Current Developments in Nutrition
Latest articles in this journal
Current Developments in Nutrition; doi:10.1093/cdn/nzz115
Abstract:Background Non-dairy beverages, produced from soy, rice, oat, almond or coconut, are increasingly being used as alternatives to dairy milk, with the perception that they are healthier and/or more sustainable products than dairy products. Objective The aim of this study was to compare the effects of supplementing either bovine milk, soy, or almond based beverages to young, growing rats fed an intact protein diet or a diet that had protein substituted with amino acids (AA-diet). Methods Three-week-old male Sprague Dawley rats were randomly assigned to five groups (n = 10/group) and fed ad libitum for four weeks. Two control groups were fed either standard AIN-93 G food (20% casein protein) or AIN-93 G with amino acids (AA) equivalent to casein protein, and water to drink. Three treatment groups were fed AIN-93 G AA and supplemented with either bovine ultra-heat treatment (UHT) milk or soy or almond UHT beverages. Rat weight gain and food intakes were recorded. During week 4, body composition was assessed using Dual-energy X-ray absorptiometry (DEXA) to determine lean soft tissue, fat and bone mass. At trial end, bone biomechanical properties and blood plasma mineral levels were measured. Results At the end of the trial, animals supplemented with almond beverage were lightest (P > 0.05), with higher plasma calcium levels (P > 0.05) and lower bone mineral content and bone density (P > 0.05), compared with animals supplemented with milk or soy beverage. Soy supplemented animals had similar bone mineral content and bone density compared with milk supplemented animals, although the soy group gained most weight (P > 0.05) and had the highest fat/lean ratio (P > 0.05) compared with other groups. Conclusions In the model tested, supplementing rats with bovine UHT milk and soy UHT beverage provided favorable bone health outcomes. Conversely, Almond UHT beverage was not an effective supplement and could be detrimental to bone mineralization and strength outcomes.
Current Developments in Nutrition; doi:10.1093/cdn/nzz111
Abstract:Background. American Indians are disproportionately affected by obesity and diabetes, and American Indian youth have the highest prevalence of obesity and diabetes among all ethnic groups in the United States. Objectives. The purposes of this study were to assess usual dietary intake in American Indian youth who attend a wellness camp program; adherence to the Dietary Guidelines for Americans 2015–2020 (DGA) and to the Healthy People 2020 Objectives; and, to compare pre- and post-camp reported diets. Methods. A total of six 24-hour dietary recalls were conducted in person with American Indian youth (aged 10–15 years; n = 26) from three different Southwest tribes. Three recalls were conducted before the wellness camp, and three were conducted after the camp. A series of two-way Analysis of Variance (ANOVA) were conducted using mixed model, to compare the nutrition differences between before and after the health camp on a statistical program, R. Results. Adherence to federal dietary recommendations was low, with few of the youth meeting the DGA recommendations for fruits (15%, average serving 0.69 cup/d) and vegetables (35%, average serving 0.59 cup/d). All of the participants exceeded the DGA recommended limit on empty calories. Nutrient analysis of total fat intake showed a significant decrease in intake after the camp, F (1, 52) = 5.68, p = .002. Conclusions. Diet is a modifiable risk factor for obesity and chronic diseases such as type 2 diabetes and needs to be an integral part of any healthy lifestyle intervention. The camp-based nutrition education did have a positive effect on youth, as observed through the total fat intake decreasing after camp. To reinforce nutrition education, future nutrition education should involve parents, be delivered beyond the week at camp and be encompassing of social determinants of health and access to healthy foods.
Current Developments in Nutrition; doi:10.1093/cdn/nzz114
Abstract:Background Alaska Native (AN) traditional foods and associated harvesting activities are beneficial to human health. Objective This study assessed longitudinal self-reported traditional food use and harvesting activities among Alaska Native and American Indian (AN/AI) participants in the Alaska Education and Research Towards Health (EARTH) study. Design In 2004–2006, southcentral Alaska EARTH study participants (n = 1320) completed a diet and activity questionnaires which were repeated in 2015–2017; results were compared between participants who completed both questionnaires (n = 388). Results In the follow-up questionnaire, > 93% of participants reported eating at least one traditional food in the past year. The top three traditional foods were fish (75%), moose (42%), and shellfish (41%). Women were more likely than men to consume traditional foods, especially fish, gathered berries, shellfish, and seal oil (p < 0.05). Participants aged 60 + in the original cohort were significantly more likely to consume fish and shellfish at follow up, while those aged 40–59 were the most likely of the three age groups to consume seal oil (p < 0.05). Between the original cohort and follow-up, there was a significant decline in the mean number of traditional foods eaten from 6.3 to 5.5, as well as reduced consumption of multiple traditional foods (p < 0.001). Over 59% of participants reported at least one traditional harvesting activity in the past year; this proportion did not significantly change between baseline and follow-up. Picking berries/greens (44%), cutting/smoking fish or meat (33%), and fishing (30%) were the most common activities. Participation in traditional harvesting activities was greater among women than men (p < 0.05), but did not differ by age. Conclusions Longitudinal follow-up demonstrated that AN/AI people maintained participation in traditional harvesting activities, but the variety of traditional foods declined significantly among both men and women. Promotion of traditional foods and harvesting activities that serve as protective factors against chronic diseases may benefit this population.
Current Developments in Nutrition; doi:10.1093/cdn/nzz112
Abstract:Objective To explain the high prevalence of vitamin D deficiency in women of reproductive age in Dhaka, Bangladesh, we compared the vitamin D status of pregnant women to their husbands and between pregnant and non-pregnant states. Methods This study was an observational sub-study of the Maternal Vitamin D for Infant Growth trial conducted in Dhaka, Bangladesh (NCT01924013). Women (N = 1,300) were enrolled in the 2nd trimester of pregnancy and randomly assigned to one of five arms consisting of different doses of vitamin D supplements or placebo, with one arm continuing supplementation until 6-months postpartum. A subgroup of trial participants and their husbands with plasma 25-hydroxyvitamin D concentration (25(OH)D) measurements (N = 84), and placebo-group trial participants with serum 25(OH)D measured in the 2nd trimester of pregnancy and 6-months postpartum (N = 89) were studied using linear mixed effects regression models. Results Mean ± standard deviation 25(OH)D in pregnant women in the 2nd trimester was 23 ± 11 nmol/L. Adjusting for age and season, 25(OH)D of pregnant women was 30 nmol/L lower (95% CI -36, -25) than men. Only 9% of total variance in 25(OH)D was explained by factors shared by spousal pairs. Selected non-shared factors (body mass index (BMI), time spent outdoors, involvement in an outdoor job, sunscreen use) did not explain the association of sex with 25(OH)D. Adjusting for age, season, and BMI, 25(OH)D was similar during pregnancy versus 6-months postpartum (mean difference: -2.4 nmol/L (95% CI -5.3, 0.4)). Conclusions In Dhaka, women of reproductive age have substantially poorer vitamin D status than men. Variation in 25(OH)D is not greatly influenced by determinants shared by spouses. Measured non-shared characteristics or pregnancy did not account for the gender differential in 25(OH)D. Further research is required to characterize the gender-specific factors that contribute to the low 25(OH)D among women observed in this setting.
Current Developments in Nutrition; doi:10.1093/cdn/nzz108
Abstract:Background Polycystic ovary syndrome (PCOS) affects approximately one in ten women worldwide. Hypomagnesemia may worsen insulin resistance (IR) due to the role magnesium (Mg) plays in glucose metabolism. Objective This review explores the relationship between serum Mg and IR among women with PCOS. Methods A review of primary research focused on both serum Mg and women with PCOS was conducted from 2011 to 2019. Studies reviewed included human subjects, written in the English language, and limited to community-dwelling women ≥ 18 years of age. Results A total of seven articles were reviewed. The findings from four epidemiological analytic studies evaluating serum Mg status suggest there may be a relationship between serum Mg levels and IR among women with PCOS. However among the three experimental trials, Mg supplementation inconsistently impacted insulin resistance among women with PCOS. Conclusions Women with PCOS are more likely to under consume Mg-rich foods and have a greater likelihood of lower serum Mg levels. While it remains unclear if dietary Mg and/or supplementation should be a nutritional strategy for all women with PCOS, current research indicates an association between adequate Mg status and improved insulin resistance. Further research evaluating dietary interventions and supplementation is warranted.
Current Developments in Nutrition; doi:10.1093/cdn/nzz109
Abstract:Apples and pears contain nutrients that have been linked to cardiovascular health. We conducted a systematic review and meta-analysis to summarize related research. Medline, Cochrane Central, and Commonwealth Agricultural Bureau databases were searched for publications on apple or pear intake and CVD/CMD. Studies in adults (healthy or at risk for CVD) that quantified apple or pear intake were included. Random-effects models meta-analysis was used when ≥ 3 studies reported the same outcome. 22 studies were eligible including 7 RCTs, 1 non-randomized trial, and 14 prospective observational studies. In RCTs, apple intake significantly decreased BMI, but made no difference in body weight, serum lipids, blood glucose, or blood pressure. In observational studies, apple or pear intake significantly decreased risk of cerebrovascular disease, cardiovascular death, T2DM, and all-cause mortality. No association was reported for cerebral infarction or intracerebral hemorrhage. In conclusion, apple or pear intake significantly decreased BMI and risk for CVD outcomes.
Current Developments in Nutrition; doi:10.1093/cdn/nzz107
Abstract:Background Infrastructure and human capital limitations motivate the design of mHealth programs, but their large-scale implementation may be challenging in a development context. Prospera Digital (PD) is a pilot mHealth intervention aiming to improve maternal and child health and nutrition designed as a Randomized Controlled Trial with three treatment arms. It was implemented during 2015–2017 in 326 treatment clinics located in 5 states in Mexico. Objective Assess with an external evaluation PD´s fidelity of implementation on six dimensions: adherence, quality, responsiveness, intervention complexity, facilitation strategies, and program differentiation. Methods A benchmark for implementation was first established by interviewing PD´s developers. Then, extensive fieldwork in the 5 states was conducted to assess its fidelity in heterogeneous contexts. The evaluation team visited 39 health clinics to assess the initial sign-up events and conduct a follow-up. Overall, the team made 28 closed observations; conducted 17 focus groups; and interviewed 74 health providers, 10 community leaders and 92 beneficiaries. Field notes from the implementation team on all clinics were also examined. Results Coordination between the Health and Social Development ministries was adequate, although some health providers were not informed about PD. Program developers added useful implementation strategies during roll-out to reinforce sign-up events. Key quality facilitators were the clarity and relevance of the SMS messages. Beneficiaries expressed high satisfaction with PD. In contrast, implementation barriers in adherence in some localities might reduce the potential impact of PD. Program differentiation was low between the three treatment arms. Conclusions PD is a promising strategy to contribute to the promotion of early childhood development in Mexico. Implementation Science Evaluation can help improve the quality of large-scale mHealth interventions by anticipating barriers and providing insights on how to increase performance. This is especially relevant to inform impact evaluation in development contexts.
Current Developments in Nutrition; doi:10.1093/cdn/nzz106
Abstract:Background There is a need to directly and accurately conceptualize and measure food insecurity in children as part of surveillance and public health efforts. Objective The aim of this study was to compare parent versus child perceptions of child-level food security status via questionnaires within a large, ethnically diverse population. Methods Cross-sectional baseline data from a cluster-randomized controlled trial involving primarily low-income, Hispanic 3rd–5th grade students and their parents was used for analysis. The sample consisted of 2408 dyadic (parent and child) pairs. Parents completed the 8-item child-referenced Household Food Security Survey Module and their responses were compared to an adaption of the 5-item Child Food Security Assessment completed by their child. Level of association between child and parent dyads perceptions were calculated using the Goodman and Kruskal's gamma statistic. A mixed effects binomial logistic regression model was used to model discordance as a function of child, parent, and household sociodemographic characteristics. Results The child sample was 53% female, mean age of 9 years, and were 63% Hispanic. The parent sample was 86% female and 65% Hispanic. Child and parent perceptions of child-level food security agreed only 21.7% of the time. There was a weak, positive association between child and parent perceptions of child-level food security (G = 0.162, P = Conclusions Results, in combination with the existing literature, suggest that parent perceptions of child-level food insecurity may underestimate child-level food insecurity experiences. Inaccurate or underestimations of the true prevalence of child-level food insecurity could be detrimental to maternal and child health efforts. The trial (NCT02668744) is registered at ClinicalTrials.gov.
Current Developments in Nutrition; doi:10.1093/cdn/nzz105
Abstract:Background Establishing healthy eating habits early impacts lifelong dietary intake, which has implications for many health outcomes. With children spending time in early care and education (ECE) programs, teachers establish the daytime meal environment through their feeding practices. Objective To determine the effect of a teacher-focused intervention to increase responsive feeding practices in two interventions, one focused exclusively on the teacher's feeding practices and the other focused on both the teacher's feeding practices and a nutrition classroom curriculum in ECE teachers in a Native American (NA) community in Oklahoma. Methods Nine tribally-affiliated ECE programs were randomly assigned to an intervention: 1) a 1.5 hour teacher-focused responsive feeding practice training (TEACHER; n = 4) and 2) TEACHER plus an additional 3 hour training to implement a 15-week classroom nutrition curriculum (TEACHER + CLASS; n = 5). Feeding practice observations were conducted during lunch at one table in one 2-to-5-year-old classroom at each program prior to and one month after the intervention. The Mealtime Observation in Child Care (MOCC) organizes teacher behaviors into eight subsections. Descriptive statistics and Shapiro-Wilk Test for Normality were calculated. Paired t-tests were calculated to determine change in each group. Clinical trials registry: NCT03251950. Results An average of 5.2 ± 2.0 (total n = 47) children and 1.7 ± 0.5 (total n = 14) teachers/center were observed at baseline, and 5.6 ± 1.7 (total n = 50) children and 1.7 ± 0.7 teachers (total n = 14) were observed/center post-intervention. Total MOCC scores (max possible = 10) improved for TEACHER (6.1 ± 0.9 vs 7.5 ± 0.3, t = 4.12, P = 0.026) but not for TEACHER + CLASS (6.5 ± 0.8 vs 6.4 ± 1.0, t = -0.11, P = 0.915). No other changes were observed. Conclusions Teacher intervention only programs demonstrated improvements in responsive feeding practices whereas the programs receiving teacher and classroom training did not. Greater burden likely decreased capacity to make changes in multiple domains. We demonstrated the ability to implement interventions in the NA ECE. Further research with larger communities is necessary.
Current Developments in Nutrition, Volume 3; doi:10.1093/cdn/nzz103
Abstract:Corrigendum to Sossamon et al. Observed Gender Differences in Intrinsic Motivation but not Perceived Competence to Prepare Healthy Foods in Adolescents. Current Developments in Nutrition, Volume 3, Issue Supplement_1, June 2019, nzz051. P04–019–19, https://doi.org/10.1093/cdn/nzz051.P04-019-19