BMC Nutrition最新文献

Background: Undernutrition among children is a public health concern in most low and middle-income countries (LMICs) and is associated with poor child growth and development. Knowledge about child feeding practices is needed for nutritional policies and programs. Hence, this study assessed the status of minimum acceptable diet (MAD) and its associated factors among children aged 6-23 months in Afghanistan.

Methods: This cross-sectional study was based on a secondary dataset of the 2022-2023 Afghanistan Multiple Indicator Cluster Survey (MICS 2022-23). Complete data from 7,876 children aged 6-23 months were analysed. The outcome variable was MAD and was defined according to the WHO and UNICEF recommendations and indicators for young child feeding practices. Bivariate and multivariate binary logistic regression analyses were used to identify factors associated with MAD.

Results: About 7.3% of children aged 6-23 months were fed with the recommended MAD. The likelihood of receiving MAD was higher in children aged 13-18 months [adjusted odds ratio (AOR) 2.01 (95%CI: 1.63-2.48)] and 19-23 months [2.11 (95%CI: 1.68-2.66)], in children belonging to households with higher wealth status [1.39 (95%CI: 1.04-1.87), 2.06 (95%CI: 1.51-2.82), and 3.07 (95%CI: 2.14-4.40) for the 3rd, 4th, and 5th quintile of wealth status, respectively], and in children living in rural areas [1.56 (95%CI: 1.21-2.01)]. On the other hand, the maternal age group 30-39 years [0.79 (95%CI: 0.64-0.96)] and non-institutional delivery [0.67 (95%CI: 0.54-0.83)] were associated with reduced odds of MAD.

Conclusion: Our study revealed that a small percentage (7.3%) of children received MAD in Afghanistan. This emphasizes the need for policies and interventions aimed at the improvement of child feeding practices to ultimately lead to better child nutrition and health in Afghanistan.

Background: Early Childhood Education and Care (ECEC) centers play an important role in fostering healthy dietary habits. The Nutrition Now project focusing on improving dietary habits during the first 1000 days of life. Central to the project is the implementation of an e-learning resource aimed at promoting feeding practices among staff and healthy dietary behaviours for children aged 0-3 years in ECEC. Implementing new interventions often presents challenges. This study explores ECEC staff views and experiences with selected strategies for implementing an e-learning resource in ECEC centers in a municipality in Southern Norway.

Methods: The study is a part of the Nutrition Now study, a hybrid type 1 non-randomized controlled trial. The implementation process followed the Dynamic Integrated Evaluation Model (DIEM). Implementation strategies were selected from the Expert Recommendations for Implementing Change (ERIC) project and included identify and prepare champions, conduct educational meetings, distribute educational materials, create a learning collaborative, and remind clinicians. ECEC teachers from participating ECEC centers in the intervention municipality were recruited as champions. Brief (5-7 min minutes), semi-structured phone interviews, covering key points, were conducted with the champions 8 times, evenly distributed over six months. The interviews were analysed using qualitative thematic analysis.

Results: In total, 29 of the invited ECEC centers (53%) participated, and 260 brief interviews (88%) were conducted with champions (n = 37). An evaluation of the feedback from the champions suggests that the five selected implementation strategies were acceptable. Five main themes were developed by qualitative analysis: 1) Being a champion resembles what I already do. 2) Educational meetings are fine but take time. I prefer when peers share experiences. 3) Newsletters were helpful and reminded me, but I do not always have enough time to read. 4) Evaluations have increased my awareness, and we do them informally and formally. 5) The regular phone calls reminded me I could receive support and express my opinion.

Conclusion: This study's findings suggest that several implementation strategies are acceptable for stakeholders in an ECEC e-learning healthy eating intervention. However, time constraints among champions may hinder deep engagement. These results provide valuable insights into how the selected implementation strategies may function in practice and how they are perceived and experienced by the ECECs staff.

Trial registration: Trial registration on June 6, 2022: ISRCTN10694967 .

Background: Obesity is a multifactorial disease reaching pandemic proportions with increasing healthcare costs, advocating the development of better prevention and treatment strategies. Previous research indicates that the gut microbiome plays an important role in metabolic, hormonal, and neuronal cross-talk underlying eating behavior. We therefore aim to examine the effects of prebiotic and neurocognitive behavioral interventions on food decision-making and to assay the underlying mechanisms in a Randomized Controlled Trial (RCT).

Method: This study uses a parallel arm RCT design with a 26-week intervention period. We plan to enroll 90 participants (male/diverse/female) living with overweight or obesity, defined as either a Waist-to-Hip Ratio (WHR) ≥ 0.9 (male)/0.85 (diverse, female) or a Body Mass Index (BMI) ≥ 25 kg/m². Key inclusion criteria are 18-60 years of age and exclusion criteria are type 2 diabetes, psychiatric disease, and Magnetic Resonance Imaging (MRI) contraindications. The interventions comprise either a daily supplementary intake of 30 g soluble fiber (inulin), or weekly neurocognitive behavioral group sessions, compared to placebo (equicaloric maltodextrin). At baseline and follow-up, food decision-making is assessed utilizing task-based MRI. Secondary outcome measures include structural MRI, eating habits, lifestyle factors, personality traits, and mood. Further, we obtain fecal and blood samples to investigate gut microbiome composition and related metabolites.

Discussion: This study relies on expanding research suggesting that dietary prebiotics could improve gut microbiome composition, leading to beneficial effects on gut-brain signaling and higher-order cognitive functions. In parallel, neurocognitive behavioral interventions have been proposed to improve unhealthy eating habits and metabolic status. However, causal evidence on how these "bottom-up" and "top-down" processes affect food decision-making and neuronal correlates in humans is still scarce. In addition, microbiome, and gut-brain-axis-related mediating mechanisms remain unclear. The present study proposes a comprehensive approach to assess the effects of these gut-brain-related processes influencing food decision-making in overweight and obesity.

Trial registration: ClinicalTrials.gov NCT05353504. Retrospectively registered on 29 April 2022.

Background: Childhood overweight and obesity are significant global public health challenges that affect approximately 340 million children worldwide. In Georgia, the prevalence of childhood obesity is alarming, with approximately 28% of 7-year-old children classified as overweight or obese in 2019. This study aimed to investigate the key factors associated with overweight and obesity among school-age children in Georgia.

Methods: Data from the Childhood Obesity Surveillance Initiative Survey (COSI), which was conducted in 2022, was analyzed. The study involved 3,334 children from 245 schools across the region. Anthropometric measurements and a structured questionnaire were utilized to evaluate body weight, dietary behaviors, physical activity behaviors, parental education, household socioeconomic status, and body mass index (BMI).

Results: Among second-grade school children in Georgia, 17.2% were overweight and 11.0% were obese, with higher percentages of boys (30.0%) than girls (26.3%). The prevalence of overweight/obesity was greater in urban-dwelling children (30.3%) than in rural children (23.6%). Significant associations were found between BMI and living area (p < 0.001), playing outside (p = 0.01), passive modes of transportation (e.g., cars) for school travel (p < 0.05), parental education (p = 0.03) and parental body weight (p < 0.05). However, no significant differences were observed in the prevalence of various dietary behaviors or screen time between normal-weight and overweight/obese children.

Conclusions: This study revealed significant associations between body weight status and certain demographic and lifestyle factors, highlighting the critical role of promoting physical activity, encouraging active transportation (e.g., walking or cycling to school) and raising parental awareness to address childhood overweight and obesity. Future interventions should prioritize creating a supportive environment for healthy behaviors and implementing early screening measures to prevent potential complications and improve overall health outcomes in children.

Background: Bisphenol A (BPA) is one of the chemical compounds used in food packaging, so it can migrate from the packaging into food. Also, environmental pollution of this compound is high due to its high use. Therefore, it may enter food chains through the environment. Aflatoxin M1 (AFM1) is one of the common mycotoxins in milk. Its presence has been reported worldwide. Infant formula is an alternative to human milk. The main ingredient of this product is cow's milk.

Aims: This study aimed to investigate the levels and risk assessment of BPA and aflatoxin M1 in infant formula.

Methods: Samples were purchased from 7 leading brands of infant formula in pharmacies. The samples were extracted according to common protocols and then injected into HPLC and analyzed with a fluorescence detector for both contaminants.

Results: BPA wasn't detected in infant formula samples, but the presence of AFM1was confirmed in 11% of the samples. Of course, there is no risk in this regard with the risk assessment.

Conclusion: Infant formula samples are not of concern for infants in terms of BPA and aflatoxin M1. However, continuous monitoring is recommended for this product.

Background: Undernutrition in children under two years is a persistent challenge in Tanzania. This study investigates demographic, maternal, and child-related factors associated with stunting, wasting, and underweight coexistence.

Methods: Secondary data from 2,158 children aged 0-23 months in the 2022 Tanzania Demographic and Health Survey (TDHS) were analyzed. Risk factors assessed included child age, birth weight, size at birth, birth order, and maternal education. Multinomial regression analysis was conducted to determine associations.

Results: The risk of coexisting undernutrition was significantly higher among children aged 12-17 months (RRR = 8.297, 95% CI = 1.768-38.931, p = 0.007) and 18-23 months (RRR = 12.860, 95% CI = 2.661-62.152, p = 0.001). Protective factors included birth weight < 2,501 g (RRR = 0.211, 95% CI = 0.056-0.783, p = 0.02), average size at birth (RRR = 0.262, 95% CI = 0.076-0.908, p = 0.035), and higher birth order (2nd-4th: RRR = 0.372, p = 0.023; 5th: RRR = 0.340, p = 0.048). Maternal education emerged as a significant risk factor (RRR = 1.327, 95% CI = 1.128-6.841, p = 0.02).

Conclusion: This study highlights critical risk factors, including maternal education, child age, and birth characteristics, for the coexistence of stunting, wasting, and underweight. Interventions should target the 12-23-month age group and address maternal education to eradicate child malnutrition in Tanzania.

Background: Increased levels of inflammation in cancer patients and survivors can make them more prone to muscle wasting and sarcopenia. Diet can be an appropriate treatment for alleviating patient complications. Therefore, this study was performed to determine the association between sarcopenia and its components with the dietary inflammatory index (DII) among breast cancer survivors.

Methods: A total of 223 female breast cancer survivors were included in this research at the Cancer Prevention Research Center of Seyyed Al-Shohada Hospital and the Iranian Cancer Control Charity Institute (MACSA). Forty-three items of dietary inflammatory index (DII) were extracted from the Food Frequency Questionnaire. Sarcopenia detection was performed according to the Asian criteria. The linear and binary logistic regression was used to assess the association between sarcopenia and its components with DII.

Results: Participants in the highest DII quartile had significantly elevated risk of impaired hand grip strength and calf circumference in both crude and adjusted models. Moreover, individuals consuming a more pro-inflammatory diet displayed a greater risk of abnormal appendicular skeletal muscle index in the crude model. After controlling for potential confounders, participants in the top quartile of DII had a 2.992-fold greater risk of possible sarcopenia than those in the bottom quartile (P value = 0.035). In addition, a decreasing linear trend was observed between higher DII score and 0.059 and 0.349- units lower in appendicular skeletal muscle mass index and hand grip strength variables in the crude Model (P-value < 0.05).

Conclusion: Diets with more pro-inflammatory features might be associated with increased risk of possible sarcopenia, as well as its components especially muscle mass and strength in women recovering from breast cancer.

The recent economic recession has reportedly worsened food insecurity in Sri Lanka. We assessed food insecurity and its impact on the growth of children aged 6-59 months through a community-based, descriptive, cross-sectional study conducted in 2022. Food insecurity was measured using the Household Food Insecurity Access Scale, and anthropometric measurements (weight, length/height) were taken using standard techniques. Weight faltering was defined as inadequate or no weight gain (flattening) or a drop in weight gain, based on the trajectory of the weight curve over two points six months apart. Additionally, food insecurity, stunting, and wasting during crisis were compared with pre-crisis data. The study included 832 children, with half of the households experiencing moderate to severe food insecurity. One-fifth of the children showed growth faltering during the crisis, and 8.9% of those with growth faltering crossed one centile line (0.67 SD). Among children facing food insecurity, the rate of growth faltering had doubled, with the residential sector (i.e., estate) tripling the risk of weight faltering. The rates of food insecurity and growth issues were notably higher during the crisis compared to pre-crisis data. This study highlights the worsening food insecurity and its significant impact on growth faltering in children under five during the 2022 economic recession.

Background and aim: Probiotics play an important role in the control and treatment of non-alcoholic fatty liver disease (NAFLD). Kefir drink is a fermented beverage and has indicated some beneficial health effects. The aim of this study was to evaluate the effects of kefir drink on liver aminotransferases, anthropometric indices, glycemic index, lipid profile, blood pressure (BP), high sensitivity C-reactive protein, and malondialdehyde in patients with NAFLD.

Methods: In an 8-week randomized clinical trial, 80 patients with NAFLD were randomized into two groups of 40. After a 2-week run-in period, the groups received a dietary plan and dietary plan plus a cup of kefir drink twice a day (500 cc/d), respectively. Also, demographic, anthropometric, laboratory, BP, dietary intake, and physical activity assessments were analyzed before and after the intervention.

Results: At last, seventy-two participants completed the study. No significant difference in changes in BP, anthropometric indices, and laboratory data (P > 0.05) except HDL-C (P = 0.02) and fat-free mass (P < 0.001) was observed between the two study groups.

Conclusion: Based on the results, Drinking 500 cc/d kefir beverage had no significant effect on liver aminotransferases and metabolic indicators, except for HDL-C and fat-free mass in patients with NAFLD.

Trial registration: IRCT20170916036204N6 (2018/08/03).

Background: The pandemic of coronavirus disease-19 (COVID-19) has a profound influence on the health of the population. This study aimed to assess the weight changes and its relation to the dietary habits and physical activity among adult Egyptian population during the second wave of COVID-19 pandemic.

Materials and methods: This cross-sectional study was conducted using anonymous online questionnaire. The questionnaire was distributed across Egypt via community-based networks, social and institutional emailing lists, and professional organizations to collect data on sociodemographic, clinical history, dietary and lifestyle habits, physical activity, anthropometric measurements, and stressing factors.

Results: The study participants (n = 1000) had a median (interquartile range) age of 34.0 (23.0-40.0) years, with 18.7% males, 96.6% having university or postgraduate education. Among them, 69.1% reported weight gain, 21.3% no change, and 9.6% weight loss. Weight loss was predicted by following COVID-19 pandemic reports daily [adjusted odds ratio (AOR) = 0.50 (95% CI, 0.27-0.93), p = 0.03], monthly income change [AOR = 2.52 (95% CI, 1.51-4.22), p < 0.001], starting antidepressants [AOR = 3.57 (95% CI, 1.08-11.76), p = 0.03], and increase in social media use [AOR = 1.81 (95% CI, 1.05-3.13), p = 0.03]. Weight gain was predicted by starting a diet during the second wave of COVID-19 pandemic [AOR = 1.57 (95% CI, 1.11-2.21), p = 0.01], physical activity during the second wave of COVID-19 pandemic [AOR = 0.49 (95% CI, 0.35-0.69), p < 0.001], and unhealthy food intake [AOR = 0.40 (95% CI, 0.28-0.57), p < 0.001] CONCLUSIONS: More intervention programs aiming to improve dietary habits and increase physical activity should be rapidly implemented to reduce the consequences of the pandemic on the Egyptians to keep healthy weight.