Aligning front-of-pack labelling with dietary guidelines: including whole grains in the health star rating.

PURPOSE: Front-of-pack labelling systems, such as the Health Star Rating (HSR), aim to aid healthy consumer dietary choices and complement national dietary guidelines. Dietary guidelines aim to be holistic by extending beyond the individual nutrients of food, including other food components that indicate diet quality, including whole grains. We aimed to test the feasibility of including whole grains in the HSR algorithm, to better inform dietary guidance in Australia coherent with existing dietary guidelines. METHODS: We assigned whole-grain points as a favourable component of the HSR based on the whole-grain content of foods. We compared the original, and three modified HSR algorithms (including altered thresholds for star ratings) using independent-samples median tests. Finally, we used Spearman's correlation to measure the strength of association between an item's nutritional composition (all components of the HSR algorithm including all favourable and unfavourable components) and their HSR using each algorithm. RESULTS: Up to 10 points were added for products with ≥ 50% whole-grain content, with no points for products with < 25%. Adjusting the HSR score cut-off by 3 points for grain products created the greatest difference in median HSR between refined and whole-grain items (up to 2 stars difference), compared to the original algorithm (a maximum of 1 star). CONCLUSIONS: The addition of whole grains to the HSR algorithm improved the differentiation of refined and whole-grain items, and therefore better aligned with dietary guidelines. Holistic approaches to food guidance systems are required to provide consistent messaging and inform positive food choices.

The Intake of Phosphorus and Nitrites through Meat Products: A Health Risk Assessment of Children Aged 1 to 9 Years Old in Serbia.

This study provides the data on dietary exposure of Serbian children to nitrites and phosphorus from meat products by combining individual consumption data with available analytical data of meat products. A total of 2603 and 1900 commercially available meat products were categorized into seven groups and analysed for nitrite and phosphorous content. The highest mean levels of nitrite content, expressed as NaNO2, were found in finely minced cooked sausages (40.25 ± 20.37 mg/kg), followed by canned meat (34.95 ± 22.12 mg/kg) and coarsely minced cooked sausages (32.85 ± 23.25 mg/kg). The EDI (estimated daily intake) of nitrites from meat products, calculated from a National Food Consumption Survey in 576 children aged 1-9 years, indicated that the Serbian children population exceeded the nitrite ADI (acceptable daily intake) proposed by EFSA (European Food Safety Authority) in 6.4% of children, with a higher proportion in 1-3-year-old participants. The mean phosphorus concentration varied from 2.71 ± 1.05 g/kg to 6.12 ± 1.33 g/kg in liver sausage and pate and smoked meat products, respectively. The EDI of phosphorus from meat products was far below the ADI proposed by EFSA, indicating that the use of phosphorus additives in Serbian meat products is generally in line with legislation.

Academy of Nutrition and Dietetics Nutrition Research Network: The Saqmolo' Project Rationale and Study Protocol for a Randomized Controlled Trial Examining the Influence of Daily Complementary Feeding of Eggs on Infant Development and Growth in Guatemala.

Adequate nutrition during the complementary feeding period is critical for optimal child growth and development and for promoting long-term educational attainment and economic potential. To prioritize limited public health resources, there is a need for studies that rigorously assess the influence of multicomponent integrated nutrition interventions in children younger than age 2 years in different contexts. This study aimed to describe the rationale and protocol for the Saqmolo' Project using the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. The Saqmolo' (ie, "egg" in the Mayan language, Kaqchiquel) Project is an individually randomized, partially blinded, controlled comparative effectiveness trial to evaluate the influence of adding delivery of a single whole egg per day to local standard nutrition care (ie, growth monitoring, medical care, deworming medication, multiple micronutrient powders for point-of-use food fortification [chispitas], and individualized complementary and responsive feeding education for caregivers) for 6 months, compared with the local standard nutrition care package alone, on child development, growth, and diet quality measures in rural indigenous Mayan infants aged 6 to 9 months at baseline (N = 1,200). The study is being executed in partnership with the Wuqu' Kawoq/Maya Health Alliance, a primary health care organization located in central Guatemala. Primary outcomes for this study are changes in global development scores, assessed using the Guide for Monitoring Global Development and the Caregiver Reported Child Development Instruments. Secondary outcomes include changes in infant hemoglobin, anthropometric measures (including z scores for weight for age, length for age, weight for length, and head circumference for age), and diet quality as measured using the World Health Organization's infant and young child feeding indicators. The results of the Saqmolo' Project may help to inform public health decision making regarding resource allocation for effective nutrition interventions during the complementary feeding period.

Do Older Women of Reproductive Age Have Better Diet Quality than Younger Women of Reproductive Age?

There is increasing recognition of the importance of nutrition for reproductive health, but little is known regarding the diet quality of younger vs. older reproductive aged women, and how their intakes relate to dietary recommendations. The purpose of the study was to examine the diets of younger (19-35 years old) compared to older (35-50 years old) reproductive aged women, and how they align with dietary recommendations. Women aged 19-50 years from the 2011-13 Australian National Nutrition and Physical Activity Survey were included (n = 2323). Dietary intakes were assessed by a single 24-h dietary recall and were compared to (i) Australian Dietary Guidelines; (ii) Acceptable Macronutrient Distribution for protein, carbohydrates, and fat; and (iii) Dietary Guideline Index (DGI). Regression analyses comparing younger and older women against recommendations were undertaken, with confounders determined a priori. There was no difference between older and younger women in meeting food group recommendations, with 26% of all women meeting recommendations for fruit, and meat and alternatives, and <20% meeting recommendations for vegetables and alternatives, grains, and dairy. Although there was no difference between older and younger women in total DGI score (mean (SE) 75.6 (1.7) vs. 74.5 (2.5), p > 0.05), older women had higher component scores in limiting saturated fat, consuming low-fat milk, and limiting adding salt during cooking. Continued health promotion for women of reproductive age should be a key priority to improve their own health and that of future generations.

Effects of Early Weight Gain Velocity, Diet Quality, and Snack Food Access on Toddler Weight Status at 1.5 Years: Follow-Up of a Randomized Controlled Infant Formula Trial.

This study followed children who participated in a feeding trial in which the type of randomized infant formula fed from 2 weeks significantly affected weight gain velocity during the first 4 months and weight-for-length Z (WLZ) scores up to 11.5 months. We focused on measures of anthropometry, dietary intakes, and parenting related to the provision of snack foods that were collected at the end of the trial (1 year) and the 1.5 years follow-up visit. We not only describe what toddlers are eating, but we also determined the independent and/or interactive effects of randomized formula group, early weight gain velocity, the nutrient content of the post-formula diet, and maternal snack food practices, on toddlers' weight status. Diet quality underwent drastic changes during this 6-month period. As infant formula disappeared from the diet, fruit and 100% fruit juice intake increased slightly, while intake of "What We Eat in America" food categories sweetened beverages and snacks and sweets more than doubled. Added sugars accounted for 5% of energy needs at 1 year and 9% at 1.5 years. Generalized linear mixed models revealed that, independent of the randomized formula group, greater velocities of weight gain during early infancy and lower access to snacks as toddlers predicted higher WLZ and a greater proportion of toddlers with overweight at 1.5 years. Energy and added sugar intake had no significant effects. These findings add to the growing body of evidence that unhealthy dietary habits are formed even before formula weaning and that, along with improving early diet, transient rapid weight gain and parental feeding practices are modifiable determinants that may reduce risks for obesity.

Southwest Harvest for Health: An Adapted Mentored Vegetable Gardening Intervention for Cancer Survivors.

Harvest for Health is a home-based vegetable gardening intervention that pairs cancer survivors with Master Gardeners from the Cooperative Extension System. Initially developed and tested in Alabama, the program was adapted for the different climate, growing conditions, and population in New Mexico. This paper chronicles the feasibility, acceptability, and preliminary efficacy of "Southwest Harvest for Health". During the nine-month single-arm trial, 30 cancer survivor-Master Gardener dyads worked together to establish and maintain three seasonal gardens. Primary outcomes were accrual, retention, and satisfaction. Secondary outcomes were vegetable and fruit (V and F) intake, physical activity, and quality of life. Recruitment was diverse and robust, with 30 survivors of various cancers, aged 50-83, roughly one-third minority, and two-thirds females enrolled in just 60 days. Despite challenges due to the COVID-19 pandemic, retention to the nine-month study was 100%, 93% reported "good-to-excellent" satisfaction, and 87% "would do it again." A median increase of 1.2 servings of V and F/day was documented. The adapted home-based vegetable gardening program was feasible, well-received, and resulted in increased V and F consumption among adult cancer survivors. Future studies are needed to evaluate the effectiveness of this program and to inform strategies to increase the successful implementation and further dissemination of this intervention.

Food Choice Decisions of Collegiate Division I Athletes: A Qualitative Exploratory Study.

Limited research has examined athletes' food and health beliefs and decisions and the congruence of these decisions with recommendations from nutrition professionals. This study aimed to improve understanding of athletes' food-related beliefs and practices to enable nutrition professionals to more effectively enhance performance while protecting athletes' health. Division I college athletes (n = 14, 64% female) from a variety of sports were recruited to participate in 20-min semi-structured phone interviews about food and nutrition-related behaviors and cognitions. Data were content analyzed to identify themes and trends. Prominent factors influencing athletes' food choices were potential benefits to health and performance, availability of foods, and recommendations from sports dietitians. Foods commonly consumed by athletes, including fruits, vegetables, and lean protein, were generally healthy and aligned with sports nutrition recommendations. Athletes avoided energy-dense nutrient-poor foods, such as fast food and fried foods, with the goal of improving performance. Some athletes took supplements (i.e., multivitamin, iron, protein) on the premise that they would improve health and enhance performance or recovery. While athletes' nutrition behaviors are generally congruent with current recommendations, findings highlighted misconceptions held by athletes related to the benefits of some supplements and the belief that packaged/processed foods were inherently less healthy than other options. Nutrition misconceptions held by athletes and incongruities between athletes' nutrition knowledge and behaviors suggest that dietitians should aim to dispel misconceptions held by athletes and provide additional guidance and information to support athletes' current healthful behaviors to ensure these behaviors extend beyond their college athletic career.

Associations between Diet Quality and Anthropometric Measures in White Postmenopausal Women.

The purpose of this cross-sectional study was to examine the relationship between diet and anthropometric measures in postmenopausal women. Data collected from 937 women enrolled in the Minnesota Green Tea Trial (NTC00917735) were used for this analysis. Dietary intake and health-related data were collected via questionnaires. Body weight, height, and waist circumference (WC) were measured by the study staff. The mean age of participants was 59.8 years and mean WC was 83 cm. Approximately 30% of the participants had WC greater than 88 cm. Healthy Eating Index-2015 score was 72.6 and the Dietary Inflammatory Index score was 0. Intakes of whole grains, dairy, protein, sodium, and saturated fat did not meet the dietary guidelines. Only 12.5% consumed the recommended daily amount of calcium (mean intake = 765 mg/day). When calcium supplements were considered, only 35.2% of the participants had adequate intakes, even though 68.9% reported taking a calcium supplement. We found that age and number of medications taken were significantly associated with waist circumference (p = 0.005). Women who reported taking two or more medications had greater WC (85 cm) compared to women who reported not taking any medications (82.2 cm), p = 0.002. Our findings suggest that achieving adequate calcium and vitamin D intake may be challenging to postmenopausal women.

Socio-Demographic Characteristics, Body Weight Status and Energy Intake among Users and Non-Users of Dietary Supplements among Government Employees in Putrajaya, Malaysia.

The use of dietary supplements is prevalent among many groups worldwide. However, few studies have examined their use among government employees. The aim of this cross-sectional study was to determine the association among sociodemographic characteristics, body weight status, and energy intake with dietary supplement use among government employees in Putrajaya, Malaysia. Simple random sampling was used to select a sample of 460 government employees from six ministries in Putrajaya, Malaysia. The data used in this study were collected through anthropometric measurements (height, weight, % body fat, waist and hip circumferences), a self-administered questionnaire (sociodemographic characteristics and dietary supplements use), and an interviewer-administered questionnaire (24-hour dietary recall; fruit and vegetable intake). The results indicated that the prevalence of dietary supplement use was 55.4%, with vitamin C (38.4%) being the most popular type of dietary supplement. Health issues (80.8%) were the most common reason for usage, internet (59.2%) was the main source of information, and pharmacies (71.8%) were the most indicated places to purchase dietary supplements. A multivariate analysis showed that participants who were female, married, had better monthly income, lived within a smaller household size, had a normal body mass index, classified as having unhealthily high body fat percentage, did not skip breakfast, and consumed at least five servings of fruits and vegetables per day were significantly more likely to use dietary supplements. In conclusion, health-conscious groups were more prone to consume dietary supplements, and due to the high prevalence of dietary supplement use, dissemination of accurate scientific information regarding dietary supplements is highly recommended among government employees.

Process Evaluation of a Farm-to-WIC Intervention.

BACKGROUND: Despite the promise of farm-to-institution interventions for addressing limited vegetable access as a barrier to intake, programs designed for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lacking. As such, little is known about the implementation of, and mechanisms of action through which, farm-to-WIC interventions affect vegetable intake and participant satisfaction with such programs. OBJECTIVE: To examine whether a farm-to-WIC intervention to promote vegetable intake was implemented as intended, differences between participants who received the intervention relative to those in a usual-care control group in intermediate outcomes of vegetable-related knowledge, attitudes, and behaviors, and secondary outcomes of physical activity and weight status; and participant satisfaction with the intervention. DESIGN: A process evaluation encompassing descriptive and comparative analyses of implementation fidelity logs and survey data collected as part of a pilot study was conducted. PARTICIPANTS/SETTING: The setting was a large, New Jersey-based, urban WIC agency. Recruited between June 3 and August 1, 2019 through 3 of the agency's 17 sites (1 intervention and 2 control sites), participants were 297 primarily Hispanic adults (160 enrolled at the intervention site and 137 at control sites). INTERVENTION: The intervention combined behaviorally focused instruction and handouts with the introduction of a WIC-based farmers' market, field trips to an area farmers' market, telephone coaching and support, and recipe demonstrations and tastings. MAIN OUTCOME MEASURES: Primary outcomes were vegetable intake (measured via self-report and objectively using dermal carotenoids as a biomarker of intake) and the redemption of vouchers provided by WIC for fruit and vegetable purchases at farmers' markets (measured objectively using data provided by WIC). For the process evaluation, logs were used to document program activities. Vegetable-related knowledge, attitudes, and behaviors, physical activity, and satisfaction with the intervention were assessed with participant questionnaires. Weight status was assessed with direct measures of height and weight. Data were collected at baseline and at mid- and post-intervention (3 and 6 months post-baseline, respectively). STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to characterize implementation fidelity. Associations between intermediate and secondary outcomes and vegetable intake were examined at baseline with Pearson correlations. Post-baseline between-group differences in the outcomes were examined with linear mixed-effects models adjusted for baseline values and covariates. Satisfaction with the intervention was assessed with inferential and thematic analyses. RESULTS: Post-intervention, measures of vegetable intake were higher in the intervention relative to the control study group. Receipt of the intervention was also associated with a greater likelihood of voucher redemption. Nearly all participants (≥94%) received the intervention as intended at the WIC-based farmers' market; smaller percentages completed 1 or more planned trips to the area farmers' market (28%) and telephone coaching and support calls (88%). Although most intermediate and secondary outcomes were associated with measures of vegetable intake at baseline, the variables did not differ between study groups post-intervention. Mean satisfaction ratings were ≥6.8 on a 7-point scale. Recipe demonstrations, learning about vegetables, field trips, and the rapport with staff were liked most about the program. Although adding days and times for field trips was suggested, limited market days and hours of operation limited the ability to do so. CONCLUSIONS: Preliminary data highlight the promise of this well-received intervention. Intermediate outcome findings suggest that other potential intervention mechanisms of action should be considered in future large-scale trials of this program. Broad-scale initiatives are needed to improve access to farmers' markets in underserved communities.

Evaluation of Nutrient Intake and Food Consumption among Dutch Toddlers.

Improving dietary habits at a young age could prevent adverse health outcomes. The aim was to gain insight into the adequacy of the dietary intake of Dutch toddlers, which may provide valuable information for preventive measures. Data obtained from the Dutch National Food Consumption Survey 2012-2016 were used, which included 672 children aged one to three years. Habitual intakes of nutrients were evaluated according to recommendations set by the Dutch Health Council. Specific food groups were evaluated according to the Dutch food-based dietary guidelines. For most nutrients, intakes were estimated to be adequate. High intakes were found for saturated fatty acids, retinol, iodine, copper, zinc, and sodium. No statement could be provided on the adequacy of intakes of alpha-linoleic acids, N-3 fish fatty acids, fiber, and iron. 74% of the toddlers used dietary supplements, and 59% used vitamin D supplements specifically. Total median intakes of vegetables, bread, and milk products were sufficient. Consumption of bread, potatoes and cereals, milk products, fats, and drinks consisted largely of unhealthy products. Consumption of unfavorable products may have been the cause of the observed high and low intakes of several nutrients. Shifting towards a healthier diet that is more in line with the guidelines may positively affect the dietary intake of Dutch toddlers and prevent negative health impacts, also later in life.

Dietary recommendations during the Covid-19 pandemic. Statement of the Committee of Human Nutrition Science of the Polish Academy of Sciences.

During the COVID-19 pandemic, care for an adequate diet, well adapted to the body's needs and the current level of physical activity, becomes of particular importance. Many dietary compounds participate in the functioning of the immune system, while vitamins D, C, A (including beta-carotene), E, B6, B12, folic acid, zinc, copper, selenium, iron, amino acids, n-3 and n-6 polyunsaturated fatty acids and intestinal microbiota are crucial in various types of defence processes. There has been no evidence that consumed food and its compounds, including those with pro-/prebiotic properties, play a significant role in preventing SARS-CoV-2 infection or alleviating its course. However, in terms of the nutritional value of food and the prevention of dysbiosis, recommending a varied diet with a high proportion of plant-based foods and an adequate amount of animal-based foods has a sound scientific basis. Malnutrition, underweight and obesity are considered independent and prognostic risk factors of severe SARS-CoV-2 infection, which reduce a patient's chances of survival. Therefore, ensuring good nutritional status, including healthy body weight, is a reasonable approach in the prevention of viral infection SARS-CoV-2 or alleviating its course. The document is accompanied by two catalogues of practical nutritional recommendations during the COVID-19 pandemic, addressed to the general population and children.

Achievement of the Targets of the 20-Year Infancy-Onset Dietary Intervention-Association with Metabolic Profile from Childhood to Adulthood.

The Special Turku Coronary Risk Factor Intervention Project (STRIP) is a prospective infancy-onset randomized dietary intervention trial targeting dietary fat quality and cholesterol intake, and favoring consumption of vegetables, fruit, and whole-grains. Diet (food records) and circulating metabolites were studied at six time points between the ages of 9-19 years (n = 549-338). Dietary targets for this study were defined as (1) the ratio of saturated fat (SAFA) to monounsaturated and polyunsaturated fatty acids (MUFA + PUFA) < 1:2, (2) intake of SAFA < 10% of total energy intake, (3) fiber intake ≥ 80th age-specific percentile, and (4) sucrose intake ≤ 20th age-specific percentile. Metabolic biomarkers were quantified by high-throughput nuclear magnetic resonance metabolomics. Better adherence to the dietary targets, regardless of study group allocation, was assoiated with higher serum proportion of PUFAs, lower serum proportion of SAFAs, and a higher degree of unsaturation of fatty acids. Achieving ≥ 1 dietary target resulted in higher low-density lipoprotein (LDL) particle size, lower circulating LDL subclass lipid concentrations, and lower circulating lipid concentrations in medium and small high-density lipoprotein subclasses compared to meeting 0 targets. Attaining more dietary targets (≥2) was associated with a tendency to lower lipid concentrations of intermediate-density lipoprotein and very low-density lipoprotein subclasses. Thus, adherence to dietary targets is favorably associated with multiple circulating fatty acids and lipoprotein subclass lipid concentrations, indicative of better cardio-metabolic health.

Pilot Study of a Farm-to-Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Intervention Promoting Vegetable Consumption.

BACKGROUND: Vegetable intake is below recommended levels among adults served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). OBJECTIVE: The aim of this study was to determine whether a novel, theory-driven, farm-to-WIC intervention to promote vegetable intake showed promise of being successful and is therefore appropriate for efficacy testing. DESIGN: From June 2019 to January 2020, the intervention was piloted in three WIC agency sites (one randomized to the intervention study group and two to the control group) selected based on similarity in size and the demographics of participants served. PARTICIPANTS/SETTING: Recruited between June 3, 2019 and August 1, 2019, participants were 297 primarily Hispanic adults served by a large WIC agency located in a densely populated urban area in New Jersey (160 were enrolled at the intervention site and 137 at control sites). INTERVENTION: The intervention combined behaviorally focused instruction and handouts with the introduction of a WIC-based farmers' market, field trips to an area farmers' market, telephone coaching and support before and after trips, and recipe demonstrations and tastings. MAIN OUTCOME MEASURES: The primary outcomes were vegetable intake (measured objectively using dermal carotenoids as a biomarker of intake and via self-report) and the redemption of vouchers provided through the WIC Farmers' Market Nutrition Program (FMNP) for fruit and vegetable purchases at farmers' markets (objectively assessed using data provided by WIC). STATISTICAL ANALYSES PERFORMED: Between-group differences in vegetable intake were examined at mid- and post-intervention (3 and 6 months post-baseline, respectively) with linear mixed-effects models adjusted for baseline vegetable intake and covariates. Logistic regression analysis was used to relate FMNP voucher redemption to study group and covariates. RESULTS: At mid-intervention, objectively measured vegetable intake was higher among participants in the control group as compared with the intervention group; self-reported intake did not differ by group. Post-intervention, objectively measured and self-reported vegetable intake were higher among participants in the intervention group as compared with the control group. Receipt of the intervention was associated with a greater likelihood of FMNP voucher redemption. Voucher redemption rates were 87% in the intervention group and 28% in the control group (odds ratio = 17.39, 95% confidence interval [8.64, 35.02]). CONCLUSIONS: Meaningful associations found between the intervention, vegetable intake, and FMNP voucher redemption suggest that the program is appropriate for efficacy testing.

Comparison of Different Dietary Indices as Predictors of Inflammation, Oxidative Stress and Intestinal Microbiota in Middle-Aged and Elderly Subjects.

During the last decades the gut microbiota has been identified as a key mediator in the diet-health interaction. However, our understanding on the impact of general diet upon microbiota is still limited. Dietary indices represent an essential approach for addressing the link between diet and health from a holistic point of view. Our aim was to test the predictive potential of seven dietary ratings on biomarkers of inflammation, oxidative stress and on the composition and metabolic activity of the intestinal microbiota. A cross-sectional descriptive study was conducted on a sample of 73 subjects aged >50 years with non-declared pathologies. Dietary inflammatory index (DII), Empirical Dietary Inflammatory Index (EDII), Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), Mediterranean adapted Diet Quality Index-International (DQI-I), Modified Mediterranean Diet Score (MMDS) and relative Mediterranean Diet Score (rMED) were calculated based on a Food Frequency Questionnaire. Major phylogenetic types of the intestinal microbiota were determined by real time polymerase chain reaction (qPCR) and fecal short chain fatty acids (SCFAs) by gas chromatography. While DII, HEI, DQI-I and MMDS were identified as predictors of Faecalibacterium prausnitzii levels, AHEI and MMDS were negatively associated with Lactobacillus group. HEI, AHEI and MMDS were positively associated with fecal SCFAs. In addition, DII and EDII explained lipoperoxidation level and Mediterranean scores the serum IL-8 concentrations. The lower detection of IL-8 in individuals with higher scores on Mediterranean indices may be partially explained by the increased levels of the anti-inflammatory bacterium F. prausnitzii in such individuals.

Dietary Inadequacy, Micronutrient Deficiencies, and Approaches to Preventing Poor Nutrition in the Gaza Strip.

Palestine refugees comprise the largest refugee population in the world, most of whom are encamped in Middle Eastern countries. In the Gaza Strip, where ∼1.4 million Palestinians reside, there are high prevalences of anemia and multiple micronutrient deficiencies (MNDs), including those of iron, zinc, vitamins A, B12, D, and E, ranging from 11.4% to 84.7% among pregnant women and 2.9% to 70.9% among preschool children. Dietary diversification and adequate food fortification are framed in policies but remain aspirational goals. Alternative, effective, targeted preventive approaches include, for women, replacement of antenatal iron-folic acid with multiple micronutrient supplementation, and for young children, point-of-use multiple micronutrient powder fortification to prevent anemia, both of which can reduce other MNDs and may bring additional health benefits. These interventions coupled with monitoring of dietary intakes, periodic assessment of MNDs, and implementation research to improve existing nutrition interventions are warranted to protect the health of the Middle East Palestinian diaspora.

Do the Dietary Intakes of Pregnant Women Attending Public Hospital Antenatal Clinics Align with Australian Guide to Healthy Eating Recommendations?

The maternal diet influences the long-term health status of both mother and offspring. The current study aimed to compare dietary intakes of pregnant women compared to food and nutrient recommendations in the Australian Guide to Healthy Eating (AGHE) and Nutrient Reference Values (NRVs). Usual dietary intake was assessed in a sample of women in their 3rd trimester of pregnancy attending antenatal outpatient clinics at John Hunter Hospital, Newcastle, New South Wales (NSW). Dietary intake was measured using the Australian Eating Survey, a validated, semi-quantitative 120-item food frequency questionnaire. Daily food group servings and nutrient intakes were compared to AGHE and NRV targets. Of 534 women participating, none met the AGHE recommendations for all food groups. Highest adherence was for fruit serves (38%), and lowest for breads and cereals (0.6%). Only four women met the pregnancy NRVs for folate, iron, calcium, zinc and fibre from food alone. Current dietary intakes of Australian women during pregnancy do not align with national nutrition guidelines. This highlights the importance of routine vitamin and mineral supplementation during pregnancy, as intakes from diet alone may commonly be inadequate. Future revisions of dietary guidelines and pregnancy nutrition recommendations should consider current dietary patterns. Pregnant women currently need more support to optimise food and nutrient intakes.

Dietary Quality and Usual Intake of Underconsumed Nutrients and Related Food Groups Differ by Food Security Status for Rural, Midwestern Food Pantry Clients.

BACKGROUND: Food pantry users represent a predominantly food insecure population, yet dietary intake may differ among food secure (FS), low FS, and very low FS clients. Usual intake of food groups and nutrients by food security status has not previously been compared among food pantry clients. OBJECTIVE: This study aimed to estimate the usual intakes of underconsumed nutrients (ie, potassium; dietary fiber; choline; magnesium; calcium; vitamins A, D, E, and C; and iron) and related food groups (ie, vegetables, fruits, whole grains, and dairy) and dietary quality, and to evaluate their relationship with food security status. DESIGN: This cross-sectional, secondary analysis used baseline data from a prior intervention study (Clinical Trial Registry: NCT03566095). A demographic questionnaire, the US Household Food Security Survey Module, and up to three 24-hour dietary recalls on nonconsecutive days, including weekdays and weekends, were collected. PARTICIPANTS/SETTING: This community-based study included a convenience sample of adult, midwestern food pantry clients (N=579) recruited from August to November 2014. MAIN OUTCOME MEASURES: Main outcomes evaluated were Healthy Eating Index-2010 scores and usual intakes of underconsumed nutrients and related food groups. STATISTICAL ANALYSES PERFORMED: Linear regression models and the National Cancer Institute method, adjusting for confounders, were used to estimate associations of food security with diet quality and usual intake, respectively. RESULTS: Being FS was associated with a higher whole grains HEI-2010 score and higher mean usual intake of whole grains compared with being low FS. Being FS was associated with higher usual intakes of iron and dairy compared with being very low FS. Being FS was associated with a higher mean usual intake of dark green vegetables compared with being low FS and very low FS. Usual intakes were below federal guidance for all subgroups of food security. CONCLUSIONS: Although food security status may differentiate dietary intake among food pantry clients, improvements are needed among all clients.

Metabolites, Nutrients, and Lifestyle Factors in Relation to Coffee Consumption: An Environment-Wide Association Study.

Coffee consumption has been inversely associated with various diseases; however, the underlying mechanisms are not entirely clear. We used data of 17,752 Third National Health and Nutrition Examination Survey participants to investigate the association of 245 metabolites, nutrients, and lifestyle factors with coffee consumption. We used data from the first phase (n = 8825) to identify factors with a false discovery rate of <5%. We then replicated our results using data from the second phase (n = 8927). Regular coffee consumption was positively associated with active and passive smoking, serum lead and urinary cadmium concentrations, dietary intake of potassium and magnesium, and aspirin intake. In contrast, regular coffee consumption was inversely associated with serum folate and red blood cell folate levels, serum vitamin E and C, and beta-cryptoxanthin concentrations, Healthy Eating Index score, and total serum bilirubin. Most of the aforementioned associations were also observed for caffeinated beverage intake. In our assessment of the association between coffee consumption and selected metabolites, nutrients, and lifestyle factors, we observed that regular coffee and caffeinated beverage consumption was strongly associated with smoking, serum lead levels, and poorer dietary habits.