Resting Energy Expenditure in the Elderly: Systematic Review and Comparison of Equations in an Experimental Population.

Elderly patients are at risk of malnutrition and need an appropriate assessment of energy requirements. Predictive equations are widely used to estimate resting energy expenditure (REE). In the study, we conducted a systematic review of REE predictive equations in the elderly population and compared them in an experimental population. Studies involving subjects older than 65 years of age that evaluated the performance of a predictive equation vs. a gold standard were included. The retrieved equations were then tested on a sample of 88 elderly subjects enrolled in an Italian nursing home to evaluate the agreement among the estimated REEs. The agreement was assessed using the intraclass correlation coefficient (ICC). A web application, equationer, was developed to calculate all the estimated REEs according to the available variables. The review identified 68 studies (210 different equations). The agreement among the equations in our sample was higher for equations with fewer parameters, especially those that included body weight, ICC = 0.75 (95% CI = 0.69-0.81). There is great heterogeneity among REE estimates. Such differences should be considered and evaluated when estimates are applied to particularly fragile populations since the results have the potential to impact the patient's overall clinical outcome.

Dietary and Lifestyle Patterns are Associated with Heart Rate Variability.

Assessment of heart rate variability (HRV) and cardiac ectopic beats is a clinically relevant topic. The present exploratory observational study aimed to inspect the relationships of lifestyle, dietary patterns, and anthropometrics with HRV, premature ventricular complexes (PVCs), and supraventricular premature complexes (SVPCs). A cross-sectional study enrolling subjects undergoing Holter monitoring was performed. Sociodemographic and clinical characteristics, body composition (full-body bio-impedentiometry), dietary patterns (validated food frequency questionnaire and 24 h dietary recall), and quality of life were assessed. Generalized additive models were estimated to evaluate the relationships between outcomes of interest and variables collected. The study enrolled 121 consecutive patients undergoing 24 h Holter monitoring. Upon univariable analysis, HRV was found to have an inverse association with mass of body fat (MBF) (p-value 0.015), while doing physical activity was associated with a significantly higher HRV (p-value 0.036). Upon multivariable analysis, fruit consumption in the 24 h dietary recall was found to be directly associated with HRV (p-value 0.044). The present findings might be useful for improving the management of patients attending cardiac rhythm labs, and to tailor ad hoc prevention strategies (modification of lifestyle and eating habits) based on Holter parameters.

Consumers' attitudes before and after the introduction of the Chilean regulation on food labelling.

The aim of the present study is to understand how the attitudes towards food labelling in the Chilean population have changed after the introduction of the Chilean law on food labelling and advertising. A computer-assisted telephone interview was conducted in 2012 and 2016, employing the same procedures. The difference in outcomes between 2012 and 2016 was assessed using a logistic regression model. One hundred and sixty-seven subjects responded to both the 2012 and 2016 survey editions (respondents). For both the unadjusted and adjusted analyses, the respondents in 2016 were more likely to be involved in a programme to lose weight and to consider food labelling the most effective intervention introduced to date to promote healthy nutrition. However, no significant differences were reported in both self-reported and objectively assessed understandings of front-of-pack-labelling. Evidence suggests a positive perception among Chileans regarding the effectiveness of the new law.

Is branding food promoting obesity? An investigation on children in San Luis Potosí

This study aims at assessing children's awareness towards branded food products in central Mexico. One-hundred and twenty children, aged 3-10 years and balanced by gender, were recruited in San Luis Potosí. Kids' heights and weights were measured in order to calculate their BMI. A cross-sectional questionnaire was administered to children's parents in order to gain socio-demographic information. Children's brand awareness was assessed using the IBAI (International Brand Awareness Inventory). Basic exploratory analyses were performed for samples' general characteristics, and ANOVA was adopted for investigating differences between the IBAI tasks. Results demonstrated that 50% of kids correctly associated the logo to the respective brand in more than 70% of the cases. About half of the sample recalled the right name of the food type in 50% of the cases. 50% of kids recognized the brand name in less than 20% of cases. Older children (7-10 y) showed a higher brand awareness when compared to younger ones (3-6 y). Children demonstrated a consistent knowledge of famous fast-food and snack products. Prevention through informative campaigns should make parents more aware of the TV contents, their kids are exposed to(AU)

Este estudio tiene como objetivo evaluar la conciencia de los niños hacia los productos alimenticios de marca en México. Ciento veinte niños, de entre 3-10 años en grupos equitativos por sexos, fueron reclutados en San Luis Potosí. Se midieron la talla y los pesos de los niños con el fin de calcular sus IMC. A los padres de los niños se les entrego un cuestionario transversal a fines de obtener información socio-demográfica. El conocimiento de la marca de los niños se evaluó, mediante el uso del IBAI (Inventario Internacional de conocimiento de la marca). Se realizó un análisis exploratorio de base para obtener las características generales de la muestra y se adoptó un anova para investigar las diferencias entre las tareas ibai . Los resultados demostraron que el 50% de los niños había asociado correctamente el logotipo de la marca respectiva en más del 70% de los casos. Aproximadamente la mitad de la muestra recordaba el nombre correcto de marca de alimentos en el 50% de los casos. 50% de los niños reconocía el nombre de la marca en menos del 20% de los casos. Los niños mayores (7-10 años) mostraron una conciencia de marca más alta si se compara con los más jóvenes (3-6 años). Los niños demostraron consistentemente tener conocimiento de los productos de comida rápida y bocadillos más conocidos. La prevención a través de campañas informativas debería conscientizar a los padres sobre los contenidos de televisión a los que que sus hijos están expuestos(AU)

Food advertising on TV and energy intake in children: results from the OBEY-AD Mexico

Food advertising on TV is a common marketing practice, and it is suspected of promoting obesogenic behaviours. The study aimed at evaluating if gadgets (toys) packaged with food increase food consumption, and if contemporary exposure to TV and/or advertising is a further promoting factor. Onehundred and twenty children (balanced according to gender and age groups, 3-6 and 7-10 years old) were randomised in an experimental setting designed as a 2x5 full factorial ad libitum eating study. The first factor was represented by the exposure to gadgets, organized on two levels, "food with gadget" (TOY) and "food alone" (NoTOY). The second one consisted in the exposure to TV and advertising along five levels (no exposure to TV, exposure to TV without advertising, exposure to TV and 1, 2, or 3 advertsements). Our results showed no significant differences when considering the groups even after taking into account the dependent variables. The medium spot group showed the lowest energy intake, but the difference between the other groups was not significant. TV advertising and the presence of gadgets (toys) do not influence caloric intake in children(AU)

La publicidad de alimentos en la televisión es una práctica común de comercialización, y se cree que puede promover comportamientos obesogénicos. El estudio tiene como objetivo evaluar si los gadgets (juguetes) empaquetados con alimentos aumentan el consumo de alimentos y si la exposición contemporánea a la televisión y / o la publicidad es un factor promotor adicional. Ciento veinte niños (agrupados por sexo y edad, 3-6 y 7-10 años de edad) fueron asignados al azar en una escuela de San Luis Potosí -México. Los niños fueron asignados al azar en el contexto experimental de un estudio de diseño factorial completo 2x5 de consumo de alimentos ad libitum. El primer factor estuvo representado por la exposición a juguetes y estuvo organizado en dos niveles: "alimento con juguetes" (TOY) y "alimento solo" (NoTOY). El segundo consistía en la exposición a la televisión y a publicidad televisiva a lo largo de cinco niveles (sin exposición a TV, exposición a TV sin publicidad, exposición a TV y a 1, 2 o 3 anuncios publicitarios). Nuestros resultados no mostraron diferencias significativas entre los grupos, incluso teniendo en cuenta las variables dependientes. Sólo en el grupo mediano al que se mostraron dos publicidades se observó el consumo de energía más bajo. La diferencia entre los otros grupos no fue significativa(AU)

Does food advertising influence snacks consumption in Chilean children? Results from an experimental ad libitum study

The present study aimed at assessing the impact of food advertising on snack consumption in Chilean children using an experimental, ad libitum, design. Forty children were enrolled in urban, middle class, school setting. They underwent anthropometric assessment, brand awareness evaluation, and their lifestyle and habits were recorded through a validated questionnaire administered to their parents. A 5-arm design was adopted, consisting in the exposure to five different levels of TV spots and advertising. No significant differences were identified in caloric intake among children randomized to different levels of TV spots and commercials exposure. No significant effects on caloric intake, caloric intake per BMI, and or glycemic load were detected, even after adjustment for confounding factors. This study suggests the need for a better analysis of the contribution of non-traditional factors to obesity onset in children, which can provide high-quality evidence in order to develop effective public health strategies to face childhood obesity epidemic(AU)

El presente estudio tuvo como objetivo evaluar el impacto de la publicidad de alimentos en el consumo colaciones en los niños chilenos mediante la utilización de un diseño experimental basado en la voluntad de los participantes (ad libitum). Se realizó la inscripción de cuarenta niños en el contexto de una escuela urbana de clase media. Se les realizó una evaluación antropométrica, un examen de reconocimiento de marca y se procedió a registrar información sobre su estilo de vida y hábitos mediante un cuestionario validado que fue entregado a los padres y firmado por los mismos. Se adoptó un diseño de 5 grupos, que consistía en evaluar la exposición a cinco niveles diferentes de publicidad y clips televisivos. No se identificaron diferencias significativas en cuanto a la ingesta calórica entre los niños asignados aleatoriamente a diferentes niveles de exposición a clips televisivos y a anuncios publicitarios. No se detectaron efectos significativos en tanto a la ingesta calórica, ingesta calórica por IMC, o la carga glucémica, incluso después de realizar el ajuste por factores de confusión. El presente estudio sugiere la necesidad de un mayor análisis respecto de la incidencia de factores no tradicionales en la aparición de la obesidad en los niños, que proporcione evidencia de alta calidad con el fin de desarrollar estrategias eficaces en materia de salud pública ante la epidemia de obesidad infantil(AU)

Dietary patterns in Mexico and obesity in children

his cross-sectional study aims to investigate food habits, socio-economic status and blood lipids profile in schoolchildren (10-11 years of age) living in a low-income area of Mexico (the city of Montemorelos), characterizing lipid concentrations among children obese and evaluating the impact of socio-economic factors and dietary habits on blood lipids profile of these children. Complete data were available for 156 children (78 boys and 78 girls), food habits and socio economic status were assessed using a questionnaire developed from the one previously used from the enKid study conducted on Spanish children. Food reported in the questionnaire was classified in four food groups (animal source food/legumes, grains/tubers, fruits/vegetables, fats/sweets), beverages were classified separately. Blood samples were analyzed to determine concentrations of: total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, glucose. Children were found to eat fats and sweets more frequently than other food groups. The 59 children, found to be obese and overweight, presented significant higher blood lipid levels (except to glucose levels) than normal weight kids. Using random forests, we found out that food and beverage consumption plays a key role in influencing blood lipids profile in children overweight and obese. Given these observations, it's crucial to develop health care policies promoting healthy eating habits among schoolchildren taking into account the specific characteristics of this geographical area in Mexico(AU)

Este estudio transversal tiene como objetivo investigar los hábitos alimentarios, el nivel socioeconómico y el perfil de lípidos sanguíneos en niños en edad escolar que viven en una zona de bajos recursos en México, caracterizando las concentraciones de lípidos en niños obesos/sobrepeso y evaluar el impacto de los factores socioeconómicos y hábitos dietéticos en el perfil de lípidos de estos niños. Mediante un cuestionario utilizado previamente en el estudio enKid realizado con niños españoles lo realizaron en forma completa 156 niños (78 niños y 78 niñas), se evaluó los hábitos alimentarios y el estado socioeconómico. Los alimentos reportados en el cuestionario se clasifica en cuatro grupos de alimentos (alimentos fuente animal / legumbres, granos / tubérculos, frutas / verduras, grasas / dulces), las bebidas fueron clasificadas por separado. Se analizaron muestras de sangre para determinar las concentraciones de: colesterol total, LDL-colesterol, HDL-colesterol, triglicéridos, glucosa. Los 59 niños, obesos/sobrepeso, presentaron niveles de lípidos en sangre significativamente más altos que los niños de peso normal. Usando Selvas Aleatorias nos enteramos de que los alimentos y el consumo de bebidas juegan un rol clave para influir en el perfil de lípidos en la sangre en niños obesos/sobrepeso. Teniendo en cuenta estas observaciones, es crucial desarrollar políticas de salud que promueven hábitos alimenticios saludables entre los escolares, teniendo en cuenta las características específicas de esta área geográfica en México(AU)

Long term interaction between dietary patterns and disease incidence: evidence from serbia

The objective of this study was to evaluate the relationship between dietary pattern and incidence of nutrition-related non-communicable diseases in Serbia, a country which has experienced a significant shift in nutrition and lifestyle habits, guided by its particular historical background and its rapid transition to liberal economy. Data was collected from annual reports published by the Statistical Office of the Republic of Serbia and the Institute of Public Health. It provides a focus on the timeframe of 1997-2014, in order to capture any changing pattern after the year 2000, in which the process of complete trade liberalization started.The results have shown a striking growing trend in both disease incidence on the one hand and processed food items such as processed meat, fruit juices, chocolate and biscuits and on the other hand. Granger causality test suggests that there exists causality that goes beyond spurious relationship between the disease of blood and blood-forming organs and immune system disorders and average per capita consumption of fruit and vegetables, poultry, processed meat, chocolates and biscuits and fruit juices. Also, we find evidence of long-term relationship between fish consumption and endocrine, metabolic and digestive diseases(AU)

El objetivo de este estudio fue evaluar la relación entre los patrones de dieta y la incidencia de las enfermedades no transmisibles relacionadas con la nutrición en Serbia, un país que ha experimentado un cambio significativo en los hábitos de nutrición y estilo de vida, guiado por sus antecedentes históricos particulares y su rápida transición hacia una economía liberal. Se recogieron datos de los informes anuales publicados por la Oficina de Estadística de la República de Serbia y el Instituto de Salud Pública. Se hizo foco en el período de 1997 a 2014, con el fin de poder detectar cualquier cambio en los patrones a partir del año 2000, cuando comenzó el proceso de liberalización total del comercio. Los resultados han mostrado llamativamente una tendencia creciente tanto en la incidencia de enfermedades como en la proliferación de alimentos procesados, tales como carne procesada, jugos de frutas, chocolate y galletas. La prueba de causalidad de Granger sugiere que existe una relación de causalidad que va más allá de la relación espuria entre las enfermedades hematológicas, las afecciones de los órganos hematopoyéticos y del sistema inmunológico y el consumo promedio per cápita de frutas y hortalizas, productos avícolas, carne procesada, chocolates, galletas y jugos de frutas. Parece evidente también la existencia de una relación a largo plazo entre la aparición de enfermedades endocrinas, metabólicas y digestivas y el consumo de pescado(AU)

What is breakfast for Mexican children?

In order to face with the concerning rising prevalence of overweight and obesity in childhood, Mexican government has implemented Nutritional Indications (NI) for preschool and schoolchildren. The aim of our study is to investigate what Mexican children have for breakfast and if they meet NI, which recommends that daily breakfast should include one food from each of the three recommended food groups (grains and tubers, animal source food and legumes, fruits and vegetables). We considered a sample of 120 male children aged 3-14 years, their mothers were asked to complete a questionnaire and to fill a breakfast diary for one week. Food was grouped in the three recommended food groups and a further group including fats and sweets was considered. Only 32 children met NI at least once a week (compliant children) and nobody followed NI throughout the week. The analysis on breakfast records showed a low intake of the fruits and vegetables food group. Children were more likely to follow NI when they had breakfast with family members. We show that children do not meet breakfast's NI, but further researches are needed to investigate the long-term impact of NI on Mexican children eating patterns(AU)

Para hacer frente al aumento de la prevalencia de sobrepeso y obesidad en la infancia, el Gobierno Mexicano ha implementado las indicaciones nutricionales (IN) para niños en etapas preescolar y escolar. El objetivo de nuestro estudio es investigar los componentes del desayuno en la dieta de niños Mexicanos, además del cumplimiento con las IN, que recomiendan que el desayuno diario debe incluir un alimento de cada uno de los tres grupos alimenticios recomendados (granos y tubérculos, alimentos de origen animal, y legumbres, frutas y verduras). Se consideró una muestra de 120 niños (de género masculino) con edades entre 3 y 14 años. Se solicitó a sus madres completar un cuestionario y realizar un registro diario de los componentes del desayuno durante una semana. Los alimentos se agruparon según dictan las IN; además, un grupo que incluye grasas y dulces fue también considerado. Sólo 32 niños cumplieron con las IN al menos una vez a la semana (los niños que cumplen) y ninguno siguió las IN durante toda la semana. El análisis sobre los registros diarios mostró un bajo consumo del grupo de alimentos compuesto por frutas y verduras. El justo seguimiento de las IN ha sido más probable cuando el desayuno se ha realizado con miembros de la familia. Se demuestra que los niños no cumplen el IN del desayuno, pero se necesitan más investigaciones para investigar el impacto a largo plazo de IN sobre los hábitos alimenticios de los niños mexicanos(AU)

Eating patterns in mexico and obesity in children: results from the nutrirun project

This study aims to compare obesity rates, physical activity levels and compliance with Nutritional Indications (NI), provided by the Estrategia contra el sobrepeso y la obesidad, between three consecutive years (2011, 2012, 2013) in children enrolled in the NutriRun project. Data were collected during the race Carrera Kinder Generación en Movimiento held in Mexico City in 2011, 2012 and 2013. A medical-dietetic questionnaire was administered to parents, investigating what kind of food their children usually had for breakfast, lunch and dinner, physical activity levels and family medical history. Children were weighed and measured and BMI was calculated. In order to evaluate compliance with NI, food reported in the medical-dietetic questionnaire for breakfast and dinner was classified in four main food groups and in other four main food categories for lunch, according to NI. The analysis of overweight/obesity in 2011, 2012 and 2013 revealed a significant reduction (p-value 0.001) of children overweight/obese and an increase of normal weight ones. However, in all the three considered years, they were found to not follow NI because of a poor consumption of fruits and vegetables and of salad. Therefore, further health care policies promoting fruits and vegetables consumption among Mexican families are needed(AU)

Este estudio tiene como objetivo comparar las tasas de obesidad, los niveles de actividad física y el cumplimiento de las Indicaciones Nutricionales (IN), proporcionada por la Estrategia contra el sobrepeso y la obesidad, entre los tres años consecutivos (2011, 2012, 2013) en los niños que participaron en el proyecto NutriRun. Los datos fueron recolectados durante la carrera Kinder Generación en Movimiento, celebrada en la Ciudad de México en 2011, 2012 y 2013. Un cuestionario médico-dietético se administró a los padres, investigando qué tipo de alimentos por lo general tenían sus hijos para el desayuno, el almuerzo y la cena, los niveles de actividad física y el historial médico de la familia. Los niños fueron pesados y medidos y se calculó el IMC. Con el fin de evaluar el cumplimiento de las NI, la comida reportada en el cuestionario médico-dietético se clasificó, para el desayuno y la cena, en cuatro grupos de alimentos principales y en otros cuatro principales categorías de alimentos para el almuerzo, de acuerdo con las NI. El análisis de las tendencias de sobrepeso/obesidad en 2011, 2012 y 2013 demostró una reducción significativa (p-valor de 0,001) de los niños obesos/sobrepeso y un aumento de peso normal. Sin embargo, en los tres años considerados, se encontró que los niños no siguen las IN, debido a un pobre consumo de frutas y verduras y de la ensalada. Por lo tanto se necesitan nuevas políticas de atención a la salud que promuevan el consumo de frutas y verduras entre las familias mexicanas(AU)

Types of food and nutrient intake in India: a literature review.

Nowadays India is undergoing an impressive economic growth accompanied by a very slow decline, almost stagnation, in malnutrition levels. In developing countries, studies on dietary patterns and their relationship with nutritional status are scarce. Over the years some nutritional studies have been performed to explore different types of food consumed in various Indian regions, among different social samples. The aim of the present paper is to review and describe trends in food and nutrition intake patterns in the different states of India. The review was carried out in PubMed, using the advanced research criteria: [food* OR ("meal pattern*") OR ("eating pattern*")] AND ("nutrient intake") AND India*. PubMed research gave back 84 results and out of these, 7 papers due to their focus on food intake and consumption levels in India have been included in this study. Food intake patterns showed that most of the Indians are vegetarians and that food items rich in micronutrients (pulses, other vegetables, fruits, nuts, oilseeds and animal foods) are generally consumed less frequently. Poor and monotonous cereals-based diet may promote inadequate nutrition intakes according to Recommended Daily Allowance (RDA) standards.

Evaluating food front-of-pack labelling: a pan-European survey on consumers' attitudes toward food labelling.

Nutrition labels on pre-packaged foods have been widely used as a medium to foster healthier eating habits in the general population, to contribute to a reduction in the incidence and prevalence of diet-related conditions. Yet, there is no convincing evidence that food labels are an effective means to achieve the desired effect at population level. Several factors have been suggested to account for this decoupling of efficacy, e.g. difficulties in understanding the information on food-labels. The present article presents the results of a survey on Europeans' understanding of nutritional labels and evaluation on the communication tools for their diffusion. A total of 7550 phone interviews were conducted in 16 European Countries: Austria, Belgium, Denmark, France, Germany, Greece, Italy, the Netherlands, Poland, Portugal, Czech Republic, Slovenia, Spain, Sweden, United Kingdom and Hungary. Consumers were asked about their opinion on nutritional information provided at different levels and their commitment to healthy behaviour.

Investigating the obesogenic effects of marketing snacks with toys: an experimental study in Latin America.

BACKGROUND: The inclusion of toys in food packages is a common marketing practice, and it is suspected of promoting obesogenic behaviours. This study aimed to determine whether toys packaged with food are indeed increasing the amount of food eaten by children, and if this effect is enhanced by contemporary exposure to TV and/or advertising. METHODS: A total of 600 children (balanced according to gender and age groups, 3-6 and 7-10 years old) were randomized in three school facilities in Argentina, Brazil and Mexico and exposed to food (snacks) alone or food associated with toys in an experimental setting. All of the children received the same meal at lunchtime. The products were packages in which chocolate was associated with toys in an egg-shaped container partially filled by chocolate. The children were asked to eat ad libitum for 20 minutes during the afternoon break. In addition, the children were randomized into two groups and either shown or not shown a movie cartoon, with three different levels of exposure to commercials in the TV viewing condition (1, 2 or 3 advertisements). RESULTS: No significant differences emerged between the "toys" and "no toys" groups even after taking into account exposure to TV, commercials and other confounding factors. CONCLUSIONS: The inclusion of toys in food packages was not shown per se to lead to an increase in the caloric intake of children.

Multifunctional food: medical evidence and methodological notes on substantiating health claims.

In nutritional research, a specific issue is about understanding how to provide a clear and solid proof of the health effects of each functional food. The problems range from regulatory perspectives down to very basic methodological issues. In addition, when multi-functionality comes into play, then several additional problems are posed in terms of the methodological appropriateness of research done. In this review, a focus is provided on some methodological issues related to (i) the general concepts of 'proving' effects in a methodological perspective and (ii) the difficulties of specifically proving functional effects of food. A specific attention is dedicated on the characteristic problems which, from a methodological perspective, arise when multi-functionality is the matter of the proof.