associated with participants characterised as severely underweight; however, FQS was not associated with other anthropometric parameters. Therefore, future well-designed cohort studies are required to address limitations of the current study.

The association of dietary choline and betaine and anthropometric measurements among Iranian children: a cross-sectional study.

BACKGROUND: Previous studies have suggested that choline and betaine are associated with improved anthropometric measures including, BMI and waist circumference however, results are largely inconsistent and limited studies exist in children. Our objective was to investigate the relationship between dietary choline and betaine, and anthropometric measurements among Iranian children. METHODS: In this cross-sectional study, dietary information was collected for 788 six-year-old children, who attended Tehran health centers in 2018. We measured dietary intakes using a valid and reliable semi-quantitative food frequency questionnaire. The USDA database was used to calculate dietary choline and betaine. We assessed anthropometric characteristics, physical activity, and socio-demographic status based on a reliable and valid protocol. Logistic regression adjusted for energy, physical activity, socio-economic status, and maternal age, physical activity, BMI, and HEI2015 was used to assess this association. RESULTS: Free choline, glycero-phospho-choline, phospho-choline, phosphatidyl-choline, total choline, and total betaine, and choline were not related to overweight, obesity, underweight and wasting in the crude and adjusted model after controlling for children's energy intake, children's physical activity, socio-economic status, maternal physical activity, and BMI. Betaine intake was associated with mid-arm circumference and risk of overweight. CONCLUSIONS: We did not find any evidence to support the association between dietary choline with anthropometric measurements among Iranian children. Further prospective studies with a large sample size in different populations are needed.

Nicotine and energy balance: A review examining the effect of nicotine on hormonal appetite regulation and energy expenditure.

Nicotine has been shown to decrease appetite, food intake (FI) and body weight, but the mechanisms are unclear. The purpose of this review was to examine research on the effects of nicotine on energy balance by exploring physiological mechanisms and hormone regulation related to FI, subjective appetite and energy expenditure (EE). We searched PubMed and MEDLINE, and included articles investigating the effects of nicotine on central appetite regulation, FI, leptin, peptide-YY (PYY), ghrelin, glucagon-like peptide-1 (GLP-1), adiponectin, cholecystokinin (CCK), orexin, and EE. A total of 65 studies were included in the qualitative synthesis and review. Our findings suggest that the decrease in appetite and FI may be attributed to nicotinic alterations of neuropeptide Y (NPY) and pro-opiomelanocortin (POMC) but the effect of nicotine on FI remains unclear. Furthermore, nicotine increases resting EE (REE) and physical activity EE (PAEE) in both smokers and non-smokers; and these increases may be a result of the catecholaminergic effect of nicotine. Decreases in body weight and appetite experienced by nicotine users results from increased EE and changes in the central hypothalamic regulation of appetite. There is not enough evidence to implicate a relationship between peripheral hormones and changes in appetite or FI after nicotine use. Although nicotine increases REE and PAEE, the effect of nicotine on other components of EE warrants further research. We conclude that further research evaluating the effect of nicotine on appetite hormones, FI and EE in humans is warranted.

Food insecurity, dietary acid load, dietary energy density and anthropometric indices among Iranian children.

OBJECTIVES: Food insecurity significantly influences diet quality which in turn has an impact on individual health. This study aimed to determine the association of food insecurity, dietary energy density (DED), dietary acid load (DAL), and the anthropometric status of children. STUDY DESIGN: A cross-sectional study. METHODS: This study was conducted in 788 6-year-old girls who were referred to health care centers affiliated with Tehran University of Medical Sciences in the south of Tehran from October 2017 to March 2018. Food frequency questionnaires (168 food items) were assessed to calculate DAL and DED. Food insecurity was assessed using the 18-item United States Department of Agriculture questionnaire. Weight and height of children were measured as anthropometric indices. RESULTS: Protein and energy intake were higher in participants with a higher DAL and DED, respectively. Energy, fat, carbohydrate, fiber, potassium, phosphorus, calcium, iron, folate, vitamin B12, mono- and poly-unsaturated fatty acid intake was inversely related to DAL. Children characterized as food insecure were more likely to be defined as thin (OR 5.36; 95% CI 3.41-8.40) than overweight (OR 0.18; 95% CI 0.12-027) and obese (OR 0.28; 95% CI 0.08-0.98, respectively). There was no significant association between DED, potential renal acid load (PRAL), and food security status. Moreover, there was no significant association between anthropometric measure and PRAL. CONCLUSION: Findings from our study revealed that there was no association between DAL and food insecurity. However, food insecure children were more likely to be characterized as thin than children categorized as food secure. More studies need to be performed in both genders to confirm our findings. LEVEL OF EVIDENCE: Level V cross-sectional descriptive study.

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

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

Association of dietary acid load and plant-based diet index with sleep, stress, anxiety and depression in diabetic women.

Diabetes is a common chronic disease with various complications. The present study was conducted to determine the association of plant-based diet index (PDI) and dietary acid load (DAL) with sleep status as well as mental health in type 2 diabetic women. In this cross-sectional study, a validated FFQ was used to assess dietary intakes of 230 diabetic patients. We created a whole PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI). DAL was calculated based on potential renal acid load and net endogenous acid production method. The Pittsburgh Sleep Quality Index and twenty-one-item Depression, Anxiety and Stress Scale were used to assess sleep and mental health disorders, respectively. Participants in the top group of uPDI had greater risk of poor sleep (OR 6·47, 95 % CI 2·75, 15·24). However, patients who were in the top group of hPDI had a lower risk of sleep problems (OR 0·28, 95 % CI 0·13, 0·62). Participants in the top group of uPDI had greater risk of depression, anxiety and stress (OR 9·35, 95 % CI 3·96, 22·07; OR 4·74, 95 % CI 2·28, 9·85; OR 4·24, 95 % CI 2·14, 8·38, respectively). In conclusion, participants with higher DAL scores and patients who adhered to animal-based diets rather than plant-based diets were more likely to be poor sleepers and have mental health disorders.

Dietary intake of fish, n-3 polyunsaturated fatty acids, and risk of inflammatory bowel disease: a systematic review and meta-analysis of observational studies.

PURPOSE: Fish consumption and dietary intake of n-3 polyunsaturated acids (PUFAs) may be associated with inflammatory bowel disease (IBD). We aimed to conduct a systematic review and summarize published articles on the association between fish consumption and dietary intake of n-3 PUFAs with the risk of IBD. METHODS: PubMed, Scopus, and Web of Science databases were used to conduct a comprehensive search and identify eligible literature published prior to January 2019. Fixed-effects model or random-effects models (DerSimonian-Laird method) were applied to pool the effect sizes. Cochrane Q test was used to trace the potential source of heterogeneity across studies. RESULTS: 12 studies (5 prospective and 7 case-control) were included in the systematic review, which ten of them were eligible for inclusion in the meta-analysis. Studies were included a total sample size of 282610 participants which 2002 of them were cases of IBD [1061 Crohn's disease (CD) and 937 ulcerative colitis (UC)]. A negative association was found between fish consumption and the incidence of CD (pooled effect size: 0.54, 95%CI: 0.31-0.96, P = 0.03). There was no relationship between total dietary n-3 PUFAs intake and IBD (pooled effect size: 1.17, 95%CI: 0.80-1.72, P = 0.41). A significant inverse association was observed between dietary long-chain n-3 PUFAs and the risk of UC (pooled effect size: 0.75, 95%CI: 0.57-0.98, P = 0.03). Moreover, no association was found between α-Linolenic acid (ALA) and IBD (pooled effect size: 1.17, 95%CI: 0.63-2.17, P = 0.62). CONCLUSIONS: Findings showed a negative association between fish consumption and the risk of CD. Moreover, there was a significant inverse association between dietary long-chain n-3 PUFAs and the risk of UC.

Knowledge of Sugars Consumption and the WHO Sugars Guideline among Canadian Dietitians and Other Health Professionals.

Purpose: The objective was to assess knowledge related to sugars consumption and World Health Organization (WHO) sugars guideline among Canadian dietitians and other health professionals. Methods: A multiple-choice style survey was administered at Dietitians of Canada and Canadian Diabetes Association conferences in 2014. Results: The study showed that only 12% of the surveyed respondents (n = 335) in 2014 were able to correctly identify the amount of added sugars consumed by Canadians, whereas two-thirds overestimated this amount. About 10% of the respondents knew that the 10% guideline by WHO for free sugars was based on evidence related to dental caries. Registered dietitians had relatively better knowledge of Canadian sugars consumption (P = 0.003), but not of the WHO free sugars guideline compared with other surveyed health professionals such as medical doctors or nurses. Conclusions: Knowledge gaps existed among surveyed Canadian health professionals on topics related to sugars consumption and the WHO sugars guideline. Future research should focus on tools to support better communication of sugars guideline and consistent use of sugars terminology.

Association between dietary patterns and sociodemographics: A cross-sectional study of Australian nursing students.

Lack of time, financial issues, and stressful clinical and educational environments in nursing studies promote higher intakes of convenience and fast foods loaded with fat and sugar, which are linked to reduced mental and physical health. In this study, we examined the dietary patterns of nursing students and their associated sociodemographic factors to inform the development of future health-promotion interventions. A total of 548 Bachelor of Nursing students were invited to complete a survey. Associations were explored using χ2 and logistic regression. Three dietary patterns were identified: healthy (fruit, vegetables, and legumes), Western (loaded with fat, sugar, and salt), and unbalanced. Only 21% of participants were classified as following a healthy dietary pattern, and more likely to be older (>35 years old) and have a personal annual income between $AUD20 000-$59 999 and $60 000-$99 999. Students with one to two and three or more children were more likely to follow a Western dietary pattern. There is a need to develop interventions to improve the dietary behaviors of nursing students by health-promoting activities and the provision of online health resources.

Association of dietary phytochemical index and mental health in women: a cross-sectional study.

Previous studies have shown that unhealthy dietary patterns are among the most important modifiable risk factors in the development of mental health disorders. We examined the association of dietary phytochemical index (DPI) with symptoms of depression, anxiety and psychological distress in Iranian women. In this cross-sectional study, a total of 488 women aged 20-50 years old attending health centres in the south of Tehran in 2018 were included. A validated and reliable FFQ was used for dietary assessment. Symptoms of depression, anxiety and psychological distress were assessed using a validated depression, anxiety, stress scales questionnaires with twenty-one-items. DPI was estimated using the following formula: (daily energy derived from phytochemical-rich foods (kJ)/total daily energy intake (kJ))×100. The mean age of the study participants was 31·9 (sd 7·7) years. The prevalence of depressive symptoms, anxiety and psychological distress among study participants was 34·6, 40·6 and 42·4 %, respectively. After controlling for potential confounders, women in the highest tertile of DPI had a lower prevalence of depressive symptoms (OR 0·22; 95 % CI 0·12, 0·38) and anxiety (OR 0·33; 95 % CI 0·20, 0·55), as well as psychological distress (OR 0·30; 95 % CI 0·18, 0·49) compared with those in the lowest tertile. In conclusion, we found a significant association between DPI and mental health in women. Prospective studies are needed to confirm these findings.