Objective assessment of shared plate eating using a wearable camera in urban and rural households in Ghana.

Background: Shared plate eating (SPE), defined as two or more individuals eating directly from the same plate or bowl, is a common household food consumption practice in many Low- and Middle-Income Countries (LMICs). Examination of household engagement in SPE remains largely unexplored, highlighting a gap in research when interpreting dietary information obtained from these settings. The dearth of research into SPE can be attributed to the inherent limitations of traditional dietary assessment methods which constrain their usability in settings where SPE is common. Objective: In this expository narrative, we describe what SPE is when it is practiced in an LMIC such as Ghana; and also compare the frequency of SPE versus individual plate eating (IPE) by different household members in rural and urban households using a wearable camera (Automatic Ingestion Monitor version 2: AIM-2). Methods: Purposive convenience sampling was employed to recruit and enroll 30 households each from an urban and a rural community (n = 60 households) in Ghana. The AIM-2 was worn on eyeglass frames for 3 days by selected household members. The AIM-2, when worn, automatically collects images to capture food consumption in participants' environments, thus enabling passive capture of household SPE dynamics. Results: A higher percentage of SPE occasions was observed for rural (96.7%) compared to urban (36.7%) households (p < 0.001). Common SPE dynamics included only adults sharing, adults and children sharing, only children sharing, and non-household member participation in SPE. Conclusion: The wearable camera captured eating dynamics within households that would have likely been missed or altered by traditional dietary assessment methods. Obtaining reliable and accurate data is crucial for assessing dietary intake in settings where SPE is a norm.

Plastics in human diets: development and evaluation of the 24-h Dietary Recall - Plastic Exposure and the Dietary Plastics Score.

Background: Humans are commonly exposed to plastic through their dietary intake and food consumption patterns. Plastic-associated chemicals (PAC), such as bisphenols and phthalates, are recognized as endocrine-disrupting and are associated with increased risk of cardiovascular disease and metabolic syndrome. However, accurate methods to assess dietary exposure to plastic products and PAC are inadequate, limiting interrogation of health impacts. Aim: To develop a tool that captures complete dietary exposure to plastics and establish a diet quality score to measure adherence to a low plastic dietary pattern. Methods: We developed the 24-h Dietary Recall - Plastic Exposure (24DR-PE) and administered it to healthy adults (n = 422). This computer-assisted, interviewer-administered tool systematically collects data on food volumes and types, packaging materials, storage, processing, cooking, and consumption methods to assess a food's exposure to plastic. Specifically, the 24DR-PE incorporates predefined criteria for identifying high-risk practices and food characteristics, such as individually packaged items or those microwaved in plastic, enabling the assignment of scores based on a theoretically derived Dietary Plastics Scoring Matrix. Conclusion: The 24DR-PE is the first tool specifically designed to capture detailed data on dietary exposures to plastic products. The next step is to validate the score using laboratory results of urine samples we collected contemporaneous to the dietary information. Once validated, the tool has potential for widespread distribution making it valuable for population monitoring, intervention guidance, and future research investigating the interplay between plastics, diet, and human health.

A nutrition-focused review of the interventions in US-living Latino communities with type II diabetes.

Type 2 diabetes (T2D) is a chronic, debilitating disease that disproportionally affects the Hispanic/Latino community residing in the United States. Optimal nutrition therapy is fundamental to the proper management of T2D and must be culturally adapted to facilitate permanent behavior change in this population. This review selected and assessed the nutrition components of interventions aimed to improve T2D outcomes in US-based Latinos/Hispanics, published from 2002 to 2023. An overview of the participant characteristics, nutrition intervention, and dietary assessment and outcomes is included. Nutrition interventions in this community benefit from the inclusion of bicultural registered dietitian nutritionist (RDNs) to assure the counseling team promotes culturally tailored nutrition recommendations based on current dietary guidelines. Nutrition assessment and outcomes should be captured with the use of validated dietary assessment tools and dietary quality indices appropriate to their target population. Standardizing these practices will facilitate intervention comparability and replicability and ultimately better target the needs of this community.

Systems Approach to Investigate the Role of Fruit and Vegetable Types on Vascular Function in Pre-Hypertensive Participants: Protocol and Baseline Characteristics of a Randomised Crossover Dietary Intervention.

The evidence on the impact of fruits and vegetable types on cardiovascular risk factors remains limited. Specifically, the utilisation of biomarkers to objectively measure dietary compliance and metabolic responses is emerging. This protocol and baseline characteristics of a pilot randomised controlled, crossover, dietary intervention study aimed to examine the effects of citrus fruits, cruciferous vegetables, or common fruits and vegetables on cardiovascular risk factors. A total of 39 volunteers with untreated prehypertension was recruited and consumed a standardised, provided diet with eight daily portions of citrus fruits and cruciferous vegetables, common fruits and vegetables, or a low fruit and vegetable diet (two portions/d, control diet) in a random order for 2 weeks each, separated by a wash-out week. A targeted cohort-based recruitment strategy was utilised and resulted in 74% of participants recruited by re-contacting preselected individuals from two cohort studies with a 15% average enrolment rate. Participants had an average age of 54.4 years (±6.1 years), BMI of 27.9 kg/m2, and BP of 135/81 mmHg and were mainly male (67%). The primary outcome was office blood pressure; secondary outcomes included arterial stiffness, lipid profiles, inflammation, cognitive function, and subjective mood. Biofluids, i.e., 24 h urine, stool, and blood samples, were collected for biomarker measurements with multiple metabolomic platforms and the gut microbial composition, together with traditional dietary biomarkers.

Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: Comparative Study.

Background: Controlling saturated fat and cholesterol intake is important for the prevention of cardiovascular diseases. Although the use of mobile diet-tracking apps has been increasing, the reliability of nutrition apps in tracking saturated fats and cholesterol across different nations remains underexplored. Objective: This study aimed to examine the reliability and consistency of nutrition apps focusing on saturated fat and cholesterol intake across different national contexts. The study focused on 3 key concerns: data omission, inconsistency (variability) of saturated fat and cholesterol values within an app, and the reliability of commercial apps across different national contexts. Methods: Nutrient data from 4 consumer-grade apps (COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!) and an academic app (Formosa FoodApp) were compared against 2 national reference databases (US Department of Agriculture [USDA]-Food and Nutrient Database for Dietary Studies [FNDDS] and Taiwan Food Composition Database [FCD]). Percentages of missing nutrients were recorded, and coefficients of variation were used to compute data inconsistencies. One-way ANOVAs were used to examine differences among apps, and paired 2-tailed t tests were used to compare the apps to national reference data. The reliability across different national contexts was investigated by comparing the Chinese and English versions of MyFitnessPal with the USDA-FNDDS and Taiwan FCD. Results: Across the 5 apps, 836 food codes from 42 items were analyzed. Four apps, including COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, significantly underestimated saturated fats, with errors ranging from -13.8% to -40.3% (all P<.05). All apps underestimated cholesterol, with errors ranging from -26.3% to -60.3% (all P<.05). COFIT omitted 47% of saturated fat data, and MyFitnessPal-Chinese missed 62% of cholesterol data. The coefficients of variation of beef, chicken, and seafood ranged from 78% to 145%, from 74% to 112%, and from 97% to 124% across MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, respectively, indicating a high variability in saturated fats across different food groups. Similarly, cholesterol variability was consistently high in dairy (71%-118%) and prepackaged foods (84%-118%) across all selected apps. When examining the reliability of MyFitnessPal across different national contexts, errors in MyFitnessPal were consistent across different national FCDs (USDA-FNDSS and Taiwan FCD). Regardless of the FCDs used as a reference, these errors persisted to be statistically significant, indicating that the app's core database is the source of the problems rather than just mismatches or variances in external FCDs. Conclusions: The findings reveal substantial inaccuracies and inconsistencies in diet-tracking apps' reporting of saturated fats and cholesterol. These issues raise concerns for the effectiveness of using consumer-grade nutrition apps in cardiovascular disease prevention across different national contexts and within the apps themselves.

Validity and Reproducibility of a Culture-Specific Electronic Food Frequency Questionnaire: A Trinidad and Tobago Diet Assessment Study.

Nutritional epidemiologists use culture-specific food frequency questionnaires (FFQs) to assess the dietary intake of groups based on country, region or ethnic groups. This study aimed to validate a culture-specific semi-quantitative electronic Food Frequency Questionnaire (e-FFQ) to estimate food group intake in the adult population of Trinidad and Tobago. A 139-item semi-quantitative e-FFQ containing local dishes and street food was administered twice to adults 18 years and older and compared against four 1-day food records (FRs) using digital photographs, which served as the reference method. The validity and reproducibility of the e-FFQ food group intake estimates were determined using paired t-tests, bivariate correlations, and cross-classifications. Reproducibility correlations between the reported food group intakes in the first and repeat administration of the e-FFQ ranged from moderate (r = .44, P ≤ .0001) for sweetened beverages to high (r = .91 P ≤ .0001) for alcohol. The cross-classification agreements ranged from 70% (street food) to 92% (alcohol). Energy-adjusted deattenuated validity correlations between the e-FFQ and FR ranged from (r = .08) for water to (r = .81) for food from animal sources, with a mean validity correlation of .36. An average of 68% of the e-FFQ estimates was correctly classified within the ±1 quintile of the exact agreement with the FRs. Agreements between the e-FFQ and FRs ranged from 55% for street foods to 95% for water, all significant at P ≤ .0001. This study shows that the culture-specific e-FFQ is a valid tool for assessing and ranking food category intake estimates of the adult population living in Trinidad and Tobago.

Serum metabolomic markers of artificially sweetened beverage consumption.

BACKGROUND: The consumption of artificially sweetened beverages is on the rise. Use of artificial sweeteners has been associated with adverse health outcomes. There is a need to identify novel objective biomarkers of artificially sweetened beverages in order to improve dietary assessment and to provide insight into their metabolic impact. OBJECTIVE: We aim to identify serum metabolites that are associated with artificially sweetened beverage consumption. METHODS: In the Atherosclerosis Risk in Communities (ARIC) study, consumption of artificially sweetened beverages was assessed using a food frequency questionnaire and fasting serum samples were collected during the first study visit (1987-1989). Participants were categorized as "non-users" if they reported almost never consumption of artificially sweetened beverages, "moderate users" for 1 glass/month to 6 glasses/week, and "heavy users" for ≥1 glasses/day. Untargeted metabolomic profiling was conducted in two subgroups (subgroup 1: n=1,866, profiled in 2010; subgroup 2 profiled in 2014: n=2,072) and 360 metabolites were analyzed. In this secondary data analysis, multivariable linear regression models were used, adjusting for demographics, health behaviors, health status, and dietary factors. Analyses were conducted in each subgroup and results were meta-analyzed. RESULTS: In a meta-analysis of 3,938 generally healthy participants (mean age 54 years, 60% women, 62% Black participants) from ARIC study visit 1, 11 serum metabolites were significantly associated with artificially sweetened beverage consumption. Heavier consumption of artificially sweetened beverages was associated with higher levels of 10 metabolites (saccharin, threonate, erythronate, glycerate, gluconate, mannitol, glucose, tryptophan betaine, trehalose, and N6-acetyllysine) and lower levels of glycocholenate sulfate. CONCLUSION: We found 11 serum metabolites related to artificially sweetened beverage intake, that consisted of known sugar substitutes, processed food additives, glucose-related compounds, and gut microbiome-related metabolites. These findings enhance our knowledge of the metabolic activity of artificial sweeteners and suggests new biomarkers for monitoring intake.

Dining Bowl Modeling and Optimization for Single-Image-Based Dietary Assessment.

In dietary assessment using a single-view food image, an object of known size, such as a checkerboard, is often placed manually in the camera's view as a scale reference to estimate food volume. This traditional scale reference is inconvenient to use because of the manual placement requirement. Consequently, utensils, such as plates and bowls, have been suggested as alternative references. Although these references do not need a manual placement procedure, there is a unique challenge when a dining bowl is used as a reference. Unlike a dining plate, whose shallow shape does not usually block the view of the food, a dining bowl does obscure the food view, and its shape may not be fully observable from the single-view food image. As a result, significant errors may occur in food volume estimation due to the unknown shape of the bowl. To address this challenge, we present a novel method to premeasure both the size and shape of the empty bowl before it is used in a dietary assessment study. In our method, an image is taken with a labeled paper ruler adhered to the interior surface of the bowl, a mathematical model is developed to describe its shape and size, and then an optimization method is used to determine the bowl parameters based on the locations of observed ruler makers from the bowl image. Experimental studies were performed using both simulated and actual bowls to assess the reliability and accuracy of our bowl measurement method.

Association between predicted level of water turnover deficit and all-cause and cause-specific mortalities among Japanese adults: The Japan Collaborative Cohort Study.

BACKGROUND: Although water is essential for maintaining health and life, the association between water turnover as an indicator of daily water requirement and water deficit and mortality is unclear. OBJECTIVE: We aimed to investigate this association in Japanese adults. METHODS: A total of 63,488 (36,739 females and 26,749 males) Japanese aged 40-79 years in the Japan Collaborative Cohort Study in 1988-1990 were followed up their mortality through 2009. Water turnover was calculated considering lifestyle and environmental factors using an equation previously developed by the International Doubly Labeled Water Database Group. Participants were classified into sex-specific quintiles based on their water turnover. Water deficit levels were calculated from water turnover and dietary water consumption, which were estimated using a validated questionnaire. RESULTS: The average daily water turnovers were 2,950 mL and 3,466 mL in females and males, respectively. During 19.4 years of median follow-up (1,039,914 person-years), 12,551 deaths were recorded. After adjusting for lifestyle and medical history, the bottom quintile was associated with higher hazard ratios (HRs) of mortality from all causes (females: HR, 1.26; 95% confidence interval, 1.12, 1.41; males: HR, 1.18; 95% CI, 1.07, 1.29) and cardiovascular disease (CVD). In spline analyses, the water turnover range with the lowest HR for all-cause mortality was 3,000-3,300 mL/day in females and the water turnover at which the HR for all-cause mortality plateaued was approximately 3,500-3,700 mL/day in males. Water deficiency levels were associated with all-cause and CVD mortality in both sexes. CONCLUSION: This study showed an L-shaped association between water turnover and deficit and all-cause and CVD mortalities (especially coronary heart disease and ischemic stroke) in adults. These findings may be useful for setting the target values of water requirement, and differences between dietary requirements and actual intake may bridge the knowledge gap in water-mortality associations.

The Carbon Isotope Ratio as an Objective Biomarker of Added Sugar Intake: A Scoping Review of Current Evidence in Human Nutrition.

Objective biomarkers of dietary intake are needed to advance nutrition research. The carbon isotope ratio (C13/C12; CIR) holds promise as an objective biomarker of added sugar (AS) and sugar-sweetened beverage (SSB) intake. This systematic scoping review presents the current evidence on CIRs from human studies. Search results (through April 12, 2024) yielded 6297 studies and 24 final articles. Studies were observational (n = 12), controlled feeding (n = 10), or dietary interventions (n = 2). CIRs were sampled from blood (n = 23), hair (n = 5), breath (n = 2), and/or adipose tissue (n = 1). Most (n = 17) conducted whole tissue (that is, bulk) analysis, 8 used compound specific isotope analysis (CSIA), and/or 2 studies used methods appropriate for analyzing breath. Studies were conducted in 3 concentrated geographic regions of the United States (n = 7 Virginia; n = 5 Arizona; n = 4 Alaska), with only 2 studies conducted in other countries. Studies that used CSIA to examine the CIR from the amino acid alanine (CIR-Ala; n = 4) and CIR analyzed from breath (n = 2) provided the most robust evidence for CIR as an objective biomarker of AS and SSBs (R2 range 0.36-0.91). Studies using bulk analysis of hair or blood showed positive, but modest and more variable associations with AS and SSBs (R2 range 0.05-0.48). Few studies showed no association, particularly in non-United States populations and those with low AS and SSB intakes. Two studies provided evidence for CIR to detect changes in SSB intake in response to dietary interventions. Overall, the most compelling evidence supports CIR-Ala as an objective indicator of AS intake and breath CIR as an indicator of short-term AS intake. Considering how to adjust for underlying dietary patterns remains an important area of future work and emerging methods using breath and CSIA warrant additional investigation. More evidence is needed to refine the utility and specificity of CIRs to measure AS and SSB intake.

Fine-Scale Dietary Polyphenol Intake Is Associated with Systemic and Gastrointestinal Inflammation in Healthy Adults.

BACKGROUND: Polyphenols are dietary bioactive compounds, many of which have anti-inflammatory properties. However, information on the intake of dietary polyphenols at the class and compound levels and their associations with gastrointestinal (GI) and systemic inflammation is lacking. OBJECTIVES: Estimate dietary polyphenol intake in healthy adults and examine its relationship with GI and systemic inflammation markers. METHODS: Healthy adults (n = 350) completed the United States Department of Agriculture Nutritional Phenotyping Study, an observational, cross-sectional study balanced for age, sex, and body mass index. Dietary intake, assessed via multiple 24-h recalls, was ingredientized and mapped to FooDB, a comprehensive food composition database. Dietary polyphenol intake (total, class, compound) was estimated and examined for its relationship to GI and systemic inflammation markers using linear models and random forest regressions. RESULTS: Mean total polyphenol intake was ∼914 mg/1000 kcal/d with flavonoids as the greatest class contributor (495 mg/1000 kcal/d). Tea, coffee, and fruits were among the largest food contributors to polyphenol intake. Total polyphenol intake was negatively associated with the GI inflammation marker, fecal calprotectin (ß = -0.004, P = 0.04). At the class level, polyphenols were categorized as prenol lipids (ß = -0.94, P < 0.01) and phenylpropanoic acids (ß = -0.92, P < 0.01) were negatively associated with plasma lipopolysaccharide-binding protein, a proxy for GI permeability. Food sources of these 2 classes included mainly olive products. We further detected a positive association between C-reactive protein and polyphenols in the "cinnamic acids and derivatives" class using hierarchical feature engineering and random forest modeling. CONCLUSIONS: Even in healthy adults, dietary polyphenol intake was negatively associated with GI inflammation and intake of prenol lipids and phenylpropanoic acids was negatively associated with GI permeability. Relationships between polyphenol intake and inflammatory outcomes varied with the resolution-total, class, compound-of polyphenol intake, suggesting a nuanced impact of polyphenols on GI and systemic inflammation. This trial was registered at clinicaltrials.gov as NCT02367287.

Evaluating the Quality and Comparative Validity of Manual Food Logging and Artificial Intelligence-Enabled Food Image Recognition in Apps for Nutrition Care.

For artificial intelligence (AI) to support nutrition care, high quality and accuracy of its features within smartphone applications (apps) are essential. This study evaluated popular apps' features, quality, behaviour change potential, and comparative validity of dietary assessment via manual logging and AI. The top 200 free and paid nutrition-related apps from Australia's Apple App and Google Play stores were screened (n = 800). Apps were assessed using MARS (quality) and ABACUS (behaviour change potential). Nutritional outputs from manual food logging and AI-enabled food-image recognition apps were compared with food records for Western, Asian, and Recommended diets. Among 18 apps, Noom scored highest on MARS (mean = 4.44) and ABACUS (21/21). From 16 manual food-logging apps, energy was overestimated for Western (mean: 1040 kJ) but underestimated for Asian (mean: -1520 kJ) diets. MyFitnessPal and Fastic had the highest accuracy (97% and 92%, respectively) out of seven AI-enabled food image recognition apps. Apps with more AI integration demonstrated better functionality, but automatic energy estimations from AI-enabled food image recognition were inaccurate. To enhance the integration of apps into nutrition care, collaborating with dietitians is essential for improving their credibility and comparative validity by expanding food databases. Moreover, training AI models are needed to improve AI-enabled food recognition, especially for mixed dishes and culturally diverse foods.

Development of the Diet Quality Questionnaire for Measurement of Dietary Diversity and Other Diet Quality Indicators.

Background: To monitor trends toward healthy and sustainable diets, there is a need for feasible survey tools, with cross-cultural validity, low-cost, and low-expertise requirements. Objectives: The objective of this research was to develop a method to gather data suitable for monitoring diet quality in the general population (women and men of all ages) that is feasible within multitopic surveys, low burden for both enumerators and respondents, valid at population level, and that captures the information necessary for understanding diet quality at global and local levels. Methods: A literature review was conducted to identify constructs of diet quality with existing consensus, indicators with existing global demand, and methods that may be feasible and valid. Results were presented to a technical advisory group for debate, resulting in consensus on a set of constructs to be measured, desired indicators, viable data collection platforms, and an approach for testing and piloting. Results: Food group-based indicators and 24-h recall period were selected as the most feasible and valid approach for population-level monitoring. A 29-item Diet Quality Questionnaire (DQQ) was developed, where each yes/no question asks about the consumption of a distinct food group on the previous day or night. The food groups were selected for the purpose of deriving indicators to capture the constructs for which there was consensus: nutrient adequacy, and protection against noncommunicable diseases, including both positive and negative risk factors. Conclusions: The DQQ is low cost and feasible to administer in existing large-scale surveys, overcoming barriers to diet data collection that have precluded the routine monitoring of diet quality in the past. This novel approach has now been used across >85 countries in the Gallup World Poll and other surveys, generating the first nationally representative available datasets on Minimum Dietary Diversity for Women and complementary diet quality indicators.

The Fully Understanding Eating and Lifestyle Behaviors (FUEL) trial: Protocol for a cohort study harnessing digital health tools to phenotype dietary non-adherence behaviors during lifestyle intervention.

Objective: Lifestyle intervention can produce clinically significant weight loss and reduced disease risk/severity for many individuals with overweight/obesity. Dietary lapses, instances of non-adherence to the recommended dietary goal(s) in lifestyle intervention, are associated with less weight loss and higher energy intake. There are distinct "types" of dietary lapse (e.g., eating an off-plan food, eating a larger portion), and behavioral, psychosocial, and contextual mechanisms may differ across dietary lapse types. Some lapse types also appear to impact weight more than others. Elucidating clear lapse types thus has potential for understanding and improving adherence to lifestyle intervention. Methods: This 18-month observational cohort study will use real-time digital assessment tools within a multi-level factor analysis framework to uncover "lapse phenotypes" and understand their impact on clinical outcomes. Adults with overweight/obesity (n = 150) will participate in a 12-month online lifestyle intervention and 6-month weight loss maintenance period. Participants will complete 14-day lapse phenotyping assessment periods at baseline, 3, 6, 12, and 18 months in which smartphone surveys, wearable devices, and geolocation will assess dietary lapses and relevant phenotyping characteristics. Energy intake (via 24-h dietary recall) and weight will be collected at each assessment period. Results: This trial is ongoing; data collection began on 31 October 2022 and is scheduled to complete by February 2027. Conclusion: Results will inform novel precision tools to improve dietary adherence in lifestyle intervention, and support updated theoretical models of adherence behavior. Additionally, these phenotyping methods can likely be leveraged to better understand non-adherence to other health behavior interventions. Trial Registration: This study was prospectively registered https://clinicaltrials.gov/study/NCT05562427.

Disaggregation of Dairy in Composite Foods in the United Kingdom.

Dairy, especially cheese, is associated with high levels of greenhouse gas emissions. Accurate estimates of dairy consumption are therefore important for monitoring dietary transition targets. Previous studies found that disaggregating the meat out of composite foods significantly impacts estimates of meat consumption. Our objective was to determine whether disaggregating the dairy out of composite foods impacts estimates of dairy consumption in Scotland. Approximately 32% of foods in the UK Nutrient Databank contain some dairy. In the 2021 Scottish Health Survey, mean daily intakes of dairy with and without disaggregation of composite foods were 238.6 and 218.4 g, respectively. This translates into an 8% underestimation of dairy consumption when not accounting for dairy in composite foods. In particular, milk was underestimated by 7% and cheese and butter by 50%, whereas yogurt was overestimated by 15% and cream by 79%. Failing to disaggregate dairy from composite foods may underestimate dairy consumption.

Identifying the Leading Sources of Saturated Fat and Added Sugar in U.S. Adults.

The 2020-2025 Dietary Guidelines for Americans recommend limiting intakes of saturated fat and added sugars (SF/AS) to <10% total energy. Data-driven approaches to identify sources of SF/AS are needed to meet these goals. We propose using a population-based approach to identify the leading food and beverage sources of SF/AS consumed by US adults. Foods and beverages reported as consumed were assessed from two, 24 h dietary recalls (24HRDR) from 36,378 adults aged 19 years and older from the 2005-2018 National Health and Nutrition Examination Survey. Intakes of SF/AS were aggregated across both 24HRDR to identify What We Eat in America food categories accounting for ≥90% of SF/AS, respectively, by the total population and within population subgroups. Data were weighted to estimate a nationally representative sample. Ninety-five discrete food categories accounted for ≥90% of the total SF/AS intakes for >88% of the representative sample of U.S. adults. The top sources of SF were cheese, pizza, ice cream, and eggs. The leading sources of AS were soft drinks, tea, fruit drinks, and cakes and pies. This analysis reflects a parsimonious approach to reliably identify foods and beverages that contribute to SF/AS intakes in U.S. adults.

Dietary Intake of 14-15-Year-Old Faroese Adolescents by an Online Assessment Tool and Associations with Wellbeing and Health Behaviour.

There is robust evidence linking diet and physical activity to major public health concerns such as cardiovascular diseases, type 2 diabetes, and osteoporosis. Dietary habits of children and adolescents are frequently discussed in health policy debates due to their modifiability, making them viable targets for prevention and health promotion initiatives. This study aimed to assess the dietary habits of 14-15-year-old Faroese adolescents using an online 24 h recall tool, examining their intake relative to public recommendations and exploring associations with health behaviour and wellbeing. A total of 78 participants (45 girls, 33 boys), with a mean age of 14.3 years, recorded their food intake and completed a questionnaire. Results indicated a higher intake of saturated fats and sugar and a lower intake of dietary fibre, n-3 fatty acids, fruits, and vegetables compared to recommendations. Healthier food intake was associated with better health behaviour and wellbeing. This very first study of Faroese adolescents' overall diet underscores the need for health-promoting interventions, and suggests the feasibility of using an online 24 h recall tool for dietary assessment in this age group, albeit with necessary adjustments for Faroese language and traditional foods.

Micronutrient intake and status in young vegans, lacto-ovo-vegetarians, pescatarians, flexitarians, and omnivores.

PURPOSE: Whether youth who follow plant-based diets in Nordic countries meet their dietary needs for micronutrients remains unclear. This study aims to evaluate micronutrient intake and status in Norwegian youth following vegan, lacto-ovo-vegetarian, pescatarian, flexitarian and omnivore diets. METHODS: Cross-sectional design, with healthy 16-to-24-year-olds (n = 165). Participants were asked to complete a questionnaire and four 24-hour dietary recalls. Dried blood spots (DBS) and spot-urine samples were collected for analysis of methyl malonic acid (MMA) (n = 65), haemoglobin (Hb) (n = 164) and urinary iodine concentration (UIC) (n = 163). RESULTS: Vegans reported highest habitual supplement usage of multivitamin (58%), B12 (90%) and macroalgae consumption (32%), while flexitarians reported highest habitual usage of omega-3 supplements (56%). For daily supplement usage, vegans reported highest use of multivitamins (42%), B12 (79%), iodine (37%) and iron (63%). Increased risk of inadequate intake (energy-adjusted) were found for vitamin D (60% within lacto-ovo-vegetarians), selenium (70% within lacto-ovo-vegetarians, 65% within omnivores), and iodine (63% within vegans). Median MMA levels suggest low risk of insufficient B12 status across all groups (MMA 0.04‒0.37µmol/l) and 2% had MMA levels indicating possible B12 deficiency and 8% had elevated levels. Median Hb levels indicated low risk of anemia across all groups (≥ 12.0 females, ≥ 13.0 g/dl males), though 7% had Hb values indicating risk of mild anemia and 4% risk of moderate anemia. The median UIC indicates mild iodine deficiency in all groups (UIC < 100 µg/l), except vegans, who were moderately iodine deficient (UIC < 50 µg/l). CONCLUSIONS: Our study indicated that the participating youth had low risk of inadequate intake of most micronutrients, partly due to high supplement usage. However, for iodine, vitamin D, and selenium higher risk of inadequate intake was found. UIC corroborated the low iodine intake among vegans. Thus, we suggest iodine status of youth in Norway should be monitored, especially among young fertile women who omits dietary iodine sources, until a mandatory iodine fortification program is implemented. Furthermore, we suggest that food education on how to secure sufficient nutrients from food in general should be provided to the Norwegian youth population, especially how to secure adequate intake of vitamin D, selenium and iodine.

The Role of Artificial Intelligence in Nutrition Research: A Scoping Review.

Artificial intelligence (AI) refers to computer systems doing tasks that usually need human intelligence. AI is constantly changing and is revolutionizing the healthcare field, including nutrition. This review's purpose is four-fold: (i) to investigate AI's role in nutrition research; (ii) to identify areas in nutrition using AI; (iii) to understand AI's future potential impact; (iv) to investigate possible concerns about AI's use in nutrition research. Eight databases were searched: PubMed, Web of Science, EBSCO, Agricola, Scopus, IEEE Explore, Google Scholar and Cochrane. A total of 1737 articles were retrieved, of which 22 were included in the review. Article screening phases included duplicates elimination, title-abstract selection, full-text review, and quality assessment. The key findings indicated AI's role in nutrition is at a developmental stage, focusing mainly on dietary assessment and less on malnutrition prediction, lifestyle interventions, and diet-related diseases comprehension. Clinical research is needed to determine AI's intervention efficacy. The ethics of AI use, a main concern, remains unresolved and needs to be considered for collateral damage prevention to certain populations. The studies' heterogeneity in this review limited the focus on specific nutritional areas. Future research should prioritize specialized reviews in nutrition and dieting for a deeper understanding of AI's potential in human nutrition.

Relative validity of an intelligent ordering system to estimate dietary intake among university students from a medical school in Shanghai, China.

BACKGROUND: Dietary assessment methods have limitations in capturing real-time eating behaviour accurately. Equipped with automated dietary-data-collection capabilities, the "intelligent ordering system" (IOS) has potential applicability in obtaining long-term consecutive, relatively detailed on-campus dietary records among university students with little resource consumption. We investigated (1) the relative validity of IOS-derived nutrient/food intakes compared to those from the 7-day food diary (7DFD); (2) whether including a supplemental food frequency questionnaire (SFFQ) improves IOS accuracy; and (3) sex differences in IOS dietary intake estimation. METHODS: Medical students (n = 221; age = 22.2 ± 2.4 years; 38.5% male and 61.5% female) completed the 7DFD and SFFQ. During the consecutive 7-day survey period, students weighed and photographed each meal before and after consumption. Then, students reviewed their 3-month diet and completed the SFFQ, which includes eight underprovided school-canteen food items (e.g., dairy, fruits, nuts). Meanwhile, 9385 IOS dietary data entries were collected. We used Spearman coefficients and linear regression models to estimate the associations among the different dietary intake assessment methods. Individual- and group-level agreement was assessed using the Wilcoxon signed-rank test, cross-classification, and Bland‒Altman analysis. RESULTS: IOS mean daily energy, protein, fat, and carbohydrate intake estimations were significantly lower (-15-20%) than those of the 7DFD. The correlation coefficients varied from 0.52 (for added sugar) to 0.88 (for soybeans and nuts), with fruits (0.37) and dairy products (0.29) showing weaker correlations. Sixty-two (milk and dairy products) to 97% (soybeans and nuts) of participants were classified into the same or adjacent dietary intake distribution quartile using both methods. The energy and macronutrient intake differences between the IOS + SFFQ and 7DFD groups decreased substantially. The separate fruit intake measurements from each assessment method did not significantly differ from each other (p > 0.05). IOS and IOS + SFFQ regression models generally yielded higher R2 values for males than for females. CONCLUSION: Despite estimation differences, the IOS can be reliable for medical student dietary habit assessment. The SFFQ is useful for measuring consumption of foods that are typically unavailable in school cafeterias, improving the overall dietary evaluation accuracy. The IOS assessment was more accurate for males than for females.