Background: This review aims to assess the effect of oral administration of probiotics and/or prebiotics in children and women of reproductive age (WRA) to improve intestinal iron absorption, hemoglobin, and ferritin levels.
Methods: Randomized controlled trials from published literature on probiotics and or prebiotics for prevention or treatment of anemia as a supplement or fortification in children or WRA till Jan 31, 2023, were included. Studies on probiotics and prebiotics in patients with anemia due to other causes were excluded. Screening and data extraction was done using Distiller SR and meta-analysis was performed using Revman 5.4.1.
Results: A total of 1925 records were identified from Pubmed, Embase, and Cochrane, of which 29 were included in the systematic review (14 supplementation and 15 fortification studies; 15 studies in children and 14 studies in WRA). The major interventions included galacto-oligosaccharide, inulin, heat-killed H61, Lactobacillus plantarum 299v, Lactobacillus reuteri, Lactobacillus acidophilus. Meta-analysis of 5 studies in WRA showed that the use of prebiotics and/or probiotics with or without iron was associated with little or no effect on hemoglobin. However, there is low certainty of evidence that the intervention led to improvement in fractional absorption of iron as compared to placebo or iron [8 studies, n = 335, mean increase 0.74%, 95%CI-0.11-1.38, p = 0.02]. Meta-analysis of 6 studies in WRA using prebiotics and/or probiotics with or without iron led to a significant increase in ferritin levels in WRA (mean increase 2.45 ng/ml, 95% CI 0.61-4.3, p = 0.009, n = 320) [Moderate certainty of evidence]. In children, meta-analysis of up to 8 studies did not result in any significant change in hemoglobin, ferritin and fractional iron absorption [low or very low certainty of evidence].
Conclusion: There is some evidence to show that the use of prebiotics or probiotics (especially Lp299v and GOS) with or without oral iron can improve iron absorption in women and lead to improvement in ferritin levels in women. However, the current evidence does not conclusively show the benefit of these interventions in improving hemoglobin levels in women and children.
Background: Healthy eating in preschools is a very important but challenging goal that can benefit from an adequate institutional and system approach. Five years ago, the Ministry of Education and Culture in the Republic of Srpska, Bosnia and Herzegovina, adopted a policy for healthy eating in preschools in the form of a rulebook and standards, whose use was not mandatory. The aim of this research was to determine the practices, perceptions, and experiences of preschool personnel related to the implementation of the abovementioned rulebook and standards.
Methods: We applied a qualitative research method and conducted six focus groups: three with teachers (n = 37) and three with managers in preschools (n = 19). The qualitative data were analyzed according to the Framework Method.
Results: We found that the practice of healthy eating in public preschool settings involves a certain number of facilitators and ongoing challenges. While there are no doubts that the existing rulebook and standards are facilitating efforts in establishing healthy eating in preschools, their implementation has not been an easy-going process, and they have encountered resistance that has appeared at several levels. The participants perceived cookers as resistant and "old-fashioned" in preparing meals, which was found to be a significant challenge that requires education training and ongoing supervision with support. Experiences with limited financial resources and rigid public procurement procedures make it difficult to obtain desired food items. All the participants agreed that long-term commitment is needed to achieve the full implementation of policy recommendations, together with tripartite and convergent education programs for personnel, parents, and children.
Conclusion: Promoting proper nutrition in preschools requires a holistic approach that addresses both feasibility and attitudes toward policies, continuous education for staff, creative strategies for implementing new eating habits, and overcoming financial challenges. Collaboration with parents and community stakeholders is crucial in creating a supportive environment for healthy eating habits in preschool settings.
Background: The production and consumption of sugar-sweetened beverages (SSBs) have been increasing over the past years, globally. However, there is overwhelming evidence linking SSBs to the rising prevalence in obesity and its comorbidities. In South Africa, the prevalence of overweight and obesity is high and is among the highest in Sub-Saharan Africa. In response to rising prevalence in obesity and its comorbidities, on 1 April 2018 the South African government introduced an SSB tax, known as the Health Promotion Levy (HPL). However, the levy has been opposed by the sugar industry, claiming that it leads to jobs losses. Against this backdrop, this study seeks to investigate the association between the HPL and employment in the sugar industry.
Methods: We employed single-group interrupted time series analyses using the Quarterly Labour Force Survey data from Statistics South Africa.
Results: Our results show that the HPL has not been associated with job losses (or generation) in the sugar-related industries in South Africa. These findings are consistent with the findings on the effects of SSB taxes on employment in other jurisdictions.
Conclusions: Considering that the HPL does not impede employment, and the overwhelming evidence on the effectiveness of SSB taxes, together with the relatively low tax burden, it is imperative that the government raises the HPL from the current 8% of the retail price to the WHO-recommended 20% threshold. The government should also consider expanding the HPL to fruit juices. Such strategies are important in encouraging people to reduce the intake of SSBs, while enabling the government to raise additional revenue for the fiscus.
Background: Recent studies suggest a link between dietary fat quality and obesity. Genetic risk scores (GRS) can predict obesity risk based on genetic factors. This study investigates how GRS and fatty acid quality affect visceral adiposity index (VAI) and body adiposity index (BAI) in overweight and obese women.
Methods: In this study, 278 overweight and obese women (aged 18-58) participated. We have used a comprehensive food frequency questionnaire (FFQ) to evaluate dietary intake and the fatty acids quality indexes. We have employed standard methods to measure biochemical factors, anthropometrics, and physical activity levels. Finally, the GRS was created by combining three SNPs [CAV-1 (rs3807992), Cry-1 (rs2287161), and MC4R (rs17782313)].
Results: The study found that there was no significant association between the quality of fat intake (as measured by CSI score and N6/N3 score) and VAI or BAI in both crude (B = 70.70, SE = 35.14, CI:1.81-139.55, P = 0.04) and adjusted models (B = 93.67, SE = 39.28, CI:16.68-17.68, P = 0.01). CSI provides information on cholesterol and saturated fats. However, there was a notable interaction between the GRS and the N6/N3 score on VAI, suggesting that obese women with high obesity-related SNPs who consumed foods with a higher ratio of N6/N3 fatty acids tended to have an increased VAI.
Conclusion: This study shows; that eating more food sources containing a higher ratio of N6/N3 may be the reason for the increase in VAI in obese women who have high obesity-related SNPs and emphasizes the matter of personalized nutrition in obesity issues.
Background: Human immunodeficiency virus continues to be a major global public health issue. Body mass index is a general indicator of nutritional status and has emerged as a powerful predictor of morbidity and mortality among adult PLHIV initiating antiretroviral therapy in resource-limited settings. However, there is a dearth of information regarding longitudinal changes in body mass index and its predictors among adult PLHIV in Ethiopia, particularly in the study area. This study aimed to assess body mass index changes and their predictors among adults living with HIV/AIDS who were receiving on antiretroviral therapy at Chiro General Hospital, Eastern Ethiopia from August 15, 2023 to September 30, 2023.
Methods: A Facility-based retrospective cohort study was implemented among 1049 randomly selected charts of adults living with HIV/AIDS. The data were collected by reviewing charts of clients and antiretroviral therapy registers. The data were entered into Epi data statistical software version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics were used to describe the characteristics of the patients. A linear mixed effect model was used to identify the predictors of body mass index change. A P value of less than 0.05 was considered statistically significant.
Results: Generally, in this study patients presented a linear increase in the mean BMI from 19 kg/m2 baseline to 21.2 kg/m2 at the 5th year of follow up. Moreover, the following variables were identified as independent predictors of BMI change: age (β = 0.58, 95% CI; 0.043, 0.072), marital status (β = -0.275, 95% CI: -0.457,-0.093 ), advanced WHO stage (β = -0.496, 95% CI: -0.548, -0.443 ), CD4 count (β = 0.001, 95% CI: 0.001, 0.001), duration of antiretroviral therapy (β = 0.005, 95% CI: 0.001,0.009), time of follow up (β = 0.205, 95% CI: 0.198,0.212), no ART shift (β = -0.844, 95% CI: -1.135, -0.552), no CPT (β = 0.591, 95% CI: 0.365,0.817), urban residence (β = 0.767, 95% CI:0.401,1.132) and good adherence to ART (β = 0.975, CI:0.302, 1.649).
Conclusion: There was a significant improvement in the mean BMI over time and a reduction in the rate of undernutrition during the follow-up period.
Background: Adult patients suffering from malnutrition in hospitals are often overlooked, especially in low-income countries. Health care professionals play a vital role in identifying and managing the nutritional needs of patients. However, their perception regarding the nutritional care of adult patients have not been thoroughly examined.
Objective: Explore the perceptions of health care professionals on nutritional care and perceived barriers in providing nutritional care for adult patients.
Methods: A phenomenological qualitative study was conducted, consisting of twenty-two in-depth interviews with purposefully selected health care professionals at comprehensive specialized hospitals from March to May 2024. The interviews were audio-recorded, and field notes were taken. The data were transcribed verbatim and translated into English. A thematic analysis was used to analyze the data.
Results: Two main themes and eight sub-themes were generated. The first theme was Health care professionals' (HCPs) gaps which include: limited scope in providing nutritional care, not recognizing nutritional care as a routine care, healthcare professionals (HCPs) role on nutrition care and limited knowledge regarding nutritional care. The second theme was challenges and barriers to providing nutritional care which includes: prioritization, lack of emphasis in the health care system, missing collaboration between professionals, and lack of resources allocated to nutritional service.
Conclusion: Respondents assume that malnutrition may not occur in adult patients; they consider it not to be a problem for adult patients. Providing adequate in-service training to healthcare providers, allocating resources, and considering malnutrition in adult patients as one of the main issues to be integrated in nutritional care as a part of daily treatment are vital.
Background: The link between obesity and cardiometabolic risk has been well recognized. We investigated the association between body fat percentage (BF%), as an appropriate indicator of obesity, and prevalence of cardiometabolic diseases using baseline data of Fasa PERSIAN cohort study.
Methods: The cross-sectional study was performed on data obtained at the first phase of the Fasa cohort study in Iran (n = 4658: M/F: 2154/2504). Anthropometric characteristics, blood pressure, cardiometabolic biomarkers, and body fat content were measured. Information on demographic and lifestyle factors, and history of cardiometabolic diseases (metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and myocardial infarction) was obtained.
Results: Cardiometabolic risk factors (body mass index, waist circumference, blood pressure, blood glucose and lipids) had an inverse association with BF% tertiles in both sexes. Women had a higher BF% and prevalence of metabolic diseases than men, but men demonstrated stronger associations between BF% and cardiometabolic diseases. In both sexes, the association between BF% and metabolic syndrome and NAFLD was stronger than that between BF% and diabetes and myocardial infarction. Addition of waist circumference to the confounders either weakened (for NAFLD and metabolic syndrome) or faded (for type 2 diabetes and myocardial infarction) the relationship of BF% and cardiometabolic diseases.
Conclusion: Strategies to decrease body fat may be effective in ameliorating the risk of milder metabolic diseases, such as metabolic syndrome, but interventions to decrease abdominal fat (estimated by waist circumference) may be more effective in preventing more serious metabolic disorders such as type 2 diabetes and myocardial infarction.
Background: College students in the United States are disproportionately impacted by food insecurity, which is associated with diminished health outcomes and poor academic performance. One key resource to support students through periods of food insecurity are on-campus food pantries, which distribute food, personal hygiene products, and other essential items. But as colleges and universities navigated through the COVID-19 pandemic, many campuses closed their food pantries as the demand for their services among students grew. Few studies, however, have assessed how food pantries at academic institutions navigated through the COVID-19 pandemic to support students. With this knowledge gap in mind, our study objectives included the following: (1) to compare staff members' perceptions on the impact of COVID-19 on food pantries of academic institutions; and (2) to provide recommendations to improve campus food pantries in navigating through future public health threats.
Methods: The research team conducted a qualitative study involving semi-structured interviews with staff members, including directors and supervisors, of food pantries located on the campuses of colleges and universities in the state of Connecticut. Participants also completed a short post-interview survey assessing demographic information and perspectives on food insecurity-related issues impacting their respective college or university. A template organizing approach was used to allow members of the research team to create a codebook of both inductive and deductive codes and identify emergent themes from the qualitative data.
Results: Twelve interviews were conducted, of which 7 participants represented four-year and 5 from 2-year institutions. Based on our thematic analysis if the interviews, we identified four central themes: (1) Persistent Pre-COVID-19 Pandemic Barriers to Food Pantry Utilization; (2) Innovative responses to the COVID-19 pandemic; (3) International Students' Reliance on Food Pantries at Four-Year Colleges and Universities; and (4) Demand for Non-Food-Related Items.
Conclusions: Our research underscores the importance of lessons gleaned by the COVID-19 pandemic, particularly through the lens of on-campus food pantry workers. Their unique insight and lessons learned ought to be considered when academic institutions deliberate allocating resources and making key decisions to help mitigate food insecurity concerns on their campuses.
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