Artificial Intelligence Applications to Public Health Nutrition.

Public health nutrition occupies a paramount position in the overarching domains of health promotion and disease prevention, setting itself apart from nutritional investigations concentrated at the individual level [...].

Choline Intake and Cognitive Function Among U.S. Older Adults.

Choline is an essential nutrient affects brain development in early life. However, evidence is lacking regarding its potential neuroprotective effects in later life from community-based cohorts. This study assessed the relationship between choline intake and cognitive functioning in a sample of older adults 60 years + from the National Health and Nutrition Examination Survey 2011-2012 and 2013-2014 waves (n = 2,796). Choline intake was assessed using two nonconsecutive 24-hour dietary recalls. Cognitive assessments included immediate and delayed word recalls, Animal Fluency, and Digit Symbol Substitution Test. The average daily dietary choline intake was 307.5 mg, and the total intake (including intake from dietary supplements) was 330.9 mg, both below the Adequate Intake level. Neither dietary OR = 0.94, 95% CI (0.75, 1.17) nor total choline intake OR = 0.87, 95% CI (0.70, 1.09) was associated with changes in cognitive test scores. Further investigation adopting longitudinal or experimental designs may shed light on the issue.

Impact of Beef and Beef Product Intake on Cognition in Children and Young Adults: A Systematic Review.

(1) Background: Undernutrition and micronutrient deficiency have been consistently linked to cognitive impairment among children and young adults. As a primary source of dietary animal protein, beef consumption holds the potential to improve diet quality and positively influence cognitive function. This study systematically reviewed evidence linking beef intake to cognition among children and young adults. (2) Methods: A literature search was conducted in seven electronic bibliographic databases for studies assessing the impact of beef consumption on cognition. (3) Results: We identified eight studies reporting results from five unique interventions. Two interventions were conducted in Kenya, two in the U.S. and one in four countries including Guatemala, Pakistan, Democratic Republic of the Congo and Zambia. Only one intervention employed a non-feeding control arm and found beef consumption to improve cognitive abilities compared to the control. However, the other interventions comparing beef consumption to other food types found no consistent result. (4) Conclusions: Evidence pertaining to the impact of beef consumption on cognition remains limited due to the small and heterogeneous set of studies. Future research should adopt a population representative sample and longer follow-up period, employ a non-feeding control arm and comprehensively measure nutrient intakes among study participants.

Pediatric Oncology and Animal-Assisted Interventions: A Systematic Review.

Animal-assisted interventions are part of the therapeutic plan in pediatric oncology. This is the first systematic review to summarize the literature and provide insights for new clinical approaches, policy, best practices, and standards. The results underline the potentially beneficial role for pediatric patients, parents, caregivers, and medical staff.

Effects of isolated soluble fiber supplementation on body weight, glycemia, and insulinemia in adults with overweight and obesity: a systematic review and meta-analysis of randomized controlled trials.

Background: There is strong epidemiologic evidence that dietary fiber intake is protective against overweight and obesity; however, results of intervention studies have been mixed. Soluble fiber beneficially affects metabolism, and fiber supplementation may be a feasible approach to improve body composition and glycemia in adults with overweight and obesity.Objective: We evaluated randomized controlled trials (RCTs) of isolated soluble fiber supplementation in overweight and obese adults on outcomes related to weight management [body mass index (BMI; in kg/m2), body weight, percentage of body fat, and waist circumference] and glucose and insulin metabolism (homeostasis model assessment of insulin resistance and fasting insulin) through a systematic review and meta-analysis.Design: We searched PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature and Cochrane Library databases. Eligible studies were RCTs that compared isolated soluble fiber with placebo treatments without energy-restriction protocols. Random-effects models were used to estimate pooled effect sizes and 95% CIs. Meta-regressions were performed to assess outcomes in relation to the intervention duration, fiber dose, and fiber type. Publication bias was assessed via Begg's and Egger's tests and funnel plot inspection.Results: Findings from 12 RCTs (n = 609 participants) from 2 to 17 wk of duration are summarized in this review. Soluble fiber supplementation reduced BMI by 0.84 (95% CI: -1.35, -0.32; P = 0.001), body weight by 2.52 kg (95% CI: -4.25, -0.79 kg; P = 0.004), body fat by 0.41% (95% CI: -0.58%, -0.24%; P < 0.001), fasting glucose by 0.17 mmol/L (95% CI: -0.28, -0.06 mmol/L; P = 0.002), and fasting insulin by 15.88 pmol/L (95% CI: -29.05, -2.71 pmol/L; P = 0.02) compared with the effects of placebo treatments. No publication bias was identified. Considerable between-study heterogeneity was observed for most outcomes.Conclusions: Isolated soluble fiber supplementation improves anthropometric and metabolic outcomes in overweight and obese adults, thereby indicating that supplementation may improve fiber intake and health in these individuals. However, the interpretation of these findings warrants caution because of the considerable between-study heterogeneity. This trial was registered at clinicaltrials.gov as NCT03003897.

Clinical Outcomes of Dietary Replacement of Saturated Fatty Acids with Unsaturated Fat Sources in Adults with Overweight and Obesity: A Systematic Review and Meta-Analysis of Randomized Control Trials.

BACKGROUND: Obesity and dyslipidemia are frequently treated with dietary interventions before pharmacotherapy is given. Diets high in unsaturated fat have proven advantageous to disease treatment. AIMS: The purpose of this systematic review and meta-analysis was to assess the evidence of the effect of saturated fatty acids (SFA) replacement with unsaturated fatty acids (UFA) in metabolically healthy adults with overweight and obesity on markers of dyslipidemia and body composition. METHODS: Keyword search was performed in PubMed, CINAHL, and Cochrane Library for randomized controlled trials (RCTs) evaluating the effects of fatty acid substitution in adults with overweight and obesity. Meta-analysis was performed on interventions assessing lipoprotein levels and body composition. Publication bias was assessed by funnel plot inspection, Begg's, and Egger's test. RESULTS: Eight RCTs enrolling 663 participants were included in the review, with intervention durations between 4 and 28 weeks. Although nonsignificant (p = 0.06), meta-analysis found UFA replacement to reduce total cholesterol concentrations by 10.68 mg/dL (95%CI -21.90 to 0.53). Reductions in low-density lipoprotein cholesterol and triglycerides were statistically nonsignificant. CONCLUSIONS: Due to null results and a small number of studies included, there is no strong evidence that replacement of SFA with UFA may benefit lipid profiles in this population.

Beverage Consumption in Relation to Discretionary Food Intake and Diet Quality among US Adults, 2003 to 2012.

BACKGROUND: A majority of Americans consume beverages and discretionary foods-foods that are typically low in nutrient value but high in sugar, sodium, fats, and cholesterol-as part of their daily diet, which profoundly impacts their energy balance and nutritional status. OBJECTIVE: This study examined consumption of different types of beverages in relation to discretionary food intake and diet quality among US adults. METHODS: Nationally representative sample of 22,513 adults from the National Health and Nutrition Examination Survey 2003 to 2012 waves were analyzed. The discretionary food category identifies energy-dense, nutrient-poor food products that do not necessarily provide essential nutrients that the human body needs, but can add variety. First-difference estimator addressed confounding bias from time-invariant unobservables (eg, eating habits, taste preferences) by using within-individual variations in diet and beverage consumption between 2 nonconsecutive 24-hour dietary recalls. RESULTS: Approximately 21.7%, 42.9%, 52.8%, 26.3%, and 22.2% of study participants consumed diet beverage, sugar-sweetened beverage (SSB), coffee, tea, and alcohol, respectively, and 90.1% consumed discretionary foods on any given day. Across beverage types, alcohol (384.8 kcal) and SSB (226.2 kcal) consumption was associated with the largest increase in daily total calorie intake; coffee (60.7 kcal) and diet-beverage (48.8 kcal) consumption was associated with the largest increase in daily calorie intake from discretionary foods, and SSB consumption was associated with the largest reduction in daily overall diet quality measured by the Healthy Eating Index 2010. The impact of beverage consumption on daily calorie intake (overall and from discretionary foods) and diet quality differed across individual sociodemographics and body-weight status. The incremental daily calorie intake from discretionary foods associated with diet-beverage consumption was highest in obese adults, and that associated with SSB was highest in normal-weight adults. CONCLUSIONS: Interventions to promote healthy eating should assess beverage consumption in the context of overall dietary behavior.

Cost-Effectiveness of Nutrition Intervention in Long-Term Care.

OBJECTIVES: To determine the cost-effectiveness of two nutrition interventions on food, beverage, and supplement intake and body weight. DESIGN: Randomized, controlled trial. SETTING: Five skilled nursing home facilities. PARTICIPANTS: Long-stay residents with orders for nutrition supplementation (N = 154). INTERVENTION: Participants were randomized into a usual care control group, an oral liquid nutrition supplement (ONS) intervention group, or a snack intervention group. Research staff provided ONS, according to orders or a variety of snack foods and beverages twice per day between meals, 5 days per week for 24 weeks and assistance to promote consumption. MEASUREMENTS: Research staff independently weighed residents at baseline and monthly during the 24-week intervention. Resident food, beverage and supplement intake and the amount of staff time spent providing assistance were assessed for 2 days at baseline and 2 days per month during the intervention using standardized observation and weighed intake procedures. RESULTS: The ONS intervention group took in an average of 265 calories more per day and the snack intervention group an average of 303 calories more per day than the control group. Staff time required to provide each intervention averaged 11 and 14 minutes per person per offer for ONS and snacks, respectively, and 3 minutes for usual care. Both interventions were cost-effective in increasing caloric intake, but neither intervention had a significant effect on body weight, despite positive trends. CONCLUSION: Oral liquid nutrition supplements and snack offers were efficacious in promoting caloric intake when coupled with assistance to promote consumption and a variety of options, but neither intervention resulted in significant weight gain.

Depression and onset of cardiovascular disease in the US middle-aged and older adults.

OBJECTIVES: To examine the relationship between depression and onset of cardiovascular disease (CVD) among the US middle-aged and older adults. METHODS: The study sample came from 1992-2010 waves of the Health and Retirement Study, a nationally representative longitudinal survey, consisting of 8597 community-dwelling adults aged 51-61 years old in 1992 with no CVD history. A score of ≥3 on the 8-item Center for Epidemiologic Studies Depression Scale was used to define clinically relevant depressive symptoms. Kaplan-Meier estimator and Cox proportional hazards model were performed to examine the association between baseline depressive symptoms and future CVD event. Subgroup analyses were conducted by sex and race/ethnicity. RESULTS: Compared with their counterparts without clinically relevant depressive symptoms, adults with clinically relevant depressive symptoms in 1992 were 27% (hazard ratio [HR] = 1.27, 95% confidence interval = 1.17-1.39) more likely to report new diagnosis of CVD during the 18 years of follow-up. A significant dose-response relationship was present between severity of depressive symptoms and elevated CVD risk. The adjusted HRs for males and Hispanics appeared moderately larger than for their female and non-Hispanic white or African American counterparts, although the differences were not statistically significant. CONCLUSION: Holistic promotion of mental health through prevention, education, treatment, and rehabilitation is warranted to reduce CVD risk in the US middle-aged and older population.

Nutrient intake and use of dietary supplements among US adults with disabilities.

BACKGROUND: Physical, mental, social, and financial hurdles in adults with disabilities may limit their access to adequate nutrition. OBJECTIVE: To examine the impact of dietary supplement use on daily total nutrient intake levels among US adults 20 years and older with disabilities. METHODS: Study sample came from 2007-2008 and 2009-2010 waves of the National Health and Nutrition Examination Survey, a nationally representative repeated cross-sectional survey. Disability was classified into 5 categories using standardized indices. Nutrient intakes from foods and dietary supplements were calculated from 2 nonconsecutive 24-hour dietary recalls. Two-sample proportion tests and multiple logistic regressions were used to examine the adherence rates to the recommended daily nutrient intake levels between dietary supplement users and nonusers in each disability category. The association between sociodemographic characteristics and dietary supplement use was assessed using multiple logistic regressions, accounting for complex survey design. RESULTS: A substantial proportion of the US adult population with disabilities failed to meet dietary guidelines, with insufficient intakes of multiple nutrients. Over half of the US adults with disabilities used dietary supplements. Dietary supplement use was associated with higher adherence rates for vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, calcium, copper, iron, magnesium, and zinc intake among adults with disabilities. Women, non-Hispanic Whites, older age, higher education, and higher household income were found to predict dietary supplement use. CONCLUSIONS: Proper use of dietary supplements under the guidance of health care providers may improve the nutritional status among adults with disabilities.

Fast-food and full-service restaurant consumption in relation to daily energy and nutrient intakes among US adult cancer survivors, 2003-2012.

BACKGROUND: Healthy diet is an essential component in cancer survivorship care planning. Cancer survivors should be particularly prudent regarding their daily food choices, with an aim of ensuring safe consumption, reducing risk of recurrence or other comorbidity, and improving quality of life. OBJECTIVE: We aimed to examine the impacts of fast-food and full-service restaurant consumption on daily energy and nutrient intakes among US adult cancer survivors. METHODS: Nationally representative data of 1308 adult cancer survivors came from the National Health and Nutrition Examination Survey 2003-2012 waves. First-difference estimator was adopted to address confounding bias from time-invariant unobservables like personal food/beverage preferences by using within-individual variations in diet and restaurant consumption status between two non-consecutive 24-hour dietary recalls. RESULTS: Fast-food and full-service restaurant consumption, respectively, was associated with an increase in daily total energy intake by 125.97 and 152.26 kcal and sodium intake by 312.47 and 373.75 mg. Fast-food consumption was significantly associated with a decrease in daily vitamin A intake by 119.88 µg and vitamin K intake by 30.48 µg, whereas full-service restaurant consumption was associated with an increase in daily fat intake by 8.99 g and omega-6 fatty acid intake by 3.85 g, and a decrease in vitamin D intake by 0.93 µg. Compared with fast-food and full-service restaurant consumption at home, consumption away from home led to further reduced diet quality. CONCLUSIONS: Individualized nutrition counseling and food assistance programs should address cancer survivors' overall dining-out behavior rather than fast-food consumption alone.