The effect of oropharyngeal mother's milk on nutritional outcomes in preterm infants: a randomized controlled trial

BACKGROUND AND OBJECTIVE

Oropharyngeal interventions are an accepted method to improve the nutritional performance of premature infants. Considering the countless benefits of breast milk and the few studies on the use of breast milk as an oral-pharyngeal intervention, this study was conducted with the aim of determining the effect of oral-pharyngeal administration of breast milk on nutritional outcomes in premature infants.

MATERIALS AND METHODS

In this clinical trial, 80 premature infants hospitalized in the neonatal intensive care unit of Amir al-Mu'minin Hospital in Semnan (a city in Iran) were randomly assigned to intervention (n = 40) and control groups (n = 40). Infants in the intervention group were given breast milk, and infants in the control group were given sterile water as a placebo. The data collection tool included demographic and clinical questions checklist, including sex, gestational age, weight, milk administration time, lavage and its amount, vomiting, abdominal distension, and so on. Data analysis was performed using SPSS23.

RESULTS

The mean volume of total milk received by infants (p = 0.047) and the mean volume of milk received by mouth (p < 0.000) at the time of discharge were higher in the intervention group. Moreover, the time to start enteral nutrition in the intervention group was lower than in the control group (P = 0.012). Administering mother's milk through the oropharyngeal method led to a reduction in infants' length of stay in the hospital (P = 0.022).

CONCLUSION

Based on the results of the present study, the oropharyngeal administration of breast milk in the first days after the birth of premature infants admitted to the hospital improves the outcomes related to their nutritional status. Therefore, it is suggested that this convenient, safe, and feasible method be used in hospitalized premature infants as soon as possible so that premature infants can benefit from the important advantages of breast milk.

Characteristics of Vitamin A Deficiency Retinopathy at a Tertiary Referral Center in the United States

PURPOSE

To explore the risk factors and fundus imaging features of vitamin A deficiency retinopathy (VADR) in an academic tertiary referral center in Atlanta, GA, United States, and to propose guidance regarding diagnostic workup and management of affected patients.

DESIGN

Single-center retrospective case series.

SUBJECTS

Nine patients seen between 2015 and 2021 at the Emory Eye Center diagnosed with VADR.

METHODS

Retrospective chart review.

MAIN OUTCOME MEASURES

Baseline serum retinol level, Snellen visual acuity, multimodal fundus imaging findings, and electroretinography findings.

RESULTS

Nine patients, 4 (44.4%) female, with a median (range) age of 68 (50-75) years were identified. The most common underlying etiologies for vitamin A deficiency included history of gastrointestinal surgery (55.6%), liver disease (44.4%), and nutritional depletion due to low-quality diet (44.4%). Only 1 (11.1%) patient had a history of bariatric surgery. Four (44.4%) patients were on some form of vitamin A supplementation before the diagnosis of VADR. Median (range) serum retinol level was 0.06 (< 0.06-0.19) mg/L. All patients had macular subretinal hyperreflective deposits resembling subretinal drusenoid deposits, although in some cases, these were scant and sparsely distributed. Six eyes of 3 patients with longstanding deficiency had defects in the external limiting membrane (ELM). Three of these eyes additionally had macular areas of complete retinal pigment epithelium and outer retinal atrophy (cRORA). Full-field electroretinography demonstrated severe rod dysfunction and mild to moderate cone system dysfunction. Many findings of VADR were reversible with vitamin A repletion. However, all eyes with ELM defects or cRORA had persistence or continued growth of these lesions.

CONCLUSION

Vitamin A deficiency retinopathy is uncommon in the developed world. However, given that early intervention can lead to dramatic visual improvement and avoid potentially permanent retinal damage, retina specialists should be familiar with its clinical presentation. The presence of nyctalopia and subretinal hyperreflective deposits in a patient with a history of gastrointestinal surgery, liver disease, and/or poor diet can be suggestive of this diagnosis, even in the presence of ongoing vitamin A supplementation. Vitamin A supplementation can vary in route and dosage and can be tailored to the individual with serial testing of serum retinol.

FINANCIAL DISCLOSURE(S)

The authors have no proprietary or commercial interest in any materials discussed in this article.

The buccal micronucleus cytome assay: New horizons for its implementation in human studies

In this report we provide a summary of the presentations and discussion of the latest knowledge regarding the buccal micronucleus (MN) cytome assay. This information was presented at the HUMN workshop held in Malaga, Spain, in connection with the 2023 European, Environmental Mutagenesis and Genomics conference. The presentations covered the most salient topics relevant to the buccal MN cytome assay including (i) the biology of the buccal mucosa, (ii) its application in human studies relating to DNA damage caused by environmental exposure to genotoxins, (iii) the association of buccal MN with cancer and a wide range of reproductive, metabolic, immunological, neurodegenerative and other age-related diseases, (iv) the impact of nutrition and lifestyle on buccal MN cytome assay biomarkers; (v) its potential for application to studies of DNA damage in children and obesity, and (vi) the growing prospects of enhancing the clinical utility by automated scoring of the buccal MN cytome assay biomarkers by image recognition software developed using artificial intelligence. The most important knowledge gap is the need of prospective studies to test whether the buccal MN cytome assay biomarkers predict health and disease.

A glimpse into plant-based fermented products alternative to animal based products: Formulation, processing, health benefits

Fermented foods and beverages are increasingly being included in the diets of people around the world, as they significantly contribute to flavor and interest in nutrition and food consumption. Plant sources, like cereals and pulses, are employed to produce vegan fermented foods that are either commercially available or the subject of ongoing scientific investigation. In addition, the inclination towards nutritionally healthy, natural, and clean-label products amongst consumers has encouraged the development of vegan fermented products alternative to animal-based products for industrial-scale production. However, as the vegan diet is more restrictive than the vegetarian diet, manufacturing food products for vegans presents a significant problem due to the limited availability of many raw materials. So further research is required on this topic. This paper aims to review the formulation, quality, microbial resources, health benefits, and safety of foods that can be categorised as vegan fermented foods and beverages.

Nutritional and chemical composition of Alpinia zerumbet leaves, a traditional functional food

Alpinia zerumbet, a species of the Zingiberaceae family, is a common plant in tropical and subtropical areas used in traditional medicine to treat various diseases and also included as food in the traditional Okinawan diet (Japan). The leaves and rhizomes of this plant are used as spice and flavoring in foods such as rice, meats, and pasta. Studies of the chemical and nutritional characteristics of fresh leaves and of leaves submitted to thermal treatments such as boiling and steaming are lacking. In the current study, the leaves of A. zerumbet were subjected to boiling or steaming for 10, 20, and 30 min as part of the thermal treatments. The study also provides noteworthy results regarding the proximate composition, physical-chemical data, minerals, phenolic compounds, antioxidant activity, volatile compounds, and LC-MS chromatographic profiles of the extracts produced with fresh leaves and with thermal treatments. The carbohydrate content of A. zerumbet leaves improved during the thermal treatments, showing an increase after steaming (18.86 to 19.79%) and boiling for 30 min (25.85%). After boiling treatment for 20 min, a significant amount of protein was found (6.79%) and all heat treatments resulted in low content of lipid (<1.0%). The boiling treatment for 10 min (BT10) resulted in the highest concentrations of total phenolic components (TPC), 339.5 mg/g, and flavonoids (TF), 54.6 mg/g, among the three thermal treatments (BT10, BT20 and BT30). The results of the steaming treatments (ST 10, 20, and 30 min) differed, with ST20 leading to higher TPC (150.4 mg/g) and TF (65.0 mg/g). The quantity of total phenolics and flavonoids, as well as the antioxidant activity, were significantly affected by the cooking method and the length of time of sample exposure to heat. The samples boiled for 30 and 10 min had higher concentrations of antioxidant activity as measured by the phosphomolybdenum and DPPH methods (151.5 mg/g of extract and 101.5 μg/mL, respectively). Thirty-eight volatile organic compounds (VOCs) were identified by chromatographic analysis of fresh and thermally treated leaves of A. zerumbet. Terpenoids were the predominant class of volatile compounds in the fresh leaves and in all thermal treatments. p-Cymene, 1,8-cineole, 4-terpineol, linalool, α-copaene and β-bisabolene have the greatest impact on overall aroma perception, with odor activity values (OAV) greater than five. Among the phenolic compounds identified by LC-HRMS in the extracts of fresh and thermally treated leaves were proanthocyanidins, (+) catechin, (-) epicatechin, quercetin-3-O-glucoronide, isorhamnetin-3-O-glucoronide, kaempferol-3-O-rutinoside, pinocembrin, alpinetin, pinostrobin, and other compounds. The present results support the traditional use of this plant as a potential food with properties that certainly contribute to health improvement.

Exploring the nutritional and health benefits of pulses from the Indian Himalayan region: A glimpse into the region's rich agricultural heritage

Pulses have been consumed worldwide for over 10 centuries and are currently among the most widely used foods. They are not economically important, but also nutritionally beneficial as they constitute a good source of protein, fibre, vitamins and minerals such as iron, zinc, folate and magnesium. Pulses, but particularly species such as Macrotyloma uniflorum, Phaseolus vulgaris L., Glycine max L. and Vigna umbellate, are essential ingredients of the local diet in the Indian Himalayan Region (IHR). Consuming pulses can have a favourable effect on cardiovascular health as they improve serum lipid profiles, reduce blood pressure, decrease platelet activity, regulate blood glucose and insulin levels, and reduce inflammation. Although pulses also contain anti-nutritional compounds such as phytates, lectins or enzyme inhibitors, their deleterious effects can be lessened by using effective processing and cooking methods. Despite their great potential, however, the use of some pulses is confined to IHR regions. This comprehensive review discusses the state of the art in available knowledge about various types of pulses grown in IHR in terms of chemical and nutritional properties, health effects, accessibility, and agricultural productivity.

Prevalence and risk factors of vitamin D deficiency among living with HIV adults receiving antiretroviral treatment in tropical area: Cross-sectional study

Background

There was found HIV infection have a higher rate of vitamin D deficiency (VDD) than the general population, even a slight deficiency, can increase the risk of osteoporosis in adults. This study aimed to determine the prevalence and risk factors of VDD in HIV-infected adults receiving antiretroviral therapy (ART) in a tropical area.

Methods

A cross-sectional study of an HIV-clinical population-based cohort was conducted at Police General Hospital (PGH), from 1st August 2020 to 31st July 2021, in Bangkok, Thailand. Serum 25(OH)D level was measured using ECLIA. All other laboratory investigations were conducted at the PGH's central lab center. The descriptive analysis utilized frequency (percentages) and mean (SD) as appropriate variable types. Chi-square tests (χ2) and independent samples t-tests were used to differentiate between VDD and non-VDD groups. To determine the association between VDD and non-VDD, gender, age (years), BMI discrepancy, ART regimens, ART-duration (years), HIV viral load, and CD4 count (cells/mm3). Univariate and multivariable logistics regression was conducted, respectively.

Results

Of 602 patients, 66.4% were females with mean age of 45.22 ± 10.23 years. The average serum 25(OH)D level was 18.69 ± 7.23 ng/ml. The prevalence of VDD (<20 ng/ml) and insufficiency (VDI) (20-29.9 ng/ml) was 58.5% and 35.2%, respectively. Risk factors associated with vitamin D inadequacy were increasing age (AOR = 1.05, 95%CI = 1.03-1.07, P < .001), efavirenz (EFV-based) use (AOR = 6.07, 95%CI = 3.57-10.31, P < .001), while male (AOR = 0.44, 95%CI = 0.29-0.66, P < .001), body mass index (BMI) lower than 18.5 (AOR = 0.26; 95% CI, 0.11-0.62, P = .002), protease Inhibitors (PIs-based) use (AOR = 0.18, 95%CI = 0.11-0.30, P < .001),and CD4 count <200 cells/mm3 (AOR = 0.41; 95% CI, 0.20-0.85, P = .017) were associated with less VDD.

Conclusion

The implementation of focused strategies for vitamin D supplementation, specifically targeting older patients and patients undergoing EFV-based ART regimen, can serve as a valuable addition to comprehensive HIV management. By optimizing vitamin D levels, there is a potential to improve health outcomes and enhance overall well-being for individuals living with HIV.

Optimum aquaculture and drying conditions for Wolffia arrhiza (L.) Wimn

This study aimed to investigate the effects of aquaculture and the optimum conditions for drying duckweed plants to maintain the highest nutritional value and bioactive substances. Protein quantification was used to screen duckweed plants subjected to the 14 treatments under aquaculture conditions. Proximate analysis of three aquaculture conditions showed the highest quantification of protein. Moreover, these samples were analyzed for total phenolics, flavonoids, and chlorophylls. The optimal drying conditions for duckweed plants with the highest protein content were determined using a factorial design with three temperature and time parameters. The results showed that the duckweed under aquaculture conditions in an outdoor cement pond with hydroponic electrical conductivity (EC) of 0.5 mS/cm contained the highest protein at 41.81 ± 3.40%. Moreover, proximate analysis of this sample showed fat, fiber, moisture, ash, and carbohydrate contents of 1.99 ± 0.08%, 4.46 ± 0.71%, 3.29 ± 0.17%, 22.06 ± 0.07% and 14.12 ± 1.63%, respectively. In addition, the optimum drying conditions for this sample were 50 °C and a drying time of 6 h. Under optimum drying conditions, this sample showed total phenolics, flavonoids, and chlorophylls contents of 55.28 ± 1.35 (μg GAE/g dry weight), 159.84 ± 6.65 (μg catechin equivalent [QE]/g dry weight) and 22.91 ± 0.15 (mg/g dry weight), respectively. In conclusion, the dried duckweed under aquaculture conditions in an outdoor cement pond with hydroponic EC 0.5 mS/cm contained the highest contents of proteins, total phenolics, total flavonoids, and total chlorophyll, which could be used as functional ingredients in health food products.

Characterization of bioactive and fruit quality compounds of promising mango genotypes grown in Himalayan plain region

Twenty mango genotypes grown in the plains of the Himalayas were characterized by their physical, physiological, biochemical, mineral and organoleptic attributes: fruit firmness, weight, peel thickness, shape, dry seed weight, respiration rate, weight loss, and shelf life. Biochemical attributes such as soluble solids, total carotenoids, total phenolic content, antioxidant activity, titratable acidity, ascorbic acid and total sugars were also determined. In addition, mineral content and fruit-softening enzymes were measured, and an organoleptic evaluation was performed. Polygalactouronase (PG), pectin methylesterase (PME) and lipoxygenase (LOX) were measured from the pulp adjacent to the peel. Similarly, biochemical attributes and mineral content were evaluated using fruit pulp, while organoleptic evaluation included fruit pulp characters and the fruit's external appearance. The results of the study showed that the 'Malda' genotype exhibited the highest total phenolic content (560.60 µg/100 g), total antioxidant (5.79 µmol TE/g), and titratable acidity (0.37%) among the tested genotypes. 'Amrapali' had the highest soluble solid content (25.20 °B), 'Jawahar' had the highest ascorbic acid content (44.20 mg/100 g pulp), 'Mallika' had the highest total flavonoid content (700.00 µg/g) and 'Amrapali' had the highest total carotenoid content (9.10 mg/100 g). Moreover, the genotypes 'Malda', 'Safed Malda'and 'Suvarnarekha' had a shelf life of 4-5 days longer than other tested genotypes. The genotypes with high biochemical attributes have practical utility for researchers for quality improvement programmes and processing industries as functional ingredients in industrial products. This study provides valuable information on the nutritional and functional properties of different mango genotypes, which can aid in developing improved varieties with enhanced health benefits and greater practical utility for processing industries.

Shifting archetype to nature's hidden gems: from sources, purification to uncover the nutritional potential of bioactive peptides

Contemporary scientific findings revealed that our daily food stuffs are enriched by encrypted bioactive peptides (BPs), evolved by peptide linkage of amino acids or encrypted from the native protein structures. Remarkable to these BPs lies in their potential health benefiting biological activities to serve as nutraceuticals or a lead addition to the development of functional foods. The biological activities of BPs vary depending on the sequence as well as amino acid composition. Existing database records approximately 3000 peptide sequences which possess potential biological activities such as antioxidants, antihypertensive, antithrombotic, anti-adipogenics, anti-microbials, anti-inflammatory, and anti-cancerous. The growing evidences suggest that BPs have very low toxicity, higher accuracy, less tissue accretion, and are easily degraded in the disposed environment. BPs are nowadays evolved as biologically active molecules with potential scope to reduce microbial contamination as well as ward off oxidation of foods, amend diverse range of human diseases to enhance the overall quality of human life. Against the clinical and health perspectives of BPs, this review aimed to elaborate current evolution of nutritional potential of BPs, studies pertaining to overcome limitations with respect to special focus on emerging extraction, protection and delivery tools of BPs. In addition, the nano-delivery mechanism of BP and its clinical significance is detailed. The aim of current review is to augment the research in the field of BPs production, identification, characterisation and to speed up the investigation of the incredible potentials of BPs as potential nutritional and functional food ingredient.

Effect of storage condition on the nutritional and anti-nutritional composition of kurkura (Ziziphus mauritiana Lam.) fruit from North-Eastern Ethiopia

Ziziphus mauritiana is used as food and medicine. It is very nutritive and contains high amounts of calcium, phosphorus, iron, vitamin C, and beta-carotene. To choose an appropriate technique for fruit preservation, this study evaluated the effect of temperature and time on the nutritional and anti-nutritional qualities of Ziziphus mauritiana fruit harvested from Kobo Woreda in North-Eastern Ethiopia. This study assessed the impact of preservation parameters on the nutritional and anti-nutritional properties of Ziziphus mauritiana fruit, such as storage temperature and preservation day (time). Ziziphus mauritiana fruit was also analyzed to evaluate storage temperature and preservation day on its nutritional and antinutritional composition and found moisture content (5.25-10.99%), ash content (4.74-10.70%), crude fiber (3.81-17.88), fat (0.49-2.16), nitrogen content (1.01-1.8%), protein content (6.33-11.27), phytate content (67.27-659.33 mg/100 g m), and tannin content (3842.46-16577.80 mg/100 g m). The findings revealed that both individual and interaction effects were highly significant differences (p-value, 0.0001) in each nutritional and antinutritional content of the fruit. The results of this study showed that it was possible to store Ziziphus mauritiana fruit using plastic bags (High-Density Polyethylene Bags), and further deep-freezing the fruit had the best effect on preserving it in its fresh state (without damage) for up to 45 days.

Nutritional quality and adulterants of cow raw milk, pasteurized and cottage cheese collected along value chain from three regions of Ethiopia

Milk is a nutritionally rich food for humans. However, fulfilling the quality of milk is a major concern for milk factories, nutrient requirements, and public health. The objective of this research was to assess the composition of raw and pasteurized milk and cheese, evaluate change in milk and cheese composition along the value chain, and identify adulteration of milk. A total of 160 composite samples were determined using lactoscan and conventional approved methods along value chain. Results indicate that there were significant (p < 0.05) changes of in milk composition along the value chain in the study regions. The range values were; total solid (8.41-11.7%), protein (2.25-3.06%), fat (2.16-3.17%), lactose (3.33-4.76%), ash (0.52-0.73%), P (62.7-84.2 mg/100 g) and Ca (78.2-109 mg/100 g) of liquid milk were obtained in all regions. Liquid milk was found to be adulterated by water along the value chains in all regions (ranged from 0 to 24.8%). Formalin (4 samples) and starch (1 sample) were detected at farmer's and collectors' respectively. In all regions, there was no significant (p > 0.05) difference in cheese nutritional quality between farmers and retailers. The grand mean for moisture, protein, fat, total ash, Ca, P and pH values were 77.1%, 17.1%, 1.42%, 1.18%, 37.8 mg/100 g, 88.2 mg/100 g and 3.7 respectively. Comparison of liquid products with the Compulsory Ethiopian Standard (CES) indicates that 80.2% for fat, protein, and SNF in raw and pasteurized milk were below the CES. In conclusion, liquid milk had poor nutritional composition and varied along the value chain in the study regions. Moreover, there is milk fraud where all dairy value chain add water into milk and milk consumers are consuming lower nutrients and paying for substandard liquid milk. Therefore, training should be provided to all value chain to improve the quality of milk products and quantification of formalin and other adulterants need to be further studied.

Nurses' knowledge, attitudes, and practice with regards to nutritional management of diabetes mellitus

BACKGROUND

The prevalence of diabetes is increasing rapidly worldwide. Nurses work collaboratively with multidisciplinary teams to improve diabetes management. Yet, little is known about nurses' role in nutritional management of diabetes. This study aimed to evaluate nurses' knowledge, attitudes, and practice (KAP) toward nutritional management of diabetes.

METHODS

This cross-sectional study was conducted with 160 nurses, who were recruited between July 4 and July 18, 2021 from two referral tertiary teaching hospitals in Iran. A validated paper-based self-reported questionnaire was used to assess nurses' KAP. Data were analyzed using descriptive statistics and multiple linear regression analysis.

RESULTS

The mean knowledge score of nurses about nutritional management of diabetes was 12.16 ± 2.83, and 61.2% showing a moderate knowledge level on nutritional management of diabetes. The mean attitudes score was 60.68 ± 6.11, with 86.92% of participants demonstrating positive attitudes. The mean practice score of study participants was 44.74 ± 7.81, with 51.9% having a moderate level of practice. Higher knowledge scores were observed among male nurses (B = -7.55, p = 0.009) and those with blended learning as a preferred learning method (B = 7.28, p = 0.029). Having an opportunity to provide education to patients with diabetes during shifts affected nurses' attitudes positively (B = -7.59, p = 0.017). Practice scores were higher among nurses who perceived themselves competent in the nutritional management of diabetes (B = -18.05, p = 0.008).

CONCLUSION

Nurses' knowledge and practice in the nutritional management of diabetes should be increased to help improve the quality of the dietary care and patient education they provide these patients. Further studies are needed to confirm the results of this study both in Iran and internationally.

Chemical and nutritional characterization of Ambelania duckei (Apocynaceae) an unexplored fruit from the Amazon region

Ambelania duckei Markgr is a species of the Apocynaceae family, native to the Amazon region that is unexplored from a nutritional point of view and studied in relation to its chemical constituents. This work presents an unprecedented study of the proximate composition, lipid profile, a chromatographic analysis, and the antioxidant activity of extracts obtained from the pulp, peel and seeds of the fruit. The results showed that potassium, calcium, and magnesium stood out as the most abundant key minerals in the fruit peel and pulp, with an emphasis on the potassium present in the fruit pulp at 1750.0 mg/100 g. The peel had the highest content of total phenolics (374.86 mg/g), flavonoids (15.54 mg/g), tannins (27.45 mg/g) and O-diphenols (379.36 mg/g; 645.71 mg/g). The antioxidant activity (AA) was highest in the peel compared to the pulp in the DPPH, ABTS, and ORAC tests showing: IC₅₀ of 29.82; 43.67; and 407.13 µg/mL, respectively but a lower activity for the Fe²⁺ chelator. The analysis of the lipid fractions from the peel, pulp, and seeds of the A. duckei fruit resulted in 14 types of fatty acids. The major fatty acids found in the three parts of the fruit were oleic acid (peel, 22.52 %), palmitic acid (pulp, 17.34 %), and linoleic acid (seeds, 47.99 %). The lipid profile and nutritional aspects had a PUFA/SFA ratio (0.4-1.8) in the different parts of the A. duckei fruit; the atherogenic and thrombogenic indexes were higher in the peel (1.23) and pulp (0.62), respectively. The ratio between the hypocholesterolemic and hypercholesterolemic fatty acids (0.5 - 3.8) calculated for the fruit are within the desirable range for a nutritious food. The chromatographic analysis of the volatile organic compounds (VOCs) from the peel and pulp of the fruit, identified 74 VOCs, of which 60.9 % are related to terpenes, and emit notes such as cucumber, green, fatty, floral, and mint, due to the presence of substances with OAVs > 10, especially α-ionone, 1,8-cineole, 2,4-decadienal, and dodecanal. The analysis of the MS and MS/MS spectra of the chromatograms obtained by LC- QTOF-HRMS led to the identification of 26 compounds in the peel, seeds and pulp of A. duckei, such as fatty acids, phenolic acid, flavonoids, proanthocyanidins, alkaloids, and terpenoids. The results show that the pulp of A. duckei has potential as nourishing food and the nutritional and chemical aspects of the peel can be applied to commercial applications.

Punica Granatum Peel Waste- An Underutilized Substrate of Therapeutic Potential: An Overview

India is the second largest consumer and producer of fruits globally. It leads to ample solid waste per year from fruit processing industries that have been proven hazardous to the surroundings. Punica granatum (Pomegranate) belongs to the Lythraceae subfamily Punicoideae, which exhibits immense nutritional properties and delicious flavoring components. The weight of this fruit mainly consists of peel, i.e., 50%, followed by 40% of arils and 10% of seeds. Thus, the major byproduct is a peel that holds many valuable bioactive compounds in higher concentrations viz saponins, carotenoids, steroids, polyphenols, quercetin derivatives, caffeic acid, phenolic acids, flavonoids, ellagitannins, p-coumaric acid, chlorogenic acid, quinic acid, anthocyanidins, triterpenoids, glycosides, tannins, and many more. Consequently, it results in wide-ranging therapeutic applications, including antioxidative, anti-microbial, antihypertensive, anti-carcinogenic, anti-genotoxic, anti-inflammatory, glucoregulation, cardio-protective, hepato-protective and nephroprotective effects along with prebiotic potential. Considering their nutritional and therapeutic aspects, these peels can be used for many purposes rather than being disposed of. With a value-added approach, it is utilized in many food and non-food sectors. So, this review aims to explore the therapeutic potential of P. granatum peel and enlighten its diverse applications in the food industry.

Proximate composition, minerals, vitamins, phytochemical constituents and anti-nutrient profile of Beilschmiedia mannii seeds and Combretum racemosum leaves for soup preparation

Several vegetables are used in food preparation to improve the aroma, taste, appearance with less attention on the nutrient and anti-nutrient content. This study investigated the proximate, vitamins, minerals and anti-nutrients profile of Beilschmiedia manni seed and Combretum racemosum leaf. Proximate composition, vitamins, mineral analysis and anti-nutrient profile were determined using standard procedures. The proximate analysis revealed that C. racemosum contained high crude protein (19.18%), crude fat (22.20%) and energy value (449.11 kJ) but low carbohydrate (43.15%) compared to B. mannii with the high carbohydrate (64.25%) content. Phytochemical screening revealed the presence of active phytochemicals in both samples. Thiamine, riboflavin and niacin were significantly (p < 0.05) high in B. mannii compared to C. racemosum. The level of macro minerals in B. mannii seeds and C. racemosum leaves was in the order of K > Ph > Na > Mg > Ca. Beilschmiedia mannii seeds and C. racemosum leaves respectively contained 45.00 mg/100 g and 163.00 mg/100 g oxalate, 70.00 mg/100 g and 113.00 mg/100 g phytate, 58.00 mg/100 g and 209.00 mg/100 g of tannin. This study has revealed that B. mannii seeds and C. racemosum leaves are potential sources of essential nutrients, phytochemicals and could play important role in food enrichment, formulation of dietary supplements and in disease managements.

Preoperative geriatric nutritional risk index is an independent prognostic factor for postoperative survival after gallbladder cancer radical surgery

Background

Currently, the surgical outcomes of gallbladder cancer (GBC) are not always satisfactory. The geriatric nutritional risk index (GNRI) can effectively assess nutritional status. This study intends to investigate whether the preoperative GNRI can predict the prognosis of GBC.

Methods

202 consecutive GBC patients who underwent treatment from 2010 to 2017 were selected and analyzed retrospectively. By using the univariate and multivariate Cox regression analyses on overall survival (OS) and recurrence-free survival (RFS), the preoperative GNRI of GBC patients was evaluated.

Results

Among the 202 patients, the GNRI of the 86 patients (42.6%) was less than 98. The patients with low preoperative GNRI had the median OS of 26 months, which was less than the median OS of 39 months among those patients who had higher preoperative GNRI (P < 0.001). Univariate analysis showed that low GNRI was related to short survival time (HR 3.656, 95% CI 2.308–5.790, P < 0.001). In addition, the results of multivariate analysis revealed that, the patients with low GNRI showed a lower OS (HR 2.207, 95% CI 1.131–4.308, P = 0.020) and RFS (HR 2.964, 95% CI 1.577–5.571, P = 0.001) than those patients with higher GNRI.

Conclusion

GNRI is an independent indicator of poor prognosis in GBC patients after GBC radical surgery.

Association of diet with clinical outcomes in dogs with dilated cardiomyopathy and congestive heart failure

INTRODUCTION

Dilated cardiomyopathy (DCM) in dogs has been associated with feeding of grain-free (GF), legume-rich diets. Some dogs with presumed diet-associated DCM have shown improved myocardial function and clinical outcomes following a change in diet and standard medical therapy.

HYPOTHESIS

Prior GF (pGF) diet influences reverse cardiac remodeling and clinical outcomes in dogs with DCM and congestive heart failure (CHF).

ANIMALS AND METHODS

A retrospective study was performed with 67 dogs with DCM and CHF for which diet history was known. Dogs were grouped by diet into pGF and grain-inclusive (GI) groups. Dogs in the pGF group were included if diet change was a component of therapy. Survival was analyzed using Kaplan-Meier curves and the Cox proportional-hazards model.

RESULTS

The median survival time was 344 days for pGF dogs vs. 253 days for GI dogs (P = 0.074). Statistically significant differences in median survival were identified when the analysis was limited to dogs surviving longer than one week (P = 0.033). Prior GF dogs had a significantly worse outcome the longer a GF diet was fed prior to diagnosis (P = 0.004) or if they were diagnosed at a younger age (P = 0.017). Prior GF dogs showed significantly greater improvement in normalized left ventricular internal diastolic diameter (P = 0.038) and E-point septal separation (P = 0.031) measurements and significant decreases in their furosemide (P = 0.009) and pimobendan (P < 0.005) dosages over time compared to GI dogs.

CONCLUSIONS

Prior GF dogs that survived at least one week after diagnosis of DCM, treatment of CHF, and diet change had better clinical outcomes and showed reverse ventricular remodeling compared to GI dogs.

Non-parental caregivers, low maternal education, gastrointestinal problems and high blood lead level: predictors related to the severity of autism spectrum disorder in Northeast China

Background

The prevalence of autism spectrum disorder (ASD) has increased rapidly in recent years. Environmental factors may play an important role in the pathogenesis of ASD. These factors may include socioeconomic factors, nutritional factors, heavy metal exposure, air pollution, etc. Our aim is to analyze possible environmental factors associated with the severity of ASD.

Methods

All participating children were divided into two groups (mild and moderate/severe) according to the severity of their symptoms, as determined by their Childhood Autism Rating Scale (CARS) scores. The socioeconomic, demographic factors and the nutritional factors that may affect the severity of ASD were included in the logistic regression to analyze whether they were predictors that affected the severity of ASD.

Results

Logistic regression showed that caregivers(P = 0.042), maternal education (P = 0.030), gastrointestinal problems (P = 0.041) and a high serum concentration of lead (P = 0.003) were statistically significantly associated with ASD severity.

Conclusion

Many environmental factors affect the severity of ASD. We concluded that non-parental caregivers, low maternal education, gastrointestinal problems and high blood lead level maybe predictors that affected the severity of ASD in northeast China.

Immunoglobulins and Lymphocyte Subsets in Children with Infantile Tremor Syndrome

In this hospital-based, cross-sectional study, immunoglobulin levels and lymphocyte subsets status were evaluated in children with infantile tremor syndrome (ITS) [neurocutaneous infantile B12 deficiency (NIB) syndrome]. Blood samples were drawn at the baseline (n = 28) and at 6 wk (n = 25) after treatment. A low IgG/IgA or IgM was more likely in untreated children than post-treatment (p = 0.0368). Low B cells were observed in 9 (36%), low T cells in 5 (20%), and low NK cells in 2 patients. T cell subset analysis showed low CD4 + helper T cells in 5 (20%) and low CD8 + cytotoxic T cells in 2 patients. Abnormally low percentage of low B cell/T cells/NK cells was more likely in untreated children than post-treatment (p = 0.0165). In conclusion, a proportion of children with ITS have changes in immunoglobulin and T cell subsets not consistent with any clearly defined immune abnormality, and not all such changes revert at 6 wk.

Sociodemographic factors and early marriage among women in Bangladesh, Ghana and Iraq: An illustration from Multiple Indicator Cluster Survey

Early marriage is a form of violation of child rights to grow and develop. The Sustainable Development Goals had included early marriage in target 5.3, aiming to eliminate by 2030. This study examines the socio-demographic factors associated with women's early marriage in Bangladesh, Ghana, and Iraq using information extracted from 2019, 2017-2018, and 2018 Multiple Indicator Cluster Surveys (MICSs) of Bangladesh, Ghana, and Iraq, respectively. The chi-square test examined the association between socio-demographic factors and early marriage separately in all three countries. In logistic regression, key factors were primarily evaluated for determining effects on early marriage separately in all three countries. The mean age of the mother at first marriage was found to be 16.86, 20.23, and 20.05 years in Bangladesh, Ghana, and Iraq successively. According to surveys conducted in Bangladesh, Ghana, and Iraq, education levels of household heads and women, wealth status, mass media, number of household members, and residence were significant factors linked to early marriage. The odds of getting married early were significantly higher among women with no formal education and primary education than women with secondary or higher education in all three countries. In terms of economic status, a negative association was found between wealth status and early marriage in both Bangladesh and Ghana. Based on the findings, the study recommended that government take the necessary steps to reduce child marriage in all three countries by raising women's education and campaigning women by media to harmful effects of early marriage, particularly women from low-income families.

Nutritional, sensory, physico-chemical, phytochemical, microbiological and shelf-life studies of natural fruit juice formulated from orange (Citrus sinensis), lemon (Citrus limon), Honey and Ginger (Zingiber officinale)

Orange (Citrus sinensis), lemon (Citrus limon), ginger (Zingiber officinale) and honey contain nutrients and phytochemicals that are beneficial to health. Most of the available fruit drinks are artificial and may contain a lot of chemicals which could be unhealthy and detrimental to the health of the consumers. This work was aimed at formulating a healthy fruit drink from the combination (blend) of orange, lemon, ginger and honey for the development of a new product. Thirty (30) different juice blends (formulae) were made and subjected to sensory evaluation, from which five best formulated juices were selected using a 9 point hedonic scale. These were then subjected to physicochemical, nutritional, phytochemical, microbiological analyses and shelf-life studies. The results of the study showed pH (3.40–4.90), Vitamin C (0.04–0.06 mg/mL), titrable acidity (0.04–0.21 citric acid mg/100mL), total soluble solids (2.90–20.69%), reducing (0.41–1.44 mg/mL) and non-reducing sugar (0.21–2.06 mg/mL). The moisture, protein, fat, ash, fibre and available carbohydrate contents ranged from 79.31-97.10 %, 0.01–0.56g/100mL, 0.05–0.11g/100mL, 0.51–1.13g/100mL, 0.01–0.09g/100mL and 16.39–22.99g/100mL respectively. The macro (K, Ca, P, Na) and micro (Zn, Fe) minerals varied differently with Potassium (K) being the most abundant. Amongst the five best formulated juices, F22 (5% lemon juice) was the most organoleptically accepted. On the other hand, F21 (10% lemon juice + sugar) which had the least overall acceptability amongst the five, was shown to be the most nutritive.

Effect of different drying methods and storage conditions on physical, nutritional, bioactive compounds and antioxidant properties of doum (Hyphaene thebaica) fruits

The present study reports effect of various drying and storage conditions on physical, bioactive compounds, and antioxidant properties of doum (H. thebaica) fruit for the first time. Three types of fruit are used such as fresh, dried from tree, and dried fruits purchased from local market. Pulp of fresh fruit was dried using sun, shade and oven at different temperatures and stored under different conditions for three months. Samples were analysed before and after drying and storage. The results showed significantly (p < 0.01) higher dry matter (98.73 g/100g), pH (7.09), tannins (27.64 mg/g), flavonoids (19.90 mg/g) and total polyphenols (7.13 mg/g) contents in pericarp than other parts of fruit. The pulp without pericarp exhibited higher ash, amino acids, proteins and vitamin C contents, however pulp of whole fresh fruit had higher Ca (1.67 mg/g), Na (640.26 mg/g) and Zn (11.63 μg/g). Pulp of fruit purchased from local market showed significantly stronger antioxidant activities (DPPH and ABTS). All parameters evaluated were significantly (p < 0.01) affected in comparison with pulp of fresh fruit but varied with respect to drying methods and storage conditions. The shade-dried samples showed higher proteins, amino acids, vitamin C, ash, fibres and acidity contents than other drying methods. Polyphenols and antioxidant activities are higher in oven-dried samples at low temperature (40 °C) as compared to others. The highest DPPH and ABTS scavenging activities are observed after drying and storage conditions for three months. Significant and positive (p < 0.01) correlations are found between antioxidant compounds and antioxidant activities. Thus, drying methods and storage conditions can preserve pulp of doum fruit with high physicochemical, bioactive compounds and antioxidant capacities for human well-being up to three months, however shade-drying followed by oven-drying are highly promising process that must be considered as suitable drying methods for doum fruits.

Data on genome resequencing of pigmented and non-pigmented Malaysian rice varieties

The genomics and genetic data of pigmented and non-pigmented Malaysian rice varieties are still limited. Hence, we performed the genome resequencing of two black rice varieties (Bali, Pulut Hitam 9), two red rice varieties (MRM16, MRQ100) and two white rice varieties (MR297 and MRQ76) using Illumina HiSeq 4000 platform with 30x sequencing coverage. We aimed to identify and annotate single nucleotide polymorphisms (SNPs) from the genome of these four pigmented and two non-pigmented rice varieties. The potential SNPs will be used in developing the functional SNP markers related to nutritional (i.e. antioxidant, folate, amylose) and quality (i.e. aromatic) traits. Raw data of the pigmented and non-pigmented rice varieties have been deposited into the European Nucleotide Archive (ENA) database with accession number PRJEB29070 and PRJEB32344, respectively.

Prevalence of dietary supplement use by gym members in Portugal and associated factors

Background

Although there seems to be an increasing interest in the use of dietary supplements in those who exercise recreationally and want to improve body composition, there is little published data regarding gym users and dietary supplement use.

Methods

This cross-sectional study describes the prevalence and type of supplements used by gyms members, the reasons for using them and the information source using a self-administered online questionnaire.

Results

Of the 459 participants (301 females) who answered the survey, 43.8% reported using dietary supplements. Users were more likely men (62.7% vs. 33.9%, p < 0.05), younger (32 ± 9 vs. 34 ± 11 years, p < 0.05) and trained more hours per week (6 ± 3 vs 4 ± 3 h, p < 0.05) than non-users. The most consumed supplements were proteins (80.1%), multivitamins and/or minerals (38.3%), sport bars (37.3%), branched-chain amino acids (BCAA’s) (36.8%) and n-3 fatty acids (35.5%). Men consumed more arginine, BCAA’s, creatine, glutamine, β-hydroxy-β-methylbutyrate (HMB), proteins, β-alanine, taurine, multivitamin/minerals, and carbohydrate supplements (p < 0.05). The most commonly cited reasons for the use of supplements were gaining muscle (55.7%), accelerating recovery (52.7%) and improving performance (47.3%). Men have more often referred increase strength, increase resistance, gain muscle mass, accelerate recovery and improve performance as reasons to use supplements than women (p < 0.05). Those who mentioned muscle gain as a reason were younger than those who did not (30.4 years vs. 33.7 years, p < 0.05). The sources of information most mentioned were registered dietitians (23.1%), internet (22.2%) and him/herself (16.6%). The majority (> 70%) of participants declared being well or very well informed about supplements, while only a minority (4%) felt very poorly or poorly informed. Most individuals purchased dietary supplements from the internet (56.2%) and supplement/health food stores (43.4%).

Conclusion

This study concluded that gyms users are large consumers of dietary supplements, and are more likely to be men, young, use protein powders, aiming to increase muscle mass, obtain information from registered dietitians, consider themselves well informed and buy supplements online.

[The application of energy adjustment models in nutritional epidemiology]

The energy adjustment models in nutritional epidemiological studies could substantially reduce the confounding effect of total energy intake from the intake of dietary components, and it could explore the real relationship between the intake of dietary component and research outcomes. Four energy adjustment models were introduced in this article, including the standard multivariate model, multivariate nutrient residual model, energy partition model, and multivariate nutrient density model. The four energy adjustment models were applied to analyze the association between the intake of saturated fatty acids and the risk of all-cause mortality based on the data of the US National Health and Nutrition Examination Survey. The consistent results of different energy adjustment models could indicate that the four models could better control the confounding effect of total energy intake.

Assessment of the application for renewal of authorisation of l-isoleucine produced by Escherichia coli FERM ABP-10641 as a nutritional additive, its extension of use in water for drinking and a new use as flavouring additive for all animal species

Following a request from the European Commission, the Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) was asked to deliver a scientific opinion on l-isoleucine produced by Escherichia coli FERM ABP-10641 (i) to renew the authorisation and to extend the use of the additive in water for drinking when used as a nutritional additive for all animal species and (ii) to evaluate a new use as a flavouring additive for all animal species. The applicant has provided evidence that the additive currently in the market complies with the existing conditions of authorisation. l-Isoleucine does not give rise to any safety concern regarding the production strain and its genetic modification. Considering that the production process has not been substantially modified and that no adverse effects have been reported in the literature search, the FEEDAP Panel considers that there is no evidence to reconsider the conclusions reached in previous assessments. Therefore, the Panel considers that the additive l-isoleucine produced by E. coli FERM ABP-10641 remains safe for the target species, consumer and for the environment when used as a nutritional additive in feed. The Panel extends these conclusions to the use of the additive as a flavouring compound. Regarding the use in water, the FEEDAP Panel reiterates its concerns over the safety for the target species of l-isoleucine administered simultaneously via water for drinking and feed owing to the risk of nutritional imbalances and hygienic reasons. l-Isoleucine is not irritant to skin and eyes and is not a dermal sensitiser but is hazardous by inhalation. The Panel confirms the previous conclusions that the additive is considered as a source of available isoleucine for non-ruminant animal species when used as a nutritional additive. It requires protection against degradation in the rumen to be as efficacious in ruminants as in non-ruminant species. The Panel considers the use of the additive in water for drinking to be equally effective than the use in feed when used as a nutritional additive. Since l-isoleucine is used in food as a flavouring compound, and its function in feed is essentially the same as that in food no further demonstration of efficacy is necessary.

sap in Burkina Faso

The palmyra palm Borassus aethiopum Mart. grow wild and gives natural stands in several localities of central-eastern and eastern regions of Burkina Faso. This work aimed to determine the nutritional, biochemical and microbiological composition of fresh palm sap from B. aethiopum Mart. during the first 4 days of tapping. The composition of palm sap was carried out by HPLC and standard methods. The sap collected during the first 4 days were sugary and contained less alcohol. The mean values of the pH, total and reducing sugars content were 4.84 ± 0.5, 11.36 ± 3.97 and 2.93 ± 1.22% w/v respectively. Sucrose, glucose, fructose and Vitamin C values were 6.75% w/v, 4.99 g/L, 7.09 g/L, 8.93% w/v respectively. Galactose and xylose were not detected. Soluble proteins, arabinose, phenols and ethanol were present in low concentration. Calcium, potassium, magnesium and ammonium were present in palm sap with highest potassium content (13.26 g/L). Lactate (2.41 ± 0.86 g/L), succinate (2.49 ± 1.46 g/L), acetate (0.01 ± 0.006 g/L), malate (0.17 ± 0.31 g/L), propionate (0.07 ± 0.04 g/L), citrate (0.19 ± 0.11 g/L), tartrate (0.08 ± 0.09 g/L) and pyruvate (0.05 ± 0.03 g/L) were detected in palm sap. The microbiological analysis of sap gave 1.23 ± 1.01 × 10⁸ cfu/mL for total aerobic flora, 7.27 ± 1.19 × 10⁵ cfu/mL for yeasts, 1.86 ± 1.63 × 10⁷ cfu/mL for lactic acid bacteria and 3.75 ± 0.75 × 10⁵ cfu/mL for acetic acid bacteria. The fresh sap from B. aethiopum presents good nutritional value and its consumption can help to improve dairy food intake of rural population. It can be used for the manufacture of various products like palm wine, syrups, sugars, functional foods, etc.

Is folate deficiency a common cause of distal symmetric polyneuropathy in Zambian clinics?

OBJECTIVES

To evaluate the odds of vitamin B12 and folate deficiencies among Zambian clinic attendees with distal symmetric polyneuropathy (DSP) and age, sex, and HIV matched controls.

METHODS

Cases were adults from clinics in urban/peri-urban Zambia. Controls were enrolled among persons not seeking personal medical care, such as a caregiver or person collecting antiretrovirals without a medical complaint. Participants underwent structured interviews, physician examination, and assessments of complete blood count, renal and liver profiles, serum vitamin B12 and folate, erythrocyte folate, plasma total homocysteine and methylmalonic acid. HIV testing and CD4 counts were performed when appropriate.

RESULTS

Among 107 consenting matched case-control pairs, 65% were female, 52% HIV positive, with mean age of 47.6 (SD 13.5) years. Among HIV positive participants, mean CD4 count was 484 (SD 221) and 482 (SD 236) for cases and controls, respectively (p = .93). DSP symptoms and severity did not differ by HIV status (p's > 0.05). Height, history of tuberculosis treatment, alcohol use, education, asset index, dietary diversity, and nutritional supplement use did not differ between cases and controls (p's > 0.05). DSP cases had at least 3:1 odds of having low serum folate (p = .0001), severely low erythrocyte folate (p = .014), and elevated total homocysteine (p = .001) levels compared to controls. Markers of vitamin B12 deficiency were not associated with case status (p's > 0.05).

CONCLUSION

Markers of folate deficiency are highly associated with DSP among Zambian clinic attendees. Future studies should consider a broader range of comorbid nutritional deficiencies, and strategies for interventions.

The Systemic Metabolic Profile Early after Allogeneic Stem Cell Transplantation: Effects of Adequate Energy Support Administered through Enteral Feeding Tube

Patients undergoing allogeneic stem cell transplantation usually require nutritional support. There is no consensus on whether enteral support through tube feeding should be preferred. A recent randomized study could not detect any difference between enteral and parenteral feeding with regard to post-transplant outcomes, whereas 2 retrospective studies described an association between enteral feeding and a favorable post-transplant outcome. We compared pre- and post-transplant plasma metabolomic profiles for 10 patients receiving mainly enteral nutritional support and 10 patients receiving mainly parenteral support. Samples were collected before conditioning and 3 weeks post-transplant; 824 metabolites were analyzed using mass spectrometry. The pretransplant metabolite profiles showed a significant overlap between the 2 groups. Post-transplant samples for both patient groups showed an increase of secondary bile acids and endocannabinoids, whereas reduced levels were seen for food preservatives, plasmalogens, and retinol metabolites. The main post-transplant differences between the groups were decreased levels of fatty acids and markers of mitochondrial activation in the control group, indicating that these patients had insufficient energy intake. A significant effect was also seen for heme/bilirubin metabolism for the parenteral support. To conclude, allotransplant recipients showed altered metabolic profiles early after transplantation; this was mainly due to the conditioning/transplantation/reconstitution, whereas the type of nutritional support had minor effects.

Donkey's Milk in the Management of Children with Cow's Milk protein allergy: nutritional and hygienic aspects

Background

The therapeutic strategy for children with cow’s milk allergy (CMA) consists in the elimination of cow’s milk (CM) from their diet. Donkey’s milk (DM) has been reported to be an adequate alternative, mainly to his nutritional similarities with human milk (HM) and excellent palatability. The aim of present prospective study was to evaluate the nutritional impact of DM on the diet of children with CMA in term of children growth.

Methods

Before the nutritional trial on children and during the study the health and hygiene risks and nutritional and nutraceuticals parameters of DM were monitored. Children with CMA were identified by the execution of in vivo and in vitro tests for CM and subsequent assessment of tolerability of DM with oral food challenge (OFC). Finally, we prescribed DM to a selected group of patients for a period of 6 months during which we monitored the growth of children. A total of 81 children, 70 with IgE mediated cow’s milk protein allergy (IgE-CMPA) and 11 with Food Protein Induced Enterocolitis Syndrome to CM (CM-FPIES), were enrolled.

Results

Seventy-eight out of 81 patients underwent the OFC with DM and only one patient with IgE-CMPA (1.5 %) reacted. Twenty-two out of 81 patients took part of the nutritional trial. All the 22 patients took and tolerated the DM, moreover DM did not change the normal growth rate of infants.

Conclusions

In conclusion, DM resulted safe in term of health and hygiene risks and nutritionally adequate: no negative impact on the normal growth rate of children was assessed. Therefore, it may be a suitable alternative for the management of IgE mediated CMA and FPIES, also in the first 6 months of life, if adequately supplemented.

Differences in nutritional status and activities of daily living and mobility in elderly hospitalized patients with heart failure

Aims

This study aims to examine the effect of differences in nutritional status on activities of daily living (ADL) and mobility recovery of hospitalized elderly patients with heart failure (HF).

Methods and results

From among 377 consecutive HF patients who underwent rehabilitation at one acute‐care hospital from January 2013 to August 2015, those who were aged ≥ 65 years could walk with assistance before hospitalization and who were hospitalized for the first time were included in this retrospective cohort study. Exclusion criteria were pacemaker surgery during hospitalization, change to other departments, death during hospitalization, and unmeasured ADL. We investigated patient characteristics, basic attributes, Geriatric Nutritional Risk Index (GNRI), ADL [motor Functional Independence Measure (motor FIM)], and Rivermead Mobility Index (RMI). Of these 377 patients, 96 met the inclusion criteria and were divided into the low GNRI group (n = 38, 83.5 ± 8.3 years, 44.7% male) and high GNRI group (n = 58, 81.0 ± 6.6 years, 55.2%). Patient characteristics and the difference between motor ADL and motility recovery and nutrition data were analysed with unpaired t‐test, χ² test, and two‐way analysis of covariance. In comparing the two groups, the following parameters were significantly lower in the low GNRI group than in the high GNRI group: body mass index (18.7 ± 2.2 vs. 23.2 ± 2.7 kg/m², P < 0.01), albumin (3.4 ± 0.4 vs. 3.8 ± 0.4 g/dL, P < 0.01), diabetes mellitus ratio (21.1% vs. 50.0%, P < 0.01), RMI at discharge (6.8 ± 2.6 vs. 8.2 ± 2.2, P = 0.01), and motor FIM at discharge (67.2 ± 19.5 vs. 75.6 ± 13.3, P = 0.02). RMI showed a significant group and term main effect and interaction effect (P < 0.05). Motor FIM showed a significant main effect of group and term (P < 0.05), and no significant interaction effect.

Conclusions

Low nutritional status in hospitalized elderly HF patients affected their recovery of mobility but did not appear to affect the recovery of ADL.

Echocardiographic phenotype of canine dilated cardiomyopathy differs based on diet type

INTRODUCTION

Canine dilated cardiomyopathy (DCM) can result from numerous etiologies including genetic mutations, infections, toxins, and nutritional imbalances. This study sought to characterize differences in echocardiographic findings between dogs with DCM fed grain-free (GF) diets and grain-based (GB) diets.

ANIMALS

Forty-eight dogs with DCM and known diet history.

METHODS

This was a retrospective analysis of dogs with DCM from January 1, 2015 to May 1, 2018 with a known diet history. Dogs were grouped by diet (GF and GB), and the GF group was further divided into dogs eating the most common grain-free diet (GF-1) and other grain-free diets (GF-o). Demographics, diet history, echocardiographic parameters, taurine concentrations, and vertebral heart scale were compared between GB, all GF, GF-1, and GF-o groups at diagnosis and recheck.

RESULTS

Dogs eating GF-1 weighed less than GB and GF-o dogs, but age and sex were not different between groups. Left ventricular size in diastole and systole was greater, and sphericity index was less for GF-1 compared with GB dogs. Diastolic left ventricular size was greater for all GF compared with that of GB dogs. Fractional shortening, left atrial size, and vertebral heart scale were not different between groups. Taurine deficiency was not identified in GF dogs, and presence of congestive heart failure was not different between groups. Seven dogs that were reevaluated after diet change (6 received taurine supplementation) had clinical and echocardiographic improvement.

CONCLUSIONS

Dietary-associated DCM occurs with some GF diets and can improve with nutritional management, including diet change. The role of taurine supplementation, even without deficiency, is uncertain.

Screening for nutritional rickets in a community

Concern has been expressed about the rising incidence of nutritional rickets with its associated long-term sequelae in children globally. In order to address the condition worldwide, it is imperative that accurate figures of its incidence are available particularly in at-risk communities. In order to obtain these figures, various screening tools and diagnostic criteria have been used with no standardization of methodologies, resulting in varying prevalences which may under- or over-estimate the prevalence depending of the techniques used. This review discusses the advantages and disadvantages of various screening tests used to diagnose rickets in communities. Clinical signs characteristic of rachitic deformities have been used extensively, but are likely to over-estimate the prevalence and are dependent on the clinical skills of the observer. Biochemical tests such as alkaline phosphatase and 25-hydroxyvitamin D have also been proposed. There is no consensus on the usefulness of alkaline phosphatase as a screening tool, while there is general agreement that the measurement of vitamin D status is unhelpful in screening for rickets. Finally, the confirmation of the presence of active rickets in suspected infants and children is dependent on radiographic findings, although these may be less helpful in adolescents whose growth plates might be closed or nearly so. In order to obtain uniformity in screening for rickets globally, the is a need for consensus among public health specialists, paediatric endocrinologists and those interested in paediatric bone disease as to the best methods to be employed to determine the prevalence of rickets, particularly in communities with limited resources.

Evaluation of nutraceutical and antinutritional properties in barnyard and finger millet varieties grown in Himalayan region

Five elite varieties of barnyard (Echinochloa frumentacea) and finger (Eleusine coracana) growing at northwestern Himalaya were investigated for nutraceutical and antinutritional properties. Barnyard millet contained higher amount of crude fiber, total dietary fiber, tryptophan content, total carotenoids, α-tocopherol compared to the finger millet whereas the finger millet contains higher amount of methionine and ascorbic acid as compared to the barnyard millet. The secondary metabolites of biological functions were analyzed and found that barnyard millet contained the higher amount of polyphenols, tannins and ortho-dihydroxy phenol content compared to finger millet. Among antinutitional compounds barnyard millet contained lower phytic acid content compare to finger millet whereas no significant difference in trypsin inhibition activity of barnyard millet and finger millet varieties were found. Barnyard millet contained higher acid phosphatase, α-galactosidase and α-amylase inhibitor activity compared to finger millet. Finger millet seeds contained about 10-13 folds higher calcium content and double amount of manganese content in comparison to barnyard millet seeds. Present study suggests that barnyard millet varieties studied under present investigation were found nutritionally superior compared to finger millet varieties.

"Las penas con pan duelen menos": The role of food and culture in Latinas with disordered eating behaviors

This study elucidated the experiences of eighteen Latina adults (mean age = 38.5 years) from "Promoviendo una Alimentación Saludable" Project who received nutritional intervention as part of the clinical trial. Half of the participants were first generation immigrants from Mexico (50%), followed by U.S. born with 16.7%. Remaining nationalities represented were Bolivia, Colombia, Guatemala, Honduras, Peru, and Venezuela with 33.3% combined. The average duration of living in the U.S. was 11.1 years. The mean body mass index (BMI) at baseline was 36.59 kg/m(2) (SD = 7.72). Based on the DSM-IV, 28% (n = 5) participants were diagnosed with binge-eating disorder, 33% (n = 6) with bulimia nervosa purging type and 39% (n = 7) with eating disorder not otherwise specified. Participants received up to three nutritional sessions; a bilingual dietitian conducted 97.8% of sessions in Spanish. In total, fifty nutritional sessions were included in the qualitative analysis. A three step qualitative analysis was conducted. First, a bilingual research team documented each topic discussed by patients and all interventions conducted by the dietitian. Second, all topics were classified into specific categories and the frequency was documented. Third, a consensus with the dietitian was performed to validate the categories identified by the research team. Six categories (describing eating patterns, emotional distress, Latino culture values, family conflicts associated with disturbed eating behaviors, lack of knowledge of healthy eating, and treatment progress) emerged from patients across all nutritional sessions. Considering the background of immigration and trauma (60%, n = 15) in this sample; the appropriate steps of nutritional intervention appear to be: 1) elucidating the connection between food and emotional distress, 2) providing psychoeducation of healthy eating patterns using the plate method, and 3) developing a meal plan.

Impact of highly active antiretroviral therapy on nutritional and immunologic status in HIV-infected children in the low-income country of Ethiopia

OBJECTIVE

HIV/AIDS and malnutrition combine to undermine the immunity of individuals and are inextricably interrelated. Although the effect of highly active antiretroviral therapy (HAART) on growth in HIV-infected children is well known, the influence of prior nutritional and immunologic status on the response to HAART is not well documented. The aim of the present study was to determine the effects of HAART on nutritional and immunological status in HIV-infected children in the low-income country of Ethiopia.

METHODS

A multicenter, retrospective cohort study was conducted on HIV-infected children receiving antiretroviral therapy at the pediatric units of public hospitals in Addis Ababa (Black Lion, Zewditu, Yekatit 12 and ALERT hospitals), Ethiopia. Nutritional status was defined as stunting (height-for-age Z score [HAZ] <-2), wasting (weight-for-height Z score [WHZ] <-2), and underweight (weight-for-age Z score [WAZ] <-2). Multivariable logistic regression was used to analyze factors associated with treatment success and to establish whether growth (baseline nutritional status) in children predicts immunologic outcomes. In all, 556 HIV-infected children receiving HAART from January 2008 to December 2009 were included in this study.

RESULTS

Over the 24-mo follow-up period, the study showed that the immunologic recovery of stunted and underweight children, regardless of their baseline nutritional status, responded equally to treatment. However, wasted children showed less immunologic recovery at the different follow-up visits. Predictors of positive shift in WHZ after 24 mo of follow-up were advanced disease stage (World Health Organization clinical stages 3 and 4) with odds ratio (OR), 0.25 (95% confidence interval [CI], 0.34-0.99; P = 0.045) and baseline severe underweight OR, 0.19 (95% CI, 0.09-0.56; P = 0.003). The independent predictors of positive shift of growth shift in WAZ over 24 mo were lower baseline age (<36 mo) with OR, 0.21 (95% CI, 0.04-0.90; P = 0.036) and baseline moderate underweight itself with OR, 0.11 (95% CI, 0.05-0.25; P = 0.0001) were predictors of positive shift (shift to normal).

CONCLUSION

Despite the apparent growth response in HIV-infected children after initiation of HAART, moderate and severe underweight are both independent predictors of a positive shift. The latter suggests that children on HAART require nutritional supplementation, especially during the early initiation of HAART.

Antidiabetic and antioxidant activity of Stevia rebaudiana extracts (Var. Morita) and their incorporation into a potential functional bread

In this study a new wheat bread was designed whose sugars were replaced with S. rebaudiana Bertoni aqueous extract. The impact of the S. rebaudiana Bertoni aqueous extract on nutritional and sensory quality, its ability to reduce sugar intake and its antioxidant properties were investigated. Functional bread with 50 % of sugars replaced with S. rebaudiana extract was compared with traditional wheat bread. The extract demonstrated alpha amylase (IC50 = 198.40 μg/mL) glucosidase (596.77 μg/mL) inhibition. The radical scavenging activity exhibited an IC50 value of 335.94 mg/mL. In comparison with the control, the bread with stevia extract was softer and had lower microbial growth during the shelf-life study. The sensory test showed that the substitution of 50 % stevia extract was more acceptable when comparing with all quality characteristics. Regarding the nutritional contribution, the content of dietary fiber and digestible carbohydrates in the bread with stevia extract was higher and lower respectively, so caloric intake was significantly reduced. The results showed that the biological properties of S. rebaudiana extract were retained after the bread making process and that the proposed bread is suitable as functional food in human nutrition.

Reducing the sodium content

The antioxidant activity and nutritional composition of four dehydrated soups (vegetables, meat, chicken and fish) packaged in four formats - carton, plastic, and aluminium bags (the last with and without modified atmosphere) - were evaluated during 12 months' storage. The results showed that all four soups had a good or very good antioxidant capacity as tested by the lipid peroxidation, deoxyribose, and Trolox equivalent antioxidant capacity (TEAC) tests. Of interest from a nutritional point of view was the finding that the lipid fraction of all the soups was below 1 %. The sodium content of the four soups and their ingredients was also analysed. By modifying some of the ingredients, a 25 % reduction in the sodium content of the soups was obtained, permitting them to be labelled as "sodium reduced". The monosodium glutamate (MSG) content of the reformulated soups (lower sodium content) was below levels permitted by European legislation.

Supplements for exotic pets

The use of supplements has become commonplace in an effort to complement traditional therapy and as part of long-term preventive health plans. This article discusses historical and present uses of antioxidants, vitamins, and herbs. By complementing traditional medicine with holistic and alternative nutrition and supplements, the overall health and wellness of exotic pets can be enhanced and balanced. Further research is needed for understanding the strengths and uses of supplements in exotic species. Going back to the animals' origin and roots bring clinicians closer to nature and its healing powers.

Brain tocopherols related to Alzheimer's disease neuropathology in humans

Randomized trials of α-tocopherol supplements on cognitive decline are negative, whereas studies of dietary tocopherols have shown benefit. We investigated these inconsistencies by analyzing the relations of α- and γ-tocopherol brain concentrations to Alzheimer's disease (AD) neuropathology among 115 deceased participants of the prospective Rush Memory and Aging Project. Associations of amyloid load and neurofibrillary tangle severity with brain tocopherol concentrations were examined in separate adjusted linear regression models. γ-Tocopherol concentrations were associated with lower amyloid load (β = -2.10, P = .002) and lower neurofibrillary tangle severity (β = -1.16, P = .02). Concentrations of α-tocopherol were not associated with AD neuropathology, except as modified by γ-tocopherol: high α-tocopherol was associated with higher amyloid load when γ-tocopherol levels were low and with lower amyloid levels when γ-tocopherol levels were high (P for interaction = 0.03). Brain concentrations of γ- and α-tocopherols may be associated with AD neuropathology in interrelated, complex ways. Randomized trials should consider the contribution of γ-tocopherol.

The role of metabonomics as a tool for augmenting nutritional information in epidemiological studies

Most chronic diseases have been demonstrated to have a link to nutrition. Within food and nutritional research there is a major driver to understand the relationship between diet and disease in order to improve health of individuals. However, the lack of accurate dietary intake assessment in free-living populations, makes accurate estimation of how diet is associated with disease risk difficulty. Thus, there is a pressing need to find solutions to the inaccuracy of dietary reporting. Metabolic profiling of urine or plasma can provide an unbiased approach to characterizing dietary intake and various high-throughput analytical platforms have been used in order to implement targeted and nontargeted assays in nutritional clinical trials and nutritional epidemiology studies. This review describes first the challenges presented in interpreting the relationship between diet and health within individual and epidemiological frameworks. Second, we aim to explore how metabonomics can benefit different types of nutritional studies and discuss the critical importance of selecting appropriate analytical techniques in these studies. Third, we propose a strategy capable of providing accurate assessment of food intake within an epidemiological framework in order establish accurate associations between diet and health.