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Mainardi F, Côté RG, Silber NK, Plestina R, Ferrer E, Angeles-Agdeppa I. Data-driven development and validation of a nutrient-based score to measure nutritional balance of meals in the Philippines. BMC Nutr 2024; 10:146. [PMID: 39478617 PMCID: PMC11523666 DOI: 10.1186/s40795-024-00954-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/22/2024] [Indexed: 11/03/2024] Open
Abstract
BACKGROUND The goal of the present study was to design an easily computable score, based on nutrient composition data instead of food groups, to evaluate the nutritional quality and balance of meals, adapted to the nutritional recommendations for Filipino adults. METHOD The score was defined as a weighted average of 9 nutrient scores. Protein, total fat, saturated fat, free sugars were scored as % of energy; calcium, fiber, sodium, vitamin C, magnesium were scored based on the local dietary reference intakes. The scoring algorithm was an adaption of a score previously developed by the authors based on US data. In the present study, the score was applied to 69,923 meals reported by 31,218 adult Filipinos aged 20 to 59 in the 2018 edition of the Philippine Expanded National Nutrition Survey to evaluate its validity and compare against exemplary meals designed as part of 24 h diet plans that meet local dietary guidelines. RESULTS Meals from these exemplary menu plans, developed by local nutrition experts, scored on average 72.2 ± 13.9 (mean ± standard deviation) while those of survey participants scored 46.1 ± 12.9. Meal scores were significantly associated with the density of positive micronutrients (e.g., Vit A, Vit C) and favourable food groups (e.g. fruits, whole grains) not directly included in the algorithm. CONCLUSION The score, between 0 and 100, is a valid tool to assess the nutritional quality of meals consumed by the PH population, accounting for both shortfall and excess nutrients, adjusted for the energy content of the meal. If applied to consumer-facing applications, it could potentially help users to understand which meals are nutritionally balanced.
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Affiliation(s)
- Fabio Mainardi
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland.
| | - Richard G Côté
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Nele Kristin Silber
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Roko Plestina
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Eldridge Ferrer
- Food and Nutrition Research Institute, Department of Science and Technology, Gen. Santos Avenue, Bicutan, Taguig City, 1631, Philippines
| | - Imelda Angeles-Agdeppa
- Food and Nutrition Research Institute, Department of Science and Technology, Gen. Santos Avenue, Bicutan, Taguig City, 1631, Philippines
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2
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Costa RM, Oliveira AG, de Souza AM, Torres KG, Pereira GS, Bezerra IWL. Prevalence of consumption of mechanically separated meat, consumer profile, nutrient intake and food choices among manufacturing workers in Northeastern Brazil. Sci Rep 2024; 14:13289. [PMID: 38858577 PMCID: PMC11164858 DOI: 10.1038/s41598-024-64247-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/06/2024] [Indexed: 06/12/2024] Open
Abstract
Mechanically separated meat (MSM) is widely used in the food industry, however, there is a lack of studies on its consumption in populations. The objective of this study was to identify the frequency and amount of MSM consumption, factors associated with MSM consumption, nutrient intake and preferential choice of food groups among MSM consumers. This was an observational, cross-sectional prospective study based on a probability sample of manufacturing workers, conducted in Brazil. Logistic and linear multiple regression with robust standard errors were used. 921 workers from 33 manufacturing companies were studied, with an average age of 38.2 ± 10.7 years, 55.9% males. MSM products are consumed by 28.8% and represent in average 10% of total daily caloric intake, and 47.3% of the daily kcal from ultra-processed products. Younger age and greater waist circumference are associated with MSM consumption. Younger age and lesser educational level are associated with increased contribution of MSM to total daily kcal intake. MSM consumers have greater consumption of energy, fats, carbohydrates and sodium. Their dietary patterns are characterized by lower consumption of in natura and minimally processed foods, such as tubers and roots, fruits, white and red meat, and eggs and greater consumption of ultra-processed foods and beverages.
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Affiliation(s)
- Raiane Medeiros Costa
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Antonio Gouveia Oliveira
- Pharmacy Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Anissa Melo de Souza
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Karina Gomes Torres
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Gabriela Santana Pereira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Ingrid Wilza Leal Bezerra
- Nutrition Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
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Valicente VM, Peng CH, Pacheco KN, Lin L, Kielb EI, Dawoodani E, Abdollahi A, Mattes RD. Ultraprocessed Foods and Obesity Risk: A Critical Review of Reported Mechanisms. Adv Nutr 2023; 14:718-738. [PMID: 37080461 PMCID: PMC10334162 DOI: 10.1016/j.advnut.2023.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/02/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
Epidemiologic evidence supports a positive association between ultraprocessed food (UPF) consumption and body mass index. This has led to recommendations to avoid UPFs despite very limited evidence establishing causality. Many mechanisms have been proposed, and this review critically aimed to evaluate selected possibilities for specificity, clarity, and consistency related to food choice (i.e., low cost, shelf-life, food packaging, hyperpalatability, and stimulation of hunger/suppression of fullness); food composition (i.e., macronutrients, food texture, added sugar, fat and salt, energy density, low-calorie sweeteners, and additives); and digestive processes (i.e., oral processing/eating rate, gastric emptying time, gastrointestinal transit time, and microbiome). For some purported mechanisms (e.g., fiber content, texture, gastric emptying, and intestinal transit time), data directly contrasting the effects of UPF and non-UPF intake on the indices of appetite, food intake, and adiposity are available and do not support a unique contribution of UPFs. In other instances, data are not available (e.g., microbiome and food additives) or are insufficient (e.g., packaging, food cost, shelf-life, macronutrient intake, and appetite stimulation) to judge the benefits versus the risks of UPF avoidance. There are yet other evoked mechanisms in which the preponderance of evidence indicates ingredients in UPFs actually moderate body weight (e.g., low-calorie sweetener use for weight management; beverage consumption as it dilutes energy density; and higher fat content because it reduces glycemic responses). Because avoidance of UPFs holds potential adverse effects (e.g., reduced diet quality, increased risk of food poisoning, and food wastage), it is imprudent to make recommendations regarding their role in diets before causality and plausible mechanisms have been verified.
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Affiliation(s)
- Vinicius M Valicente
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Ching-Hsuan Peng
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, United States
| | - Kathryn N Pacheco
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Luotao Lin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Elizabeth I Kielb
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States
| | - Elina Dawoodani
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Afsoun Abdollahi
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Richard D Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States.
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4
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Fournier E, Łuszczki E, Isacco L, Chanséaume-Bussiere E, Gryson C, Chambrier C, Drapeau V, Chaput JP, Thivel D. Toward an Integrated Consideration of 24 h Movement Guidelines and Nutritional Recommendations. Nutrients 2023; 15:2109. [PMID: 37432285 DOI: 10.3390/nu15092109] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 07/12/2023] Open
Abstract
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.
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Affiliation(s)
- Elora Fournier
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Edyta Łuszczki
- Institute of Health Sciences, Medical College of Rzeszów University, 35-310 Rzeszów, Poland
| | - Laurie Isacco
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | | | | | | | - Vicky Drapeau
- Department of Physical Education, Faculty of Education, Université Laval, Quebec, QC G1V 0A6, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 5B2, Canada
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CRNH Auvergne, 63000 Clermont-Ferrand, France
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Yin W, Yu H, Wang Y, Qiu R, Han L. Spatial Differences of Nutrient Adequacy in Coastal Areas of China. Nutrients 2022; 14:4763. [PMID: 36432450 PMCID: PMC9698695 DOI: 10.3390/nu14224763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/30/2022] [Accepted: 11/08/2022] [Indexed: 11/12/2022] Open
Abstract
Ensuring nutrient adequacy for all is a common goal of the international community, but spatial difference is one of the barriers to its development. Exploring nutrient adequacy in coastal areas of China can help regions where food production systems and economic development systems are under mutual stress to reduce nutritional disparities and improve nutrition levels. This paper used the transformation food-to-nutrient model to calculate nutrient production and nutrient consumption in 11 coastal provinces of China and analyzed their spatial patterns, after which spatial differences in nutrient adequacy (including energy, protein and fat) were analyzed. The results showed that nutrient production and nutrient consumption in coastal areas of China showed significant spatial differences, in which nutrient production was mainly concentrated in land food, and the three provinces of Shandong, Jiangsu and Hebei contributed more. Guangdong had the highest nutrient consumption; in contrast, Shanghai, Tianjin, and Hainan had the lowest consumption. Nutrient adequacy was not optimistic, with fat being particularly significant, and nutrient surplus quantity was mainly concentrated in Shandong and Jiangsu and nutrient deficiency quantity was mainly concentrated in Guangdong. Overall, the study area had adequate levels of protein and was deficient in energy and fat levels, with surplus or shortage of 2.41 million tonnes, 2620 billion kcal and 9.97 million tonnes, respectively.
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Affiliation(s)
- Wei Yin
- Management College, Ocean University of China, Qingdao 266100, China
| | - Huijuan Yu
- Management College, Ocean University of China, Qingdao 266100, China
- Institute of Marine Development, Ocean University of China, Qingdao 266100, China
| | - Yecheng Wang
- Management College, Ocean University of China, Qingdao 266100, China
| | - Rongshan Qiu
- Management College, Ocean University of China, Qingdao 266100, China
| | - Limin Han
- Management College, Ocean University of China, Qingdao 266100, China
- Institute of Marine Development, Ocean University of China, Qingdao 266100, China
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Puwanant M, Boonrusmee S, Jaruratanasirikul S, Chimrung K, Sriplung H. Dietary diversity and micronutrient adequacy among women of reproductive age: a cross-sectional study in Southern Thailand. BMC Nutr 2022; 8:127. [PMCID: PMC9641308 DOI: 10.1186/s40795-022-00619-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 10/18/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Adequate nutritional intake of both macronutrients and micronutrients is essential for maintaining good health throughout life, particularly for women of reproductive age (WRA). The Minimum Dietary Diversity for WRA (MDD-W), or the sum of dietary diversity, is recommended as a simple indicator to identify at-risk WRA populations. However, there are no studies on the MDD-W among WRA in Thailand.
Objectives
To determine food group diversity, MDD-W, and micronutrient intake of WRA in Southern Thailand.
Participants
From December 2020 to November 2021, 120 healthy, young WRA (average age 33.2 ± 4.5 years) were enrolled.
Methods
A 24-h food record was used to quantitatively and qualitatively assess the food consumed. Dietary diversity was classified into ten food groups. The macronutrients and 15 micronutrients were calculated using the software program INMUCAL, which is the standard program for calculating nutrients in Thai food. The calculated intake of each micronutrient was transformed to the probability of adequacy (PA).
Results
The most common foods consumed were rice, followed by meat, eggs, fruits, and vegetables. Fewer than 40% of the participants consumed beans, dairy products, vitamin A-rich fruits and vegetables, dark green vegetables, and pulses. The average MDD-W score was 5 (range 2–8). The mean caloric intake (1,865 cal/day) was adequate for non-lactating WRA but was approximately 300 kcal/day lower than the recommendation for lactating WRA. Most WRA consumed lower amounts of micronutrients than those recommended. The mean PA (MPA) of the 15 micronutrients was 0.33 (range 0.0–0.9).
Conclusions
Non-pregnant WRA in Songkhla consumed adequate macronutrients but inadequate micronutrients. A nutritional education program regarding the importance of micronutrients should be provided to the public, with special attention to WRA.
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Zhou CN, Li M, Xiao R, Zhao FJ, Zhang FS. Significant Nutritional Gaps in Tibetan Adults Living in Agricultural Counties Along Yarlung Zangbo River. Front Nutr 2022; 9:845026. [PMID: 35464003 PMCID: PMC9024302 DOI: 10.3389/fnut.2022.845026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/16/2022] [Indexed: 01/06/2023] Open
Abstract
Background Dietary intake and nutritional assessing data from a representative sample of adult population living in an agricultural zone on Tibet Plateau are still lacking nowadays. This study aimed to assess the daily dietary intakes and respective food sources in 552 local residents (≥ 18 years old, 277 men and 275 women) living in 14 agricultural counties along the Yarlung Zangbo River on Tibet Plateau. Methods Food consumption data were collected using a validated cultural-specific food frequency questionnaire that contained all local Tibetan foods and analyzed with three fixed factors: gender, age, and region. Nutrient intakes were calculated using Chinese food composition tables. Nutritional gaps and the percentages of participants who had inadequate and excessive nutrient intakes were calculated by estimated average requirement (EAR) cut-point methods. Results Compared with the dietary reference intakes, 68.4% of nutrient intakes were inadequate. Fiber, Ca, I, Zn, Se, and vitamin (Va, Vc, and folic acid) intakes appeared to be particularly deficient. The dietary energy intake was 7838.8 ± 537.1 KJ/d, with 78 and 84% of EAR values for men and women, respectively. The dietary intakes of most nutrients were below the estimated energy requirement/EAR or adequate intake values, while more than 70% of the participants had excessive intake of carbohydrate, especially the elderly (aged ≥ 51 years). The nutritional gap of Cu was more than 300%. Almost 100% of the participants was vulnerable to fiber, Se, and Va shortfalls due to the deficiency in sole food sources. The top five food sources of Se intake were highland barley (34.2%), meat (13%), rice (12.4%), eggs (12.2%), and cultural-specific beverages (7.8%). Eggs (42.1%), tubers (62.2%), vegetables (66.4%), and highland barley (49.7%) were the first contributors of Va, Ve, Vc, and folic acid, respectively. Conclusion The dietary intake of a large sample of Tibetan adult population living in agricultural counties of Tibetan Autonomous Region is alarmingly insufficient. Gender inequality is common, and regional difference is widespread due to rapid urbanization. Young Tibetan adults aged 18–30 years are particularly vulnerable to micronutrient shortfalls and currently facing the risk of nutrition-insecurity-related dietary inadequacy. The respondents who belong to the elderly category (≥51 years of age) are facing the risk of “double burden of malnutrition” characterized by the coexistence of undernutrition, including micronutrient deficiencies and overweight or obesity.
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Affiliation(s)
- Chen-ni Zhou
- Key Laboratory of Plant-Soil Interactions, Ministry of Education, College of Resources and Environmental Sciences, National Academy of Agriculture Green Development, China Agricultural University, Beijing, China
- Key Laboratory of Alpine Vegetation Ecological Security in Tibet, Institute of Tibet Plateau Ecology, Tibet Agricultural and Animal Husbandry University, Nyingchi, China
| | - Mo Li
- Key Laboratory of Plant-Soil Interactions, Ministry of Education, College of Resources and Environmental Sciences, National Academy of Agriculture Green Development, China Agricultural University, Beijing, China
| | - Ran Xiao
- Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, College of Resources and Environment, Southwest University, Chongqing, China
| | - Fang-jie Zhao
- College of Resources and Environmental Science, Nanjing Agricultural University, Nanjing, China
| | - Fu-suo Zhang
- Key Laboratory of Plant-Soil Interactions, Ministry of Education, College of Resources and Environmental Sciences, National Academy of Agriculture Green Development, China Agricultural University, Beijing, China
- *Correspondence: Fu-suo Zhang,
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Melián-Fleitas L, Franco-Pérez Á, Caballero P, Sanz-Lorente M, Wanden-Berghe C, Sanz-Valero J. Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression. Nutrients 2021; 13:3945. [PMID: 34836200 PMCID: PMC8622081 DOI: 10.3390/nu13113945] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To review the scientific literature on the influence of verified nutrition, food and diet interventions on occupational health. METHOD This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Diet, Food, and Nutrition" and "Occupational Health" and applying the filters "Clinical Trial", "Humans" and "Adult: 19+ years"; the search was conducted on 29 May 2021. RESULTS A total of 401 references were retrieved from the bibliographic databases, with an additional 16 identified through a secondary search; among the studies retrieved, 34 clinical trials were selected after applying the inclusion and exclusion criteria. The interventions were grouped into seven categories: (1) dietary interventions associated with exercise or educational programs; (2) individual environmental interventions or other educational actions; (3) educational interventions oriented toward lifestyle, dietetics, physical activity and stress management; (4) economic incentives; (5) multicomponent interventions (combination of mindfulness, e-coaching and the addition of fruits and vegetables); or dietary interventions (facilitating greater food supply in cafeterias); or interventions focused on physical exercise. CONCLUSIONS Given that most people spend a large part of their time in the workplace and, therefore, eat at least one of their daily meals there, well-planned interventions-preferably including several strategies-have been demonstrated, in general, as useful for combating overweight and obesity. From the meta-regression study, it was observed that the interventions give better results in people who presented high Body Mass Index (BMI) values (obesity). In contrast, intervention 2 (interventions related to workplace environment) would not give the expected results (it would increase the BMI).
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Affiliation(s)
- Liliana Melián-Fleitas
- Nutrition Department, University of Granada, 18012 Granada, Spain;
- Geriatric Service, Insular Hospital, Health Services Management of the Health Area of Lanzarote, 35500 Arrecife, Spain
| | - Álvaro Franco-Pérez
- Playa Blanca Health Center, Health Services Management of the Health Area of Lanzarote, 35580 Playa Blanca, Spain;
| | - Pablo Caballero
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - María Sanz-Lorente
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- Center of Public Health, Consellería of Universal Health and Public Health, 46940 Manises, Spain
| | - Carmina Wanden-Berghe
- Health and Biomedical Research Institute of Alicante, University General Hospital, 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- National School of Occupational Medicine, Carlos III Health Institute, 28029 Madrid, Spain
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Lowe C, Kelly M, Sarma H, Richardson A, Kurscheid JM, Laksono B, Amaral S, Stewart D, Gray DJ. The double burden of malnutrition and dietary patterns in rural Central Java, Indonesia. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 14:100205. [PMID: 34671750 PMCID: PMC8484895 DOI: 10.1016/j.lanwpc.2021.100205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/15/2022]
Abstract
Background Indonesia is undergoing a nutrition transition (NT) comprised of rising rates of overweight/obesity and consumption of high fat food/snacks but is still struck by undernutrition, causing a double burden of malnutrition. Little research pertains to the double burden of malnutrition and its associations with diet in rural Indonesia using primary village level data. Methods We conducted a 24-hour food recall and food frequency questionnaire and assessed anthropometric status of rural villagers from four villages in Central Java, Indonesia. Exploratory principal component analysis was used to identify dietary patterns and multi-level modeling was performed to identify variables associated with dietary pattern indicative of the NT. Findings 1,521 participants were included in analysis. Double burden of malnutrition was prevalent whereby 32.3% of children were stunted, 68.8% of women 35–49 years-old were overweight, and 39% of homes were classified as double burden. The NT was evident in a dietary pattern associated with soft drink, snacks, and animal products. There was small but significant correlation between undernutrition and stunting status among children (r = −0.139, p < 0.01). The NT was associated with young age (B = 1.696, 95% CI = 1.508–1.885) but not with overweight (B = −0.099, 95% CI = −0.184–−0.013). Interpretation Our findings suggest that whilst the typical pattern of the double burden of malnutrition (stunted child/overweight adult) exists in rural Central Java, dietary patterns indicative of the NT are predominant among children, not adults. Overweight among adults may not be necessarily due to a diet indicative of the NT, and nutrition interventions in rural Central Java should focus on educating parents of young children about the health-risks of a diet associated with a NT. Funding Funding was obtained from the UBS-Optimus Foundation and the National Health and Medical Research Council.
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Affiliation(s)
- Callum Lowe
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia
| | - Mattthew Kelly
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia
| | - Haribondhu Sarma
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia
| | - Alice Richardson
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia
| | - Johanna M Kurscheid
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia.,Health Systems Support Unit, Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel 4051, Switzerland
| | - Budi Laksono
- Yayasan Wahana Bakti Sejahtera (YWBS) Foundation, Semarang 50183, Indonesia
| | - Salvador Amaral
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia
| | - Donald Stewart
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia.,School of Medicine, Griffith Health, Griffith University, South Brisbane, QLD, Australia
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia
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10
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Osteosarcopenic adiposity syndrome update and the role of associated minerals and vitamins. Proc Nutr Soc 2021; 80:344-355. [DOI: 10.1017/s0029665121000586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The objectives are to present an updated synopsis on osteosarcopenic adiposity (OSA) syndrome and evaluate the roles of selected micronutrients in its prevention and management. OSA refers to the concurrent deterioration of bone (osteopenia/osteoporosis), muscle (sarcopenia) and adipose tissue expansion. It portrays the most advanced stage in a continuum of body composition disorders. Although OSA has been widely studied involving the populations of different backgrounds, its prevalence is hard to collate because different methodologies and criteria were used for its diagnosis. Another critical health aspect is the presence of low-grade chronic inflammation (LGCI) which contributes to OSA and vice versa. Nutrition is important in the prevention and management of both OSA and LGCI. Although micronutrients act in numerous metabolic and physiological processes, their roles here are presented in relation to OSA (and its components) and LGCI in general and relevant to the COVID-19 pandemic. These include calcium, magnesium, phosphorus, potassium, sodium and vitamins D and K; their interactions, physiological ratios and synergism/antagonism are discussed as well. In conclusion, calcium, magnesium and vitamin D have a profound impact on OSA and its components, and the latter two also on LGCI. Potassium and vitamin K are vital in bone, muscle functioning and possibly adipose tissue modification. Both, but particularly vitamin D, surfaced as important modulators of immune system with application in COVID-19 infections. While both phosphorus and sodium have important roles in bone, muscle and can impact adiposity, due to their abundance in food, their intake should be curbed to prevent possible damaging effects.
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