'Old Is Gold': How Traditional Indian Dietary Practices Can Support Pediatric Diabetes Management.

Nutrition is crucial for maintaining normal growth, development, and glycemic control in young people with diabetes (PwD). Undue restrictions cause nutrient deficiencies as well as poor adherence to meal plans. Widespread availability of low-cost, ultra-processed, and hyperpalatable food is further damaging. Most families struggle to find ways to provide nutritious, yet attractive, food with a low glycemic index (GI). India is one of the oldest continuous civilizations with a rich and diverse cultural and culinary heritage. Traditional dietary practices, including the centuries-old 'Thali' (meaning plate) concept, emphasize combinations (grains, lentils, vegetables, dairy, spices, prebiotics and probiotics, and fats) of local, seasonal, and predominantly plant-based ingredients. These practices ensure that all of the necessary food groups are provided and fit well with current evidence-based recommendations, including the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 Guidelines. Techniques for the preparation, cooking, and preservation of food further impact the GI and nutrient availability. These practices benefit nutrient density, diet diversity, and palatability and thus improve adherence to meal plans and glycemic control. This narrative review describes the ancient wisdom, food composition, and culinary practices from across India which are still valuable today. These may be of benefit worldwide to improve glycemic control as well as quality of life, especially in PwD.

The Need for Culturally Competent Care Within Gastroenterology Services: Evidence from Research with Adults of South Asian Origin Living with Inflammatory Bowel Disease.

BACKGROUND AND AIMS: It is widely acknowledged that the incidence of inflammatory bowel disease [IBD] is rising within South Asian populations, yet research into the experiences of this group of patients is rare. In this study the lived experiences of UK South Asian adults with IBD, including support from gastroenterology services, was investigated. METHODS: A sample of 33 patients representing the diversity of the UK South Asian population were recruited through five gastroenterology clinics in England. In-depth semi-structured interviews were conducted, audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Although many experiences align with those of the general IBD population, participants believed that South Asian cultures and/or religions can lead to additional challenges. These are linked to: family and friends' understanding of IBD; self and family attributions regarding IBD; stigma surrounding ill health; the taboo of bowel symptoms; managing 'spicy food'; beliefs about food and ill health; roles within the family; living with extended family; the use of complementary and alternative therapies; and visits to family overseas. Religious faith helped many to cope with having IBD, but symptoms could hamper their ability to practise faith. Gastroenterology services were viewed positively, but unmet needs were identified, some of which were culturally specific. CONCLUSION: Gastroenterology services have an important role to play in helping patients to overcome the challenges they encounter in their everyday life, both by providing individual patients with culturally appropriate care and advice, and via interventions to increase awareness and understanding of IBD within wider South Asian communities.

Where we eat is who we are: a survey of food-related travel patterns to Singapore's hawker centers, food courts and coffee shops.

BACKGROUND: The development of empirically-grounded policies to change the obesogenic nature of urban environment has been impeded by limited, inconclusive evidence of the link between food environments, dietary behaviors, and health-related outcomes, in part due to inconsistent methods of classifying and analyzing food environments. This study explores how individual and built environment characteristics may be associated with how far and long people travel to food venues,that can serve as a starting point for further policy-oriented research to develop a more nuanced, context-specific delineations of 'food environments' in an urban Asian context. METHODS: Five hundred twenty nine diners in eight different neighborhoods in Singapore were surveyed about how far and long they travelled to their meal venues, and by what mode. We then examined how respondents' food-related travel differed by socioeconomic characteristics, as well as objectively-measured built environment characteristics at travel origin and destination, using linear regression models. RESULTS: Low-income individuals expended more time traveling to meal destinations than high-income individuals, largely because they utilized slower modes like walking rather than driving. Those travelling from areas with high food outlet density travelled shorter distances and times than those from food-sparse areas, while those seeking meals away from their home and work anchor points had lower thresholds for travel. Respondents also travelled longer distances to food-dense locations, compared to food-sparse locations. CONCLUSION: Those seeking to improve food environments of poor individuals should consider studying an intervention radius pegged to typical walking distances, or ways to improve their transport options as a starting point. Policy-focused research on food environments should also be sensitive to locational characteristics, such as food outlet densities and land use.

Compromised Vitamin B12 Status of Indian Infants and Toddlers.

BACKGROUND: Vitamin B12 deficiency is prevalent worldwide especially in vegetarian communities. Its deficiency in early childhood may result in serious neurological and cognitive deficits. It is important to know the prevalence among our infants and toddlers so that nutritional policy changes could be suggested in this regard. OBJECTIVE: To evaluate the vitamin B12 status of apparently healthy Indian children between 6 and 23 months of age. METHODS: Apparently healthy Indian children (n = 210), of age 6 to 23 months, attending pediatric outpatient department were recruited and samples obtained to evaluate their hemogram and levels of vitamin B12, folate, and ferritin. Data were analyzed to obtain the mean levels and the proportion of participants deficient in vitamin B12. The dietary habits of the children were also analyzed and correlated with their vitamin B12 status. RESULTS: Vitamin B12 deficiency was observed in 37.6% of the participants. CONCLUSIONS: There is a high prevalence of vitamin B12 deficiency in our infants and toddlers, and there is need to initiate supplement to prevent any possible neurological consequences. Early initiation of animal milk had a positive effect on the vitamin B12 status of the child, though it was not significant.

The Retail Food Environment, Store Foods, and Diet and Health among Indigenous Populations: a Scoping Review.

PURPOSE OF THE REVIEW: Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS: Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.

Prelacteal feeding practices in Pakistan: a mixed-methods study.

BACKGROUND: Prelacteal feeding, the feeding a newborn substances or liquids before breastfeeding, is a common cultural practice in Pakistan, but is associated with neonatal morbidity and mortality because it delays early initiation of breastfeeding. In this study, we sought to examine the social and cultural factors associated with prelacteal feeding in Pakistan. METHODS: This mixed-method study used data from the Pakistan Demographic and Health Survey (PDHS) 2012-13. Findings from the survey were complemented by qualitative interviews with mothers and healthcare providers. In a subset of PDHS dyads (n = 1361) with children (0-23 months), descriptive statistics and bivariate and multivariable logistic regression analysis examined factors associated with prelacteal feeding. The qualitative study included in-depth interviews with six mothers and six health care providers, which were analyzed using NVivo software version 10. RESULTS: In PDHS, a majority of children (64.7%) received prelacteal feeding. The most common prelacteal food was milk other than breast milk (24.5%), while over a fifth (21.8%) of mothers reported giving honey and sugar water. Factors associated with prelacteal feeding included: birth at public health facilities (AOR 0.46, 95% CI 0.02, 0.95), maternal primary education (AOR 2.28, 95% CI 1.35, 3.85), and delayed breastfeeding initiation (AOR 0.03, 95% CI 0.01, 0.61). In our qualitative study, the major themes found associated with prelacteal feedings included: easy access to prelacteal substances at health facilities, deliveries in private health facilities, prelacteals as a family tradition for socialization, insufficient breast milk, Sunna of Holy Prophet, and myths about colostrum. CONCLUSIONS: These data indicate that prelacteal feeding is a well-established practice and social norm in Pakistan. Policies and interventions aimed at promoting breastfeeding need to take these customs into consideration to achieve the desired behavioral changes.

Food, culture, and identity in multicultural societies: Insights from Singapore.

The choice of food practices can be influenced by one's identity in many societies, but has mostly been evaluated in light of the maintenance of cultural identity in migrant populations. This study focused on understanding the influence of identity on food practices among individuals in multicultural societies. We conducted 18 focus group discussions (n = 130) among Indian, Chinese and Malay women in Singapore. Focus group transcripts were analysed using Thematic Analysis both inductively and deductively. Deductive analysis was framed within a Social Representations Approach, a social psychological theory that allows a deeper understanding of the contextual aspects of identity. Participants highlighted the central position of food in social events, cultural celebrations, and persistent traditional beliefs about health (such as 'hot-cold balance'). These beliefs extended to the perception of certain traditional foods possessing medicinal properties. Importantly, the consumption of these traditional foods was accepted as necessary for the maintenance of health by the women. We propose that while cultural food practices are integral to identity preservation and identity continuity for Singaporean women from all three racial groups, this is different to other multicultural societies such as Canada where communities preserve their cultural food practices, in part, due to fear of cultural identity loss. In addition, cross-cultural food practices are readily adopted in participants' daily lives for a number of reasons such as the promotion of health, convenience, and variety. At times, this adoption blurred boundaries between different cultural cuisines. Food practices in multicultural societies like Singapore are thus a reflection of everyday multiculturalism, multicultural social policies, and attitudes towards traditional healthful food practices, and these aspects need to be considered in the development of public health policies and interventions.

Tackling the question of micronutrients intake as one of the main levers in terms of Inuit food security.

PURPOSE OF REVIEW: The Inuit population living in North Canada is facing a drastic change in lifestyle, which has brought about a dramatic nutrition transition characterized by a decrease in the traditional foods consumption and an increasing reliance on processed, store-bought foods. This rapid dietary shift leads to a significant public health concern, as wild-harvested country foods are rich in many micronutrients including vitamins, trace elements and minerals while the most frequently eaten Western foods mainly provide energy, fat, carbohydrates and sodium. This review addresses the emerging strategies to tackle food insecurity in this population. RECENT FINDINGS: Recent studies indicate that diets with a higher fraction of traditional foods (and a lower fraction of ultra-processed foods) exhibit a better Healthy Eating Index. This provides a basis to develop new dietary policies anchored in contemporary food realities. SUMMARY: In Northern remote communities, improving food security requires holistic approaches. A mixed strategy that targets the revitalization of traditional foods systems and local food production initiatives seems the most promising strategy, to meet the dietary needs in terms of micronutrients, with respect to the cultural identity of local populations.

Educational nutritional intervention program improved the quality of diet of women with breast cancer in adjuvant treatment / Programa de intervenção nutricional educativa melhorou a qualidade da dieta de mulheres com câncer de mama em tratamento adjuvante

ABSTRACT Objective To assess the outcome of an educational nutritional intervention in the quality of diet of women with breast cancer in adjuvant treatment. Methods Women with breast cancer and admitted for surgical treatment were divided in an intervention group (n=18) and a comparison group (n=78), and participated in a nonrandomized clinical trial. Participants were assessed before and after the treatment and/or intervention. A food frequency questionnaire was applied and the quality of diet was calculated using the Brazilian Healthy Eating Index Revised. The educational nutritional intervention lasted 12 months and was carried out through phone calls twice a month, personal meetings, and monthly handouts. It oriented an intake of at least 400g of vegetables and fruits per day and at most 500g of red/processed meat per week. Results We observed a significant improvement in the diet quality of the intervention group (+5.7). Nutritional education in the intervention group reached its objectives, with a rise in the intake of vegetables and fruits reflecting a significant increase in the score of total fruits (+1.9) and whole fruits (+1.1), and a decrease in the score of meat, eggs, and legumes (-3.3) by means of a reduction in the intake of red/processed meat (p<0.05). Also, a rise in the punctuation of calories from solid fats, alcohol, and added sugar was observed (+5.0, p<0.05) due to lower intake of these components. The comparison group presented no significant differences. Conclusion The nutritional intervention contributed to improving the quality of the diet during breast cancer treatment and possibly altered these women's prognoses.

RESUMO Objetivo O estudo objetivou analisar o impacto de uma intervenção nutricional educativa na qualidade da dieta de mulheres com câncer de mama em tratamento adjuvante. Métodos Mulheres com câncer de mama admitidas para tratamento cirúrgico, divididas em grupo intervenção (n=18) e grupo comparação (n=78), participaram de um ensaio clínico não randomizado. As participantes foram avaliadas antes e após o tratamento e/ou intervenção. Um questionário de frequência alimentar foi aplicado, e a qualidade da dieta foi calculada pelo Índice de Qualidade da Dieta Revisado. A intervenção nutricional educativa ocorreu por meio de ligações quinzenais, encontros presenciais e materiais informativos, durante 12 meses, com orientações visando à ingestão de pelo menos 400g/dia de vegetais e frutas, e não mais que 500g/semana de carne vermelha/processada. Resultados O grupo de intervenção melhorou significativamente a qualidade da dieta (+5,7). Além disso, houve aumento da ingestão de frutas e vegetais, representado por elevação significativa na pontuação de frutas totais (+1,9) e frutas integrais (+1,1) e redução considerável na pontuação de carnes, ovos e leguminosas (-3,3), a qual se deu pela diminuição do consumo de alimentos embutidos e carne bovina (p<0,05). Ainda, observou-se aumento na pontuação do componente que avalia as quilocalorias provenientes das gorduras sólidas, bebidas alcoólicas e açúcar de adição (+5,0, p<0,05) devido ao menor consumo desses alimentos. O grupo comparação não apresentou diferenças significativas. Conclusão A intervenção nutricional contribuiu para melhorar a qualidade da dieta durante o tratamento para câncer de mama e, possivelmente, o prognóstico dessas mulheres.

Utilization of a Diet Optimization Model in Ensuring Adequate Intake among Pregnant Women in Selangor, Malaysia.

Achieving nutritional requirements for pregnant women in rural or suburban households while maintaining the intake of local and culture-specific foods can be difficult. Usage of a linear programming approach can effectively generate diet optimization models that incorporate local and culturally acceptable menus. This study aimed to determine whether a realistic and affordable diet that achieves recommended nutrient intakes for pregnant women could be formulated from locally available foods in Malaysia. A cross-sectional study was conducted to assess the dietary intake of 78 pregnant women using a 24-h dietary recall and a 3-day food record. A market survey was also carried out to estimate the cost of raw foods that are frequently consumed. All linear programming analyses were done using Excel Solver to generate optimal dietary patterns. Our findings showed that the menus designed from diet optimization models using locally available foods would improve dietary adequacy for the seven food groups based on the Malaysian Dietary Guidelines 2010 (MDG 2010) and the 14 nutrients based on Recommended Nutrient Intake 2017 (RNI 2017) in pregnant women. However, inadequacies remained for iron and niacin, indicating that these nutrients may require supplementation.

Postcranial morphological variation between hunter-gatherers and horticulturalists from the lower Paraná River Delta, Argentina.

INTRODUCTION: Although pre-Hispanic hunter-gatherer and horticulturalist (known as Guaraní) societies from the lower Paraná River Delta (Argentina) presented differences in diet, pottery decoration, mortuary practices, and places of origin, differences in skeletal morphology between such groups have never been systematically explored. This work focuses on variations in humeral and femoral external linear measurements and derived structural properties of adult individuals from both societies as well as on variations in body mass and stature. MATERIALS AND METHODS: Bone length, epiphyseal size, and midshaft breadth were measured in 82 adult humeri and 100 femora from hunter-gatherer and Guaraní archeological sites. Epiphyseal and midshaft robusticity, residual strength, midshaft shape and area, stature, and body mass were then estimated. Mann-Whitney tests were run to compare the hunter-gatherer and Guaraní samples. RESULTS: Male Guaraní individuals presented stronger humeri and more robust femoral and humeral proximal epiphyses than hunter-gatherers. In addition, female Guaraní individuals showed rounder femoral diaphyses in comparison with female hunter-gatherers. Concerning stature, the Guaraní individuals were found to be shorter than hunter-gatherers, regardless of sex. No statistical differences were found in body mass. DISCUSSION: Despite the fact that skeletal variations between Guaraní and hunter-gatherers could be a consequence of differences in mechanical loadings and genetic composition, bone robusticity is also positively correlated with increased age, but as the age composition of the Guaraní sample could not be estimated, skeletal variation between the samples could be a consequence of differences in age distribution.

Ecological and cultural shifts of hunter-gatherers of the Jomon period paralleled with environmental changes.

OBJECTIVES: Holocene hunter-gatherers adapted to climatic and environmental changes over time. Carbon and nitrogen stable isotope analysis of human skeletal remains from the Inariyama shell mound of the Final Jomon period have revealed large dietary variations in the population. This study analyzed radiocarbon dates of these individuals to test temporal changes in diet and its relationship with tooth ablation. MATERIALS AND METHODS: Twenty-nine human skeletal remains from Inariyama were included in this study. Extracted bone collagen samples were purified to graphite. Then, radiocarbon dating of these samples was performed using the accelerator mass spectrometer. RESULTS: The radiocarbon ages of Inariyama ranged about, 3,230-2,140 cal BP and showed three peaks of occupation. In the early and late phases, terrestrial resource consumption and incisor extraction were observed, while marine resource consumption and canine extraction were observed in the middle phase. DISCUSSION: These temporal changes of diet and tooth ablation types occurred in parallel with climatic cooling and environmental change and help reveal how Holocene hunter-gatherers adapted to the changing environments.

The Pattern of Complementary Foods in American Infants and Children Aged 0⁻5 Years Old-A Cross-Sectional Analysis of Data from the NHANES 2011⁻2014.

Proper nutrition early in life can influence children’s present and future health. While several authoritative sources provide eating/food recommendations, only a few studies have assessed whether these recommendations are followed. The goal of this paper was to examine food and nutrient intakes on any given day during infancy and early childhood among various ethnicities. Twenty-four-hour dietary recall data of 0⁻5 years-old children (n = 2431) from the National Health and Nutrition Examination Survey (NHANES) 2011⁻2014 was used to estimate intakes of nutrients and food groups and prevalence of inadequate intake. Data was analyzed separately for various age groups and ethnicities, and differences in means by age and or race/ethnicity were determined by t-tests with p < 0.05 as significant. The results indicate that intakes of all food groups were expectedly low at 0⁻11 months, increased with age, and were influenced by race/ethnicity. Mixed dish consumption, which also increased with age, made substantial contributions to children’s food group intakes. However, there was a substantial percentage of the population among all age and race/ethnic groups who did not consume the recommended amounts for each food group and had inadequate intakes of key nutrients, such as calcium, vitamin D, and vitamin E. Non-Hispanic black children consumed less dairy and more protein foods, and a significantly greater proportion of these children had inadequate intakes of calcium and vitamin D compared to their peers. In conclusion, the results from this study suggest that a substantial population of American infants and children from 0 to five years of age did not meet food group recommendations and had inadequate intakes of key nutrients such as calcium, vitamin D, and vitamin E from foods.

Effects of Different Dietary Interventions on Calcitriol, Parathyroid Hormone, Calcium, and Phosphorus: Results from the DASH Trial.

The "Dietary Approaches to Stop Hypertension" (DASH) diet, rich in fiber and low-fat dairy, effectively lowers blood pressure. DASH's effect on calcitriol and other markers of bone-mineral metabolism is unknown. This secondary analysis of the DASH trial aimed to determine the effect of dietary patterns on blood concentrations of calcitriol, parathyroid hormone (PTH), ionized calcium, and urinary excretion of calcium and phosphorus. Outcomes were available in 334 participants in the trial. After a 3-week run-in on the control diet, participants were randomized to control, fruits and vegetables (F&V), or DASH diets. Outcomes were assessed at the end of run-in, and during the last week of the intervention period. Mean age of participants was 45.7 ± 10.7 years, 46% female, and 57% African-American. Mean ± Standard Deviation(SD) baseline serum concentrations of calcitriol, PTH, and ionized calcium were 37.8 ± 9.2 pg/mL, 46.1 ± 18.5 pg/mL and 5.2 ± 0.23 mg/dL, respectively. Mean (±SD) urinary calcium and phosphorus excretions were 150.1 ± 77.8 and 708.0 ± 251.8 mg/24 h, respectively. Compared with control, DASH reduced calcitriol -3.32 pg/mL (p = 0.004). Otherwise, there was no significant effect on other biomarkers. DASH lowered serum calcitriol perhaps more among African-Americans. These results raise important questions about the interpretation and clinical significance of low calcitriol concentrations in the setting of recommended diets.

Breastfeeding, weaning, and dietary practices during the Western Zhou Dynasty (1122-771 BC) at Boyangcheng, Anhui Province, China.

OBJECTIVES: Here we investigate breastfeeding and weaning practices and adult dietary habits at the Western Zhou Dynasty (1122-771 BC) site of Boyangcheng () located in Anhui Province, China. In addition, we utilize the differences in bone collagen turnover rates between rib and long bones from the same individual to examine past life histories, such as changes in diet or residence. MATERIALS AND METHODS: Bone collagen from both the rib and long bones (either femora or humeri) of 42 individuals was measured for stable isotope ratios of carbon (δ13 C) and nitrogen (δ15 N). In addition, δ13 C and δ15 N values are reported for 35 animals (dogs, cows, horses, pigs, and deer). RESULTS: The human δ13 C values range from -20.7‰ to -12.0‰ with a mean value of -18.8 ± 1.6‰. The human δ15 N values range from 9.1‰ to 13.4‰ with a mean value of 10.9 ± 1.0‰. The animals display a wide range of δ13 C (-21.5‰ to -8.2‰; -15.8 ± 4.5‰) and δ15 N values (4.0‰ to 9.5‰; 6.5 ± 1.8‰). CONCLUSIONS: The adult δ13 C and δ15 N results indicate that mixed C3 (rice) and C4 (millet) terrestrial diets with varying levels of animal protein (mostly pigs and deer) were consumed. The elevated subadult δ15 N results return to adult levels by approximately 3-4 years of age, indicating that the weaning process was completed during this period. Individuals between 2 and 10 years old, with lower δ13 C and δ15 N results than the adult mean, possibly consumed more plant-based diets, and this is consistent with Chinese medical teachings ∼1500 years later during the Tang Dynasty (AD 618-907). The isotopic offsets between the ribs and long bones revealed that five adults experienced dramatic dietary shifts in their later lives, switching from predominately C3 /C4 to C3 diets. This research provides the first isotopic information about ancient Chinese breastfeeding and weaning practices and establishes a foundation for future studies to examine diachronic trends.

Caregiver-infant's feeding behaviours are associated with energy intake of 9-11 month-old infants in rural Ethiopia.

Inappropriate complementary feeding, both in quantity and quality, is a major determinant of undernutrition. However, little is known about how infant-caregiver's feeding behaviours affect infants' energy intake. Therefore, the objective of this study was to characterize infant-caregiver feeding behaviours and investigate their association with infants' energy intake. The study involved 106 mother-child pairs recruited from seven randomly selected kebeles of Mecha district, West Gojam, Ethiopia. The feeding styles were assessed through observations of 1-day, in-home, feeding episodes that were videotaped and coded into self-feeding, responsive, active, distracting, and social feeding behaviours. Infants' haemoglobin and anthropometric measurements were taken. The association between feeding behaviour scores and energy intake per meal was investigated. The mean food intake of the infants was very low (11.4 ± 7.0 g/kg body weight per meal) compared to the minimum theoretical gastric capacity (30 g/kg body weight per meal). Infants' haemoglobin concentration was negatively associated with energy intake (ρ = 0.178, p = .03). Infants' responsive and active positive feeding styles were positively associated with energy intakes (ρ = 0.258 and 0.432, p = .004 and p < .001, respectively) as well as caregivers' responsive positive feeding styles (ρ = 0.237, p = .007). Both haemoglobin concentrations and feeding styles were associated with infant's energy intake. Anaemia prevention and control measures should be reinforced. Current nutrition education programmes should give emphasis on ways to effectively incorporate culturally adapted responsive feeding messages in this and similar settings.

A cosmopolítica da gestação, do parto e do pós-parto: autoatenção e medicalização entre os índios Munduruku / The cosmopolitics of pregnancy, childbirth and postpartum: self-attention and medicalization among Munduruku Indians

A pesquisadora Raquel Paiva Dias-Scopel, do Instituto Leônidas e Maria Deane (ILMD/Fiocruz Amazônia), levanta questões sobre a valorização e respeito à diversidade étnica e cultural dos povos indígenas e a difícil interface com o processos de medicalização e do direito ao acesso aos serviços de saúde biomédicos. O livro é parte da Coleção Saúde dos Povos Indígenas, da Editora Fiocruz e partiu da tese de doutorado defendida em 2014 no Programa de Pós-Graduação em Antropologia Social da Universidade Federal de Santa Catarina (UFSC). Foi publicado pela primeira vez em 2015 pela Associação Brasileira de Antropologia com o título A Cosmopolítica da Gestação, Parto e Pós-Parto: práticas de autoatenção e processo de medicalização entre os índios Munduruku. No prefácio da primeira edição, sua orientadora, a doutora em antropologia e professora titular da UFSC, Esther Jean Langdon, ressalta que o conceito fundamental deste livro é da autoatenção, que aponta para o reconhecimento da autonomia e da criatividade da coletividade, principalmente da família, como núcleo que articula os diferentes modelos de atenção ou cuidado da saúde.

Influence of Dietary Salt Knowledge, Perceptions, and Beliefs on Consumption Choices after Stroke in Uganda.

BACKGROUND: Previous research on Uganda's poststroke population revealed that their level of dietary salt knowledge did not lead to healthier consumption choices. PURPOSE: Identify barriers and motivators for healthy dietary behaviors and evaluate the understanding of widely accepted salt regulation mechanisms among poststroke patients in Uganda. METHODS: Convergent parallel mixed methods triangulation design comprised a cross-sectional survey (n = 81) and 8 focus group discussions with 7-10 poststroke participants in each group. We assessed participant characteristics and obtained insights into their salt consumption attitudes, perceptions, and knowledge. Qualitative responses were analyzed using an inductive approach with thematic analytic procedures. Relationships between healthy dietary salt compliance, dietary salt knowledge, and participant characteristics were assessed using logistic regression analyses. RESULTS: Healthy dietary salt consumption behaviors were associated with basic salt knowledge (P < .0001), but no association was found between compliance and salt disease-related knowledge (P = .314). Only 20% and 7% obtained health-related salt knowledge from their health facility and educational sources, respectively, whereas 44% obtained this information from media personalities; 92% of participants had no understanding of nutrition labels, and only 25% of the study population consumed potash-an inexpensive salt substitute that is both rich in potassium and low in sodium. CONCLUSION: One barrier to healthy dietary consumption choices among Uganda's stroke survivors is a lack of credible disease-related information. Improving health-care provider stroke-related dietary knowledge in Uganda and encouraging the use of potash as a salt substitute would help reduce hypertension and thereby lower the risk of stroke.

Type 2 Diabetes in People from Culturally and Linguistically Diverse Backgrounds: Perspectives for Training and Practice from Nutritional Therapy and Dietician Professions.

OBJECTIVE: To explore the perspectives of nutritional therapy and dietician practitioners, undergraduate students and academics working with people with type 2 diabetes and who are from culturally and linguistically diverse (CALD) backgrounds. METHODS: A qualitative study design of in-depth semi-structured one-on-one interviews with a total of 24 participants (8 practitioners, 8 students and 8 academics) in the fields of nutritional therapy and dietetics. Open-ended questions focused on the perspectives and experiences (learning, practice and teaching) of working with people of CALD backgrounds who have type 2 diabetes. All interviews were recorded for thematic and textual analysis. RESULTS: Inter-related themes which were confirmed with investigator triangulation were the understanding of (i) the concepts of culture and diversity, (ii) the concepts and influences of health, diabetes and food across cultures, (iii) influences within and across cultures and (iv) systems and resourcing. Overarching perspectives across these themes suggested frustration in having sufficient capacity to assess comprehensively, to deliver effective, comprehensive and high quality management plans, and to achieve required health behavioural changes with people from different CALD backgrounds. CONCLUSIONS: There's a need for improvements in the undergraduate education and training and in professional development programs; training and resourcing of interpreters in delivery of health-related information and working with health professionals; for focus on culturally appropriate management plans that involve consultation with key decision makers in families and communities; and, reviews of the systems for supporting and resourcing nutritional therapists and dieticians in professional development from undergraduate to practice levels.

Turkish version of the Intuitive Eating Scale-2: Validity and reliability among university students.

Intuitive Eating is defined as "the dynamic process-integrating attunement of mind, body, and food". The purpose of this study was, therefore, adapt the IES-2 to the Turkish language and reliability and validity of IES-2 among Turkish populations. We also examined the instrument's internal consistency and test-retest reliability and analysed the relationships between the IES-2 and several variables so as to evaluate the convergent and discriminant validity. Three hundred seventy-seven undergraduate and postgraduate women and men between the ages of 19-31 years (mean 22.3, SD = 3.53) attending two large private universities in Istanbul, Turkey. The best solution from the principal factors analysis of the 23 items of the IES-2 revealed four factors corresponding to the four subscales (F1: Eating for physical rather than emotional reasons; F2: Unconditional permission to eat; F3: Reliance on hunger and satiety cues; F4: Body-food choice congruence), as reported by the authors of the questionnaire. Bartlett's test of sphericity gave X2 = 9043.49 (p < 0.001), while the Kaiser-Meyer-Olkin index was 0.87 (KMO were 0.89 for women and 0.83 for men). The test-retest reliability of the IES-2 was 0.88 for the IES-2 total score. The IES-2 had a = 0.82. These findings support the notion that intuitive eating is a viable concept for university students and the IES can be used to examine adaptive eating behaviors in this population.