Current Developments in Nutrition
Latest articles in this journal
Current Developments in Nutrition, Volume 3; doi:10.1093/cdn/nzz088
Abstract:Corrigendum to: nzz037.P15–023-19, Alterations in Cholesterol Metabolism and Genetics as Key Players in Mild Cognitive Impairment. https://doi.org/10.1093/cdn/nzz037.P15-023-19.
Current Developments in Nutrition; doi:10.1093/cdn/nzz096
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Current Developments in Nutrition; doi:10.1093/cdn/nzz095
Abstract:Growth of infants fed isocaloric infant formulas differing in nutritional content was studied. Twenty-three of 109 randomized clinical trials reported some difference in weight, length or head circumference between formula groups. Logistic regression demonstrated no relationship between finding a significant difference in a growth outcome with enrollment prior to 15 d or observation of 15 wk, parameters specified in regulation. Sample size and year of publication also were not correlated with report of a significant growth difference, though reporting separate data by sex was (p = 0.012). The difference in mean weight gain between control and test formula groups was comparable to that between formula-fed and breast-fed infants (1 g/d) and smaller than that between male and female infants (4 g/d). Encouraging alternate study designs with flexible enrollment ages and infants who transition from breastfeeding to formula would gain information on physiologic outcomes and common feeding behaviors, as well as growth.
Current Developments in Nutrition, Volume 3; doi:10.1093/cdn/nzz092
Abstract:Corrigendum to: Impact of Dietary Protein Source on Muscle Performance: An in-vivo Behav-ioral Assay (OR26-05-19) doi: https://doi.org/10.1093/cdn/nzz033.OR26-05-19
Current Developments in Nutrition; doi:10.1093/cdn/nzz089
Abstract:Background The American Indian (AI) population experiences significant diet-related health disparities including diabetes and cardiovascular disease. Due to the relatively small sample size of AIs, the population is rarely included in large national surveys such as the National Health and Nutrition Examination Survey. This exclusion hinders efforts to characterize potentially important differences between AI men and women, track the costs of these disparities, and effectively treat and prevent these conditions. Objective We examine the sex differences in diabetes prevalence, comorbidity experience, healthcare utilization, and treatment costs among AIs within a Northern Plains Indian Health Service (IHS) service unit. Methods We assessed data from a sample of 11,144 persons using an IHS service unit in the Northern Plains region of the United States. Detailed analyses were conducted for adults (n = 7,299) of prevalence of diabetes by age and sex. We described sex differences in comorbidities, healthcare utilization, and treatment costs among the adults with diabetes. Results In our sample, adult males and females had a similar prevalence of diabetes (10.0% and 11.0%, respectively). The prevalence of cardiovascular disease among males and females with diabetes was 45.7% and 34.0% respectively. Among adults with diabetes, males had statistically higher prevalence of hypertension and substance use disorders compared to females. The males were statistically less likely to have a non-substance use mental health disorder. Although males had higher utilization and costs for hospital inpatient services than females, the differences were not statistically significant. Conclusions In this AI population, there were differences in comorbidity profiles between adult men and women with diabetes, which have differential mortality and cost consequences. Appropriate diabetes management addressing gender-specific comorbidities, such as substance use disorders for men and non-substance use mental health disorders for women, may help reduce additional comorbidities or complications to diabetes.
Current Developments in Nutrition; doi:10.1093/cdn/nzz093
Abstract:Background Anemia affects around 1.6 billion people worldwide, often due to iron deficiency. In Bangladesh, high levels of anemia have been observed alongside little iron deficiency. Elevated levels of groundwater iron could constitute a significant source of dietary iron. Objective We aimed to quantify the effect of groundwater iron on anemia in non-pregnant women and young children in Bangladesh, taking into account dietary factors that may affect iron absorption. Methods We analyzed data on 1,871 non-pregnant women and 987 children (6–37 m) from the 2015 baseline survey of the Food and Agricultural Approaches to Reducing Malnutrition cluster-randomized trial (clinicaltrials.gov ID: NCT02505711) in Sylhet, Bangladesh. We used logistic regression with robust standard errors to assess effects of self-reported groundwater iron, dietary intake, and sociodemographic characteristics on anemia, considering interactions between groundwater iron and dietary factors. Results Groundwater iron presence was associated with less anemia in women (OR: 0.74, 95% CI: 0.60, 0.90) and children (OR: 0.58, 95% CI: 0.44, 0.76). This effect was modified by dietary factors. In women, the effect of groundwater iron on anemia was stronger if no vitamin C-rich or heme-iron foods were consumed, and there was a clear dose-response relationship. In children, vitamin C-rich food intake strengthened the effect of groundwater iron on anemia, while there was no evidence for interaction by iron-rich foods. Conclusions Heme-iron and vitamin C consumption reduced the effect of groundwater iron on anemia among women but not children in Bangladesh, which may be due to higher levels of iron deficiency and lower iron intakes among children. Vitamin C consumption appears to enhance iron absorption from groundwater in children and they may thus benefit from consuming more vitamin C-rich fruits and vegetables. Even among women and children consuming heme-iron or vitamin C-rich foods and groundwater iron, anemia prevalence remained elevated, pointing to additional causes of anemia beyond iron deficiency.
Current Developments in Nutrition; doi:10.1093/cdn/nzz091
Abstract:Background The Dietary Approaches to Stop Hypertension (DASH) diet is widely recommended to lower blood pressure, but its mechanisms of action are unclear. Lines of evidence suggest an interaction with the renin-angiotensin-aldosterone system (RAAS). Objective We conducted a randomized, controlled, cross-over feeding trial to test RAAS-related mechanisms underlying the DASH diet in patients with isolated systolic hypertension (ClinicalTrials.gov: NCT00123006). Methods Participants entered a one-week run-in period on a control (CON) diet and then consumed the DASH or CON diets for 4 weeks each in randomized sequence. Calorie content was controlled to maintain weight, and sodium intake was set at 3 g daily. After each diet, participants had hormonal and hemodynamic assessments obtained at baseline, in response to RAAS inhibition with captopril 25 mg (CAP), and to graded angiotensin II infusion (1 ng and 3 ng/kg x 45mins). Primary outcomes were mean arterial pressure (MAP) and renal blood flow (RBF), and secondary outcomes were diastolic function, pulse wave velocity (PWV), plasma renin activity (PRA), and aldosterone (ALDO) responses by diet. Results In total, 44 (19 female) participants completed the study. DASH + CAP significantly lowered MAP vs CON + CAP (83 ± 11 mmHg vs 88 ± 14 mmHg, p < 0.01). RBF was increased with DASH + CAP vs CON + CAP (486 ± 149 cc/min vs 451 ± 171 cc/min, p < 0.001). Study diet did not change PWV but CAP reduced diastolic function on the DASH diet (p < 0.05). DASH + CAP significantly increased PRA vs CON + CAP (1.52 ± 1.78 ng/ml/min vs.0.89 ± 1.17 ng/ml/min; p < 0.001). ALDO sensitivity to angiotensin II infusion was greater with DASH when compared to CON (17.4 ± 7.7 ng/ml vs 13.8 ± 6.2 ng/dl, p < 0.05) as was DASH + CAP vs CON + CAP (15.1 ± 5.3 ng/dl vs 13.1 ± 5.9 ng/ml, p < 0.05). Conclusions The DASH diet interacts with the RAAS resulting in vascular and hormonal responses similar to a natriuretic effect, which appears to augment the hypotensive effect of ACE-inhibition in individuals with isolated systolic hypertension.
Current Developments in Nutrition; doi:10.1093/cdn/nzz084
Abstract:Background The program “Santé Nutritionnelle à Assise Communautaire à Kayes” (SNACK) in Mali aimed to improve child linear growth through a set of interventions targeted to mothers and children during pregnancy and up to the child's second birthday. Distributions of cash to mothers and/or lipid-based nutrient supplement (LNS) to children 6–23 months of age were added to SNACK to increase attendance at community health centers (CHCs). Objectives The aim of this study, which was embedded in a cluster randomized impact evaluation of the program, was to assess the incentive value of the cash on CHC attendance. Methods We used a mixed methods approach. We collected quantitative data on cash receipt and CHC attendance in a midline survey of mother-child pairs (n = 3,443). A program impact pathway analysis guided qualitative data collection and analysis. Twelve CHCs were purposively selected in study groups that received cash. We conducted semi-structured, continuous observations of cash distributions in 11 CHCs (n = 22) and semi-structured qualitative interviews with frontline workers (FLWs) (n = 71) and mothers (n = 22) who were purposively selected from the midline survey. Results FLWs knowledge of the objective and implementation plan of the cash program component was limited. A challenging physical environment and insufficient cash available for each distribution were identified as causes of irregularities in cash distributions. Most mothers mentioned having to return several times to receive their cash. Child health was identified as the main motivation to attend CHCs and cash was described as an additional benefit. Conclusion Implementation constraints related to remoteness and inaccessibility may have undermined the incentive value of the cash transfers in the SNACK program. Additional research is needed to identify interventions that not only incentivize mothers to participate but that can be implemented effectively and with high quality in challenging contexts such as rural areas of Mali.
Current Developments in Nutrition; doi:10.1093/cdn/nzz086
Abstract:This state-of-the-art review aims to highlight the challenges to quantify vitamin activity in foods that contain several vitamers of one group, using as examples the fat-soluble vitamins A and D as well as the water-soluble folate. The absorption, metabolism and physiology of these exampless are described along with the current analytical methodology, with an emphasis on approaches tostandardisation. Moreover, the major food sources for the vitamins are numerated The paper focuses particularly on outlining the so-called SLAMENGHI factors influencing a vitamer's’ abiltiy to act as a vitamin, that is, molecular species, linkage, amount, matrix, effectors of absorption, nutrition status, genetics, host-related factors and the interaction of these. After summarising the current approaches to estimating the total content of each vitamin group, the review concludes by outlining the research gaps and future perspectives in vitamin analysis. There are not standardised methods for the quantification of the vitamers of vitamin A, vitamin D and folate in foods. For folate and beta-carotene, a difference in vitamer activity between foods and supplements has been confirmed, while no difference has been observed for vitamin D. For differences in vitamer activity between provitamin A carotenoids and retinol and between 25OHD and vitamin D international consensus is lacking. The challenges facing each of the specific vitamin community are the gaps in knowledge about bioaccesibility and bioavailability for each of the various vitamers. The differences between the vitamins make it difficult to formulate a common strategy for assessing the quantitative differences between the vitamers. In the future, optimised stationary digestive models and the more advanced dynamic digestive models combined with in-vitro models for bioavailability may more closely resemble in vivo results. New knowledge will enable us to transfer nutrient recommendations into improved dietary advice to increase public health throughout the human life cycle.
Current Developments in Nutrition; doi:10.1093/cdn/nzz087
Abstract:Vitamin D status is determined mainly by its formation in skin by the photochemical action of solar UVB light on precursor, 7-dehydrocholesterol. Because of seasonal variation in intensity of solar ultraviolet light, vitamin D status falls in winter and rises in summer. It has been presumed that there is no functional store of vitamin D. Thus, to avoid deficiency, a nutritional supply would be required in winter. However, there is now evidence that the main circulating metabolite of vitamin D, 25-hydroxyvitamin D, accumulates in skeletal muscle cells which provide a functional store during the months of winter. The mechanism is mediated by muscle cell uptake of circulating vitamin D-binding protein (DBP) through a megalin-cubilin membrane transport process. DBP then binds to cytoplasmic actin to provide an array of high affinity binding sites for 25-hydroxyvitamin D. The repeated passage of 25-hydroxyvitamin D into and out of muscle cells would account for its long residence time in blood.