Dietetics

(1) Background: Patient education materials are frequently used by dietitians to support counselling and reinforce key concepts. No studies have examined the quality of dietetic patient education materials for diabetes and common gastrointestinal conditions. (2) Methods: Materials relating to the dietary management of diabetes and gastrointestinal conditions (IBD, IBS, lactose intolerance, coeliac disease and low-FODMAP diets) were evaluated by three dietitian raters. Readability was assessed, and materials with a reading grade level ≤ 7 were considered readable. The PEMAT was used to assess understandability and actionability. Clarity was determined using the CDCCCI. (3) Results: Overall readability scores were satisfactory with a median grade level of 6 (IQR: 5–8). Readability scores did not differ between material types (p = 0.09). The health literacy demand of materials was suboptimal, with a mean understandability score of 65.9 ± 15.1% and an actionability score 49.6% ± 20.8%. Both scores fell below the benchmark of ≥70%. These did not differ between material types (p = 0.06 and p = 0.15, respectively). Clarity scores were below the benchmark of ≥90% (mean score 64.2 ± 14.8%). Only 6.6% of materials achieved a score of ≥90. (4) Conclusions: Improvements to the health literacy demand and clarity of dietetic patient education materials are required. Areas for future improvement have been identified. Full article

Recently, there has been increased scientific and clinical interest in the potential harms associated with ultra-processed foods, including poor mental health, aggression, and antisocial behavior. Research spanning epidemiology, mechanistic pre-clinical work, addiction science, microbiome and exposome science, and human intervention trials has underscored that nutrition is of relevance along the criminal justice continuum. As such, the emerging dietetics research is salient to the thousands of international psychologists and allied mental health professionals that are engaged in justice work, including forensics, prevention, and intervention. In addition, relationships between nutrition and behavior relate to “food crime”, an emergent area unifying criminal justice researchers with psychology, public health, and other interdisciplinary sectors. Food crime scrutinizes the vast harms, including non-communicable diseases and adverse behavioral outcomes, as influenced by the distribution of addictive ultra-processed food products. Here, we examine the emergent research, including biophysiological mechanisms, and evidence indicating that dietary patterns/components intersect with psychosocial vulnerabilities linked with risks of antisocial behavior and justice involvement. Viewed through a prevention lens, the study of nutrition and aggressive behavior should be prioritized, especially if the outcomes emerge as externalities of the global consumption of ultra-processed food. In the context of criminal justice and behavior, there is a need for forensic examination of how industry influence and power structures can undermine matters of food justice. Full article

While homocysteine is produced as an intermediate metabolite during methionine metabolism, increased blood homocysteine levels are associated with various diseases. In a previous cross-sectional study, we reported a significant negative association between the serum concentrations of homocysteine in 227 young women and their dietary fiber intake. In the present study, we examined the relationship between dietary fiber intake from food sources and serum levels of homocysteine and its metabolites. Homocysteine and its metabolites 5-methyltetrahydrofolate (5MTHF), cystathionine, glycine, methionine, and S-adenosyl-methionine were measured using LC-MS/MS. The soluble, insoluble, and total fiber intake from fruits and mushrooms was significantly inversely correlated with the homocysteine concentrations. Furthermore, the soluble, insoluble, and total fiber intake from fruits was significantly positively associated with the serum 5MTHF concentrations, while the fiber intake from mushrooms was positively correlated with the cystathionine concentration and negatively correlated with the methionine and glycine concentrations. These results suggest that ingesting dietary fiber in the form of fruits and mushrooms maintains a low concentration of homocysteine by activating two different homocysteine-scavenging metabolic pathways. Full article

Neurological disorders are increasing globally due to their complex nature, influenced by genetics and environmental factors. Effective treatments remain limited, and early diagnosis is challenging. Recent evidence indicates that metabolic activities play a crucial role in the onset of neural defects. Molecular changes offer new diagnostic markers and dietary targets for disease management. Diets such as MIND, DASH, omega-3 fatty acids, and polyphenols show promise in protecting brain metabolism through their anti-inflammatory properties. Personalized dietary interventions could mitigate neurodegenerative diseases. This review highlights the effects of various dietary interventions, including calorie restriction, fasting, and ketogenic diets, on neurological disorders. Additionally, it emphasizes the nutritional impacts on immunomodulation and the underlying mechanisms, including the influence of gut microbiota on brain function. Dietary interventions could serve as adjunctive therapies in disease management. Full article

Mindful eating is the direct application of mindfulness to eating related issues. This approach has been developed to reduce suffering due to food and body image, to improve the capacity to follow the stimuli of hunger and satiety and to minimize the use of food as psychological compensation. The aim of this review is to analyze the results of clinical trials adopting a mindful eating approach to address cardiometabolic risk factors partly related to dysfunctional eating behavior. The selection of literature included articles published until 31 December 2023. The inclusion criteria were controlled randomized clinical trials, an intervention duration ≥4 weeks and indication of a clinical outcome. Fourteen studies were included. The sample sizes ranged from 18 to 194 participants, and the interventions lasted between 4 and 24 weeks. Their effects on body weight, BMI, waist circumference, serum glucose, glycated hemoglobin and C-reactive protein were assessed using a meta-analysis. Mindful eating was as effective as other recognized types of interventions regarding the clinical outcomes examined, but in many cases, they were more effective in terms of factors which may lead to improvement over a longer period. In particular, our analysis showed that mindful eating effectively reduced suffering related to food and body image. Full article

Neurocognitive deficits in children could be irreversible and detrimental to the overall wellbeing of children. Typically, children with this illness live lives below their mental and intellectual potential. The aim of this paper was to review primary evidence on the association between inflammatory biomarkers on neurocognition in children. Electronic databases such as Scopus, Cochrane Library, and PubMed were systematically searched to include all published data from 2000 to October 2023. The keywords included serum biomarker, cognition, executive function, intellectual ability, brain-derived neurotrophic factor, neurocognitive deficits, tau proteins, and children. A total of 8512 journal publications were obtained, but after the removal of duplicates, commentaries, and review papers, 9 papers were accepted for review. C-reactive protein, brain-derived neurotrophic factor (BDNF) tumor necrosis factor alpha (TNF-α), fibrinogen, plasma leptin, soluble tumor necrosis factor receptor 1 (sTNFR1), and copper were associated with neurocognition in the subjects. This review revealed that there is no research published in sub-Saharan Africa and most of the sample sizes in the studies were small. Full article

Caries is very common in the elderly as there are several aggravating factors, such as a decrease of the ability to self-care and, by extension, insufficient oral hygiene, a carious diet, limited exposure to fluoride, xerostomia, gingival recession, and limited access to dental care. This study aimed to review the dietary risk factors for root caries prevalence in older adults, from socially active people to frail patients. A comprehensive search strategy was used to select studies from PubMed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. Root caries is prevalent in the elderly due to gingival recession and root exposure to the oral environment. Dietary risk factors significantly affect root caries prevalence in older adults, including a high intake of sugars and an alteration of their composition preference in this age group. Caries risk appears more significant in frail, institutionalized patients fed softer food or supplements. Full article

Declines in the mineral content of food have been reported in several countries. This study monitored reported changes in the mineral content of plant foods in Australian food composition databases between 1991 and 2022. Commonly consumed plant foods (n = 130), grouped as fruit, vegetables, legumes, grains, and nuts in raw unprocessed form, were matched between three reference databases from 1991, 2010, and 2022. Absolute and percentage differences in mineral content (iron, zinc, calcium, and magnesium) were calculated. During this 30-year period, 62 matched foods had updated mineral content. Iron content decreased significantly for fruit (48%) and vegetables (20%), although absolute differences were small (0.09–0.14 mg/100 g). Zinc content declined by 15% for fruit (absolute difference 0.03 mg/100 g), but no differences were observed for calcium and magnesium content. Potential reasons for any reported differences could not be explored using food composition data alone, due to biological, agricultural, and/or analytical factors. Nutritionally, these small differences are unlikely to have a major impact on the population’s nutritional status, although efforts to improve fruit and vegetable consumption are encouraged to meet recommendations. Full article

Coenzyme Q₁₀ (CoQ₁₀) is an essential compound for energy production in the mitochondria and the antioxidation of lipid-soluble substances in cells. As it can be biosynthesized in cells, CoQ₁₀ is not an essential nutrient. However, its intake through meals contributes to the maintenance of CoQ₁₀ levels in the body. Therefore, understanding the effects of daily diet on serum CoQ₁₀ levels is crucial. This study investigated the effect of a two-week diet without meat or poultry, which are rich in CoQ₁₀ content, on serum CoQ₁₀ levels of 22 young women aged 20–21 years. Upon restricting the intake of meat and poultry, the participants’ average daily intake of CoQ₁₀ from meals decreased from 2.1 ± 0.6 to 1.1 ± 0.5 mg/day. Simultaneously, the average serum reduced, oxidized, and total CoQ₁₀ levels decreased by 14%, 31%, and 16%, respectively, after the two-week dietary intervention, whereas the reduced serum CoQ₁₀ ratio increased significantly. These results suggest that meat and poultry are significant sources of CoQ₁₀ in the diet. Dietary habits affect serum CoQ₁₀ levels; however, further research is required to determine whether people who follow long-term diets with lower serum CoQ₁₀ levels, such as a healthy reference diet proposed by the EAT-Lancet Commission in addition to vegetarian and vegan diets, need CoQ₁₀ supplementation to maintain health and achieve healthy longevity. Full article

The patient voice is missing from the evidence regarding the dietary management of diverticular disease. This study aimed to determine the patient experiences of imposed dietary restrictions during the medical treatment of acute, uncomplicated diverticulitis. An Interpretive Phenomenological Analysis methodology guided participant selection, data collection, and the data analysis of a qualitative interview study. Four interviews were conducted with adults admitted to hospital with acute, uncomplicated diverticulitis. Six themes were interpreted. Five themes were found to inter-relate as a cycle, which was embedded within a driving theme of ‘corrupted diet-disease knowledge of patients, family, and healthcare providers’. The cycle commenced with a theme of ‘fear of food’, which was followed by the theme of an ‘internal locus of control with rigid constraint’. ‘Loss of culture and social stigma’ ensued, which led to ‘vulnerability amid self-perceived failure’, and finally ‘overshadowed psychological pain’. The cycle recommenced with a renewed fear of food. The thematic phenomenon of the ‘Fear of Food in Gastrointestinal Disease Framework’ was developed. Adults with diverticular disease and at least one hospitalisation for acute, uncomplicated diverticulitis were interpreted to experience a cyclical thematic phenomenon represented by the ‘Fear of Food in Gastrointestinal Disease Framework’. Further qualitative research is required to evaluate the transferability of the framework to other conditions. Full article

The excess consumption of a high-fat diet has been identified as one of the factors contributing to obesity. Women are at higher risk of adult obesity than men, predisposing them to a different set of detrimental disease conditions. Furthermore, aging studies show that physiological decline also has a serious impact on changes in the endocrine properties of white adipose tissue. However, there is still relatively little known about the factors associated with obesity and aging and their compounding impacts on women’s health. To investigate changes in adipocytokine secretion profiles, obesity was induced in female C3H/HeJ mice through the long-term consumption of a high-fat diet. Weight gain measurements and the Echo MRI analysis of fat composition showed that increases were due solely to the high fat content in the diet. Adipocytokine secretions were analyzed in media conditioned from harvested visceral fat tissue that was organ-cultured ex vivo. Adipocytokine analysis performed across diets and ages showed that there were significant increases in Adiponectin and Leptin secretion in high-fat diets, accelerating increases in Resistin secretion in high-fat diets. Aging induced the increased secretion of Lipcalin-2, Pentraxin-3, Serpin E1, MCP-1, and ICAM-1, regardless of diet. Furthermore, the comparisons of organoid-cultured protein secretions and flash-frozen tissue samples differed greatly, suggesting the WAT organoid cultures may yield information that is more reflective of in situ conditions. Taken together, our results show that high-fat diets and aging in C3H/HeJ female mice significantly impact secretions from adipose tissue, which may contribute to women’s health issues. Full article

In the United States, there is a high prevalence of diet-related diseases in low-income communities that lack access to fresh produce. Greater access to local farmers’ markets may affect individual and household intake of fruits and vegetables. However, barriers to farmers’ market access remain. The purpose of this study is to evaluate the differences between participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) who regularly shop at farmers’ markets and those who do not. We found that regular farmers’ market shoppers tended to consume on average more fruits and vegetables than WIC participants who did not regularly shop at farmers’ markets. Differences in the importance of various store or market characteristics, barriers to fruit and vegetable consumption, and fruit and vegetable procurement methods were also found. Full article

The purpose of this study was to investigate nutrition perspectives, basic nutrition knowledge, and preferred sources of nutrition information among students at a southwestern university in the US. An original online survey was used to evaluate common sources of nutrition information, factors viewed as comprising a healthy dietary pattern, and attitudes toward nutrition information and recommendations. A total of 316 participants completed the survey. Prioritizing fruits and vegetables was the most common response (97%) for characterizing healthy eating. When asked which factors characterize a non-healthy pattern of eating, eating sweets was the top response (83%). The most common sources of nutrition information reported were word of mouth/friends and family (56%), followed by social media (45%). The majority felt that nutrition recommendations are constantly changing (78%) and that nutrition information is confusing (55%). Our data indicate that most students rely primarily on informal sources of nutrition information. However, our preliminary data also suggest that many students have a fair understanding of basic principles of healthy eating. More research in a broader and more diverse sample is needed to validate these findings. Full article

The importance of digital tools for dietary assessment has increased in recent years, both commercially and scientifically. In the field of nutrition research, the digitization of dietary assessment methods presents many opportunities and risks. One of the main challenges is ensuring scientific quality while maintaining good usability. In this context, an evaluation tool was developed based on the guidelines of the European Food Safety Authorization (EFSA; 2009 and 2014), complemented by the usability aspect of health-related applications. This was followed by a literature search concerning the available dietary assessment tools, which were analyzed according to the evaluation criteria. Eight applications were included in the study after reviewing the inclusion and exclusion criteria for the digital tools. A total of thirty-eight requirements in eight main categories were defined for the evaluation, which the best possible dietary assessment tool should meet. The evaluation showed that none of the tested tools currently meet all the defined requirements or categories. The aspects of usability and the accuracy of data collection showed a positive correlation, suggesting a direct link between the two categories and providing an important approach for future developments. Full article

Obesity is considered an important risk factor for the onset of asthma, playing a key role in enhancing the disease’s severity. However, there is increasing evidence linking not only obesity but also overweight with a higher risk of asthma. Although the correlation between obesity and asthma has already been reported, several aspects are still not fully elucidated, mainly about the inflammatory processes underlying both diseases. It is well known that Western-type calorically rich diets and overfeeding can act as triggers of chronic metabolic inflammation, but few studies have examined associations between ultra-processed foods (UPFs) intake, despite its positive correlation with obesity, and biomarkers of inflammation. In addition to their nutrient composition, UPF may have chemical additives and contaminants from packaging, whose effects on health and food addiction are still under research. In this review, we provide an overview of the current data that identify the associations between the obese asthma phenotype and UPF consumption, highlighting the potential central role played by the intestinal microbiota. Full article

(1) Background: Walnut consumption has been associated with having a positive effect on controlling and/or reducing the co-morbidities associated with cardiovascular disease (CVD). The effects of consuming walnuts of Portuguese origin on risk factors related to CVD were evaluated by measuring glucose, urea, TC, HDL-C, LDL-C, TG, AST, and ALT levels, anthropometric profiles, and blood pressure. (2) Methods: This trial study involved 24 volunteers, both female (n = 15) and male (n = 9), from Fernando Pessoa University, Porto. It consisted of a daily intake of 25 g of walnut kernels over a period of 45 days. Before and after intake, biochemical parameters, BMI and BP were measured. (3) Results: Despite the intake of nuts revealing a reduction in mean values of most of the parameters assessed, a significant drop was only observed in AST (p = 0.04).There was also a significant reduction in the mean values for Glu (p = 0.01), UR (p = 0.01) and HDL-C (p = 0.02) for women but not for men. (4) Conclusions: The dose and the period of intake were not effective in lowering the lipid profile but may have had a protective effect on liver function. The benefits were greater in women than in men. Full article

The popularity of vegetarian and vegan diets is growing due to increased awareness of the environmental and health benefits of such diets. However, despite the consumption of meatless diets being associated with decreased risk of chronic diseases and mortality, followers of these diets are prone to certain nutritional inadequacies, which could limit health benefits. The main nutrients of concern are vitamin B12, vitamin D, iodine, selenium, calcium, and iron. It is essential for all those following vegetarian and vegan diets to implement vitamin B12 supplementation. To prevent vitamin B12 deficiency, adults should take one oral dose of 50–100 μg cyanocobalamin daily or 2000 μg weekly divided into two oral cyanocobalamin doses. Iodine supplementation is essential for pregnant and breastfeeding women and is recommended for vegetarians and vegans who are unable to access sea vegetables or iodine-fortified foods. The recommended dose of iodine supplement for adults is 150 μg daily. Selenium supplementation should be reserved for individuals with clinical evidence of deficiency due to concerns of adverse effects on lipid profiles and type 2 diabetes risk. It is recommended that vegetarian and vegan adults should supplement 4000 International Units (IU)/d of oral vitamin D to prevent deficiency as sunlight exposure is unreliable due to a range of lifestyle and environmental factors. This recommendation also applies to omnivores. As a precaution, those wishing to transition to a more plant-based diet should consider how they will substitute the nutrition they currently obtain from animal-based foods with plant-based sources or appropriate supplementation. Full article

This study aimed to explore the dietetic treatment experiences of individuals with high eating disorder (ED) symptomatology attending a metabolic and bariatric clinic. An exploratory mixed methods cross-sectional study was conducted. Eighteen participants completed the survey, which included an adapted version of the Eating Disorders Treatment Experience Survey (EDTES), the Eating Disorder Examination Questionnaire Short (EDE-QS), and quantitative and qualitative questions relating to the roles and helpfulness of a dietitian in treatment. Data regarding the most and least helpful dietitians were collected. Differences between groups were tested with the Wilcoxon signed ranks test. A reflexive thematic analysis was used to analyse open-ended responses. The mean EDE-QS score reported by participants was 20.9 (SD = 6.0). The dietitians who were perceived as the most helpful were those who took into consideration an individual’s treatment preferences and choices (Z = −1.96, p = 0.05). Three themes were constructed: (1) nutrition knowledge and skills, (2) person-centred care, and (3) roles of the multidisciplinary team. Although further research is required, our findings suggest that the role of a dietitian in this setting may extend beyond weight-loss advice, and with additional training, could include individualised and collaborative supportive care that overlaps with ED treatment. Full article

The demand for low-sodium products is growing worldwide and is compelled by the growing number of related illnesses. However, the quality of these products could be improved, likened to products produced with common salt (NaCL), because the replacement of sodium compromises the flavor of the product. Reducing sodium salts also poses an essential challenge for the meat industry, since sodium chloride (NaCl) fulfills essential technological functions. High sodium consumption has harmful health implications for cardiovascular and hypertension disorders. As a result, this study aimed to analyze the effect of KCl with Glycine and AMP on the physicochemical and sensory characteristics, purchase intent, and consumer perception of roasted chicken. NaCl/KCl replacement levels (0%, 25%, 50%, 75%, and 100%) were established, and consumer perception, liking, emotions, and purchase intent were evaluated. The different KCl levels, except for firmness, did not impact the physicochemical attributes. Even though higher replacement levels of KCl (75–100%) impacted chicken tenderness, it had no notable impact on panelists’ liking scores and purchase intent. Health claims about the sodium content in roasted chicken have also been shown to significantly increase purchase intent, based on enhancing consumer’s emotional responses. Regarding emotional responses, feelings of being unsafe and worried decreased their scores among the highest KCl replacement levels (75% and 100%). Positive emotional responses (feeling satisfied and pleased) were decisive consumer purchase intent predictors. Full article