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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (31 August 2020) | Viewed by 89883

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Special Issue Editors

Dr. Maria G. Grammatikopoulou

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Guest Editor

Unit of Immunonutrition & Clinical Nutrition, Department of Rheumatology & Clinical Immunology, Larissa University Hospital, Faculty of Medicine, University of Thessaly, Larissa, Greece
Interests: vulnerable populations; pediatric patients; nutrition recommendations; dietary interventions; nutritional status; evidence-based nutrition
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Markos Klonizakis

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Guest Editor

Department of Nursing and Midwifery, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP, UK
Interests: Current research interests include lifestyle interventions in the cardiovascular function of clinical and high-risk populations
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

From novel dietary indexes and biomarkers to more contemporary nutritional issues including sustainability, health literacy, and food security, nutrition research is constantly evolving. Grounded on the pillars of nutrition epidemiology, nutritional science is updated while moving towards a more evidence-based approach.

The present Special Issue aims to embrace updated multidisciplinary research on all challenges and important aspects of nutrition today, including principles of hydration, new supplementation delivery methods, evidence on personalized nutrition and health, as well as epidemiological and methodological issues related to the science of nutrition and dietetics. The authors of original articles, opinion papers, as well as narrative and systematic reviews are welcome to submit and showcase their research.

Dr. Maria G. Grammatikopoulou
Prof. Markos Klonizakis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

nutrition epidemiology
hydration
dietary index
nutrition methodology
poverty
guidelines
non-communicable disease

Published Papers (10 papers)

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Research

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12 pages, 474 KiB

Open AccessArticle

Adherence to Dietary Recommendations, Nutrient Intake Adequacy and Diet Quality among Pediatric Cystic Fibrosis Patients: Results from the GreeCF Study

by Dimitrios Poulimeneas, Maria G. Grammatikopoulou, Panagiota Devetzi, Argyri Petrocheilou, Athanasios G. Kaditis, Theodora Papamitsou, Stavros E. Doudounakis and Tonia Vassilakou

Nutrients 2020, 12(10), 3126; https://doi.org/10.3390/nu12103126 - 13 Oct 2020

Cited by 23 | Viewed by 4364

Abstract

Nutrition is an important component of cystic fibrosis (CF) therapy, with a high-fat diet being the cornerstone of treatment. However, adherence to the dietary recommendations for CF appears suboptimal and burdensome for most children and adolescents with CF, leading to malnutrition, inadequate growth, compromised lung function and increased risk for respiratory infections. A cross-sectional approach was deployed to examine the degree of adherence to the nutrition recommendations and diet quality among children with CF. A total of 76 children were recruited from Aghia Sophia’s Children Hospital, in Athens, Greece. In their majority, participants attained their ideal body weight, met the recommendations for energy and fat intake, exceeding the goal for saturated fatty acids consumption. Carbohydrate and fiber intake were suboptimal and most participants exhibited low or mediocre adherence to the Mediterranean diet prototype. It appears that despite the optimal adherence to the energy and fat recommendations, there is still room for improvement concerning diet quality and fiber intake. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

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17 pages, 527 KiB

Open AccessArticle

A Priori and a Posteriori Dietary Patterns in Women of Childbearing Age in the UK

by Karim Khaled, Vanora Hundley, Orouba Almilaji, Mareike Koeppen and Fotini Tsofliou

Nutrients 2020, 12(10), 2921; https://doi.org/10.3390/nu12102921 - 24 Sep 2020

Cited by 10 | Viewed by 3735

Abstract

Poor diet quality is a major cause of maternal obesity. We aimed to investigate a priori and a-posteriori derived dietary patterns in childbearing-aged women in UK. An online survey assessed food intake, physical activity (PA), anthropometry and socio-demographics. An a priori defined diet quality was determined via Mediterranean diet (MD) adherence score and Exploratory Factor Analysis (EFA) derived dietary patterns (DPs). Multiple linear regression explored associations between DPs with anthropometric measures, PA and socio-demographics. Participants (n = 123) had low-to-medium MD adherence (average MD-score: 4.0 (2.0)). Age was positively associated with higher MD adherence (X² (2) = 13.14, p = 0.01). EFA revealed three DPs: ‘fruits, nuts, vegetables and legumes’ (“Vegetarian-style” DP); ‘sweets, cereals, dairy products and potatoes’ (“Dairy, sweets and starchy foods” DP); and ‘eggs, seafood and meats’ (“Protein-rich” DP). “Vegetarian-style” DP was positively associated with higher maternal educational level (p < 0.01) and PA (p = 0.01), but negatively with white ethnicity (p < 0.01). “Dairy, sweets and starchy foods” DP was positively associated with white ethnicity (p = 0.03) and negatively with age (p = 0.03). “Protein-rich” DP was positively associated with age (p < 0.001) and negatively with PA (p = 0.01). A poor diet quality was found among childbearing-aged women; notably in the younger age category, those of white ethnicity, that were more physically inactive and with a lower socioeconomic background. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

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24 pages, 1024 KiB

Open AccessArticle

Development and Validation of the Short Healthy Eating Index Survey with a College Population to Assess Dietary Quality and Intake

by Sarah Colby, Wenjun Zhou, Chelsea Allison, Anne E. Mathews, Melissa D. Olfert, Jesse Stabile Morrell, Carol Byrd-Bredbenner, Geoffrey Greene, Onikia Brown, Kendra Kattelmann and Karla Shelnutt

Nutrients 2020, 12(9), 2611; https://doi.org/10.3390/nu12092611 - 27 Aug 2020

Cited by 27 | Viewed by 6590

Abstract

Because diet quality (DQ) is associated with risk of chronic disease and is a common construct assessed in health-related research, validated tools to assess DQ are needed that have low respondent and researcher burden. Thus, content experts develop the Short Healthy Eating Index (sHEI) tool and an associated scoring system. The sHEI scoring system was then refined using a classification and regression tree (CRT) algorithm methodology with an iterative feedback process with expert review and input. The sHEI scoring system was then validated using a concurrent criterion validation process that included the sHEI DQ scores (calculated from responses from 50 participants) being compared to the participants’ Healthy Eating Index scores derived from 24 h recalls. The total HEI score from the CRT algorithm highly correlated with the 24 h recall HEI score (0.79). For individual food group items, the correlation between the CRT algorithm scoring and the 24 h recall data scoring ranged from 0.44 for refined grains to 0.64 for whole fruits. The sHEI appears to be a valid tool for estimating overall dietary quality and individual items (with correlations > 0.49) for fruits, vegetables, dairy, added sugar, sugar from sugar-sweetened beverages, and calcium. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

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11 pages, 285 KiB

Open AccessArticle

Malnutrition and Food Insecurity Might Pose a Double Burden for Older Adults

by Konstantinos Gkiouras, Stavros Cheristanidis, Theopoula D. Papailia, Maria G. Grammatikopoulou, Nikolaos Karamitsios, Dimitrios G. Goulis and Theodora Papamitsou

Nutrients 2020, 12(8), 2407; https://doi.org/10.3390/nu12082407 - 11 Aug 2020

Cited by 21 | Viewed by 4546

Abstract

Although food insecurity has been associated with a disadvantageous socioeconomic status, especially in older adults, its association with comorbidities is less clear. The scope of the present cross-sectional study was to assess the prevalence of food insecurity among older adults and evaluate the association between food insecurity, malnutrition, chronic disease, multimorbidity and healthcare utilization. A total of 121 older adults (mean (standard deviation) age: 72.6 (8.1)) were recruited from a Primary Care Health Center from 10 August 2019 to 10 September 2019. Food insecurity and malnutrition status were assessed by the Household Food Insecurity Access Scale and Mini Nutritional Assessment tool, respectively. Recorded variables included financial, family data and comorbidities. The prevalence of food insecurity in the sample reached 50.4%, with men and older adults malnourished or at risk for malnutrition, exhibiting high risk for food insecurity. Multimorbidity, frequency of health care utilization and medication adherence were not associated with food insecurity, possibly due to the free health services and remunerated medications offered by the Greek government. However, male gender and malnutrition risk were significant predictors of food insecurity in the multiple logistic analyses. This study highlights the need for mainstreaming food insecurity assessment among older adults with comorbidities, especially those at risk for malnutrition. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

18 pages, 947 KiB

Open AccessArticle

Impact of Intensive Lifestyle Treatment (Diet Plus Exercise) on Endothelial and Vascular Function, Arterial Stiffness and Blood Pressure in Stage 1 Hypertension: Results of the HINTreat Randomized Controlled Trial

by Anastasios Vamvakis, Eugenia Gkaliagkousi, Antonios Lazaridis, Maria G. Grammatikopoulou, Areti Triantafyllou, Barbara Nikolaidou, Nikolaos Koletsos, Panagiota Anyfanti, Christos Tzimos, Pantelis Zebekakis and Stella Douma

Nutrients 2020, 12(5), 1326; https://doi.org/10.3390/nu12051326 - 07 May 2020

Cited by 20 | Viewed by 6448

Abstract

Lifestyle modification is an important component of essential hypertension (EH) therapy. The aim of the Hypertension Intensive Nutrition Treatment (HINTreat) parallel, randomized controlled trial was to examine the effect of a 6-month intensive lifestyle treatment (ILT) (diet plus exercise with monthly visits) compared to the usual care. A total of 76 adults with stage 1 EH were randomized (38 in each group). Dietary analysis, anthropometry, physical activity, biochemical and urine profile, blood pressure (BP), asymmetric dimethylarginine (ADMA), central hemodynamics, β-stiffness index and carotid intima media-thickness were evaluated. The dietary inflammatory index (DII) was calculated for each participant from the intake of 29 nutrients/food components. At the end of the trial, participants in the ILT group reduced their 24h urinary Na excretion (p ≤ 0.001), daytime systolic BP (p ≤ 0.048) and mean carotid β-stiffness index (p ≤ 0.005) and ameliorated their lipidemic profile compared to the standard care. Univariate analysis for the total sample showed a strong association between DII and ADMA levels (β = 0.089, p ≤ 0.01). ILT is effective in improving the inflammatory components of the diet and selected cardiometabolic parameters, including arterial stiffness. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

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16 pages, 1141 KiB

Open AccessArticle

Assessing Non-Invasive Liver Function in Patients with Intestinal Failure Receiving Total Parenteral Nutrition—Results from the Prospective PNLiver Trial

by Elisabeth Blüthner, Ulrich-Frank Pape, Martin Stockmann, Mirjam Karber, Sebastian Maasberg, Sophie Pevny, Undine Gerlach-Runge, Andreas Pascher, Johann Pratschke, Frank Tacke and Jan Bednarsch

Nutrients 2020, 12(5), 1217; https://doi.org/10.3390/nu12051217 - 26 Apr 2020

Cited by 8 | Viewed by 2664

Abstract

Liver abnormalities in intestinal failure (IF) patients receiving parenteral nutrition (PN) can progress undetected by standard laboratory tests to intestinal failure associated liver disease (IFALD). The aim of this longitudinal study is to evaluate the ability of non-invasive liver function tests to assess liver function following the initiation of PN. Twenty adult patients with IF were prospectively included at PN initiation and received scheduled follow-up assessments after 6, 12, and 24 months between 2014 and 2019. Each visit included liver assessment (LiMAx [Liver Maximum Capacity] test, ICG [indocyanine green] test, FibroScan), laboratory tests (standard laboratory test, NAFLD [non-alcoholic fatty liver disease] score, FIB–4 [fibrosis-4] score), nutritional status (bioelectrical impedance analysis, indirect calorimetry), and quality of life assessment. The patients were categorized post-hoc based on their continuous need for PN into a reduced parenteral nutrition (RPN) group and a stable parenteral nutrition (SPN) group. While the SPN group (n = 9) had significantly shorter small bowel length and poorer nutritional status at baseline compared to the RPN group (n = 11), no difference in liver function was observed between the distinct groups. Over time, liver function determined by LiMAx did continuously decrease from baseline to 24 months in the SPN group but remained stable in the RPN group. This decrease in liver function assessed with LiMAx in the SPN group preceded deterioration of all other investigated liver function tests during the study period. Our results suggest that the liver function over time is primarily determined by the degree of intestinal failure. Furthermore, the LiMAx test appeared more sensitive in detecting early changes in liver function in comparison to other liver function tests. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

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Review

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17 pages, 314 KiB

Open AccessReview

Rehabilitation Nutrition for Injury Recovery of Athletes: The Role of Macronutrient Intake

by Sousana K. Papadopoulou

Nutrients 2020, 12(8), 2449; https://doi.org/10.3390/nu12082449 - 14 Aug 2020

Cited by 31 | Viewed by 28497

Abstract

An adequate and balanced diet is of utmost importance in recovery and rehabilitation. “Rehabilitation nutrition” for injury recovery of athletes is similar to sports nutrition, except for the differences that concern the prevention of the risk or presence of sarcopenia, malnutrition, or dysphagia. Rehabilitation nutrition also aims, combined with training, to an adequate long-term nutritional status of the athlete and also in physical condition improvement, in terms of endurance and resistance. The aim of this paper is to define the proper nutrition for athletes in order to hasten their return to the sports after surgery or injury. Energy intake should be higher than the energy target in order to fight sarcopenia—that is 25–30 kcal/kg of body weight. Macro- and micro-nutrients play an important role in metabolism, energy production, hemoglobin synthesis, lean mass and bone mass maintenance, immunity, health, and protection against oxidative damage. Nutritional strategies, such as supplementation of suboptimal protein intake with leucine are feasible and effective in offsetting anabolic resistance. Thus, maintaining muscle mass, without gaining fat, becomes challenging for the injured athlete. A dietary strategy should be tailored to the athlete’s needs, considering amounts, frequency, type and, most of all, protein quality. During rehabilitation, simultaneous carbohydrates and protein intake can inhibit muscle breakdown and muscle atrophy. The long-term intake of omega-3 fatty acids enhances anabolic sensitivity to amino acids; thus, it may be beneficial to the injured athlete. Adequate intakes of macronutrients can play a major role supporting athletes’ anabolism. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

20 pages, 389 KiB

Open AccessReview

Sarcopenia: A Contemporary Health Problem among Older Adult Populations

by Sousana K. Papadopoulou

Nutrients 2020, 12(5), 1293; https://doi.org/10.3390/nu12051293 - 01 May 2020

Cited by 183 | Viewed by 21281

Abstract

Sarcopenia, a geriatric disease characterized by a progressive loss of skeletal muscle mass and loss of muscle function, constitutes a rising, often undiagnosed health problem. Its prevalence in the elderly population is largely considered variable, as it ranges from 5% to 50% depending on gender, age, pathological conditions as well as diagnostic criteria. There is no one unified approach of treatment or assessment, which makes sarcopenia even harder to assess. There is a pressing need to provide better diagnosis, diagnostics, prevention, and individualized health care. Physical activity and nutrition are the main studied ways to prevent sarcopenia, and they also offer better outcomes. This review aims to report the prevalence of sarcopenia in older adults, its etiology, prevention, and treatment techniques. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

15 pages, 2373 KiB

Open AccessReview

Efficacy of Vitamin D₃ Buccal Spray Supplementation Compared to Other Delivery Methods: A Systematic Review of Superiority Randomized Controlled Trials

by Maria G. Grammatikopoulou, Konstantinos Gkiouras, Meletios P. Nigdelis, Dimitrios P. Bogdanos and Dimitrios G. Goulis

Nutrients 2020, 12(3), 691; https://doi.org/10.3390/nu12030691 - 04 Mar 2020

Cited by 7 | Viewed by 4885

Abstract

(1) Background: Vitamin D deficiency is an important public health concern and supplementation is common for this deficiency. Many different modes of delivering supplementation have been proposed in order to enhance absorption and utilization. The present review compared the efficacy of vitamin D₃ buccal spray against other forms of supplementation delivery. (2) Methods: The protocol was registered at PROSPERO (CRD42019136146). Medline/PubMed, CENTRAL and clinicaltrials.gov were searched from their inception until September 2019, for randomized controlled trials (RCTs) that compare vitamin D₃ delivery via sublingual spray against other delivery methods. Eligible RCTs involved humans, of any age and health status, published in any language that evaluated changes in plasma 25(OH)D concentrations. Three reviewers independently extracted data, assessed risk of bias (RoB) and the quality of the trials. (3) Results: Out of 9759 RCTs, four matched the predefined criteria. Intervention duration ranged from 30 days to 3 months whereas vitamin D₃ dosage ranged between 800 and 3000 IU/day. One RCT advocated for the superiority of buccal spray in increasing plasma 25(OH)D concentrations, although several limitations were recorded in that trial. The rest failed to report differences in post-intervention 25(OH)D concentrations between delivery methods. Considerable clinical heterogeneity was observed due to study design, intervention duration and dosage, assays and labs used to perform the assays, population age and health status, not allowing for synthesis of the results. (4) Conclusions: Based on the available evidence, delivery of vitamin D₃ via buccal spray does not appear superior to the other modes of delivery. Future RCTs avoiding the existing methodological shortcomings are warranted. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

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Other

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7 pages, 435 KiB

Open AccessCommentary

A Diet for Healthy Weight: Why Reaching a Consensus Seems Difficult

by Moul Dey and Purna C. Kashyap

Nutrients 2020, 12(10), 2997; https://doi.org/10.3390/nu12102997 - 30 Sep 2020

Cited by 1 | Viewed by 3286

Abstract

Overweight and obesity are global health problems that contribute to the rising prevalence of non-communicable diseases, such as type 2 diabetes, heart disease, and certain cancers. The World Health Organization recognizes obesity as a primarily diet-induced, preventable condition, yet losing weight or keeping weight loss permanent is a universal challenge. In the U.S., formal dietary guidelines have existed since 1980. Over the same time-period, the incidence of obesity has skyrocketed. Here, we present our perspective on why current dietary guidelines are not always supported by a robust body of scientific data and emphasize the critical need for accelerated nutrition research funding. A clear understanding of the interaction of dietary patterns with system-level biological changes in a precise, response-specific manner can help inform evidence-based nutrition education, policy, and practice. Full article

(This article belongs to the Special Issue Contemporary Issues in Nutrition Research)

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