Food-based dietary guidelines for children and adolescents

Effectiveness of tableware to improve eating behavior and cardiometabolic health: A systematic review and meta-analysis

INTRODUCTION

This study determined whether tableware-based intervention promotes healthy eating behavior and address cardiometabolic risk factors.

METHODS

PubMed, Web of Science, Scopus, Embase, ClinicalTrials.gov, and ICTRP were searched from the earliest date available to July 2024. Data were pooled to calculate mean differences and 95% confidence intervals using a random or fixed effect model. This study was registered with PROSPERO (CRD42024573343).

RESULTS

Twenty-seven publications with 5319 participants were included in this review. The effectiveness of tableware was mostly evaluated through plate models, followed by lunchboxes, forks, spoons, placemats, and take-out containers. Tableware significantly reduced bite rate (d = -1.04 bites per minute), protein intake (d = -14.13 g), and starch intake (d = -26.27 g), body weight (d = -1.24 kg), body mass index (d = -0.41 kg/m2), waist circumference (d = -1.24 cm), HbA1c (d = -0.41%), 2-hour postprandial glucose (d = -2.47 mmol/L), and high-density lipoprotein cholesterol (d = -1.61 mg/dL). Tableware significantly increased the proportion of vegetables taken (d = 5%), with a positive trend for increasing meal duration and fruit intakes. Tableware had no significant effect on blood pressure, total cholesterol, triglycerides, low-density lipoprotein, and fasting blood glucose (unless 12 months duration).

CONCLUSIONS

Tableware might be a practical tool to promote healthy food choices and weight loss, address fast eating, and improve cardiometabolic health across populations of various age groups.

Effects of Nutrition-Specific Interventions to Prevent and Control Nutrition-Related Anemia in Infants, Children, and Adolescents: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Anemia is a prevalent health issue among children and adolescents worldwide, with malnutrition being among the most common causes. Nutrition-related anemia can be prevented or controlled through targeted interventions.

OBJECTIVE

This study aimed to evaluate the effects of nutrition interventions on ferritin concentration, hemoglobin concentration, anemia prevalence, and nutrition-related anemia prevalence in infants, children, and adolescents-and to compare outcomes by intervention and age group using network meta-analysis of randomized controlled trials.

METHODS

Web of Science, PubMed, Scopus, EBSCO, the Cochrane Library, China National Knowledge Infrastructure Database, Weipu Database, and Wanfang Database were comprehensively searched to identify randomized controlled trials on the effects of nutrition interventions (micronutrient supplementation, macronutrient supplementation, and nutrition education) until September 30, 2023. Two groups of researchers screened the literature and extracted data based on set inclusion and exclusion criteria. Reviewers used the Cochrane tool for assessing risk-of-bias in randomized controlled trials and used the Grading of Recommendations, Assessment, Development, and Evaluation for evaluating the strength of evidence for inclusion in network meta-analysis. The study population was categorized into infants and preschool-aged children (aged 6 to 59 months), school-aged children (aged 6 to 11 years), and adolescents (aged 12 to 18 years). The study evaluated the mean difference, risk ratio, and 95% credible interval of outcomes for each intervention across different age groups using network meta-analysis.

RESULTS

Sixty-one randomized controlled trials were included in this analysis. In network meta-analysis, micronutrient supplementation, macronutrient supplementation, and nutrition education were found to have significant effects on hemoglobin concentrations in infants and preschool-aged children. Lipid-based nutrient supplementation resulted in the highest increase in hemoglobin concentration, whereas multiple micronutrient supplementation resulted in the largest reduction in risk of anemia and iron deficiency anemia. In school-aged children, iron supplementation increased hemoglobin concentration, whereas micronutrient supplementation also increased hemoglobin concentration and reduced anemia risk. In adolescents, iron supplementation improved hemoglobin concentration and lowered anemia risk.

CONCLUSIONS

The effectiveness of nutrition interventions in improving nutrition-related anemia varies across intervention types and age groups. Micronutrient and iron supplementation consistently improved hemoglobin levels and related indicators, with evidence quality ranging from low to moderate. MMN and LNS had positive effects on hemoglobin concentrations and anemia in infants and preschool-aged children, which is supported by low-to-moderate quality evidence. For adolescents, although micronutrient and iron supplementation showed positive effects, the overall evidence quality was generally low, highlighting the need for further high-quality clinical research to validate these findings.

Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review

Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.

The Importance of Nutrition in Menopause and Perimenopause-A Review

Menopause is associated with an increased prevalence of obesity, metabolic syndrome, cardiovascular diseases, and osteoporosis. These diseases and unfavorable laboratory values, which are characteristic of this period in women, can be significantly improved by eliminating and reducing dietary risk factors. Changing dietary habits during perimenopause is most effectively achieved through nutrition counseling and intervention. To reduce the risk factors of all these diseases, and in the case of an already existing disease, dietary therapy led by a dietitian should be an integral part of the treatment. The following review summarizes the recommendations for a balanced diet and fluid intake, the dietary prevention of cardiovascular diseases, the role of sleep, and the key preventive nutrients in menopause, such as vitamin D, calcium, vitamin C, B vitamins, and protein intake. In summary, during the period of perimenopause and menopause, many lifestyle factors can reduce the risk of developing all the diseases (cardiovascular disease, insulin resistance, type 2 diabetes mellitus, osteoporosis, and tumors) and symptoms characteristic of this period.

Avoidance of added salt for 6-12-month-old infants: A narrative review

Most nutrition guidelines recommend avoiding foods with added salt for infants aged 6-12 months. However, the reason for no added salt lacks enough and reliable evidence. We re-searched and re-studied the relevant evidence. We searched PubMed and the Cochrane database for English-language studies published from 1904 through 2021. We also searched the databases of the websites of different national institutions. Randomized clinical trials (RCTs), systematic reviews, observational studies, and dietary guidelines were included in this review. The kidneys of infants aged 6-12 months have adequate sodium excretion capacity. There is insufficient evidence that high salt (sodium) intake early in life might lead to hypertension or salty diet preference in adults. Infants aged 6-12 months might be at risk of low sodium intake of only 150-300 mg of sodium/day, which may not meet the body's needs, if their supplementary food is not adequately salted.

Toward an Integrated Consideration of 24 h Movement Guidelines and Nutritional Recommendations

While physical activity, sleep and sedentary behaviors are almost always considered independently, they should be considered as integrated human behaviors. The 24 h Movement approach proposes a concomitant consideration of these behaviors to promote overall health. Not only do these behaviors impact energy expenditure, but they have also been shown to separately impact energy intake, which should be further explored when considering the entire integration of these movement behaviors under the 24 h movement approach. After an evaluation of the prevalence of meeting the 24 h Movement and dietary recommendations, this review summarizes the available evidence (using English publications indexed in PubMed/MEDLINE) regarding the association between the 24 h Movement Guidelines and eating habits. Altogether, the results clearly show the beneficial impact of promoting the 24 h guidelines simultaneously, highlighting that the higher the number of respected movement recommendations, the better eating behaviors in both children and adults. Importantly, our results point out the importance of emphasizing the need to reach sedentary guidelines for better eating habits. Movement and dietary behaviors appear closely related, and giving recommendations on one might impact the other. Combining the 24 h Movement with dietary Guidelines might be more efficient than promoting them separately in public health strategies.