Journal Current Developments in Nutrition-
Current Developments in Nutrition; doi:10.1093/cdn/nzaa069
This paper is based on a session at ASN 2019 entitled nutrients, foods, diets, people: promoting healthy eating. A summary of the four presentations at this session is included in this paper. The overarching themes that link these four presentations are sustainability and food systems. The subjects range from newer definitions of healthy eating to linking sustainable production to sustainable consumption. Two of the papers discuss the importance of the cost of a healthy diet and information as facilitators or barriers to consuming a healthy diet.
Current Developments in Nutrition, Volume 4; doi:10.1093/cdn/nzaa034
Background Controversial findings have been reported in human and animal studies regarding the influence of n–6 (ω-6) to n–3 (ω-3) fatty acid ratios on obesity and health. Two confounding factors may be related to interactions with other dietary lipid components or sex-specific differences in fatty acid metabolism. Objective This study investigated main and interactive effects of total dietary lipid, ratio of n–6 to n–3 fatty acids, and sex on growth, adiposity, and reproductive health in wild-type zebrafish. Methods Male and female zebrafish (3 wk old) were fed 9 diets consisting of 3 ratios of n–6 to n–3 fatty acids (1.4:1, 5:1, and 9.5:1) varied within 3 total lipid amounts (80, 110, and 140 g/kg) for 16 wk. Data were then collected on growth, body composition (determined by chemical carcass analysis), and female reproductive success (n = 32 breeding events/diet over 4 wk). Main and interactive effects of dietary lipid and sex were evaluated with regression methods. Significant differences within each dietary lipid component were relative to the intercept/reference group (80 g/kg and 1.4:1 ratio). Results Dietary lipid and sex interacted in their effects on body weight (P = 0.015), total body length (P = 0.003), and total lipid mass (P = 0.029); thus, these analyses were stratified by sex. Female spawning success decreased as dietary total lipid and fatty acid ratio increased (P = 0.030 and P = 0.026, respectively). While total egg production was not associated with either dietary lipid component, females fed the 5:1 ratio produced higher proportions of viable embryos compared with the 1.4:1 ratio [median (95% CI): 0.915 (0.863, 0.956) vs 0.819 (0.716, 0.876); P < 0.001]. Conclusions Further characterization of dietary lipid requirements will help define healthy balances of dietary lipid, while the sex-specific responses to dietary lipid identified in this study may partially explain sex disparities in the development of obesity and its comorbidities.
Current Developments in Nutrition; doi:10.1093/cdn/nzaa037
Background Food security is defined as physical and economic access to sufficient food to meet the dietary requirements for a productive and healthy life. Evidence from the literature suggests that over 800 million people worldwide are food insecure.VGD is the largest social safety net of the Government of Bangladesh targeting ultra-poor women to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture. Objectives The objective of this study is to explore the factors associated with food security among Vulnerable Group Development (VGD) women in Bangladesh. Methods A total of 870 women (435 per group) participated in the baseline survey and another 800 women (400 per group) participated in the endline survey. Participants in the intervention group received monthly rations of 30 kg fortified rice (FFR) and the control group received 30 kg of non-FFR for 12 months. Multiple logistic regression analysis was used to establish both crude and confounder-adjusted relationships between the primary outcome and response variables. Written consent was proved by study participants. This study (PR-14091) was approved by the Research Review Committee and Ethical Review Committee. Results Severe food insecurity in the endline survey reduced approximately from 50% to 6.3% in both groups. The hunger scale also improved between baseline and endline survey. More than 97% of respondents at endline reported no hunger compared to 80% at baseline; only 3% of women in both groups reported moderate hunger at endline. Multivariable regression model showed that ownership of a house and land for agriculture, wealth index (richest quintile), and absence of fever were significantly associated with food security (P < 0.05). Conclusion Our analysis shows VGD rice distribution programme significantly improve the food security status of the vulnerable women however ownership of a house and land for agriculture was the most significant factors associated with household food security in VGD programme areas of Bangladesh.
Current Developments in Nutrition; doi:10.1093/cdn/nzaa036
Background Due to the lack of resources in remote Aboriginal communities within the Northern Territory of Australia, Aboriginal people requiring chronic maintenance hemodialysis often have to relocate from their home communities to Darwin city permanently to receive on going care. This phenomenon can cause distressing isolation from important traditional food, land and family. Objective To identify the relationship to traditional food from an Aboriginal perspective and the enablers and barriers to accessing traditional food post relocation from remote regions of the Northern Territory Australia to the urban city of Darwin. Methods A qualitative study design with a total of 12 Aboriginal participants (4 males; 8 females) receiving on going hemodialysis at the Nightcliff Renal Unit. Participants had all relocated from a remote region to Darwin. Interviews were conducted between July and September 2018 in Darwin, Australia. Data interpretation was conducted by an Aboriginal researcher and co-authors with a combined thirty years of experience conducting research with Aboriginal people in a health context. Data analysis comprised an inductive thematic analysis approach with an Indigenist knowledge interpretation lens to construct, reaffirm and protect Indigenous views. Results Traditional food was an important part of participant's identity and strongly connected to social, emotional, spiritual and physical health and well-being. Access to traditional food post relocation is associated with enablers and barriers including mobility, local knowledge, social support networks, commercial access and economics. Conclusion Dialysis patients who are dislocated from remote Aboriginal communities to Darwin experience clear disruption to traditional food access, consumption, availability and knowledge dissemination to the younger generations.
Current Developments in Nutrition; doi:10.1093/cdn/nzaa038
Background A number of investigations have highlighted the importance of vitamin C in maintaining brain health. Biologically, Objective The present study explored the interaction between gender and plasma vitamin C on cognitive performance, and the effect of different levels of plasma vitamin C (adequate/inadequate) on various cognitive tasks by gender. Methods This retrospective analysis was conducted on healthy adults (n = 80, Female = 52, Male = 28, 24–96 years) with a range of blood plasma vitamin C concentrations. Cognitive assessments included the Swinburne-University-Computerized-Cognitive-Assessment-Battery (SUCCAB) and two pen and paper tests, the Symbol-Digits-Modalities-Test (SDMT) and the Hopkins-Verbal-Learning-Test-Revised (HVLT-R). Food frequency questionnaires were used to elucidate dietary consumption. Results After adjusting for a number of potential covariates such as age, number of prescribed medications and dose of vitamin C supplementation, results indicated a significant interaction (P < 0.001) between plasma vitamin C and gender on cognitive function, on both the computerized and pen and paper assessments. A novel finding was that the performance of males with inadequate plasma vitamin C was poorer on tasks involving components of memory (short/delayed), inhibition and visual perception, whereas females presenting with inadequate vitamin C were more compromised on tasks involving psychomotor performance/motor speed. Additionally, females with adequate vitamin C levels exhibited higher performance than males on tasks involving recall, recognition, attention and focus. Conclusions Further larger scale investigations are required to establish a cause and effect relationship and to elucidate whether differences in cognitive function between genders may be attributed to plasma vitamin C status.
Current Developments in Nutrition, Volume 4; doi:10.1093/cdn/nzaa035
The challenges to achieving sustainability in food and nutrition are daunting. The present paper summarizes 3 individual papers that are part of this special collection. The lynchpin for synthesizing the papers is sustainability and food systems. Within each of these domains are embedded a myriad of factors, each of which are essential for the sustainable transformation of food systems. Controversies surrounding the concepts of a healthy diet, sustainable agricultural production, and maximizing the dietary impacts of food environments are discussed and evaluated in the context of the current food and nutrition landscape.
Current Developments in Nutrition, Volume 4; doi:10.1093/cdn/nzaa029
Chronic stress increases the risk of excess intake of calorie-dense foods. Low-income minority caregivers in the United States are cumulatively exposed to stressors and unhealthy foods, but evidence of this association is limited in this population group. The objective of the current study was to assess the association between chronic stress and unhealthy dietary behaviors among low-income African-American caregivers in Detroit, Michigan. Data came from Detroit Dental Health Project, a longitudinal study of pairs of African-American caregivers and children during 2002-2007. A sample of 912 female caregivers were included and their baseline (2002-2003) survey responses were analyzed to identify those with chronic stress and patterns of dietary behaviors. The likelihood of having unhealthy dietary behaviors was compared between chronically stressed caregivers and others, and the mediator role of depressive symptoms or current smoking was tested. Approximately 10% of caregivers experienced chronic stress as they all reported discrimination, residential movement, and lack of social support. Twenty-five percent of the caregivers were found to have an unhealthy dietary pattern characterized by excess intake of high fatty foods and soda. Chronically stressed caregivers were more likely to exhibit unhealthy dietary behaviors (prevalence ratio: 1.39; 95% CI: 1.05, 1.84), and this relation was significantly mediated by depressive symptoms, not current smoking. These findings suggest that chronic stress played a role in negatively influencing dietary behaviors. As this association might be mediated by depressive symptoms, an intervention to reduce depressive symptoms can be considered as an effective strategy to promote healthy dietary behaviors among chronically stressed minority caregivers.
Current Developments in Nutrition; doi:10.1093/cdn/nzaa039
Team-based active learning has been associated with enhanced communication and critical thinking skills, and improved clinical competency in other allied-health disciplines, but little is known about this pedagogical technique in nutrition. This study compared content retention and perceptions of a team-based, active learning course redesign intervention in an undergraduate nutrition class pre- (n = 32) and post- (n = 43) intervention. Assessment scores improved overall (69% to 75%, p = <0.01) and within three content domains: Dietary Guidelines (75% to 84%, p = 0.03), the exchange system (38% to 49%, <0.01), and dietary assessment (59% to 73%, <0.01). Thus, incorporation of team-based active learning was effective to improve content knowledge among undergraduate nutrition students as assessed by performance on exam questions overall and in some but not all content domains. Non-significant changes in student evaluations suggest that this is an acceptable, non-inferior strategy to facilitate learning in undergraduate courses.
Current Developments in Nutrition; doi:10.1093/cdn/nzaa032
Background Food insecurity remains a major obstacle to achieving health and well-being for individuals living with HIV in western Kenya. Studies have shown that pregnant women are vulnerable to experiencing food insecurity worldwide, with significant consequences for both maternal and child health. The Shamba Maisha cluster randomized controlled trial in western Kenya (translating to “farming for life” in Swahili) tested the effects of a multisectoral livelihood intervention consisting of agricultural and finance trainings, farm inputs, and a loan on health and food security among 746 farmers living with HIV in Kisumu, Homa Bay, and Migori Counties. Objective We conducted a qualitative sub-study within the Shamba Maisha trial (NCT02815579) to understand the experiences and perspectives of pregnant women living with HIV enrolled in the trial. Methods Thirty women who had experienced a pregnancy during the Shamba Maisha study period, comprising 20 women in the intervention arm and 10 women in the control arm, completed in-depth interviews using a semi-structured interview guide. Results Intervention participants interviewed noted improvements in maternal nutrition compared to previous pregnancies, which they attributed to the livelihood intervention. Key identified pathways to improved nutrition included improved access to vegetables, increased variety of diet through vegetable sales, and improved nutritional awareness. Women in the intervention arm also perceived increased weight gain compared to prior pregnancies and increased strength and energy throughout pregnancy. Conclusions Livelihood interventions represent a promising solution to alleviate food insecurity for pregnant women in order to improve maternal and child health outcomes.
Current Developments in Nutrition; doi:10.1093/cdn/nzaa025
Citrus fruit and in particular flavonoid compounds from citrus peel have been identified as agents with utility in the treatment of cancer. This review provides a background and overview regarding the compounds found within citrus peel with putative anti-cancer potential as well as the associated in vitro and in vivo studies. Historical studies have identified a number of cellular processes that can be modulated by citrus peel flavonoids including cell proliferation, cell cycle regulation, apoptosis, metastasis, and angiogenesis. More recently, molecular studies started to elucidate the underlying cell signaling pathways that are responsible for the flavonoids’ mechanism of action. This growing data supports further research into the chemo-preventative potential of citrus peel extracts, and purified flavonoids in particular. This critical review highlights new research in the field as well as synthesizes the pathways modulated by flavonoids and other polyphenolic compounds into a generalized schema.