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1.  Pomegranate (Punicagranatum) juice decreases lipid peroxidation, but has no effect on plasma advanced glycated end-products in adults with type 2 diabetes: a randomized double-blind clinical trial 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.28551.
Diabetes mellitus characterized by hyperglycemia could increase oxidative stress and formation of advanced glycated end-products (AGEs), which contribute to diabetic complications. The purpose of this study was to assess the effect of pomegranate juice (PJ) containing natural antioxidant on lipid peroxidation and plasma AGEs in patients with type 2 diabetes (T2D).
Materials and methods
In a randomized, double-blind, placebo-controlled trial, 44 patients (age range 56±6.8 years), T2D were randomly assigned to one of two groups: group A (PJ, n=22) and group B (Placebo, n=22). At the baseline and the end of 12-week intervention, biochemical markers including fasting plasma glucose, insulin, oxidative stress, and AGE markers including carboxy methyl lysine (CML) and pentosidine were assayed.
At baseline, there were no significant differences in plasma total antioxidant capacity (TAC) levels between the two groups, but malondialdehyde (MDA) decreased levels were significantly different (P<0.001). After 12 weeks of intervention, TAC increased (P<0.05) and MDA decreased (P<0.01) in the PJ group when compared with the placebo group. However, no significant differences were observed in plasma concentration of CML and pentosidine between the two groups.
The study showed that PJ decreases lipid peroxidation. Therefore, PJ consumption may delay onset of T2D complications related to oxidative stress.
PMCID: PMC4565065  PMID: 26355954
human nutrition; metabolism; health claims
2.  Protective effects of Carissa opaca fruits against CCl4-induced oxidative kidney lipid peroxidation and trauma in rat 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.28438.
Carbon tetrachloride (CCl4) is a potent nephrotoxin, as it causes acute as well as chronic toxicity in kidneys. Therefore, this study was carried out to assess the pharmacological potential of different fractions of Carissa opaca fruits on CCl4-induced oxidative trauma in the kidney.
The parameters studied in this respect were the kidney function tests viz, serum profile, urine profile, genotoxicity, characteristic morphological findings, and antioxidant enzymatic level of kidneys.
The protective effects of various fractions of C. opaca fruits against CCl4 administration were reviewed by rat renal function alterations. Chronic toxicity caused by 8-week treatment of CCl4 to the rats significantly decreased the pH level, activities of antioxidant enzymes, and glutathione contents, whereas a significant increase was found in the case of specific gravity, red blood cells, white blood cells, level of urea, and lipid peroxidation in comparison to control group. Administration of various fractions of C. opaca fruit with CCl4 showed protective ability against CCl4 intoxication by restoring the urine profile, activities of antioxidant enzymes, and lipid peroxidation in rat. CCl4 induction in rats also caused DNA fragmentation and glomerular atrophy by means of dilation, disappearance of Bowmen's space, congestion in the capillary loops, dilation in renal tubules, and foamy look of epithelial cells of tubular region, which were restored by co-admiration of various fractions of C. opaca.
Results revealed that the methanolic fractions of C. opaca are the most potent and helpful in kidney trauma.
PMCID: PMC4563101  PMID: 26350293
Carissa opaca fruits; oxidative trauma; genotoxicity; lipid peroxidation; DNA fragmentation
3.  Effect of a high intake of cheese on cholesterol and metabolic syndrome: results of a randomized trial 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27651.
Cheese is generally rich in saturated fat, which is associated with increased risk for cardiovascular diseases. Nevertheless, recent reports suggest that cheese may be antiatherogenic.
The goal of this study was to assess whether intake of two types of Norwegian cheese, with widely varying fat and calcium content, might influence factors of the metabolic syndrome and serum cholesterol levels differently.
A total of 153 participants were randomized to one of three groups: Gamalost®, a traditional fat- and salt-free Norwegian cheese (50 g/day), Gouda-type cheese with 27% fat (80 g/day), and a control group with a limited cheese intake. Blood samples, anthropometric measurements, blood pressure, and questionnaires about lifestyle and diet were obtained at inclusion and end.
At baseline, there were no differences between the groups in relevant baseline characteristics, mean age 43, 52.3% female. After 8 weeks’ intervention, there were no changes in any of the metabolic syndrome factors between the intervention groups compared with the control group. There were no increases in total- or LDL cholesterol in the cheese groups compared with the control. Stratified analysis showed that those in the Gouda group with metabolic syndrome at baseline had significant reductions in total cholesterol at the end of the trial compared with control (−0.70 mmol/L, p=0.013), and a significantly higher reduction in mean triglycerides. In the Gamalost group, those who had high total cholesterol at baseline had a significant reduction in total cholesterol compared with control (−0.40 mmol/L, p=0.035).
In conclusion, cholesterol levels did not increase after high intake of 27% fat Gouda-type cheese over 8 weeks’ intervention, and stratified analysis showed that participants with metabolic syndrome had reduced cholesterol at the end of the trial.
PMCID: PMC4543447  PMID: 26294049
dairy; intervention; Gamalost; Gouda; cardiovascular diseases
4.  Simplified dietary acute tryptophan depletion: effects of a novel amino acid mixture on the neurochemistry of C57BL/6J mice 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27424.
Diet and nutrition can impact on the biological processes underpinning neuropsychiatric disorders. Amino acid (AA) mixtures lacking a specific neurotransmitter precursor can change the levels of brain serotonin (5-HT) or dopamine (DA) in the central nervous system. The availability of these substances within the brain is determined by the blood–brain barrier (BBB) that restricts the access of peripheral AA into the brain. AA mixtures lacking tryptophan (TRP) compete with endogenous TRP for uptake into the brain across the BBB, which in turn leads to a decrease in central nervous 5-HT synthesis.
The present study compared the effects of a simplified acute tryptophan depletion (SATD) mixture in mice on blood and brain serotonergic and dopaminergic metabolites to those of a commonly used acute tryptophan depletion mixture (ATD Moja-De) and its TRP-balanced control (BAL).
The SATD formula is composed of only three large neutral AAs: phenylalanine (PHE), leucine (LEU), and isoleucine (ILE). BAL, ATD Moja-De, or SATD formulas were delivered to adult male C57BL/6J mice by gavage. TRP, monoamines, and their metabolites were quantified in blood and brain regions (hippocampus, frontal cortex, amygdala, caudate putamen, and nucleus accumbens).
Both ATD Moja-De and SATD significantly decreased levels of serum and brain TRP, as well as brain 5-HIAA and 5-HT compared with BAL. SATD reduced HVA levels in caudate but did not alter total DA levels or DOPAC. SATD decreased TRP and serotonergic metabolites comparably to ATD Moja-De administration.
A simplified and more palatable combination of AAs can manipulate serotonergic function and might be useful to reveal underlying monoamine-related mechanisms contributing to different neuropsychiatric disorders.
PMCID: PMC4538305  PMID: 26278978
acute tryptophan depletion; dopamine; amino acid; formulation; mice; serotonin
5.  An assessment of the test–retest reliability of the New Nordic Diet score 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.28397.
There is a growing interest in the New Nordic Diet (NND) as a potentially health promoting, environmentally friendly, and palatable regional diet. Also, dietary scores are gaining ground as a complementary approach for examining relations between dietary patterns and various health outcomes. A score assessing adherence to the NND has earlier been published, yet not tested for reliability.
To assess the test–retest reliability of the NND score in a sample of parents of toddlers, residing in Southern Norway.
A questionnaire survey was completed on two occasions, approximately 14 days apart, by 67 parents of toddlers [85% females, mean age 34 years (SD=5.3 years)]. The NND score was constructed from 24 items and comprised 10 subscales that summarize meal pattern and intake of typical Nordic foods. Each subscale was dichotomized by the median and assigned values of ‘0’ or ‘1’. Adding the subscales yielded a score ranging from 0 to 10, which was further trichotomized. Test–retest reliability of the final NND score and individual subscales was assessed by Pearson's correlation coefficient and Spearman's rank correlation coefficient, respectively. Additionally, cross tabulation and kappa measure of agreement (k) were used to assess the test–retest agreement of classification into the NND score, and the subscales.
Test–retest correlations of the NND score and subscales were r=0.80 (Pearson) and r=0.54–0.84 (Spearman), respectively, all p<0.001. There were 69% (k=0.52) and 67–88% (k=0.32–0.76) test–retest correct classification of the trichotomized score and the dichotomized subscales, respectively.
The NND score and the 10 subscales appear to have acceptable test–retest reliability when tested in a sample of parents of toddlers.
PMCID: PMC4534623  PMID: 26268707
New Nordic Diet; health; dietary pattern; adherence; diet score; test–retest reliability
6.  Consuming a multi-ingredient thermogenic supplement for 28 days is apparently safe in healthy adults 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27999.
Thermogenic (TRM) supplements are often used by people seeking to decrease body weight. Many TRM supplements are formulated with multiple ingredients purported to increase energy expenditure and maximize fat loss. However, in the past some TRM ingredients have been deemed unsafe and removed from the market. Therefore, it is important to verify the safety of multi-ingredient TRM supplements with chronic consumption.
To assess the safety of daily consumption of a multi-ingredient TRM supplement over a 28-day period in healthy adults.
Twenty-three recreationally active adults (11M, 12F; 27.1±5.4 years, 171.6±9.6 cm, 76.8±16.1 kg, 26±5 BMI) were randomly assigned either to consume a multi-ingredient TRM supplement (SUP; n=9) or remain unsupplemented (CRL; n=14) for 28 days. Participants maintained their habitual dietary and exercise routines for the duration of the study. Fasting blood samples, resting blood pressure, and heart rate were taken before and after the supplementation period. Samples were analyzed for complete blood counts, comprehensive metabolic, and lipid panels.
Significant (p<0.05) group by time interactions were present for diastolic BP, creatinine, estimated glomerular filtration rate (eGFR), chloride, CO2, globulin, albumin:globulin (A/G), and high-density lipoprotein (HDL). Dependent t-tests conducted on significant variables revealed significant (p<0.05) within-group differences in SUP for diastolic BP (+6.2±5.3 mmHG), creatinine (+0.09±0.05 mg/dL), eGFR (−11.2±5.8 mL/min/1.73), globulin (−0.29±0.24 g/dL), A/G (+0.27±0.23), and HDL (−5.0±5.5 mg/dL), and in CRL for CO2 (−1.9±1.5 mmol/L) between time points. Each variable remained within the accepted physiological range.
Results of the present study support the clinical safety of a multi-ingredient TRM containing caffeine, green tea extract, and cayenne powder. Although there were statistically significant (p<0.05) intragroup differences in SUP from pre- to postsupplementation for diastolic BP, creatinine, eGFR, globulin, A/G, and HDL, all remained within accepted physiological ranges and were not clinically significant. In sum, it appears as though daily supplementation with a multi-ingredient TRM is safe for consumption by healthy adults for a 28-day period.
PMCID: PMC4513183  PMID: 26205229
weight loss supplement; safety; clinical; hematology; nutrition; fat burner
7.  Leucine supplementation improves leptin sensitivity in high-fat diet fed rats 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27373.
Several studies have reported the favorable effect of leucine supplementation on insulin resistance or insulin sensitivity. However, whether or not leucine supplementation improves leptin sensitivity remains unclear.
Forty-eight male Sprague-Dawley rats were fed with either a high-fat diet (HFD) or HFD supplemented with 1.5, 3.0, and 4.5% leucine for 16 weeks. At the end of the experiment, serum leptin level was measured by ELISA, and leptin receptor (ObR) in the hypothalamus was examined by immunohistochemistry. The protein expressions of ObR and leptin-signaling pathway in adipose tissues were detected by western blot.
No significant differences in body weight and food/energy intake existed among the four groups. Serum leptin levels were significantly lower, and ObR expression in the hypothalamus and adipose tissues was significantly higher in the three leucine groups than in the control group. These phenomena suggested that leptin sensitivity was improved in the leucine groups. Furthermore, the expressions of JAK2 and STAT3 (activated by ObR) were significantly higher, and that of SOCS3 (inhibits leptin signaling) was significantly lower in the three leucine groups than in the control group.
Leucine supplementation improves leptin sensitivity in rats on HFD likely by promoting leptin signaling.
PMCID: PMC4482813  PMID: 26115673
leptin sensitivity; leptin signaling; leucine; high-fat diet
8.  Economic benefits of the Mediterranean-style diet consumption in Canada and the United States 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27541.
The Mediterranean-style diet (MedDiet) is an established healthy-eating behavior that has consistently been shown to favorably impact cardiovascular health, thus likely improving quality of life and reducing costs associated with cardiovascular disease (CVD). Data on the economic benefits of MedDiet intakes are, however, scarce.
The objective of this study was to estimate the annual healthcare and societal cost savings that would accrue to the Canadian and American public, independently, as a result of a reduction in the incidence of CVD following adherence to a MedDiet.
A variation in cost-of-illness analysis entailing three stages of estimations was developed to 1) identify the proportion of individuals who are likely to adopt a MedDiet in North America, 2) assess the impact of the MedDiet intake on CVD incidence reduction, and 3) impute the potential savings in costs associated with healthcare and productivity following the estimated CVD reduction. To account for the uncertainty factor, a sensitivity analysis of four scenarios, including ideal, optimistic, pessimistic, and very-pessimistic assumptions, was implemented within each of these stages.
Significant improvements in CVD-related costs were evident with varying MedDiet adoption and CVD reduction rates. Specifically, CAD $41.9 million to 2.5 billion in Canada and US $1.0–62.8 billion in the United States were estimated to accrue as total annual savings in economic costs, given the ‘very-pessimistic’ through ‘ideal’ scenarios.
Closer adherence to dietary behaviors that are consistent with the principles of the MedDiet is expected to contribute to a reduction in the monetary burdens of CVD in Canada, the United States, and possibly other parts of the world.
PMCID: PMC4481044  PMID: 26111965
cardiovascular disease; public health; healthy eating; nutrition economics; cost-of-illness analysis
9.  Indicators of dietary patterns in Danish infants at 9 months of age 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27665.
It is important to increase the awareness of indicators associated with adverse infant dietary patterns to be able to prevent or to improve dietary patterns early on.
The aim of this study was to investigate the association between a wide range of possible family and child indicators and adherence to dietary patterns for infants aged 9 months.
The two dietary patterns ‘Family Food’ and ‘Health-Conscious Food’ were displayed by principal component analysis, and associations with possible indicators were analysed by multiple linear regressions in a pooled sample (n=374) of two comparable observational cohorts, SKOT I and SKOT II. These cohorts comprised infants with mainly non-obese mothers versus infants with obese mothers, respectively.
A lower Family Food score indicates a higher intake of liquid baby food, as this pattern shows transition from baby food towards the family's food. Infants, who were younger at diet registration and had higher body mass index (BMI) z-scores at 9 months, had lower Family Food pattern scores. A lower Family Food pattern score was also observed for infants with immigrant/descendant parents, parents who shared cooking responsibilities and fathers in the labour market compared to being a student, A lower Health-Conscious Food pattern score indicates a less healthy diet. A lower infant Health-Conscious Food pattern score was associated with a higher maternal BMI, a greater number of children in the household, a higher BMI z-score at 9 months, and a higher infant age at diet registration.
Associations between infant dietary patterns and maternal, paternal, household, and child characteristics were identified. This may improve the possibility of identifying infants with an increased risk of developing unfavourable dietary patterns and potentially enable an early targeted preventive support.
PMCID: PMC4481065  PMID: 26111966
SKOT; dietary patterns; family; maternal; paternal; child; characteristics
10.  Association between dietary pattern and risk of cardiovascular disease among adults in the Middle East and North Africa region: a systematic review 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27486.
This paper reviews the evidence related to the association of dietary pattern with coronary heart disease (CHD), strokes, and the associated risk factors among adults in the Middle East and North Africa (MENA) region.
A systematic review of published articles between January 1990 and March 2015 was conducted using Pro-Quest Public Health, MEDLINE, and Google Scholar. The term ‘dietary pattern’ refers to data derived from dietary pattern analyses and individual food component analyses.
The search identified 15 studies. The available data in the MENA region showed that Western dietary pattern has been predominant among adults with fewer adherences to the traditional diet, such as the Mediterranean diet. The Western dietary pattern was found to be associated with an increased risk of dyslipidaemia, diabetes, metabolic syndrome (MetS), body mass index (BMI), and hypertension. The Mediterranean diet, labelled in two studies as ‘the traditional Lebanese diet’, was negatively associated with BMI, waist circumference (WC), and the risk of diabetes, while one study found no association between the Mediterranean diet and MetS. Two randomised controlled trials conducted in Iran demonstrated the effect of the dietary approach to stop hypertension (DASH) in reducing metabolic risk among patients with diabetes and MetS. Likewise, the consumption of dairy products was associated with decreased blood pressure and WC, while the intake of whole grains was associated with reduced WC. In addition, the high consumption of black tea was found to be associated with decreased serum lipids. The intake of fish, vegetable oils, and tea had a protective effect on CHD, whereas the intake of full-fat yoghurt and hydrogenated fats was associated with an increased risk of CHD.
There appears to be a significant association of Western dietary pattern with the increased risk of CHD, strokes, and associated risk factors among adults in the MENA region. Conversely, increased adherence to Mediterranean and/or DASH dietary patterns or their individual food components is associated with a decreased risk of CHD and the associated risk factors. Therefore, increasing awareness of the high burden of CHD and the associated risk factors is crucial, as well as the need for nutrition education programs to improve the knowledge among the MENA population regarding healthy diets and diet-related diseases.
PMCID: PMC4472555  PMID: 26088003
coronary heart disease; stroke; dietary patterns; food items; obesity; diabetes; hypertension; metabolic syndrome; the Middle East; North Africa
11.  A multi-ingredient, pre-workout supplement is apparently safe in healthy males and females 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27470.
Pre-workout supplements (PWS) have become increasingly popular with recreational and competitive athletes. While many ingredients used in PWS have had their safety assessed, the interactions when combined are less understood.
The purpose of this study was to examine the safety of 1 and 2 servings of a PWS.
Forty-four males and females (24.4±4.6 years; 174.7±9.3 cm; 78.9±18.6 kg) from two laboratories participated in this study. Subjects were randomly assigned to consume either one serving (G1; n=14) or two servings (G2; n=18) of PWS or serve as an unsupplemented control (CRL; n=12). Blood draws for safety panels were conducted by a trained phlebotomist before and after the supplementation period.
Pooled data from both laboratories revealed significant group×time interactions (p<0.05) for mean corpuscular hemoglobin (MCH; CRL: 30.9±0.8–31.0±0.9 pg; G1: 30.7±1.1–30.2±0.7 pg; G2: 30.9±1.2–30.9±1.1 pg), MCH concentration (CRL: 34.0±0.9–34.4±0.7 g/dL; G1: 34.1±0.9–33.8±0.6 g/dL; G2: 34.0±1.0–33.8±0.8 g/dL), platelets (CRL: 261.9±45.7–255.2±41.2×103/µL; G1: 223.8±47.7–238.7±49.6×103/µL; G2: 239.1±28.3–230.8±34.5×103/µL), serum glucose (CRL: 84.1±5.2–83.3±5.8 mg/dL; G1: 86.5±7.9–89.7±5.6 mg/dL; G2: 87.4±7.2–89.9±6.6 mg/dL), sodium (CRL: 137.0±2.7–136.4±2.4 mmol/L; 139.6±1.4–140.0±2.2 mmol/L; G2: 139.0±2.2–138.7±1.7 mmol/L), albumin (CRL: 4.4±0.15–4.4±0.22 g/dL; G1: 4.5±0.19–4.5±0.13 g/dL; G2: 4.6±0.28–4.3±0.13 g/dL), and albumin:globulin (CRL: 1.8±0.30–1.8±0.28; G1: 1.9±0.30–2.0±0.31; G2: 1.8±0.34–1.8±0.34). Each of these variables remained within the clinical reference ranges.
The PWS appears to be safe for heart, liver, and kidney function in both one-serving and two-serving doses when consumed daily for 28 days. Despite the changes observed for select variables, no variable reached clinical significance.
PMCID: PMC4471216  PMID: 26085481
caffeine; hematology; toxicity; nitrates; sports supplement
12.  The influences of purple sweet potato anthocyanin on the growth characteristics of human retinal pigment epithelial cells 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27830.
Anthocyanins have been proven to be beneficial to the eyes. However, information is scarce about the effects of purple sweet potato (Ipomoea batatas, L.) anthocyanin (PSPA), a class of anthocyanins derived from purple sweet potato roots, on visual health.
The aim of this study was to investigate whether PSPA could have influences on the growth characteristics (cellular morphology, survival, and proliferation) of human retinal pigment epithelial (RPE) cells, which perform essential functions for the visual process.
The RPE cell line D407 was used in the present study. The cytotoxicity of PSPA was assessed by MTT assay. Then, cellular morphology, viability, cell cycle, Ki67expression, and PI3K/MAPK activation of RPE cells treated with PSPA were determined.
PSPA exhibited dose-dependent promotion of RPE cell proliferation at concentrations ranging from 10 to 1,000 µg/ml. RPE cells treated with PSPA demonstrated a predominantly polygonal morphology in a mosaic arrangement, and colony-like cells displayed numerous short apical microvilli and typical ultrastructure. PSPA treatment also resulted in a better platform growing status, statistically higher viability, an increase in the S-phase, and more Ki67+ cells. However, neither pAkt nor pERK were detected in either group.
We found that PSPA maintained high cell viability, boosted DNA synthesis, and preserved a high percentage of continuously cycling cells to promote cell survival and division without changing cell morphology. This paper lays the foundation for further research about the damage-protective activities of PSPA on RPE cells or human vision.
PMCID: PMC4464420  PMID: 26070791
PSPA; RPE cells; morphology; survival; proliferation
13.  Role of poultry meat in a balanced diet aimed at maintaining health and wellbeing: an Italian consensus document 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27606.
The relationship between the consumption of meat and health is multifaceted, and it needs to be analyzed in detail, with specific attention to the relevant differences that characterize the effects of the different meat types, as yet considered by only a limited literature. A variable but moderate energy content, highly digestible proteins (with low levels of collagen) of good nutritional quality, unsaturated lipids (mainly found in the skin and easily removed), B-group vitamins (mainly thiamin, vitamin B6, and pantothenic acid), and minerals (like iron, zinc, and copper) make poultry meat a valuable food. Epidemiological studies performed across the world, in highly diverse populations with different food preferences and nutritional habits, provide solid information on the association between poultry consumption, within a balanced diet, and good health. Consumption of poultry meat, as part of a vegetable-rich diet, is associated with a risk reduction of developing overweight and obesity, cardiovascular diseases, and type 2 diabetes mellitus. Also, white meat (and poultry in particular) is considered moderately protective or neutral on cancer risk. The relevance of poultry meat for humans also has been recognized by the UN Food and Agricultural Organization (FAO), who considers this widely available, relatively inexpensive food to be particularly useful in developing countries, where it can help to meet shortfalls in essential nutrients. Moreover, poultry meat consumption also contributes to the overall quality of the diet in specific ages and conditions (prior to conception, during pregnancy up to the end of breastfeeding, during growth, and in the geriatric age) and is suitable for those who have an increased need for calorie and protein compared to the general population.
PMCID: PMC4462824  PMID: 26065493
human nutrition; poultry meat consumption; poultry meat composition; balanced diet
14.  Development and validation testing of a short nutrition questionnaire to identify dietary risk factors in preschoolers aged 12–36 months 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27912.
Although imbalances in dietary intakes can have short and longer term influences on the health of preschool children, few tools exist to quickly and easily identify nutritional risk in otherwise healthy young children.
To develop and test the validity of a parent-administered questionnaire (NutricheQ) as a means of evaluating dietary risk in young children (12–36 months).
Following a comprehensive development process and internal reliability assessment, the NutricheQ questionnaire was validated in a cohort of 371 Irish preschool children as part of the National Preschool Nutrition Survey. Dietary risk was rated on a scale ranging from 0 to 22 from 11 questions, with a higher score indicating higher risk.
Children with higher NutricheQ scores had significantly (p<0.05) lower mean daily intakes of key nutrients such as iron, zinc, vitamin D, riboflavin, niacin, folate, phosphorous, potassium, carotene, retinol, and dietary fibre. They also had lower (p<0.05) intakes of vegetables, fish and fish dishes, meat and infant/toddler milks and higher intakes of processed foods and non-milk beverages, confectionery, sugars and savoury snack foods indicative of poorer dietary quality. Areas under the curve values of 84.7 and 75.6% were achieved for ‘medium’ and ‘high’ dietary risk when compared with expert risk ratings indicating good consistency between the two methods.
NutricheQ is a valid method of quickly assessing dietary quality in preschoolers and in identifying those at increased nutritional risk.
In Context
Analysis of data from national food and nutrition surveys typically identifies shortfalls in dietary intakes or quality of young children. This can relate to intakes of micronutrients such as iron or vitamin D as well as to the balance of macronutrients they consume (e.g. fat or sugar). Alongside this lie concerns regarding overweight and obesity and physical inactivity. This combination of risk factors has potential negative effects for both short and longer term health. Hence, screening tools, such as NutricheQ described here, offer an opportunity for early identification and subsequent appropriate timely intervention from 12 months of age. This paper describes the development and validation of NutricheQ, a short user-friendly questionnaire. Designed to be administered by parents or carers, it aims to help healthcare professionals identify children at risk based on known, evidence-based nutritional risk factors. It is hoped in the longer term that this tool can be adapted for use globally and improve child health through early identification, which can be followed up by targeted, cost-effective interventions.
PMCID: PMC4461756  PMID: 26058751
preschool children; toddlers; nutrient-poor diets; dietary quality; screening tools; nutritional risk
15.  Reducing the risk of heart disease among Indian Australians: knowledge, attitudes, and beliefs regarding food practices – a focus group study 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.25770.
Australia has a growing number of Asian Indian immigrants. Unfortunately, this population has an increased risk for coronary heart disease (CHD). Dietary adherence is an important strategy in reducing risk for CHD. This study aimed to gain greater understanding of the knowledge, attitudes and beliefs relating to food practices in Asian Indian Australians.
Two focus groups with six participants in each were recruited using a convenience sampling technique. Verbatim transcriptions were made and thematic content analysis undertaken.
Four main themes that emerged from the data included: migration as a pervasive factor for diet and health; importance of food in maintaining the social fabric; knowledge and understanding of health and diet; and elements of effective interventions.
Diet is a complex constructed factor in how people express themselves individually, in families and communities. There are many interconnected factors influencing diet choice that goes beyond culture and religion to include migration and acculturation.
Food and associated behaviors are an important aspect of the social fabric. Entrenched and inherent knowledge, attitudes, beliefs and traditions frame individuals’ point of reference around food and recommendations for an optimal diet.
PMCID: PMC4458512  PMID: 26051008
Asian Indians; South Asian; diet; heart disease; food practices; attitudes; knowledge
16.  Socio-economic status and ethnicity are independently associated with dietary patterns: the HELIUS-Dietary Patterns study 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.26317.
Differences in dietary patterns between ethnic groups have often been observed. These differences may partially be a reflection of differences in socio-economic status (SES) or may be the result of differences in the direction and strength of the association between SES and diet.
We aimed to examine ethnic differences in dietary patterns and the role of socio-economic indicators on dietary patterns within a multi-ethnic population.
Cross-sectional multi-ethnic population-based study.
Amsterdam, the Netherlands.
Principal component analysis was used to identify dietary patterns among Dutch (n=1,254), South Asian Surinamese (n=425), and African Surinamese (n=784) participants. Levels of education and occupation were used to indicate SES. Linear regression analysis was used to examine the association between ethnicity and dietary pattern scores first and then between socio-economic indicators and dietary patterns within and between ethnic groups.
‘Noodle/rice dishes and white meat’, ‘red meat, snacks, and sweets’ and ‘vegetables, fruit and nuts’ patterns were identified. Compared to the Dutch origin participants, Surinamese more closely adhered to the ‘noodle/rice dishes and white meat’ pattern which was characterized by foods consumed in a ‘traditional Surinamese diet’. Closer adherence to the other two patterns was observed among Dutch compared to Surinamese origin participants. Ethnic differences in dietary patterns persisted within strata of education and occupation. Surinamese showed greater adherence to a ‘traditional’ pattern independent of SES. Among Dutch participants, a clear socio-economic gradient in all dietary patterns was observed. Such a gradient was only present among Surinamese dietary oatterns to the ‘vegetables, fruit and nuts’ pattern.
We found a selective change in the adherence to dietary patterns among Surinamese origin participants, presumably a move towards more vegetables and fruits with higher SES but continued fidelity to the traditional diet.
PMCID: PMC4454783  PMID: 26041009
dietary patterns; non-Western ethnic minority groups; education; occupation; socio-economic status; HELIUS study
17.  Cooked oatmeal consumption is associated with better diet quality, better nutrient intakes, and reduced risk for central adiposity and obesity in children 2–18 years: NHANES 2001–2010 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.26673.
None of the studies of whole grains that have looked either at diet or weight/adiposity measures have focused exclusively on oatmeal.
The objective of this study was to assess the association between oatmeal consumption and nutrient intake, diet quality, and weight/adiposity of children aged 2–18.
A nationally representative sample of children aged 2–18 (N=14,690) participating in National Health and Nutrition Examination Survey 2001–2010 was used. Intake was determined from a single 24-h dietary recall. Diet quality was measured using the Healthy Eating Index-2010 (HEI-2010). Covariate-adjusted regression analyses, using appropriate sample weights, were used to determine differences between oatmeal consumers and non-consumers for demographics, nutrient intakes, diet quality, and weight/adiposity measures (p<0.01). Logistic regression was performed to calculate odds ratios for weight measures and obesity (p<0.05).
Compared to non-consumers, oatmeal consumers were more likely to be younger and less likely to be smokers. Consumers had higher intakes of dietary fiber, vitamin A, thiamin, riboflavin, calcium, phosphorus, magnesium, iron, copper, and potassium, and significantly lower intakes of total, monounsaturated and saturated fatty acids, cholesterol, and sodium. Oatmeal consumers had higher dietary quality scores attributable to higher intakes of whole grains and lower intakes of refined grains and empty calories. Children consuming oatmeal were at lower risk for having central adiposity and being obese.
Consumption of oatmeal by children was associated with better nutrient intake, diet quality, and reduced risk for central adiposity and obesity and should be encouraged as part of an overall healthful diet.
PMCID: PMC4447723  PMID: 26022379
children; oatmeal; cooked cereal; NHANES; nutrient intake; diet quality; obesity
18.  Antibacterial activity of fresh pomegranate juice against clinical strains of Staphylococcus epidermidis 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.27620.
Polyphenols have received a great deal of attention due to their biological functions. Pomegranate (Punica granatum L.) is a polyphenol-rich fruit. In the past decade, studies testing the antimicrobial activity of pomegranates almost exclusively used solvent extracts instead of fresh pomegranate juice (FPJ). The use of FPJ instead of solvent extracts would reduce toxicity issues while increasing patient acceptance. We established a model to test FPJ as a natural antimicrobial agent.
To evaluate the antimicrobial activity of FPJ on clinical isolates of multidrug-resistant Staphylococcus epidermidis strains.
Sixty strains of S. epidermidis isolated from ocular infections were grown in the presence of FPJ, and minimum inhibitory concentration (MIC) was determined by broth and agar dilution methods.
FPJ at 20% had a MIC equal to 100% (MIC100%) on all 60 strains tested. This inhibition of FPJ was confirmed by the growth kinetics of a multidrug-resistant strain exposed to different concentrations of FPJ. Additionally, the antimicrobial activity of FPJ was compared against commercial beverages containing pomegranate: Ocean Spray® had a MIC100% at 20%, followed by Del Valle® with a MIC15% at 20% concentration only. The beverages Jumex® and Sonrisa® did not have any antimicrobial activity. FPJ had the highest polyphenol content and antioxidant capacity.
Overall, FPJ had antimicrobial activity, which might be attributed to its high polyphenol content and antioxidant capacity.
PMCID: PMC4440876  PMID: 25999265
pomegranate juice; Staphylococcus epidermidis; antimicrobial activity; antioxidant capacity; ocular infections
19.  Nutrient intake of pregnant women at high risk of gestational diabetes 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.26676.
The prevalence of gestational diabetes (GDM) has been increasing along with the obesity pandemic. It is associated with pregnancy complications and a risk of type 2 diabetes.
To study nutrient intake among pregnant Finnish women at increased risk of GDM due to obesity or a history of GDM.
Food records from obese women or women with GDM history (n=394) were examined at baseline (≤20 weeks of pregnancy) of the Finnish Gestational Diabetes Prevention Study.
The pregnant women had a mean fat intake of 33 en% (SD 7), saturated fatty acids (SFA) 12 en% (SD 3), and carbohydrate 46 en% (SD 6). Sucrose intake among pregnant women with GDM history was 7 en% (SD 3), which was different from the intake of the other pregnant women, 10 en% (SD 4) (p<0.001). Median intakes of folate and vitamins A and D provided by food sources were below the Finnish national nutrition recommendation, but, excluding vitamin A, supplements raised the total intake to the recommended level. The frequency of use of dietary supplements among pregnant women was 77%.
The observed excessive intake of SFA and low intake of carbohydrates among women at high risk of GDM may further increase their risk of GDM. A GDM history, however, seems to reduce sucrose intake in a future pregnancy. Pregnant women at high risk of GDM seem to have insufficient intakes of vitamin D and folate from food and thus need supplementation, which most of them already take.
PMCID: PMC4439424  PMID: 25994096
nutrition; pregnancy; diabetes; obesity; maternal nutrition; diet
20.  Oral administration of marine collagen peptides prepared from chum salmon (Oncorhynchus keta) improves wound healing following cesarean section in rats 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.26411.
The goal of the present study was to investigate the wound-healing potential of marine collagen peptides (MCPs) from chum salmon skin administered to rats following cesarean section (CS).
Ninety-six pregnant Sprague-Dawley rats were randomly divided into four groups: a vehicle group and three MCP groups. After CS, rats were intragastrically given MCPs at doses of 0, 0.13, 0.38, 1.15 g/kg*bw, respectively. On postoperative days 7, 14, and 21, the uterine bursting pressure, skin tensile strength, hydroxyproline (Hyp) concentrations, and histological and immunohistochemical characteristics of the scar tissue were examined.
In the MCP groups, the skin tensile strength, uterine bursting pressure, and Hyp were significantly higher than those in the vehicle group at all three time points (p<0.05). The formation of capillary, fibroblast, and collagen fiber, the expression of platelet-endothelial cell adhesion molecule-1, basic fibroblast growth factor, and transforming growth factor beta-1 were increased in the MCP groups (p<0.05).
MCPs could accelerate the process of wounding healing in rats after CS.
PMCID: PMC4432022  PMID: 25976613
cesarean section; marine collagen peptide; wound healing; basic fibroblast growth factor; transforming growth factor beta 1; CD31
21.  Iron status of schoolchildren (6–15 years) and associated factors in rural Nigeria 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.26223.
Schoolchildren are vulnerable to anaemia because of their higher iron need to meet the demands of puberty and adolescence.
The survey determined the haemoglobin levels of schoolchildren aged 6–15 years and the factors affecting their haemoglobin status.
Data were obtained through a cross sectional survey of 450 randomly selected schoolchildren in Ede-Oballa, Nsukka, Enugu State, Nigeria. Ninety were selected for clinical examination, biochemical tests, and nutrient intake study. Haemoglobin, malaria, and stool analysis were carried out by the cyanmethaemoglobin, thin blood film, and wet mount direct methods, respectively. Iron intake was determined by a three-day weighed food intake.
Results showed that the schoolchildren had pallor (35.6%), brittle hair (31.1%), koilonychia (2.2%), oedema (4.4%) and sore/smooth tongue (7.8%). The children also had malaria (58.9%) and Entamoeba histolytica (42.2%), hookworm (36.7%), tapeworm (35.6%), whipworm (34.5%), and roundworm (27.9%) infestations. Iron intake was inadequate (<100% of recommended nutrient intake) for most of the children. The mean haemoglobin levels of the schoolchildren were low. The 6–9, 10–12, and 13–15 year olds had 9.0, 9.1, and 9.3 g/dl, respectively. Most (85.5%) of them had anaemia. Moderate anaemia was prevalent in 62.2%. Severe anaemia affected the 6–9 year olds more. Malaria (P<0.001), Entamoeba histolytica (P<0.01), hookworm (P<0.05), tapeworm (P<0.01), and whipworm (P<0.001) caused significant reduction in haemoglobin level. Age (b=1.284, P<0.05), birth order (b=−0.629, P<0.01), frequency of illness attack (b=−1.372, P<0.01), household size (b=−0.526, P<0.05), and frequency of skipping breakfast (b=−1.542, P<0.001) were factors that influenced the haemoglobin status of the children.
The schoolchildren had poor iron status as a result of consumption of plant sources of iron with low bioavailability, parasitic infections, birth order, skipping of breakfast, large household size, and frequent bouts of illnesses.
PMCID: PMC4424235  PMID: 25952679
anaemia; iron intake; parasitic infections; schoolchildren; rural area
22.  Relative validity and reliability of a quantitative food frequency questionnaire for adults in Guam 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.26276.
Guam is a US territory in the western Pacific with a diverse population that includes understudied ethnic groups such as Chamorros and Filipinos. A food frequency questionnaire (FFQ) to estimate dietary intake was needed to facilitate studies of diet and health among adults living in Guam.
To develop and validate an FFQ to assess dietary intake over a 1-year period among adult Guam residents.
A three-part study was conducted: 1) an initial cross-sectional study using 24-h recalls to identify a food and beverage list for the FFQ and resulting in a final FFQ containing 142 food and drink items; 2) to test reliability, 56 different individuals completed the FFQ twice; and 3) to test relative validity, self-administered FFQs and up to 2 days of food record data from an additional 109 individuals were collected, and daily nutrient intake from the two methods was compared.
The reliability of the FFQ was very good (ρ range=0.65–0.75), and the relative validity of the FFQ was good for women (median Spearman's correlation [ρ] between instruments of 0.45 across 20 nutrients and an interquartile range [IQR] of 0.42–0.58) and generally adequate for men (median ρ=0.31, IQR=0.23–0.55). Validity was also good for Chamorros (median ρ=0.47, IQR=0.38–0.53) and generally adequate for Filipinos (median ρ=0.42, IQR=0.20–0.62). Correlations after energy adjustment were lower (overall median ρ=0.20, IQR=0.14–0.26).
The FFQ can be used to rank nutrient intake for adults in Guam and may be helpful in the analysis of relationships between diet and chronic disease in Guam.
PMCID: PMC4422845  PMID: 25947296
food frequency questionnaire; dietary assessment; relative validation; Guam
23.  Lower serum magnesium concentration is associated with diabetes, insulin resistance, and obesity in South Asian and white Canadian women but not men 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.25974.
A large proportion of adults in North America are not meeting recommended intakes for magnesium (Mg). Women and people of South Asian race may be at higher risk for Mg deficiency because of lower Mg intakes relative to requirements and increased susceptibility to diabetes, respectively.
This study compared serum Mg concentrations in South Asian (n=276) and white (n=315) Canadian women and men aged 20–79 years living in Canada's Capital Region and examined the relationship with diabetes, glucose control, insulin resistance, and body mass index.
Serum Mg concentration was lower in women of both races and South Asians of both genders. Racial differences in serum Mg were not significant after controlling for use of diabetes medication. A substantial proportion of South Asian (18%) and white (9%) women had serum Mg <0.75 mmol/L indicating hypomagnesemia. Use of diabetes medication and indicators of poorer glucose control, insulin resistance, and obesity were associated with lower serum Mg in women, but not in men.
These results suggest that the higher incidence of diabetes in South Asians increases their risk for Mg deficiency and that health conditions that increase Mg requirements have a greater effect on Mg status in women than men.
PMCID: PMC4422846  PMID: 25947295
adults; body mass index; glucose; homeostatic model assessment of insulin resistance; magnesium status; McAuley's index; quantitative insulin sensitivity check index
24.  Comparative validity of the ASSO–Food Frequency Questionnaire for the web-based assessment of food and nutrients intake in adolescents 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.26216.
A new web-based food frequency questionnaire (the ASSO–FFQ) was developed within the ASSO Project funded by the Italian Ministry of Health.
The aim of the present study is to assess the validity of the ASSO–FFQ at food groups, energy, and nutrients level.
Design and subjects
The validation study compared the ASSO–FFQ against a weighted food record (WFR) measuring foods, beverages and supplements intake, compiled during the week following the ASSO–FFQ administration. Ninety-two subjects aged 14–17, recruited from secondary schools in Palermo (Italy), completed the ASSO–FFQ and WFR. The intake of 24 food groups, energy, and 52 nutrients were taken as main outcomes. Tests for paired observations, Spearman and Pearson’s correlation coefficients (cc), kappa statistics and classification in quintiles, Bland–Altman plots and multiple regressions, on untransformed and transformed data were used for the statistical analysis.
High cc (≥0.40) were found for soft drinks, milk, tea/coffee, vegetables, and lactose; fair energy-adjusted cc (0.25–0.40) for water, alcoholic drinks, breakfast cereals, fishery products, savory food, fruit juice, eggs, and 19 nutrients. The subjects classified in the same or adjacent quintile for food groups ranged from 40% (alcoholic drinks) to 100% (dried fruit); for energy and nutrients from 43% (phosphorus, thiamin, niacin) to 77% (lactose). Mean differences were not significant for water, soft drinks, meat, sweets, animal fats, milk and white bread, and vitamin B12 and folate. Limits of Agreement were broad for all food groups and nutrients. School, gender, alcohol consumption and between meals mainly affected most food groups’ intake differences. Gender stratification showed females had increased Pearson’s cc for energy and 28 nutrients, such as almost all fats, carbohydrates, vitamins and minerals.
The ASSO–FFQ could be applied in epidemiological studies for the assessment of dietary consumption in adolescents to adequately rank food, energy and nutrient intakes at a group level.
PMCID: PMC4400301  PMID: 25882537
food frequency questionnaire; intake; nutrient; adolescent; validation; validity
25.  NUTRALYS® pea protein: characterization of in vitro gastric digestion and in vivo gastrointestinal peptide responses relevant to satiety 
Food & Nutrition Research  2015;59:10.3402/fnr.v59.25622.
Pea protein (from Pisum sativum) is under consideration as a sustainable, satiety-inducing food ingredient.
In the current study, pea-protein-induced physiological signals relevant to satiety were characterized in vitro via gastric digestion kinetics and in vivo by monitoring post-meal gastrointestinal hormonal responses in rats.
Under in vitro simulated gastric conditions, the digestion of NUTRALYS® pea protein was compared to that of two dairy proteins, slow-digestible casein and fast-digestible whey. In vivo, blood glucose and gastrointestinal hormonal (insulin, ghrelin, cholecystokinin [CCK], glucagon-like peptide 1 [GLP-1], and peptide YY [PYY]) responses were monitored in nine male Wistar rats following isocaloric (11 kcal) meals containing 35 energy% of either NUTRALYS® pea protein, whey protein, or carbohydrate (non-protein).
In vitro, pea protein transiently aggregated into particles, whereas casein formed a more enduring protein network and whey protein remained dissolved. Pea-protein particle size ranged from 50 to 500 µm, well below the 2 mm threshold for gastric retention in humans. In vivo, pea-protein and whey-protein meals induced comparable responses for CCK, GLP-1, and PYY, that is, the anorexigenic hormones. Pea protein induced weaker initial, but equal 3-h integrated ghrelin and insulin responses than whey protein, possibly due to the slower gastric breakdown of pea protein observed in vitro. Two hours after meals, CCK levels were more elevated in the case of protein meals compared to that of non-protein meals.
These results indicate that 1) pea protein transiently aggregates in the stomach and has an intermediately fast intestinal bioavailability in between that of whey and casein; 2) pea-protein- and dairy-protein-containing meals were comparably efficacious in triggering gastrointestinal satiety signals.
PMCID: PMC4400298  PMID: 25882536
pea protein; dairy proteins; satiety; gastrointestinal peptides; in vitro gastric digestion

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