Main nutritional deficiencies

Analysis of nutritional composition in opaque2- and crtRB1-based single- and double-biofortified super sweet corn

Sweet corn has emerged as a favorite food item worldwide owing to its kernel sweetness. However, traditional sweet corn cultivars are poor in provitamin-A (proA) and essential amino acids, viz., lysine and tryptophan. So far, no sweet corn hybrid with high nutritional qualities has been commercialized elsewhere. Here, we analyzed accumulation of provitamin-A (proA), lysine, and tryptophan in a set of mutant versions of (i) crtRB1-, (ii) o2-, and (iii) crtRB1 + o2-based sweet corn inbreds and hybrids with (iv) traditional sweet corn (wild-type: O2 + CrtRB1). The crtRB1- and crtRB1 + o2-based genotypes possessed significantly higher proA (17.31 ppm) over traditional sweet corn (2.83 ppm), while o2- and crtRB1 + o2-based genotypes possessed significantly higher lysine (0.345%) and tryptophan (0.080%) over traditional sweet corn (lysine 0.169%, tryptophan 0.036%). Late sowing favored high kernel lysine, proA, and green cob yield among hybrids. Sweetness (17.87%) among the improved inbreds and hybrids was comparable to the original sweetcorn genotypes (17.84%). Among the four genotypic classes, crtRB1 + o2-based improved genotypes showed stronger association among traits over genotypes with o2 and crtRB1 genes alone. Significant association was observed among (i) proA and BC (r = 0.99), (ii) proA and BCX (r = 0.93), (iii) lysine and tryptophan (r = 0.99), and (iv) green cob yield with fodder yield (r = 0.73) in sweet corn hybrids. The study demonstrated that combining crtRB1 and o2 genes did not pose any negative impact on nutritional, yield, and agronomic performance. Sweet corn with crtRB1 + o2 assumes significance for alleviating malnutrition through sustainable and cost-effective approach.

R425 first year student nurses 'experience of encounters with death of a patient during clinical placement

BACKGROUND

In the course of caring, nurses often experience the death of patients, and this experience has an effect on the nurse. Every nurse responds to this experience in a different way, and it can be either a negative emotional response, or a positive emotional response. As part of their curriculum, R425 first-year student nurses are placed in clinical facilities to acquire competency in nursing skills, and here they may be exposed to patients dying. R425 is a South African Nursing Council regulation relating to the approval of and the minimum requirements for the education and training of a nurse (General, Psychiatric, and Community) and Midwife, leading to registration. End-of-life care can be rewarding, yet emotionally and psychologically challenging. Little is known about R425 first-year student nurses' experiences of patients dying while being cared for by nurses on clinical placement. The study, therefore, explored and describes R425 first-year student nurses' experiences of the death of a patient during clinical placement.

METHOD

A qualitative exploratory descriptive and contextual research design was adopted, and a purposive, nonprobability sampling approach applied. Data were collected through unstructured individual interviews with 15 R425 first-year student nurses. Data were analysed using content analysis.

RESULTS

Four themes emerged, namely, knowledge, psychological trauma, low self-esteem, and nutritional disorders, and subthemes were identified. Results reveal both negative and positive responses to encountering the death of patients, with more negative responses, and fewer positive responses.

CONCLUSION

Results show that first-year student nurses struggle to cope with the death of a patient, mainly because they lack knowledge and the skills required to provide end-of-life nursing. It is the requirement for student nurses to be competent in a skill, 'last office', which involves laying out of a dead person. Such skill can be deferred in the first year of study, and can only be introduced at a later stage, either in third year or fourth year of study, when students are better equipped with knowledge and skills relating to dealing with death. There is a need to review the curriculum of R425 first-year student nurses, so that outcomes such as death and dying can be introduced in the third or fourth year of study.

Assessment and management of vitamin status in children with CKD stages 2-5, on dialysis and post-transplantation: clinical practice points from the Pediatric Renal Nutrition Taskforce

Children with chronic kidney disease (CKD) are at risk for vitamin deficiency or excess. Vitamin status can be affected by diet, supplements, kidney function, medications, and dialysis. Little is known about vitamin requirements in CKD, leading to practice variation.The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric kidney dietitians and pediatric nephrologists, was established to develop evidence-based clinical practice points (CPPs) to address challenges and to serve as a resource for nutritional care. Questions were formulated using PICO (Patient, Intervention, Comparator, Outcomes), and literature searches undertaken to explore clinical practice from assessment to management of vitamin status in children with CKD stages 2-5, on dialysis and post-transplantation (CKD2-5D&T). The CPPs were developed and finalized using a Delphi consensus approach. We present six CPPs for vitamin management for children with CKD2-5D&T. We address assessment, intervention, and monitoring. We recommend avoiding supplementation of vitamin A and suggest water-soluble vitamin supplementation for those on dialysis. In the absence of evidence, a consistent structured approach to vitamin management that considers assessment and monitoring from dietary, physical, and biochemical viewpoints is needed. Careful consideration of the impact of accumulation, losses, comorbidities, and medications needs to be explored for the individual child and vitamin before supplementation can be considered. When supplementing, care needs to be taken not to over-prescribe. Research recommendations are suggested.

Triangulating nutrigenomics, metabolomics and microbiomics toward personalized nutrition and healthy living

The unique physiological and genetic characteristics of individuals influence their reactions to different dietary constituents and nutrients. This notion is the foundation of personalized nutrition. The field of nutrigenetics has witnessed significant progress in understanding the impact of genetic variants on macronutrient and micronutrient levels and the individual's responsiveness to dietary intake. These variants hold significant value in facilitating the development of personalized nutritional interventions, thereby enabling the effective translation from conventional dietary guidelines to genome-guided nutrition. Nevertheless, certain obstacles could impede the extensive implementation of individualized nutrition, which is still in its infancy, such as the polygenic nature of nutrition-related pathologies. Consequently, many disorders are susceptible to the collective influence of multiple genes and environmental interplay, wherein each gene exerts a moderate to modest effect. Furthermore, it is widely accepted that diseases emerge because of the intricate interplay between genetic predisposition and external environmental influences. In the context of this specific paradigm, the utilization of advanced "omic" technologies, including epigenomics, transcriptomics, proteomics, metabolomics, and microbiome analysis, in conjunction with comprehensive phenotyping, has the potential to unveil hitherto undisclosed hereditary elements and interactions between genes and the environment. This review aims to provide up-to-date information regarding the fundamentals of personalized nutrition, specifically emphasizing the complex triangulation interplay among microbiota, dietary metabolites, and genes. Furthermore, it highlights the intestinal microbiota's unique makeup, its influence on nutrigenomics, and the tailoring of dietary suggestions. Finally, this article provides an overview of genotyping versus microbiomics, focusing on investigating the potential applications of this knowledge in the context of tailored dietary plans that aim to improve human well-being and overall health.

Unveiling the Spectrum of Ophthalmic Manifestations in Nutritional Deficiencies: A Comprehensive Review

This comprehensive review explores the intricate relationship between nutrition and ocular health, focusing on the crucial roles of essential nutrients like Vitamin A, Vitamin B1 (thiamine), Vitamin B12, Vitamin C, Vitamin D, Vitamin E, Zinc, and Folate (Vitamin B9) in maintaining eye well-being. Nutrient deficiencies have significant consequences, leading to various eye-related issues, from night blindness to age-related conditions such as cataracts and macular degeneration. It is imperative to address these deficiencies, emphasizing the importance of a well-rounded diet with the necessary nutrients. When necessary, supplementation and regular eye examinations are vital components for effectively monitoring ocular health. Public health campaigns and educational initiatives also play a key role in raising awareness about the profound impact of nutrition on eye health. Future research should explore personalized nutrition plans, nutrigenomics, longitudinal studies, and targeted nutritional interventions. Such investigations will not only enhance our understanding of this crucial connection but also have the potential to reduce the global burden of eye diseases.

Authentication of protein, fat, carbohydrates, and total energy in commercialized high protein sports foods with their labeling data

The popularity of high-protein sports food items among athletes and the bodybuilding community has risen dramatically. This study aimed to authenticate the reported per serving food label content of protein, fat, carbohydrate, and total energy in commercially available high-protein sports foods available in Egyptian markets. A cross-sectional study was performed on a total of forty-five samples of nine products that included protein bars, cookies, vegan bars, puffs, whey protein, protein drinks, peanut butter, pancake mix, and Greek yogurt. Protein and fat analysis were done according to Kheldahl and Folich methods, respectively, while carbohydrate was calculated by difference. Total energy was calculated according to their content. A significant (p < 0.001) difference was found between the laboratory-assessed content and the reported food label values in protein, carbohydrate, and energy. Protein sport food products had significantly lower protein content (11.6 ± 4.67) obtained from laboratory measurement than the label reported value (17.17 ± 7.22). The fat content in vegan protein was 149.3% higher than the label values (1.67 vs. 0.67 g/serving). The mean fat content per serving of 30 out of 45 samples was significantly higher than the food label values in the bar (37.8%), puffs (32.7%), vegan protein (149.3%), and protein drinks (28.6%). These differences may result in compromised performance and undesired fat gain, as opposed to a desired increase in muscle mass, which could compromise the desired impact of the consumed sports foods.

Nutritional deficiencies in low-sociodemographic-index countries: a population-based study

Background

We aimed to estimate the burden of nutritional deficiency according to sex and age in countries with a low sociodemographic index (SDI).

Methods

Following the methods of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, estimated annual percentage changes (EAPCs) were calculated to determine trends in the age-standardized rates of incidence and disability-adjusted life-years (DALYs) of nutritional deficiency and its main subcategories from 1990 to 2019 in low-SDI countries.

Findings

From 1990 to 2019, the age-standardized incidence and DALY rates of nutritional deficiency showed decreasing trends, with EAPCs of -0.90 [95% confidence interval (CI), 1.06 to -0.75] and -3.20 (95% CI, -3.29 to -3.10), respectively, in low-SDI countries. In 2019, of the subcategories analyzed, vitamin A deficiency had the highest age-standardized incidence rate and protein-energy malnutrition had the highest age-standardized DALY rate. From 1990 to 2019, the greatest decrease in the age-standardized incidence rate was observed for vitamin A deficiency and the greatest decrease in the age-standardized DALY rate was observed for protein-energy malnutrition. At the national level, from 1990 to 2019, the greatest increase in the age-standardized incidence rate of overall nutritional deficiency was observed in males in Afghanistan (EAPC: 0.28; 95% CI, 0.07 to 0.49). Of the age groups analyzed, the highest incidence and DALY rates of overall nutritional deficiency and dietary iron deficiency were observed in children aged 1-4 years.

Interpretation

The age-standardized incidence and DALY rates of nutritional deficiency decreased significantly from 1990 to 2019, especially for vitamin A deficiency and protein-energy malnutrition. Overall nutritional deficiency and dietary iron deficiency occurred primarily in children aged 1-4 years.