Local Foods Can Increase Adequacy of Nutrients Other than Iron in Young Urban Egyptian Women: Results from Diet Modeling Analyses.

BACKGROUND: Nutrition transition and recent changes in lifestyle in Middle Eastern countries have resulted in the double burden of malnutrition. In Egypt, 88% of urban women are overweight or obese and 50% are iron deficient. Their energy, sugar, and sodium intakes are excessive, while intakes of iron, vitamin D, and folate are insufficient. OBJECTIVE: This study aimed to formulate dietary advice based on locally consumed and affordable foods and determine the need for fortified products to meet the nutrient requirements of urban Egyptian women. METHODS: Food intakes were assessed using a 4-d food diary collected from 130 urban Egyptian women aged 19-30 y. Food prices were collected from modern and traditional markets to calculate diet cost. Population-based linear and goal programming analyses (Optifood tool) were used to identify "limiting nutrients" and to assess whether locally consumed foods (i.e., consumed by >5% of women) could theoretically improve nutrient adequacy at an affordable cost (i.e., less than or equal to the mean diet cost), while meeting recommendations for SFAs, sugars, and sodium. The potential of hypothetical fortified foods for improving intakes of micronutrients was also assessed. RESULTS: Iron was the most limiting nutrient. Daily consumption of fruits, vegetables, milk or yogurt, meat/fish/eggs, and tahini (sesame paste) were likely to improve nutrient adequacy for 11 out of 12 micronutrients modeled. Among fortified foods tested, iron-fortified rice, milk, water, bread, or yogurt increased the minimized iron content of the modeled diet from 40% to >60% of the iron recommendation. CONCLUSIONS: A set of dietary advice based on locally consumed foods, if put into practice, can theoretically meet requirements for most nutrients, except for iron for which adequacy is harder to achieve without fortified products. The acceptability of the dietary changes modeled needs evaluation before promoting them to young Egyptian women.

Computer-based tailored dietary counselling improves the nutrient adequacy of the diet of French pregnant women: a randomised controlled trial.

During pregnancy, mothers-to-be should adapt their diet to meet increases in nutrient requirements. Pregnant women appear to be keener to adopt healthier diets, but are not always successful. The objective of the present study was to determine whether a guided, stepwise and tailored dietary counselling programme, designed using an optimisation algorithm, could improve the nutrient adequacy of the diet of pregnant women, beyond generic guidelines. Pregnant women (n 80) who attended Notre-Dame-de-Bon-Secours Maternity Clinic were randomly allocated to the control or intervention arm. Dietary data were obtained twice from an online 3-d dietary record. The nutrient adequacy of the diet was calculated using the PANDiet score, a 100-point diet quality index adapted to the specific nutrient requirements for pregnancy. Women were supplied with generic dietary guidelines in a reference booklet. In the intervention arm, they also received nine sets of tailored dietary advice identified by an optimisation algorithm as best improving their PANDiet score. Pregnant women (n 78) completed the 12-week dietary follow-up. Initial PANDiet scores were similar in the control and intervention arms (60·4 (sd 7·3) v. 60·3 (sd 7·3), P = 0·92). The PANDiet score increased in the intervention arm (+3·6 (sd 9·3), P = 0·02) but not in the control arm (-0·3 (sd 7·3), P = 0·77), and these changes differed between arms (P = 0·04). In the intervention arm, there were improvements in the probabilities of adequacy for α-linolenic acid, thiamin, folate and cholesterol intakes (P < 0·05). Tailored dietary counselling using a computer-based algorithm is more effective than generic dietary counselling alone in improving the nutrient adequacy of the diet of French women in mid-pregnancy.

The contribution of milks and formulae to micronutrient intake in 1-3 years old children in urban China: a simulation study.

BACKGROUND AND OBJECTIVES: A recent dietary survey in 5 big cities in China provided information on various milk options consumed by 1-3 years old children. To investigate the nutritional role of these milks (young-child formula (YCF), cow's milk, others), simulation analyses based on this survey were performed. METHODS AND STUDY DESIGN: We studied daily intakes of calcium, iron, zinc, vitamins A, B-1, B-2, C and E and compared these to the Chinese DRIs. In Scenario 1, consumption of cow's milk, kid's milk and/or soy milk was replaced with matching amounts of YCF (n=66 children). In Scenario 2, where 348 children exclusively consumed YCF, YCF was replaced with matching amounts of cow's milk. RESULTS: Scenario 1 revealed significant increases in total dietary intakes of iron, vitamins A, B-1, C and E upon substitution of the various milks with YCF. The proportions of children not meeting the Estimated Average Requirement (EAR) for these nutrients dropped from 29, 26, 61, 53 and 54 % to 12, 11, 50, 27 and 24%, respectively. In Scenario 2, the hypothetical substitution of YCF by cow's milk increased the proportions of children not meeting the EAR for these nutrients, calcium and zinc from 11, 6, 49, 15, 28, 42, and 8 to 45, 24, 78, 69, 59, 44, and 20, respectively. Execution of Scenario 2 in subgroups of 1-2- and 2-3 years old children revealed similar results. CONCLUSIONS: YCF may help to reduce the risk of insufficient intake of several key micronutrients for toddlers, independent of age.

Theoretical Impact of Replacing Whole Cow's Milk by Young-Child Formula on Nutrient Intakes of UK Young Children: Results of a Simulation Study.

BACKGROUND: Research into the role of young-child formulae (YCF) in a child's diet is limited and there is no consensual recommendation on its use. We evaluated the theoretical nutritional impact of replacing the existing practice of consuming cow's milk by YCF. METHODS: From the UK Diet and Nutrition Survey of Infants and Young Children, whole cow's milk consumers, aged 12-18 months (n = 591) were selected for simulation scenarios. In Scenario 1, we tested the replacement of all whole cow's milk (434 ± 187 ml/day) by a matching volume of YCF, and in Scenario 2, all whole cow's milk was replaced by the on-pack recommended daily intake of 300 ml. Nutrient intakes before and after simulation scenarios were compared and evaluated against nutrient recommendations. RESULTS: Intakes of protein and saturated fatty acids were significantly decreased, whereas essential fatty acid intakes were increased. The prevalence of nutrient inadequacy before simulation was 95.2% for vitamin D and 53.8% for iron. After simulation, inadequacy decreased to 4.9% (Scenario 1) and 0% (Scenario 2) for vitamin D and to 2.7% (Scenario 1) and 1.1% (Scenario 2) for iron. CONCLUSIONS: Replacement of habitual cow's milk intake by a matching volume or 300 ml of YCF may lead to nutritional intakes more in line with recommendations in young children.

Perceived thickness and creaminess modulates the short-term satiating effects of high-protein drinks.

Previous research suggests that increasing beverage protein content enhances subsequent satiety, but whether this effect is entirely attributable to post-ingestive effects of protein or is partly caused by the distinct sensory characteristics imparted by the presence of protein remains unclear. To try and discriminate nutritive from sensory effects of added protein, we contrasted effects of three higher-energy (about 1·2 MJ) and one lower-energy (LE: 0·35 MJ) drink preloads on subsequent appetite and lunch intake. Two higher-energy drinks had 44% of energy from protein, one with the sensory characteristics of a juice drink (HP2, low-sensory protein) and the second a thicker and creamier (HPþ, high-sensory protein) drink. The high-carbohydrate preload (HCþ, high-sensory carbohydrate) was matched for thickness and creaminess to the HPþ drink. Participants (healthy male volunteers, n 26) consumed significantly less at lunch after the HPþ(566 g) and HCþ(572 g) than after HP2 (623 g) and LE (668 g) drinks, although the compensation for drink energy accounted for only 50% of extra energy at best. Appetite ratings indicated that participants felt significantly less hungry and more full immediately before lunch in HPþ and HCþ groups compared with LE, with HP2 being intermediate. The finding that protein generated stronger satiety in the context of a thicker creamier drink (HPþ but not HP2) and that an isoenergetic carbohydrate drink (HCþ), matched in thickness and creaminess to the HPþ drink, generated the same pattern of satiety as HPþ, both suggest an important role for these sensory cues in the development of protein-based satiety.

Associations between Perceived Social Eating Norms and Initiation and Maintenance of Changes in Dietary Habits during the First COVID-19 Lockdown in France.

Changes in dietary habits of the French population have been reported during the national lockdown that was enforced due to the COVID-19 pandemic. This study investigated whether perceived social eating norms were associated with the initiation and maintenance of dietary changes that took place as a result of lockdown. An online study collected information on (1) changes in consumption implemented during the lockdown and the maintenance of these changes, and (2) perceptions about changes in consumption implemented during lockdown by household members, relatives out of home, and the general population. The changes in consumption were classified as foods to increase or to decrease according to French national recommendations. The perception of changes to dietary habits by household members and relatives out of home was related to the changes made by individuals for each of the food categories (all p < 0.05) but not to the perception of changes made the general population. Increased consumption of foods to increase was more likely to be maintained when there was a positive perception of the changes made by household members (p = 0.03). These results highlight the influence of the perception of social eating norms, especially by household members and relatives, on the implementation of dietary changes during lockdown and suggest that social eating norms can have a lasting influence.

Perceptions of Tailored Dietary Advice to Improve the Nutrient Adequacy of the Diet in French Pregnant Women.

Tailored dietary counseling could be specifically efficient during pregnancy, a period accompanied by a rise in nutrition awareness, but little is known about the expectations of pregnant women in this regard. We studied these expectations regarding tailored dietary advice in French women during their pregnancy, as well as their motivations and the perceived barriers and enablers. In French pregnant women, we evaluated the perceptions of tailored dietary advice provided by stepwise dietary counseling based on three types of dietary changes, consisting of: (1) a modification of the amounts consumed, (2) substitutions within the food subgroups, and (3) substitutions between food subgroups. A sequential explanatory mixed-method approach was designed. Using qualitative data from a focus group study (n = 40), we intended to explore in depth the women's expectations regarding dietary advice and adherence to a tailored approach. These were combined with quantitative and qualitative data from a 6-week online longitudinal study (n = 115), using questionnaires designed to assess the modifications of dietary habits during pregnancy and to evaluate each type of dietary change. Both studies confirmed that most women in our samples did indeed intend to institute changes regarding healthier dietary practices during pregnancy. The principal motivation behind changes to their habits was to ensure the health and well-being of both their babies and themselves. The proposal of dietary advice that is tailored to both the current diet and the specific needs of pregnant women, but that is also positive and credible, was perceived as enabling implementing healthier dietary practices during pregnancy. Regarding the implementation of the dietary changes proposed, the enablers and barriers identified differed between modifications of the amounts consumed and substitutions. The women displayed interest in all types of dietary changes. This gave relevance to combining different types of changes in order to propose dietary counseling during pregnancy. Tailored dietary counseling was identified by French pregnant women in our samples as enabling them to adopt a healthier diet. However, perceived barriers might limit the implementation of dietary changes, especially when they involved marked modifications to their usual diet.

Future-proof and sustainable healthy diets based on current eating patterns in the Netherlands.

BACKGROUND: To keep global warming <1.5°C as recommended by the Intergovernmental Panel on Climate Change (IPCC), eating patterns must change. However, future diets should be modeled at a national level and respect cultural acceptability. OBJECTIVES: We aimed to identify diets among Dutch adults satisfying nutritional and selected environmental requirements while deviating minimally from the baseline diet among Dutch adults. METHODS: We calculated per capita food system greenhouse gas emission (GHGE) targets derived from the IPCC 1.5-degree assessment study. Using individual adult dietary intake from the National Food Consumption Survey in the Netherlands (2007-2010) to form a baseline, we used quadratic optimization to generate diets that followed the baseline Dutch diet as closely as possible, while satisfying nutritional goals and remaining below GHGE targets. We considered 12 scenarios in which we varied GHGE targets [2050: 1.11 kg of carbon dioxide equivalent (kg CO2-eq) per person per day (pppd); 2030: 2.04 kg CO2-eq pppd; less strict 2030: 2.5 kg CO2-eq pppd; no target], modeled eating patterns (food-based dietary guidelines; flexitarian; pescatarian; lacto-ovo-vegetarian; vegan), and conducted exploratory analyses (food diversity; acceptability; food chain interdependency). RESULTS: Optimized solutions for 2030 required major decreases (<33% of baseline values) in consumption of beef, pork, cheese, snacks, and butter and increased consumption (>150% of baseline values) of legumes, fish and shellfish, peanuts, tree nuts, vegetables, soy foods, and soy drink. Eight food groups were within 33%-150% of the baseline diet among Dutch adults. The optimized solution complying to the lowest GHGE target (2050) lacked food diversity, and the (lacto-ovo) vegetarian and vegan optimized diets were prone to nutritional inadequacies. CONCLUSIONS: Within Dutch eating habits, satisfying optimization constraints required a shift away from beef, cheese, butter, and snacks toward plant-based foods and fish and shellfish, questioning acceptability. Satisfying 2050 food system GHGE targets will require research in consumer preferences and breakthrough innovations in food production and processing.

Urban Egyptian Women Aged 19-30 Years Display Nutrition Transition-Like Dietary Patterns, with High Energy and Sodium Intakes, and Insufficient Iron, Vitamin D, and Folate Intakes.

BACKGROUND: Recent changes in Egyptian dietary habits can be attributed to more urban and sedentary lifestyles and to alterations in the dietary and economic context. The mean BMI of Egyptian women is one of the highest worldwide, and 50% have iron deficiency. OBJECTIVE: The aim was to quantify food and nutrient intakes of urban Egyptian women and conduct a detailed analysis of micronutrients commonly consumed in inadequate amounts, such as iron, vitamin D, and folate. METHODS: Urban Egyptian women aged 19-30 y (n = 130) were recruited during 2016-2017. Energy needs were estimated using the Henry equation, assuming a low physical activity level (1.4). Dietary intakes and iron bioavailability were estimated from a 4-d food diary. Macronutrient intakes were compared with WHO/FAO population goals and micronutrient intakes with Egyptian recommendations. Iron needs were determined for each subject. RESULTS: The mean BMI (kg/m2) was 27.9 ± 4.9. The mean total energy intake (TEI; 2389 ± 715 kcal/d) was significantly higher than needs (2135 ± 237 kcal/d; P = 0.00018). Total fat (33%TEI) and SFA (11%TEI) intakes were slightly higher than population goals (15-30%TEI and <10%TEI, respectively). Diets provided 18 ± 8 g/d of fiber, 98 ± 54 g/d of total sugars, and nearly twice the recommended sodium intake (intake: 2787 ± 1065 mg/d; recommendation: <1500 mg/d). Estimated dietary iron bioavailability was low (9.2% ± 1.6%), and 79% of women consumed less iron than the average requirement (17.5 ± 7 mg/d). Overall, 82% and 80% of women consumed less vitamin D and folate, respectively, than recommended. CONCLUSIONS: Egyptian women aged 19-30 y have high intakes of energy and sodium, whereas iron, vitamin D, and folate intakes are insufficient, with only low concentrations of bioavailable iron. These results call for further investigation into measures that would improve this population's diet quality.

Postprandial ghrelin responses are associated with the intermeal interval in time-blinded normal weight men, but not in obese men.

OBJECTIVE: To investigate the relation between ghrelin responses and meal initiation and the effects of BMI and energy status on this. DESIGN: The experiment had a randomised, cross-over design. SETTING AND SUBJECTS: Nine normal-weight (age: 33.2+/-4.8 y, BMI: 23.2+/-0.5 kg/m2) and eleven obese (age: 40.8+/- 4.7 y, BMI: 33.2+/-0.8 kg/m2) healthy men were recruited from a pool of volunteers and by advertisements. INTERVENTIONS: Subjects followed a three-day energy restrictive and a three-day energy balanced diet separated by one month. Each diet was followed by a time-blinded (overnight) stay at the research facility. Subjects received a breakfast (preload) and were instructed to ask for lunch when they felt hungry. Ghrelin, insulin, glucose, free fatty acids, appetite, IMI and energy intake during lunch were assessed. RESULTS: Postprandial decreases in ghrelin (r=-0.54; p<0.05) and the AUC of the ghrelin response (r=-0.57, p=0.01) were associated with the intermeal interval, independent of diet, but in normal weight subjects only. Lunch request was preceded by an increase in ghrelin, reaching at least 93% of fasting values. These preprandial increases in ghrelin were correlated with IMI, after energy restriction only. Ghrelin concentrations but not changes in ghrelin were correlated with appetite. CONCLUSION: Meal-related changes in ghrelin are correlated with the IMI in normal weight subjects only, independent of diet. Ghrelin concentrations may need to reach a certain threshold level before the next meal is initiated.

Dose-dependent effects of beverage protein content upon short-term intake.

Protein is considered to be more satiating than carbohydrate, quantified by energy adjustment and subjective appetite. However, the effect of increasing protein content upon short-term energy adjustment in beverage contexts is unclear. This study used a repeated-measures, cross-over design. 28 male volunteers (18-35 years) ate a standard breakfast in the laboratory and 210 min later consumed one of four preloads 30 min prior to an ad libitum pasta meal. Three of the preloads were isocaloric ( approximately 1155 kJ) mixed composition dairy fruit drinks (300 g) of low (13% protein energy/87% carbohydrate energy), medium (25% protein energy/75% carbohydrate energy) and high (50% protein energy/50% carbohydrate energy) protein content. The control drink was a low energy (328 kJ) alternative. Results indicated a dose response effect of preload protein level on intake (g) at the ad libitum meal. Ad libitum intake was: control (637.6g+/-39.7), low (596.9 g+/-40.5), medium (546.9 g+/-34.7), and high protein (533.6g+/-42.3). 100% compensation was not achieved; however total energy intake after the medium and high protein drinks did not differ significantly from control. There were no significant differences in hunger and fullness ratings. Our findings support the view that increasing the protein composition of beverages relative to carbohydrate proportionally affects short-term subsequent intake in controlled conditions.

Satiating effects of protein but not carbohydrate consumed in a between-meal beverage context.

Previous research has suggested that protein is the most satiating macronutrient; however some experiments have found no difference in satiating efficiency of protein and carbohydrate during short intervals after consumption. There is also evidence that the satiating effects of carbohydrate are minimal when in a beverage rather than solid context. To evaluate whether protein-based satiety was evident in a drink context, and clarify further effects of preload time on satiety, the present study compared iso-energetic dairy fruit drink preloads ( approximately 1250 kJ), differing in macronutrient composition and consumed at two time intervals in the morning. Using a counterbalanced within-subjects design, 18 unrestrained lean male volunteers consumed 300 ml of carbohydrate-enriched (CHO), protein-enriched and low-energy control (327 kJ) dairy fruit drinks, 120 min and 30 min before an ad libitum lunch. Significantly less energy was consumed at lunch after the protein (3234 kJ) compared to the control (3468 kJ, p<0.05) and CHO preloads (3588 kJ, p<0.05). However, this was not sufficient to show complete energy compensation. Preload time of consumption did not impact upon any measures. Only satiety ratings at the beginning of lunch varied significantly by preload type, reflecting differences in test meal intake. These findings are consistent with previous research that protein is more satiating than carbohydrate. The roles of sensory and hedonic characteristics are discussed.

Mathematical Optimization to Explore Tomorrow's Sustainable Diets: A Narrative Review.

A sustainable diet is, by definition, nutritionally adequate, economically affordable, culturally acceptable, and environmentally respectful. Designing such a diet has to integrate different dimensions of diet sustainability that may not be compatible with each other. Among multicriteria assessment methods, diet optimization is a whole-diet approach that simultaneously combines several metrics for dimensions of diet sustainability. This narrative review based on 67 published studies shows how mathematical diet optimization can help with understanding the relations between the different dimensions of diet sustainability and how it can be properly used to identify sustainable diets. Diet optimization aims to find the optimal combination of foods for a population, a subpopulation, or an individual that fulfills a set of constraints while minimizing or maximizing an objective function. In the studies reviewed, diet optimization was used to examine the links between dimensions of diet sustainability, identify the minimum cost or environmental impact of a nutritionally adequate diet, or identify food combinations able to combine ≥2 sustainability dimensions. If some constraints prove difficult to fulfill, this signals an incompatibility between nutrient recommendations, over-monotonous food-consumption patterns, an inadequate supply of nutrient-rich foods, or an incompatibility with other dimensions. If diet optimization proves successful, it can serve to design nutritionally adequate, culturally acceptable, economically affordable, and environmentally friendly diets. Diet optimization results can help define dietary recommendations, tackle food security issues, and promote sustainable dietary patterns. This review emphasizes the importance of carefully choosing the model parameters (variables, objective function, constraints) and input data and the need for appropriate expertise to correctly interpret and communicate the results. Future research should make improvements in the choice of metrics used to assess each aspect of a sustainable diet, especially the cultural dimension, to improve the practicability of the results.

A clear trade-off exists between the theoretical efficiency and acceptability of dietary changes that improve nutrient adequacy during early pregnancy in French women: Combined data from simulated changes modeling and online assessment survey.

BACKGROUND: During pregnancy, the diet of a mother-to-be should be adapted to meet increases in nutrient requirements. We analyzed the theoretical efficiency and acceptability of different types of tailored dietary changes for pregnant women. METHODS: The nutrient adequacy of the diet was evaluated using the PANDiet score, by comparing the nutrient intakes of 344 non-pregnant premenopausal women (18-44y) with dietary reference intakes for the first trimester of pregnancy. Simulations were performed to evaluate the theoretical efficiency of three types of ten successive tailored dietary changes in improving nutrient adequacy, with graded difficulty in implementation. The acceptability (declared intention to use in the diet) of most efficient dietary changes was evaluated during an online randomized study including 115 French pregnant women (22-41y). RESULTS: Modifying the amount consumed of foods (type-1) did not modify the food repertoire and resulted in the smallest theoretical efficiency (increase in the PANDiet score of 9.8±0.2 points), but changes were the most acceptable (probability of the intention to use: 0.30-0.78). Conversely, replacing food items by items from the same group or eaten at the same time (type-3) broadened the food repertoire (3.6±1.3 food subgroups added) and resulted in the greatest theoretical efficiency (+23.9±0.3) but changes were the least acceptable (0.07-0.23). Replacing food items within the same subgroup (type-2) slightly broadened the food repertoire (+8.0±1.3 foods) and resulted in moderate theoretical efficiency (+14.8±0.2) and intermediate acceptability (0.11-0.35). CONCLUSION: A clear trade-off exists between the theoretical efficiency and acceptability of dietary changes, with a graded broadening of the food repertoire.

Dietary changes needed to reach nutritional adequacy without increasing diet cost according to income: An analysis among French adults.

OBJECTIVE: To explore the dietary changes needed to achieve nutritional adequacy across income levels at constant energy and diet cost. MATERIALS AND METHODS: Individual diet modelling was used to design iso-caloric, nutritionally adequate optimised diets for each observed diet in a sample of adult normo-reporters aged ≥20 years (n = 1,719) from the Individual and National Dietary Survey (INCA2), 2006-2007. Diet cost was estimated from mean national food prices (2006-2007). A first set of free-cost models explored the impact of optimisation on the variation of diet cost. A second set of iso-cost models explored the dietary changes induced by the optimisation with cost set equal to the observed one. Analyses of dietary changes were conducted by income quintiles, adjusting for energy intake, sociodemographic and socioeconomic variables, and smoking status. RESULTS: The cost of observed diets increased with increasing income quintiles. In free-cost models, the optimisation increased diet cost on average (+0.22 ± 1.03 euros/d) and within each income quintile, with no significant difference between quintiles, but with systematic increases for observed costs lower than 3.85 euros/d. In iso-cost models, it was possible to design nutritionally adequate diets whatever the initial observed cost. On average, the optimisation at iso-cost increased fruits and vegetables (+171 g/day), starchy foods (+121 g/d), water and beverages (+91 g/d), and dairy products (+20 g/d), and decreased the other food groups (e.g. mixed dishes and salted snacks), leading to increased total diet weight (+300 g/d). Those changes were mostly similar across income quintiles, but lower-income individuals needed to introduce significantly more fruit and vegetables than higher-income ones. CONCLUSIONS: In France, the dietary changes needed to reach nutritional adequacy without increasing cost are similar regardless of income, but may be more difficult to implement when the budget for food is lower than 3.85 euros/d.

Individual Diet Modeling Shows How to Balance the Diet of French Adults with or without Excessive Free Sugar Intakes.

Dietary changes needed to achieve nutritional adequacy for 33 nutrients were determined for 1719 adults from a representative French national dietary survey. For each individual, an iso-energy nutritionally adequate diet was generated using diet modeling, staying as close as possible to the observed diet. The French food composition table was completed with free sugar (FS) content. Results were analyzed separately for individuals with FS intakes in their observed diets ≤10% or >10% of their energy intake (named below FS-ACCEPTABLE and FS-EXCESS, respectively). The FS-EXCESS group represented 41% of the total population (average energy intake of 14.2% from FS). Compared with FS-ACCEPTABLE individuals, FS-EXCESS individuals had diets of lower nutritional quality and consumed more energy (2192 vs. 2123 kcal/day), particularly during snacking occasions (258 vs. 131 kcal/day) (all p-values < 0.01). In order to meet nutritional targets, for both FS-ACCEPTABLE and FS-EXCESS individuals, the main dietary changes in optimized diets were significant increases in fresh fruits, starchy foods, water, hot beverages and plain yogurts; and significant decreases in mixed dishes/sandwiches, meat/eggs/fish and cheese. For FS-EXCESS individuals only, the optimization process significantly increased vegetables and significantly decreased sugar-sweetened beverages, sweet products and fruit juices. The diets of French adults with excessive intakes of FS are of lower nutritional quality, but can be optimized via specific dietary changes.

Effect of a high-protein breakfast on the postprandial ghrelin response.

BACKGROUND: The most satiating macronutrient appears to be dietary protein. Few studies have investigated the effects of dietary protein on ghrelin secretion in humans. OBJECTIVE: This study was designed to investigate whether a high-protein (HP) breakfast is more satiating than a high-carbohydrate breakfast (HC) through suppression of postprandial ghrelin concentrations or through other physiologic processes. DESIGN: Fifteen healthy men were studied in a single-blind, crossover design. Blood samples and subjective measures of satiety were assessed frequently for 3 h after the consumption of 2 isocaloric breakfasts that differed in their protein and carbohydrate content (58.1% of energy from protein and 14.1% of energy from carbohydrate compared with 19.3% of energy from protein and 47.3% of energy from carbohydrate). The gastric emptying rate was indirectly assessed with the acetaminophen absorption test. RESULTS: The HP breakfast decreased postprandial ghrelin secretion more than did the HC breakfast (P < 0.01). Ghrelin concentrations were correlated with glucose-dependent insulinotropic polypeptide (r = -0.65; 95% CI: -0.85, -0.29) and glucagon concentrations (r = -0.47; 95% CI: -0.75, -0.03). Compared with the HC breakfast, the HP breakfast increased glucagon (P < 0.0001) and cholecystokinin (P < 0.01), tended to increase glucose-dependent insulinotropic polypeptide (P = 0.07) and glucagon-like peptide 1 (P = 0.10), and decreased the gastric emptying rate (P < 0.0001). Appetite ratings were not significantly different between the 2 treatments, and the HP breakfast did not significantly affect ad libitum energy intake. CONCLUSIONS: The HP breakfast decreased postprandial ghrelin concentrations more strongly over time than did the HC breakfast. High associations between ghrelin and glucose-dependent insulinotropic polypeptide and glucagon suggest that stimulation of these peptides may mediate the postprandial ghrelin response. The HP breakfast also reduced gastric emptying, probably through increased secretion of cholecystokinin and glucagon-like peptide 1.

Higher satiety ratings following yogurt consumption relative to fruit drink or dairy fruit drink.

OBJECTIVES: To compare the satiating power of semisolid and liquid yogurts with fruit beverages and dairy fruit drinks. DESIGN AND PROCEDURES: Thirty-two volunteers (16 men and 16 women), ages 18 to 35 years, consumed a 200-kcal preload stimulus on four separate occasions. A tray lunch was presented 90 minutes after the preload and food consumption was measured. METHODS: The stimuli were: a semisolid yogurt containing pieces of peach and eaten with a spoon (378 g), the same yogurt in a drinkable homogenized form (378 g), a peach-flavored dairy beverage (400 mL), and a peach juice beverage (400 mL). Participants rated hunger, thirst, satiety, and desire to eat at baseline and at 20-minute intervals after ingestion. RESULTS: The two yogurts (semisolid and liquid) led to lower hunger and higher fullness ratings as compared with the fruit drink or dairy fruit drink. There was no difference in satiety profiles between the yogurt that was eaten with a spoon and the drinkable version. Energy intakes at lunch were the same across all four conditions (mean+/-standard deviation, 806+/-43 kcal). CONCLUSIONS: The two yogurts were more satiating than the two beverages. However, lower hunger and higher fullness ratings after yogurt consumption did not lead to energy compensation at the next meal.

Drinking Water Intake Is Associated with Higher Diet Quality among French Adults.

This study aimed to examine the association between drinking water intake and diet quality, and to analyse the adherence of French men and women to the European Food Safety Authority 2010 Adequate Intake (EFSA AI). A representative sample of French adults (≥18) from the Individual and National Survey on Food Consumption (INCA2) was classified, by sex, into small, medium, and large drinking water consumers. Diet quality was assessed with several nutritional indices (mean adequacy ratio (MAR), mean excess ratio (MER), probability of adequate intakes (PANDiet), and solid energy density (SED)). Of the total sample, 72% of men and 46% of women were below the EFSA AI. This percentage of non-adherence decreased from the small to the large drinking water consumers (from 95% to 34% in men and from 81% to 9% in women). For both sexes, drinking water intake was associated with higher diet quality (greater MAR and PANDiet). This association remained significant independently of socio-economic status for women only. Low drinking water consumers did not compensate with other sources (beverages and food moisture) and a high drinking water intake was not a guarantee for reaching the EFSA AI, meaning that increasing consumption of water should be encouraged in France.

Role of Young Child Formulae and Supplements to Ensure Nutritional Adequacy in U.K. Young Children.

The European Food Safety Authority (EFSA) states that young child formulae (YCFs) "cannot be considered as a necessity to satisfy the nutritional requirements" of children aged 12-36 months. This study quantifies the dietary changes needed to ensure nutritional adequacy in U.K. young children who consume YCFs and/or supplements and in those who do not. Dietary data from 1147 young children (aged 12-18 months) were used to identify, using linear programming models, the minimum changes needed to ensure nutritional adequacy: (i) by changing the quantities of foods initially consumed by each child (repertoire-foods); and (ii) by introducing new foods (non-repertoire-foods). Most of the children consumed neither YCFs, nor supplements (61.6%). Nutritional adequacy with repertoire-foods alone was ensured for only one child in this group, against 74.4% of the children consuming YCFs and supplement. When access to all foods was allowed, smaller food changes were required when YCFs and supplements were initially consumed than when they were not. In the total sample, the main dietary shifts needed to ensure nutritional adequacy were an increase in YCF and a decrease in cow's milk (+226 g/day and -181 g/day, respectively). Increasing YCF and supplement consumption was the shortest way to cover the EFSA nutrient requirements of U.K. children.