Introduction: Adequate nutrition is one of the pillars of public health. Before developing and implementing effective intervention programmes to improve nutrition at the population level, it is ...important to know the nutritional situation of the target group. Assessment of energy and nutrient intake: The estimation of nutrient intake from food consumption requires reliable data on food composition. These data are also the fundamentals of food-based dietary guidelines for healthy nutrition, containing the necessary information on food sources for different nutrients. Furthermore, food composition tables can provide information on chemical forms of nutrients and the presence and amounts of interacting components, and thus provide information on their bioavailability. For some nutrients such as vitamin A, vitamin E and niacin, the concept of equivalence has been introduced to account for differences in the availability and biological activity of different chemical forms. Non-nutritive food components: Although most food composition tables focus on energy, macro- and micronutrients, interest in non-nutritive components is increasing. Considering the beneficial effects of biologically active secondary plant cell compounds such as polyphenols and carotenoids, more data on these are needed. On the other hand, there are a number of naturally occurring or ‘man-made’ non-nutritive substances with negative effects, and to control exposure, the main dietary sources must be known. Another aspect is contaminants, which could have detrimental effects on consumers’ health. Among these are agrochemicals, industrial pollutants reaching the food chain and substances formed during food preparation. A valid risk assessment requires data on exposure, and thus on the contents of contaminants in foods. However, these data are highly variable and may significantly differ even within narrowly confined regions. Current food composition databases are far from complete: The fact that composition tables generally do not provide information about the origin of substances found in food can also influence their usability. For example, the German Nutrient Data base does not discriminate between naturally occurring and added sucrose impeding the estimation of added sucrose intake that should be limited. Points of focus: Considering the increasing number of persons relying on community nutrition and catering, healthy menu lines can improve the consumers’ diets and contribute to nutrient supply. The development and implementation of appropriate guidelines also need food composition databases (FCBs) to compose meals. The ever-increasing number of new food preparations and manufactured products has resulted in a need for procedures for regularly updated data. Moreover, there is a lack of data particularly for essential trace elements such as copper, chromium or molybdenum and also vitamin K, as well as the already mentioned non-nutritive components. Limited comparability between countries is another issue. Regional differences arise especially from the use of local varieties, different soil quality or meteorological aspects. This variability is further increased with composite meals because of variation in recipes. Conclusion: Information about food composition is necessary for the assessment of diet quality and the development and application of food-based dietary guidelines, providing a useful tool for the field of public health nutrition. In this regard, more attention should be paid to the preparation, extension and maintenance of FCBs.
Global burdens of cardiovascular disease (CVD), diabetes and cancer are on the rise. Little quantitative data are available on the global impact of diet on these conditions. The objective of this ...study was to develop systematic and comparable methods to quantitatively assess the impact of suboptimal dietary habits on CVD, diabetes and cancer burdens globally and in 21 world regions.
Using a comparative risk assessment framework, we developed methods to establish for selected dietary risk factors the effect sizes of probable or convincing causal diet-disease relationships, the alternative minimum-risk exposure distributions and the exposure distributions. These inputs, together with disease-specific mortality rates, allow computation of the numbers of events attributable to each dietary factor.
Using World Health Organization and similar evidence criteria for convincing/probable causal effects, we identified 14 potential diet-disease relationships. Effect sizes and ranges of uncertainty will be derived from systematic reviews and meta-analyses of trials or high-quality observational studies. Alternative minimum-risk distributions were identified based on amounts corresponding to the lowest disease rates in populations. Optimal and alternative definitions for each exposure were established based on the data used to quantify harmful or protective effects. We developed methods for identifying and obtaining data from nationally representative surveys. A ranking scale was developed to assess survey quality and validity of dietary assessment methods. Multi-level hierarchical models will be developed to impute missing data.
These new methods will allow, for the first time, assessment of the global impact of specific dietary factors on chronic disease mortality. Such global assessment is not only possible but is also imperative for priority setting and policy making.
Background/Aim: The objective of this review was to collect data on the dietary intake of total fat and saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA), especially ...linoleic (LA), α-linolenic (ALA), eicosapentaenoic and docosahexaenoic fatty acids, in adults from various countries and to compare them with current recommendations for fat intake. Methods: Weighted mean intake data were collected from national dietary surveys, large cross-sectional studies and/or studies with focus on health and nutrition. Thereof, only studies with diet recalls, weighing records or food frequency questionnaires were considered. Results: Data from 28 countries were included, representing Africa (3), America (4), Asia (5), Australia/New Zealand (2) and Europe (14). Total fat intake ranged from 11.1 (China, Guangxi Bai Ku Yao and Han populations) to 50.7 (rural dwellers in Nigeria) percentages of total energy (%E). SFA intake varied from 3.1 (China, Guangxi Bai Ku Yao and Han populations) to 25.4%E (rural dwellers in Nigeria). Mean MUFA and PUFA intake ranged from 3.5 (China, Guangxi Bai Ku Yao and Han populations) to 22.3 (Greece), and 3.3 (India) to 11.3%E (Taiwan), respectively. The mean intake of LA and ALA was between 2.7 (India) and 7.2 (Austria), and 0.4 (France) and 1.0%E (Finland). Conclusion: With regard to recommendations for fat intake, no general advice for improvements can be given worldwide. Due to different dietary patterns, only regionally specific recommendations can be made about what would be necessary to modify and improve fat quantity and quality of the diet.
•An international study derived insights into salt intake and associated behaviours.•One third of participants were not interested in making efforts towards salt reduction.•Salt intake was ...underestimated and dietary sources were not evident to participants.•Salt reduction was viewed as healthy and important and people wanted to learn more.•These insights should be used to develop behaviour change strategies and policies.
Salt reduction is important for reducing hypertension and the risk of cardiovascular events, nevertheless worldwide salt intakes are above recommendations. Consequently strategies to reduce intake are required, however these require an understanding of salt intake behaviours to be effective. As limited information is available on this, an international study was conducted to derive knowledge on salt intake and associated behaviours in the general population. An online cohort was recruited consisting of a representative sample from Germany, Austria, United States of America, Hungary, India, China, South Africa, and Brazil (n=6987; aged 18–65years; age and gender stratified). Participants completed a comprehensive web-based questionnaire on salt intake and associated behaviours. While salt reduction was seen to be healthy and important, over one third of participants were not interested in salt reduction and the majority were unaware of recommendations. Salt intake was largely underestimated and people were unaware of the main dietary sources of salt. Participants saw themselves as mainly responsible for their salt intake, but also acknowledged the roles of others. Additionally, they wanted to learn more about why salt was bad for health and what the main sources in the diet were. As such, strategies to reduce salt intake must raise interest in engaging in salt reduction through improving understanding of intake levels and dietary sources of salt. Moreover, while some aspects of salt reduction can be globally implemented, local tailoring is required to match level of interest in salt reduction. These findings provide unique insights into issues surrounding salt reduction and should be used to develop effective salt reduction strategies and/or policies.
The D-A-CH reference value (D-A-CH arises from the initial letters of the common country identification for the countries Germany (D), Austria (A) and Switzerland (CH)) for folate equivalents had ...been set at 400 μg/d for adults in the year 2000. By that time, the prevention of cardiovascular diseases through reduction of homocysteine was considered an important target of the reference value. Since that time a number of research papers revealed that in spite of an inverse association between folate-rich diet and chronic diseases, a preventive effect of folic acid intake on cardiovascular events was not supported by randomized controlled trials, and the reduction of plasma homocysteine levels to around 10-12 μmol/l did not reduce the risk for thromboembolic and cardiovascular diseases in persons already affected by these diseases. These results together with the observation that folate intakes below 400 μg/d result in a sufficient folate status justified a review of the current literature and-consequently-a reduction of the reference value to 300 μg/d for adults. This reference value is expressed as dietary folate equivalents that take into account the difference in bioavailability between folic acid and all types of folates in food. The recommendation to take a daily supplement of 400 μg of synthetic folic acid for women who intend to get pregnant and until the end of the first trimester of pregnancy is maintained.
To compare macronutrient intakes out of home-by location-to those at home and to investigate differences in total daily intakes between individuals consuming more than half of their daily energy out ...of home and those eating only at home.
Data collected through 24-h recalls or diaries among 23 766 European adults. Participants were grouped as 'non-substantial', 'intermediate' and 'very substantial out-of-home' eaters based on energy intake out of home. Mean macronutrient intakes were estimated at home and out of home (overall, at restaurants, at work). Study/cohort-specific mean differences in total intakes between the 'very substantial out-of-home' and the 'at-home' eaters were estimated through linear regression and pooled estimates were derived.
At restaurants, men consumed 29% of their energy as fat, 15% as protein, 45% as carbohydrates and 11% as alcohol. Among women, fat contributed 33% of energy intake at restaurants, protein 16%, carbohydrates 45% and alcohol 6%. When eating at work, both sexes reported 30% of energy from fat and 55% from carbohydrates. Intakes at home were higher in fat and lower in carbohydrates and alcohol. Total daily intakes of the 'very substantial out-of-home' eaters were generally similar to those of individuals eating only at home, apart from lower carbohydrate and higher alcohol intakes among individuals eating at restaurants.
In a large population of adults from 11 European countries, eating at work was generally similar to eating at home. Alcoholic drinks were the primary contributors of higher daily energy intakes among individuals eating substantially at restaurants.
Lactic acid bacteria have been shown to stimulate the secretion of cytokines by lymphocytes and monocytes in a strain-dependent manner. Therefore, in this study, the effect of a daily intake of ...probiotic yogurt on cytokine production in young healthy women was compared with that of a conventional product. For 2 weeks each, subjects consumed 100 g, then 200 g of either a probiotic or a conventional, commercially available yogurt, both containing Lactobacillus bulgaricus and Streptococcus thermophilus with additional Lactobacillus casei DN 114 001 in the probiotic product. Cytokine production in blood culture following stimulation with phytohaemmaglutinin and lipopolysaccharide was measured using Cytometric Bead Array and enzyme-linked immunosorbent assay. Stimulated production of tumour necrosis factor-α increased significantly following consumption of conventional or probiotic yogurt (+63% and +24% compared with baseline, respectively, P < 0.001). There was also a significantly higher production of interleukin (IL)-1β in the conventional (+40%, P = 0.006) and of interferon gamma in the probiotic group (+108%, P < 0.05). IL-10 decreased following consumption of the probiotic product, but increased significantly after intake cessation (+129%, P < 0.001). No significant differences in cytokine responses between the conventional and the probiotic yogurt were observed. Both conventional and probiotic yogurt enhanced the stimulated production of pro-inflammatory cytokines.
PURPOSE: This study was carried out to investigate the effect of vitamins E and C on cognitive performance among the elderly in Iran. METHODS: About 256 elderly with mild cognitive impairment, aged ...60–75 years, received 300 mg of vitamin E plus 400 mg of vitamin C or placebo daily just for 1 year. BACKGROUND: Demographic characteristics, anthropometric variables food consumption, cognitive function by Mini-Mental State Examination (MMSE), and some of the oxidative stress biomarkers were examined. RESULTS: Antioxidant supplementation reduced malondialdehyde level (P < 0.001) and raised total antioxidant capacity (P < 0.001) and glutathione (P < 0.01). The serum 8-hydroxydeoxyguanosine remained unchanged (P < 0.4). After adjusting for the covariates effects, MMSE scores following 6- (25.88 ± 0.17) and 12-month antioxidant supplementation (26.8 ± 0.17) did not differ from control group (25.86 ± 0.18 and 26.59 ± 0.18, respectively). CONCLUSION: Despite significant improvement in most of the oxidative stress biomarkers, antioxidants’ supplementation was not observed to enhance cognitive performance. A large number of kinetic and/or dynamic factors could be suspected.
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