Dietary Reference Intakes based on chronic disease endpoints: outcomes from a case study workshop for omega 3's EPA and DHA

Vegetarian Dietary Patterns for Adults: A Position Paper of the Academy of Nutrition and Dietetics

It is the position of the Academy of Nutrition and Dietetics that, in adults, appropriately planned vegetarian and vegan dietary patterns can be nutritionally adequate and can offer long-term health benefits such as improving several health outcomes associated with cardiometabolic diseases. Vegetarian dietary patterns exclude meat, poultry, and seafood, and vegan dietary patterns exclude all foods of animal origin. Registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs) play a pivotal role in providing meal-planning strategies and evidence-based nutrition information to clients currently following vegetarian or vegan dietary patterns or who may benefit from and express interest in following vegetarian or vegan dietary patterns. RDNs and NDTRs can work with their clients to create tailored, lifestyle-oriented, nutritionally balanced, and culturally suitable vegetarian and vegan dietary patterns that optimize health benefits while reducing concerns about nutrient inadequacies. Adults follow vegetarian and vegan dietary patterns for various reasons. The aim of this Position Paper is to inform health care practitioners, including RDNs and NDTRs, about the evidence-based benefits and potential concerns of following vegetarian and vegan dietary patterns for different populations of nonpregnant, nonlactating adults. This Position Paper is supported by current evidence, including several systematic reviews. As leaders in evidence-based nutrition care, RDNs and NDTRs should aim to support the development and facilitation of vegetarian and vegan dietary patterns and access to nutrient-dense plant-based meals. Promoting a nutrient-balanced vegetarian dietary pattern on both individual and community scales may be an effective tool for preventing and managing many diet-related conditions. This Position was approved in January 2025 and will remain in effect until December 31, 2032.

Growth patterns in infants born to women with pregestational overweight/obesity supplemented with docosahexaenoic acid during pregnancy

BACKGROUND

Previous studies of maternal docosahexaenoic acid (DHA) supplementation during pregnancy have controversial and contrasting results on the short and long-term effects on early child growth. The impact of this nutritional intervention on the postnatal growth patterns in the offspring of women with pregestational overweight/obesity (PGO) also remains controversial.

OBJECTIVE

To analyze the postnatal growth patterns during the first 4 months of life in the offspring of women with PGO randomly supplemented with 800 mg/day (PGO-800) compared with normative doses of 200 mg/day (PGO-200) of DHA during pregnancy (<15 weeks of gestation until delivery).

METHODS

This study evaluated the growth patterns during the first 4 months of life of 169 infants of the women that participated in the MIGHT study (NCT02574767). We included the infants of women from the PGO-200 (n = 81) and PGO-800 group (n = 88). The growth patterns (weight, length, and head circumference) and change in z-score (World health Organization charts) were evaluated.

RESULTS

Throughout the first 4 months of life, the infants of the PGO-800 group had lower weight-for-length z-score (coef. -0.65, 95% confidence interval [CI] -1.07, -0.22, p = 0.003) and lower body mass index-for-age z-score (coef. -0.56, 95% CI -0.99, -0.12, p = 0.012) compared with the PGO-200 group adjusted by maternal body mass index, gestational weight gain, gestational age, insulin in cord blood and infant feeding (exclusive breastfed, not breastfed, and partially breastfed).

CONCLUSIONS

Maternal supplementation with DHA during pregnancy could beneficially limit the offspring's postnatal weight gain during the first 4 months of life.

Foundational Nutrition: Implications for Human Health

Human nutrition, and what can be considered "ideal" nutrition, is a complex, multi-faceted topic which many researchers and practitioners deliberate. While some attest that basic human nutrition is relatively understood, it is undeniable that a global nutritional problem persists. Many countries struggle with malnutrition or caloric deficits, while others encounter difficulties with caloric overconsumption and micronutrient deficiencies. A multitude of factors contribute to this global problem. Limitations to the current scope of the recommended daily allowances (RDAs) and dietary reference intakes (DRIs), changes in soil quality, and reductions in nutrient density are just a few of these factors. In this article, we propose a new, working approach towards human nutrition designated "Foundational Nutrition". This nutritional lens combines a whole food approach in conjunction with micronutrients and other nutrients critical for optimal human health with special consideration given to the human gut microbiome and overall gut health. Together, this a synergistic approach which addresses vital components in nutrition that enhances the bioavailability of nutrients and to potentiate a bioactive effect.

Assessing the Highest Level of Evidence from Randomized Controlled Trials in Omega-3 Research

Over the years, there has been heightened interest in the health benefits of n-3 polyunsaturated fatty acids (PUFA) in reducing chronic diseases such as, cardiovascular disease (CVD), cancer, type 2 diabetes, and acute macular degeneration (AMD). Due to inconsistent findings in the evidence, a review to critically examine the plethora of evidence from randomized controlled trials (RCTs) in n-3 PUFA research was undertaken. The aim of this review is to study the highest level of evidence and to identify gaps in n-3 PUFA research. RCTs were originally designed for pharmaceutical research and later adopted for nutrition and food-related research. RCTs with active diseases assume that n-3 PUFA will have "drug" like effects, and this high expectation may have led to the inconsistent evidence in the literature. The inconsistency in the literature may be related to varying doses of n-3 PUFA, sources of n-3 PUFA (food vs. supplement; plant vs. marine), type of n-3 PUFA (mixture vs. purified), trial duration, population characteristics, sample size, and genetic variation. For future research, there is a need to distinguish between primary and secondary prevention, and to focus RCTs on primary prevention of chronic diseases by n-3 PUFA which is lacking in the literature.

Progress in enrichment of n-3 polyunsaturated fatty acid: a review

n-3 Polyunsaturated fatty acids (n-3 PUFA) has been widely used in foods, and pharmaceutical products due to its beneficial effects. The content of n-3 PUFA in natural oils is usually low, which decreases its added value. Thus, there is an increasing demand on the market for n-3 PUFA concentrates. This review firstly introduces the differences in bioavailability and oxidative stability between different types of PUFA concentrate (free fatty acid, ethyl ester and acylglycerol), and then provides a comprehensive discussion of different methods for enrichment of lipids with n-3 PUFA including physical-chemical methods and enzymatic methods. Lipases used for catalyzing esterification, transesterification and hydrolysis reactions play an important role in the production of highly enriched various types of n-3 PUFA concentrates. Lipase-catalyzed alcoholysis or hydrolysis reactions are the mostly employed method to prepare high-quality n-3 PUFA of structural acylglycerols. Although many important advantages offered by lipases in enrichment of n-3 PUFA, the high cost of enzyme limits its industrial-scale production. Further research should focus on looking for biological enzymes with extraordinary catalytic ability and clear selectivity. Other novel technologies such as protein engineering and immobilization may be needed to modify lipases to improve its selectivity, catalytic ability and reuse.

Science-based policy: targeted nutrition for all ages and the role of bioactives

Globally, there has been a marked increase in longevity, but it is also apparent that significant inequalities remain, especially the inequality related to insufficient 'health' to enjoy or at least survive those later years. The major causes include lack of access to proper nutrition and healthcare services, and often the basic information to make the personal decisions related to diet and healthcare options and opportunities. Proper nutrition can be the best predictor of a long healthy life expectancy and, conversely, when inadequate and/or improper a prognosticator of a sharply curtailed expectancy. There is a dichotomy in both developed and developing countries as their populations are experiencing the phenomenon of being 'over fed and under nourished', i.e., caloric/energy excess and lack of essential nutrients, leading to health deficiencies, skyrocketing global obesity rates, excess chronic diseases, and premature mortality. There is need for new and/or innovative approaches to promoting health as individuals' age, and for public health programs to be a proactive blessing and not an archaic status quo 'eat your vegetables' mandate. A framework for progress has been proposed and published by the World Health Organization in their Global Strategy and Action Plan on Ageing and Health (WHO (2017) Advancing the right to health: the vital role of law. https://apps.who.int/iris/bitstream/handle/10665/252815/9789241511384-eng.pdf?sequence=1&isAllowed=y . Accessed 07 Jun 2021; WHO (2020a) What is Health Promotion. www.who.int/healthpromotion/fact-sheet/en/ . Accessed 07 Jun 2021; WHO (2020b) NCD mortality and morbidity. www.who.int/gho/ncd/mortality_morbidity/en/ . Accessed 07 Jun 2021). Couple this WHO mandate with current academic research into the processes of ageing, and the ingredients or regimens that have shown benefit and/or promise of such benefits. Now is the time for public health policy to 'not let the perfect be the enemy of the good,' but to progressively make health-promoting nutrition recommendations.

The influence of a basic military training diet on whole blood fatty acid profile and the Omega-3 Index of Australian Army recruits

This study described the whole blood fatty acid profile and Omega-3 Index (O3I) of Australian Army recruits at the commencement and completion of basic military training (BMT). Eighty (80) males (17-34 y, 77.4±13.0 kg, 43.5±4.3 mL/kg/min) and 37 females (17-45 y, 64.3±8.8 kg, 39.3±2.7 mL/kg/min) volunteered to participate (N=117). Whole blood samples of each recruit were collected using a finger prick in weeks 1 and 11 (n=82) and analysed via gas chromatography for the relative proportions of each fatty acid (mean [95% CI]). The macronutrient characteristics of the diet offerings was also determined. At commencement there was a low omega-3 status (sum of omega-3; 4.95% [4.82-5.07]) and O3I (5.03% [4.90-5.16]) and no recruit recorded an O3I >8% (desirable). The omega-6/omega-3 (7.04 [6.85-7.23]) and arachidonic acid / eicosapentaenoic acid (AA/EPA) (18.70 [17.86-19.53]) ratios for the cohort were also undesirable. The BMT mess menu provided a maximum of 190 mg/day of eicosapentaenoic acid (EPA) and 260 mg/day of docosahexaenoic acid (DHA). The O3I of the recruits was lower by week 11 (4.62% [4.51-4.78], p<0.05), the omega-6/omega-3 increased (7.27 [7.07-7.47] p<0.05) and the AA/EPA remained elevated (17.85 [16.89-18.81]). In conclusion, Australian Army recruits' omega-3 status remained undesirable during BMT and deserves nutritional attention. Novelty Bullets • Australian Army recruits' Omega-3 Index, at the commencement of BMT, was reflective of the Western-style diet. • The BMT diet offered minimum opportunity for daily EPA and DHA consumption. • Every recruit experienced a further reduction of their Omega-3 Index during BMT.

Determination and Chemometrics-Assisted Comparative Analysis of Active Components in Different Tissue of Rana chensinensis

In this study, the chemical composition of different tissues of Rana temporaria chensinensis David derived from the same individual was analyzed by comparative approach. First, pre-column derivatization combined with high performance liquid chromatography (HPLC) was established to determine the content of 1-methyl hydantoin in samples, which used S1–S5 samples. The results indicated that 1-methyl hydantoin was determined in Oviductus Ranae (OR), Rana chensinensis ovum (RCO), Rana chensinensis meat (RCM), and Rana chensinensis skin (RCS), except for Rana chensinensis bone (RCB). Moreover, the content of it in RCS was the highest. In addition, the contents of six polyunsaturated fatty acids (PUFAs) in different tissues of Rana chensinensis were measured by HPLC, including eicosapentaenoic acid (EPA), α-linolenic acid (ALA), docosahexaenoic acid (DHA), arachidonic acid (ARA), linoleic acid (LA) and oleic acid (OA). The results indicated that OR, RCO, RCM, RCS, and RCB all contained the above six PUFAs. With the aid of chemometrics methods, the results of principal component analysis (PCA), hierarchical cluster analysis (HCA), and orthogonal partial least squares discriminant analysis (OPLS-DA) combined with the sequencing results of the total PUFAs content of each sample, showed that different tissues of Rana chensinensis could be divided into four categories, and the RCO sample was divided into one category because of the highest PUFAs content, which was a good source of PUFA. For comparison, OR and other tissue from the perspective of PUFAs, we also established OPLS-DA models of them. It could be found that the RCM was the most similar to the OR in the diversity and content of PUFAs. This study provided a theoretical basis for the further development and utilization of RCO, RCM, RCS, and RCB as by-products of OR.