Effects of dietary interventions for metabolic acidosis in chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND AND HYPOTHESIS: Metabolic acidosis is a common complication of kidney disease and can result in further disease progression. Alkali therapy has been used to treat metabolic acidosis for decades. However, some concerns have been raised regarding its safety and long-term tolerability. Existing data suggest that dietary interventions can be beneficial in the management of chronic kidney disease (CKD). This systematic review and meta-analysis aims to summarize findings from studies comparing dietary interventions with placebo/usual care/no treatment in the management of metabolic acidosis in outpatient adults with CKD. METHODS: Medline, Embase, Cochrane Central, CINAHL, and Web of Science Core Collection were searched from inception to June 2022. Our primary outcome measure was change in serum bicarbonate. Any dietary intervention looking to manipulate dietary acid load was considered as an intervention. Data screening and extraction were performed by two independent reviewers. Random effects meta-analysis was performed to pool data. RESULTS: Dietary interventions resulted in clinically significant improvement in serum bicarbonate (mean difference (MD):2.98, 95% CI: [0.77, 5.19]; I2: 91%) and higher eGFR levels (MD: 3.16, 95%CI: [0.24, 6.08], I2: 67%) compared to controls. Serum potassium, albumin and body mass index remained unchanged. Dietary interventions were reported to be safe. Subgroup analyses indicated a superiority of plant-based over non-plant-based interventions in the improvement of acid-base balance and eGFR, however, these findings are from low quality and heterogenous studies. CONCLUSION: Our findings support the beneficial effects of dietary interventions aimed at reducing acid or adding base in the management of metabolic acidosis and kidney function in adults with CKD, with no adverse effects on serum potassium and nutritional status. Well-designed clinical trials looking at the treatment of metabolic acidosis with dietary interventions with a focus on adding base through fruit and vegetables are required.

Visualizing the structural and chemical heterogeneity of fruit and vegetables using advanced imaging techniques: fundamentals, instrumental aspects, applications and future perspectives.

Fruit and vegetables (F&V) are vastly complicated products with highly diverse chemical and structural characteristics. Advanced imaging techniques either combine imaging with spectral information or can provide excellent tissue penetration, and enable the possibility to target, visualize and even qualify the chemical and physical (structural) heterogeneity within F&V. In this review, visible and/or near infrared hyperspectral imaging, Fourier transform infrared microspectroscopic imaging, Raman imaging, X-ray and magnetic resonance imaging to reveal chemical and structural information in a spatial context of F&V at the macro- (entire products), meso- (tissues), and micro- (individual cells) scales are comprehensively summarized. In addition, their basic concepts and operational procedures, particularly sample preparation and instrumental parameter adjustments, are addressed. Finally, future challenges and perspectives of these techniques are put forward. These imaging techniques are powerful tools to assess the biochemical and structural heterogeneity of F&V. Cost reduction, sensor fusion and data sharing platforms are future trends. More emphasis on aspects of knowledge and extension at the level of academia and research, especially on how to select techniques, choose operational parameters and prepare samples, are important to overcome barriers for the wider adoption of these techniques to improve the evaluation of F&V quality.

Hyperspectral imaging reveals chemical heterogeneity of fruit and vegetables.Imaging techniques provide spatial insights in fruit and vegetables at multiple scales.Future trends are cost reduction, sensor fusion and data sharing.Instrumental adjustment and sample preparation should receive more attention.

Does fruit and vegetable consumption impact mental health? Systematic review and meta-analyses of published controlled intervention studies.

Associations between fruit and vegetable (FV) consumption and mental health are suggested, largely from observational studies. This systematic review aimed to identify and summarise all published controlled intervention studies investigating the effects of FV consumption on mental health in adults. Four academic databases (Medline, PsycINFO, PubMed, Web of Science) were searched on 16 September 2022, over all years, for studies that used an intervention design; included FV consumption; included an appropriate non-FV-consumption control; used a validated measure of mental health and were conducted in healthy adults or adults with solely a depressive or anxiety-related condition. Study details were tabulated and combined using meta-analyses. Risk of bias was assessed using the domains of the Cochrane Collaboration. Six studies, enrolling 691 healthy adults and reporting on one or more mental health outcomes, were found. Meta-analyses found small and imprecise effects of FV consumption for: psychological well-being (4 studies, 289 participants) standardised mean difference (SMD) = 0·07 (95 % CI -0·17, 0·30), P = 0·58, I2 = 0 %; depressive symptomology (3 studies, 271 participants) SMD = -0·15 (95 % CI -0·40, 0·10), P = 0·23, I2 = 47 % and anxiety-related symptomology (4 studies, 298 participants) SMD = -0·15 (95 % CI -0·39, 0·08), P = 0·20, I2 = 71 %. Some benefit for psychological well-being was found in change-from-baseline data: SMD = 0·28 (95 % CI 0·05, 0·52), P = 0·02, I2 = 0 %. Risk of bias was high in many studies. Limitations include the consideration only of published studies and stem from the studies found. Given the few, limited studies available and the small size of effects, stronger evidence is needed before recommending FV consumption for mental health.

Genomic selection for crop improvement in fruits and vegetables: a systematic scoping review.

To ensure the nutritional needs of an expanding global population, it is crucial to optimize the growing capabilities and breeding values of fruit and vegetable crops. While genomic selection, initially implemented in animal breeding, holds tremendous potential, its utilization in fruit and vegetable crops remains underexplored. In this systematic review, we reviewed 63 articles covering genomic selection and its applications across 25 different types of fruit and vegetable crops over the last decade. The traits examined were directly related to the edible parts of the crops and carried significant economic importance. Comparative analysis with WHO/FAO data identified potential economic drivers underlying the study focus of some crops and highlighted crops with potential for further genomic selection research and application. Factors affecting genomic selection accuracy in fruit and vegetable studies are discussed and suggestions made to assist in their implementation into plant breeding schemes. Genetic gain in fruits and vegetables can be improved by utilizing genomic selection to improve selection intensity, accuracy, and integration of genetic variation. However, the reduction of breeding cycle times may not be beneficial in crops with shorter life cycles such as leafy greens as compared to fruit trees. There is an urgent need to integrate genomic selection methods into ongoing breeding programs and assess the actual genomic estimated breeding values of progeny resulting from these breeding programs against the prediction models. Supplementary Information: The online version contains supplementary material available at 10.1007/s11032-024-01497-2.

Environmental impact and nutritional quality of adult diet in France based on fruit and vegetable intakes.

PURPOSE: To describe the nutritional quality and environmental impact of self-selected diets of adults in France in relation to their fruit and vegetable (FV) intakes. METHODS: Estimates of food and nutrient intakes were taken from the national INCA3 Survey on food intakes carried out in France in 2014-2015. The population (n = 2121 adults) was split into five quintiles of FV intakes, in g/d (Q1 representing the lowest intake, and Q5 the highest). The nutritional quality of diets was assessed through 4 indicators: mean adequacy ratio (MAR), solid energy density, mean excess ratio (MER) and Programme National Nutrition Santé guideline score 2 (PNNS-GS2). The environmental impacts were measured with environmental footprint (EF) scores and 4 additional indicators: climate change, ozone depletion, fine particulate matter and water use. Indicators were compared between quintiles. Analysis was conducted on diets adjusted to 2000 kcal. RESULTS: MAR and PNNS-GS2 increased with increased FV quintiles, while solid energy density decreased. Fibre, potassium, vitamin B9 and vitamin C densities increased with increasing FV intakes. Climate change, ozone depletion and fine particulate matter impacts of diets decreased with increasing quintiles of FV consumption. Conversely, water use impact increased. CONCLUSION: Higher intake of FV is associated with higher nutritional quality of diets and lower environmental impact, except for water use. Given the benefits of fruit and vegetables for human health and the environment, their negative impact on water use could be improved by working on the agricultural upstream, rather than by changing individuals' food choices and reducing their consumption.

The effect of increased fruit and vegetable consumption on blood pressure and lipids: a pooled analysis of six randomised controlled fruit and vegetable intervention trials.

BACKGROUND: Increasing fruit and vegetable (FV) consumption is associated with reduced cardiovascular disease risk in observational studies but with little evidence from randomised controlled trials (RCTs). The impact of concurrent pharmacological therapy is unknown. OBJECTIVE: To pool data from six RCTs to examine the effect of increasing FV intake on blood pressure (BP) and lipid profile, also exploring whether effects differed by medication use. DESIGN: Across trials, dietary intake was assessed by diet diaries or histories, lipids by routine biochemical methods and BP by automated monitors. Linear regression provided an estimate of the change in lipid profile or BP associated with a one portion increase in self-reported daily FV intake, with interaction terms fitted for medication use. RESULTS: The pooled sample included a total of 554 participants (308 males and 246 females). Meta-analysis of regression coefficients revealed no significant change in either systolic or diastolic BP per portion FV increase, although there was significant heterogeneity across trials for systolic BP (I2 = 73%). Neither adjusting for change in body mass index, nor analysis according to use of anti-hypertensive medication altered the relationship. There was no significant change in lipid profile per portion FV increase, although there was a significant reduction in total cholesterol among those not on lipid-lowering therapy (P < 0.05 after Bonferroni correction). CONCLUSION: Pooled analysis of six individual FV trials showed no impact of increasing intake on BP or lipids, but there was a total cholesterol-lowering effect in those not on lipid-lowering therapy.

Mediators and moderators of the effects of a school-based intervention on adolescents' fruit and vegetable consumption: the HEIA study.

OBJECTIVE: To examine whether targeted determinants mediated the effects of the HEalth In Adolescents (HEIA) intervention on fruit and vegetable (FV) consumption and explore if these mediating effects were moderated by sex, parental education or weight status. DESIGN: Cluster-randomised controlled trial. SETTING: The HEIA study (2007-2009) was a Norwegian 20-month multi-component school-based intervention to promote healthy weight development. FV consumption and targeted determinants were self-reported at baseline, mid-way (8 months) and post-intervention (20 months). PARTICIPANTS: Adolescents (11-13-year-old) in twenty-five control schools (n 746) and twelve intervention schools (n 375). RESULTS: At post-intervention, more adolescents in the intervention group compared with the control group had knowledge of the FV recommendations (OR: 1·4, 95 % CI 1·1, 1·9) and reported a decreased availability of vegetables at home (ß: -0·1, 95 % CI -0·2, 0·0). Availability/accessibility of FV at home, availability of vegetables at dinner, taste preferences for different types of FV and knowledge of the FV recommendations were positively associated with the consumption of FV. However, none of the post-intervention determinants significantly mediated the intervention effects on FV consumption. Although no moderating influences by sex, parental education or weights status were observed on the mediating effects, exploratory analyses revealed significant moderations in the b-paths. CONCLUSIONS: Since none of the targeted determinants could explain the increase in FV consumption, it remains unclear why the intervention was effective. Reporting on a wide range of mediators and moderators in school-based interventions is needed to reveal the pathways through which intervention effects are achieved.

Did COVID-19 influence fruit and vegetable consumption? Explaining and comparing pandemic peak and post-peak periods.

The COVID-19 pandemic, one of the worst global health crises in the last century, impacted nearly every aspect of people's lives, including their dietary choices and food consumption patterns. It arrived during a long shift in American diets featuring increasingly large portions of processed foods as well as fruit and vegetable consumption that is well below recommended levels. Improving the latter has been a key part of policymakers' efforts to improve consumers' diets. This study surveyed individuals in the US South to determine the factors influencing their consumption of fruit and vegetables during the pandemic peak and how these have changed post-peak. During the peak, food venue, demographics, and concerns about diet and the seriousness of the virus heavily affected consumption. Greater amounts of fresh fruit and vegetables were consumed post-peak pandemic. Changes post-peak were predicted by food venue. Cooking meals at home was the main positive predictor for consumption. US policymakers should try and leverage the changes since the peak to promote greater consumption of fruit and vegetables.

Application of methyl jasmonate to control chilling tolerance of postharvest fruit and vegetables: a meta-analysis and eliciting metabolism review.

Chilling injury is one of the most significant limitations for low temperature storage of postharvest fruits and vegetables, causing quality deterioration and economic loss. Increasing studies indicated that methyl jasmonate (MeJA) is critical in regulating the postharvest fruit and vegetables chilling tolerance. Based on a meta-analysis, the review analyzed the action of exogenous MeJA application on the chilling index in postharvest fruit and vegetables and summarized MeJA's mechanisms for controlling postharvest chilling injury. The meta-analysis found that MeJA treatment remarkably inhibited postharvest fruit and vegetable chilling injury. Moreover, we concluded the following function mechanism of MeJA on postharvest fruit and vegetable chilling tolerance: (1) Enhancing membrane integrity and energy supply, (2) Increasing antioxidant activity, (3) Enhancing arginine pathway, (4) Enhancing sugar metabolism, (5) Regulating phenolic metabolism, (6) Activating CBF pathway, (7) Regulating HSP accumulation and expression, and (8) Crosstalk with phytohormone. Finally, we summarized the regulatory mechanisms of MeJA on postharvest fruit and vegetable biological processes at the transcriptional and post-translational levels.

Geographical and sociodemographic disparities in fruit and vegetables consumption among adults in Burkina Faso: baseline results from the 2013 WHO STEPS survey.

BACKGROUND: Evidence on sociodemographic determinants and spatial variations in the fruit and/or vegetable (FV) consumption was reported. This study aimed to explore geographical and sociodemographic disparities in the level of FV consumption among adults in Burkina Faso, using the national baseline data. METHODS: This was a cross-sectional secondary study of primary data obtained by the 2013 (September to October) World Health Organization Stepwise Approach to Surveillance survey conducted in Burkina Faso. The participants were 4402 women and men aged 25-64 years and living in all 13 Burkinabè Regions. Descriptive and analytical analyses were performed using Student's t test, ANOVA, the chi-square test, Fisher's exact test and logistic regressions. RESULTS: The prevalence of a typical daily consumption of at least three servings was 4.1% (95% CI: 3.6-4.8) for fruits and 6.6% (95% CI: 5.9-7.3) for vegetables. The national prevalence of adequate FV intake was 5.1% (95% CI: 4.4-5.8), and for two Regions ("Centre-Ouest" and "Nord") the pooled prevalence was 22.4%, while in the other eleven Regions its was significantly lower, 2.4% (p = 0.0001). Using quartiles derived from the national level of consumption, each of these two Regions had a higher proportion (about 50%) of their participants in the fourth quartile (the higher level). The associated sociodemographic factors with the adequate intake were being rural residents (aOR = 1.7, p = 0.011) and women (aOR = 1.3; p = 0.03). CONCLUSION: Except for the Regions of "Centre-Ouest" and "Nord" of Burkina Faso, the prevalence of adequate consumption of FV was very low in its other eleven Regions. Measures to increase consumption in urban people are urgent while women should be the key actor in the family-based approaches implementation and the nutrition education promoting FV consumption.

Implementation of four strategies in Dutch day-care centres to stimulate young children's fruit and vegetable consumption.

The day-care setting is an ideal place to encourage children's fruit and vegetable (=F&V) eating. Whereas many studies have focused on the effectiveness to increase F&V consumption, little is known about how to successfully implement effective strategies in daily practice. This study aimed to investigate how day-care professionals evaluated the implementation of a self-chosen strategy to support children's F&V eating. Thirteen day-care locations chose one out of five promising strategies and implemented this strategy for 10-12 weeks. Before (N = 98) and after the study (N = 49), day-care professionals completed a questionnaire to assess their implementation experiences, the impact on children's F&V eating as well as their future intention to use the strategy (on a 5-point scale). Parents (N = 152) completed a short questionnaire at the end of the study to capture their experiences and potential transfer effects to the home situation. Results showed that acceptability, appropriateness, feasibility and sustainability of the strategies were generally satisfactory (scores ≥3.5 on a 5-point scale), but the strategy of cooking scored less favourable on appropriateness and sustained implementation. Children's willingness to taste F&V varieties (3.4 ± 0.7 vs. 2.8 ± 0.8; p < 0.001) and eating pleasure for vegetables (3.4 ± 0.6 vs. 3.1 ± 0.8; p = 0.01) increased, whereas children's F&V consumption did not change (p > 0.14). Parents valued the day-cares' efforts to encourage children's F&V consumption and a small group (∼20%) experienced positive effects at home. This study shows that implementing a self-chosen F&V strategy at the day-care is acceptable, appropriate and feasible for day-care professionals and has potential to positively impact children's F&V eating behaviour. Future research should investigate the effects of long-term implementation on children's eating behaviour and examine how structural implementation can be further supported.

Working With Rural Producers to Expand EBT in Farmers' Markets: A Case Study in Hardeman County, Tennessee.

Rural residents tend to eat less fruits and vegetables, placing them at higher risk of chronic diseases compared with urban residents. Farmers' markets can provide increased access to fresh produce for rural communities. Encouraging markets to accept Supplemental Nutrition Assistance Program (SNAP) benefits through Electronic Benefit Transfer (EBT) can expand access to healthy foods to low-income residents. Rural markets are less likely to accept SNAP compared with urban markets. Rural producers have identified lack of knowledge and limited support about the application process as barriers for accepting SNAP. This case study details how our Extension program helped a rural producer through the SNAP application process. We started with a workshop to inform rural producers about the benefits of accepting SNAP. After the workshop, we provided hands-on support and assistance to help one producer navigate the EBT application process as well as how to implement and advertise SNAP at the market. Implications for practitioners about tips to help producers overcome challenges and barriers for EBT acceptance are discussed.

"Something Fun to Look Forward to": Lessons From Implementing the Prescription for Health Farmers' Market Initiative in Rural Upper Michigan.

Fruit and vegetable (FV) prescription programs are an increasingly popular community-based approach to addressing food insecurity and improving nutrition by connecting local health care and food systems. The Prescription for Health farmers' market FV prescription program was piloted in a rural, low-access low-income Michigan community in 2017. The program enrolled 33 adult participants with chronic disease and provided weekly farmers' market FV vouchers, educational nutrition handouts, and seasonal healthy recipes over 10 weeks. Weight, blood pressure, and the following self-rated variables were assessed pre- and post program: dietary habits, food literacy, physical health, and mental health. While most metrics remained generally unchanged, one of the strongest findings from our data included significant improvement in quality of life. Increased social interaction as a result of the attending the farmers' market was a prominent theme from informal open-ended participant feedback. Given the ongoing public health crisis of loneliness and social isolation, this finding led us to consider the farmers' market as an avenue for creating opportunities for meaningful social connection among participants and farmers. To this end, we discuss health outcomes of the Prescription for Health pilot program, reflect on unique aspects of implementing this program in a rural area, and explore future opportunities for farmers' market prescription programs as an innovative form of nature-based social prescribing.

Effect of the multicomponent healthy high school intervention on meal frequency and eating habits among high school students in Denmark: a cluster randomized controlled trial.

BACKGROUND: Previous studies have shown that multicomponent interventions may improve meal frequency and eating habits in children, but evidence among young people is limited. This study evaluated the effect of the Healthy High School (HHS) intervention on daily intake of breakfast, lunch, water, fruit, and vegetables at 9-month follow-up. METHODS: The study included first-year students (≈16 years) attending high school in Denmark. Participating schools were randomized into the HHS intervention (N = 15) or control group (operating as usual) (N = 15). The intervention was designed to promote well-being (primary outcome) by focusing on healthy habits including meals, stress prevention, and strong peer relations. It included a curriculum, structural and organisational initiatives, a workshop, and a smartphone application. Students completed self-administered online questionnaires at the beginning of the school year and nine months later. To account for clustering of data, we used multilevel logistic regression analyses to estimate odds ratios (OR). We applied an intention-to-treat approach with multiple imputations of missing data. RESULTS: At baseline 4577 of 5201 students answered the questionnaire and 4512 at follow-up. In both groups the proportion of students eating breakfast decreased from approximately 50% to 40% from baseline to follow-up, and lunch frequency decreased from approximately 50% to 47%. Daily water intake, intake of fresh fruit and intake of vegetables remained unchanged from baseline to follow-up. There were no significant between group differences on any of the outcomes at first follow-up: breakfast: OR = 0.85 (95% CI: 0.65;1.10), lunch: OR = 0.96 (95% CI: 0.75;1.22), water intake: OR = 1.14 (95% CI: 0.92;1.40), intake of fresh fruit: (OR = 1.07, 95% CI: 0.84;1.37), vegetables: (OR = 1.01, 95% CI: 0.77;1.33). CONCLUSION: No evidence of an effect of the HHS intervention was found for any of the outcomes. Future studies are warranted to explore how health promoting interventions can be integrated in further education to support educational goals. Moreover, how to fit interventions to the lives and wishes of young people, by also including systems outside of the school setting. TRIAL REGISTRATION: ISRCTN, ISRCTN43284296 . Registered 28 April 2017 - retrospectively registered.

Effects of the DAGIS randomized controlled trial on home environment and children's food consumption according to the degree of implementation.

BACKGROUND: Combining process evaluation data with effectiveness data and examining the possible mediators of intervention effects elicits valuable knowledge about how and for whom these interventions are effective. The aim of this study was to examine whether the parental degree of implementation (DOI) of a home-involving preschool intervention affected children's food consumption via home mediators. METHODS: The five-month Increased Health and Wellbeing in Preschools (DAGIS) intervention involved 476 participating children aged 3-6 years and was conducted in 2017-2018. Parents reported children's food consumption (g/day) outside childcare hours, the availability of foods at home, role modelling of food consumption, and the norms related to food consumption. In addition, parents reported the extent to which they had implemented the intervention program at home. Mediation analyses were conducted to examine the effect of low and high DOI compared to control group on the change in children's consumption of fruit and vegetables (FV), sugary everyday foods, sugary treats, and sugar-sweetened beverages (SSB) via food availability in the home, parental role modelling and parental norms. RESULTS: Compared to the control group, there was a direct effect of a high DOI on diminishing consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No indirect effects were detected. In the high DOI group, a change in parental norm was associated with increased FV consumption showing an indirect effect (B 4.31, 95% CI 0.23, 10.59). In the low DOI group, there was an indirect effect via decreased food availability leading to decreased sugary everyday food consumption (B -2.17, 95% CI -5.09,  -0.09). CONCLUSIONS: Combining process evaluation and effectiveness data revealed a decrease in children's SSB consumption only in the high DOI group, as well as indirect effects on children's consumption of FV and sugary everyday foods. In order to gain more intervention effects, further studies are required in order to examine parental facilitators and barriers to the implementation of interventions and how to impact effectively the determinants of the targeted behavior. TRIAL REGISTRATION: ISRCTN57165350 (8 January, 2015).

Examining fruit and vegetable intake in low-income older adults using the Veggie Meter®.

BACKGROUND: Older adults report low fruit and vegetable (FV) intake. The lack of objective, field-based assessments of FV intake is a limitation when assessing the effectiveness of interventions. AIM: To examine if self-reported FV intake was correlated with Veggie Meter® scores among low-income older adults. The Veggie Meter® is a portable tool that uses pressure-mediated reflection spectroscopy to estimate skin carotenoid measurements. METHODS: A cross-sectional assessment of FV intake, food security, and Veggie Meter® score in low-income older adults was conducted. Bivariate analyses quantified the association between FV intake and Veggie Meter® score. RESULTS: Participants (n = 154) were mostly female (69.3%), non-white (66.2%) and at risk for food insecurity (65.6%). Mean Veggie Meter® score was 172.3 ± 77.2 and had a small significant positive correlation with FV intake (r= 0.192, p = 0.018). CONCLUSION: The Veggie Meter® may objectively indicate FV intake. Research to validate the Veggie Meter® in older, diverse populations is needed.

The effects of increasing fruit and vegetable intake in children with asthma: A randomized controlled trial.

BACKGROUND: A high fruit and vegetable (F&V) diet reduces asthma exacerbations in adults; this has not been examined in children to date. OBJECTIVE: To investigate the effect of a 6-month, high F&V diet on the time to first asthma exacerbation in children with asthma, in a parallel-group, randomized, controlled trial. METHODS: Children (aged 3-11 years) with asthma, history of exacerbations and usual low F&V intake (≤3 serves/day) were randomized to the intervention (high F&V diet) or control group (usual diet) for 6 months. The primary outcome was time to first exacerbation requiring medical intervention. Secondary outcomes included exacerbation rate, lung function, plasma TNF-α, CRP, and IL-6, faecal microbiota and peripheral blood mononuclear cell (PBMC) histone deacetylase (HDAC) activity and G-protein coupled receptor (GPR) 41/43 and HDAC (1-11) expression. RESULTS: 67 children were randomized between September 2015 and July 2018. F&V intake (difference in change (∆): 3.5 serves/day, 95% CI: [2.6, 4.4] p < 0.001) and plasma total carotenoids (∆: 0.44 µg/ml [0.19, 0.70] p = 0.001) increased after 6 months (intervention vs control). Time to first exacerbation (HR: 0.81, 95% CI: [0.38, 1.69], p = 0.569; control vs. intervention) and exacerbation rate (IRR: 0.84, [0.47, 1.49], p = 0.553; control vs. intervention) were similar between groups. In per-protocol analysis, airway reactance z-scores increased in the intervention versus control group (X5 ∆: 0.76 [0.04, 1.48] p = 0.038, X20 ∆: 0.93 [0.23, 1.64] p = 0.009) and changes in faecal microbiota were observed though there was no difference between groups in systemic inflammation or molecular mechanisms. In the control group, CRP and HDAC enzyme activity increased, while GPR41 expression decreased. No adverse events attributable to the interventions were observed. CONCLUSION & CLINICAL RELEVANCE: A high F&V diet did not affect asthma exacerbations over the 6-month intervention, though warrants further investigation as a strategy for improving lung function and protecting against systemic inflammation in children with asthma.

Derivation and Validation of a Total Fruit and Vegetable Intake Prediction Model to Identify Targets for Biomarker Discovery Using the UK National Diet and Nutrition Survey.

BACKGROUND: Dietary assessments in research and clinical settings are largely reliant on self-reported questionnaires. It is acknowledged that these are subject to measurement error and biases and that objective approaches would be beneficial. Dietary biomarkers have been purported as a complementary approach to improve the accuracy of dietary assessments. Tentative biomarkers have been identified for many individual fruits and vegetables (FVs), but an objective total FV intake assessment tool has not been established. OBJECTIVES: To derive and validate a prediction model of total FV intake (TFVpred) to inform future biomarker studies. METHODS: Data from the National Diet and Nutrition Survey (NDNS) were used for this analysis. A modeling group (MG) consisting of participants aged >11 years from the NDNS years 5-6 was created (n = 1746). Intake data for 96 FVs were analyzed by stepwise regression to derive a model that satisfied 3 selection criteria: SEE ≤80, R2 >0.7, and ≤10 predictors. The TFVpred model was validated using comparative data from a validation group (VG) created from the NDNS years 7-8 (n = 1865). Pearson's correlation coefficients were assessed between observed and predicted values in the MG and VG. Bland-Altman plots were used to assess agreement between TFVpred estimates and total FV intake. RESULTS: A TFVpred model, comprised of tomatoes, apples, carrots, bananas, pears, strawberries, and onions, satisfied the selection criteria (R2 = 0.761; SEE = 78.81). Observed and predicted total FV intake values were positively correlated in the MG (r = 0.872; P < 0.001; R2 = 0.761) and the VG (r = 0.838; P < 0.001; R2 = 0.702). In the MG and VG, 95.0% and 94.9%, respectively, of TFVpred model residuals were within the limits of agreement. CONCLUSIONS: Intakes of a concise FV list can be used to predict total FV intakes in a UK population. The individual FVs included in the TFVpred model present targets for biomarker discovery aimed at objectively assessing total FV intake.

Phytohormones in postharvest storage of fruit and vegetables: mechanisms and applications.

As a ubiquitous and essential part of phytophysiology, phytohormones have attracted tremendous attention for effective regulation of development and senescence of agricultural products. However, the postharvest mechanisms of phytohormones have not been thoroughly understood. This review provides an overview of common phytohormones for extending the shelf life of fruit and vegetables. The modulation principles are discussed in detail based on defence gene expression activation, sensitivity of senescence-related phytohormones inhibition, antioxidant enzymes activity stimulation, and cell membrane integrity maintenance. The applications of jasmonates, salicylic acids, cytokinins, gibberellins, polyamines, and brassinosteroids in preserving fruit and vegetables based on defence signaling network stimulation, senescence-related phytohormones expression or sensitivity repression, as well as antioxidant system enhancement and cell membrane integrity sustentation are introduced. The challenges and problems to be solved are discussed, and new trends of expanding lifespan by combining phytohormones with other treatments are also suggested. Although phytohormones have been demonstrated to have promising efforts in maintaining agricultural products, more novel and effective combination treatments should be developed to complement each other.

Identifying individuals with multiple non-communicable disease risk factors in Kenya: a latent class analysis.

OBJECTIVES: Non-communicable diseases (NCDs) are the leading causes of death globally. In Kenya, the number of deaths resulting from NCDs is projected to surpass malaria and tuberculosis by 2030. Studies in Kenya show increasing NCDs; the aim of the present study is to examine the clustering of NCDs and risk factors in Kenya. STUDY DESIGN: This is a cross-sectional study using data from the 2015 Kenya STEPwise Survey. METHODS: This study examined relationships between NCDs (e.g. obesity, hypertension and diabetes) and health behaviours (e.g. sedentary activity, and fruit and vegetable consumption). Survey probability weights, which estimated the sampling design effect, were applied to consider the sampling units, and stratifications were used during sampling so that the results could be generalisable to the national adult Kenyan population. In total, 4350 adults were included in the study sample. RESULTS: Overall, 24.43% of participants were classified as having hypertension, 1.88% as having type 2 diabetes, and 27.94% were classified as being overweight or obese. The best-fit model was a four-class solution. Class 1 is best described as 'young with high NCD risk' and had the highest sedentary activity. Class 2 is best described as 'poor rural with lower NCD risk' with a high chance of smoking and alcohol consumption. Class 3 is best described as 'rural with high NCD risk' and had the highest fruit and vegetable consumption. Class 4 is best described as 'wealthy young urban dwellers with high NCD risk' with a high chance of alcohol consumption and smoking. Individuals in Class 4 had the highest chance (40%) of being overweight/obese, a 2% chance of type 2 diabetes and a 23% chance of having hypertension. CONCLUSIONS: NCDs are clustered in groups with high-risk behaviours. The group with the highest chance of having NCDs also had the highest chance of engaging in high-risk behaviours. The findings of this study suggest that smoking and alcohol consumption increase NCD risk in rural areas. Tailored and targeted interventions are needed to curb the increasing NCD prevalence in Kenya.