Grains are the main energy and carbohydrate sources for human nutrition globally. Governmental and non-governmental authorities recommend whole grains as a healthy food choice. The role of ...contaminants in (whole) grains and how to mitigate any potential risk following their consumption has not been reported. With this narrative review, we shed light on the potential human health risk from contaminants in whole grains and elaborate strategies to mitigate such risk. We found that grains represent a significant source of food-borne contaminants, the main ones being; mycotoxins including (A) aflatoxin B1; (B) ochratoxin A; (C) fumonisin B1; (D) deoxynivalenol; (E) zearalenone; toxic metals like arsenic, cadmium and lead; as well as process contaminants such as acrylamide. Whole grains usually contain more contaminants than refined products. However, whole grains also provide more nutrients that may reduce the impact of these contaminants. Strict regulatory thresholds aim to minimize the risk of contaminants to public health. The consumer can further impact on the mitigation of any risk by eating a healthy diet filled with nutrient-dense foods such as whole grains and probiotics. The risk posed by contaminants from whole grains do not outweigh the known nutritional benefits of whole grain consumption.
Currently, there is considerable emphasis on the relationship between dietary sugar consumption and various health outcomes, with some countries and regions implementing national sugar reduction ...campaigns. This has resulted in significant efforts to quantify dietary sugar intakes, to agree on terms to describe dietary sugars and to establish associated recommendations. However, this information is infrequently collated on a global basis and in a regularised manner. The present review provides context regarding sugar definitions and recommendations. It provides a global review of the available data regarding dietary sugar intake, considering forms such as total, free and added sugars. A comprehensive breakdown of intakes is provided by age group, country and sugar form. This analysis shows that free sugar intakes as a percentage of total energy (%E) are the highest for children and adolescents (12–14%E) and the lowest for older adults (8%E). This trend across lifecycle stages has also been observed for added sugars. The available data also suggest that, while some reductions in sugar intake are observed in a few individual studies, overall intakes of free/added sugars remain above recommendations. However, any wider conclusions are hampered by a lack of detailed high-quality data on sugar intake, especially in developing countries. Furthermore, there is a need for harmonisation of terms describing sugars (ideally driven by public health objectives) and for collaborative efforts to ensure that the most up-to-date food composition data are used to underpin recommendations and any estimates of intake or modelling scenarios.
The Zika virus is a positive sense, single-stranded RNA arbovirus in the Flaviviridae family, genus Flavivirus. This virus was initially isolated in Africa and is transmitted to nonhuman primates and ...humans by mosquitoes. Initial reports describe sporadic mild viral infection with fever, arthralgia, myalgia and conjunctivitis in Africa and Asia. However, its geographic distribution has significantly increased, and it has caused large outbreaks in the Yap Islands in 2007, in French Polynesia in 2013 and in Brazil in 2015. Multiple cases of Guillain-Barre´ syndrome occurred in French Polynesia and Columbia during outbreaks, and infections in pregnant women in Brazil have been associated with microcephaly and fetal loss. The viremic phase in humans is short, and diagnosis usually depends on positive immunoglobulin M titers with serum neutralization tests for confirmation. Treatment is directed at symptoms; there are no antiviral drugs available. Transmission can also occur through sexual contact with infected men and through blood transfusion. Prevention is important in women and includes limiting travel to endemic areas when possible, control of mosquito populations and condom use when appropriate. The Centers for Disease Control and Prevention is actively involved in tracking these infections and providing up-to-date information.
Globally, diet quality is poor, with populations failing to achieve national dietary guidelines. Such failure has been consistently linked with malnutrition and poorer health outcomes. In addition to ...the impact of diet on health outcomes, it is now accepted that what we eat, and the resulting food system, has significant environmental or planetary health impacts. Changes are required to our food systems to reduce these impacts and mitigate the impact of climate change on our food supply. Given the complexity of the interactions between climate change, food and health, and the different actors and drivers that influence these, a systems-thinking approach to capture such complexity is essential. Such an approach will help address the challenges set by the UN 2030 Agenda for sustainable development in the form of the sustainable development goals (SDG). Progress against SDG has been challenging, with an ultimate target of 2030. While the scientific uncertainties regarding diet and public and planetary health need to be addressed, equal attention needs to be paid to the structures and systems, as there is a need for multi-level, coherent and sustained structural interventions and policies across the full food system/supply chain to effect behaviour change. Such systems-level change must always keep nutritional status, including impact on micronutrient status, in mind. However, benefits to both population and environmental health could be expected from achieving dietary behaviour change towards more sustainable diets.
An increasing number of food-based recommendations promote a plant-based diet to address health concerns and environmental sustainability in global food systems. As the main sources of iodine in many ...countries are fish, eggs and dairy products, it is unclear whether plant-based diets, such as the EAT-Lancet reference diet, would provide sufficient iodine. This is important as iodine, through the thyroid hormones, is required for growth and brain development; adequate iodine intake is especially important before, and during, pregnancy. In this narrative review, we evaluated the current literature and estimated iodine provision from the EAT-Lancet reference diet. There is evidence that those following a strict plant-based diet, such as vegans, cannot reach the recommended iodine intake from food alone and are reliant on iodine supplements. Using the EAT-Lancet reference diet intake recommendations in combination with iodine values from UK food tables, we calculated that the diet would provide 128 μg/d (85 % of the adult recommendation of 150 μg/d and 51–64 % of the pregnancy recommendation of 200–250 μg/d). However, if milk is replaced with unfortified plant-based alternatives, total iodine provision would be just 54 μg/d (34 % and 22–27 % of the recommendations for adults and pregnancy, respectively). Plant-based dietary recommendations might place consumers at risk of iodine deficiency in countries without a fortification programme and where animal products provide the majority of iodine intake, such as the UK and Norway. It is essential that those following a predominantly plant-based diet are given appropriate dietary advice to ensure adequate iodine intake.
To identify the main foods determining saturated fatty acid (SFA) intakes and model the impact of food exchanges to improve compliance with dietary fat recommendations in Irish children.
Estimated ...food and nutrient intakes were obtained from a cross-sectional study, the National Children's Food Survey II. Participants were categorised into low, medium, and high SFA consumers, and the contribution of food categories to SFA intakes were compared. A food-exchange model was developed, whereby a selected range of high SFA foods were exchanged with lower SFA or unsaturated fat alternatives.
Participants were randomly selected from primary schools throughout the Republic of Ireland.
A representative sample of 600 Irish children (5-12 years).
The main determinants of low and high SFA consumers were milk, cheese, and butter. These foods, including snack foods, and meat and meat products, were considered
xchangeable foods within the model. Compared with baseline data, modelled intakes for total fat, SFA, monounsaturated fatty acids (MUFA) and
-fat presented decreases of 3.2, 2.7, 1.6 and <0.1% of total energy (% TE), respectively. Polyunsaturated fatty acid (PUFA), omega 6, omega 3 and alpha-linolenic acid showed increases of 1.0, 0.8, 0.2 and 0.1% TE, respectively. Compliance with total fat, MUFA and
-fat recommendations remained adequate (100%). Adherence to SFA and PUFA recommendations improved from 18 to 63%, and 80 to 100%, respectively.
The food-exchange model decreased SFA intakes and increased PUFA intakes, suggesting modest dietary changes to children's diets can effectively improve their overall dietary fat profile.
Increased whole-grain (WG) consumption reduces the risk of CVD, type 2 diabetes and some cancers, is related to reduced body weight and weight gain and is related to improved intestinal health. ...Definitions of 'WG' and 'WG food' are proposed and used in some countries but are not consistent. Many countries promote WG consumption, but the emphasis given and the messages used vary. We surveyed dietary recommendations of fifty-three countries for mentions of WG to assess the extent, rationale and diversity in emphasis and wording of any recommendations. If present, recommendations were classified as either 'primary', where the recommendation was specific for WG, or 'secondary', where recommendations were made in order to achieve another (primary) target, most often dietary fibre intake. In total, 127 organisations were screened, including government, non-governmental organisations, charities and professional bodies, the WHO and European Food Safety Authority, of which forty-nine including WHO provide a WG intake recommendation. Recommendations ranged from 'specific' with specified target amounts (e.g. x g WG/d), 'semi-quantitative' where intake was linked to intake of cereal/carbohydrate foods with proportions of WG suggested (e.g. x servings of cereals of which y servings should be WG) to 'non-specific' based on 'eating more' WG or 'choosing WG where possible'. This lack of a harmonised message may result in confusion for the consumer, lessen the impact of public health messages and pose barriers to trade in the food industry. A science-based consensus or expert opinion on WG recommendations is needed, with a global reach to guide public health decision making and increase WG consumption globally.
Adult women require routine care for the acute and chronic health problems found in both sexes, and they require specialized care for women's health problems, including disease prevention, disease ...screening, and disease management. Internists should direct primary care and participate in specialized care and to the extent possible follow guidelines published by various professional organizations. They should understand the use of ultrasound in breast cancer screening, the management of pregnancy, and other gynecologic problems, including vaginal bleeding, pelvic pain, and investigation for pelvic malignancy. Finally, all management decisions need discussions on the potential benefit or harm in each step of a woman's care with an emphasis on personal preferences.
The global population is rapidly ageing. Adequate nutritional status can play a key role in preventing or delaying the progression of age-related diseases. The aim of this study was to estimate the ...usual intake of energy, macronutrients, dietary fibre and salt in order to determine compliance with recommendations and to identify the sources of these nutrients in older adults (≥65 years) in Ireland. This study is based on data from the cohort of older adults aged ≥65 years (
= 226) in the Irish National Adult Nutrition Survey (NANS) (2008-2010) which estimated food and nutrient intakes in a representative sample of adults 18-90 years using a 4 day weighed food record. This study found that while intakes of macronutrients are generally sufficient in this population group, older adults in Ireland have high intakes of total fat, saturated fat, sugar and salt and low intakes of dietary fibre. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt) to support successful ageing of our population.
Cereals and cereal products have a long history of use by humans. Recently, there have been some discussions regarding level of processing as a descriptor to define food products, including ...cereal-based foods. This has led to a somewhat emotional debate on food processing. Given the widespread inclusion of cereals in the diet, this review highlights the history of cereal processing as well as their consumption by humans. It provides an evidence-based discussion on their production, contribution to human nutrition, benefits and disadvantages. The present review illustrates the impact of processing on nutrients, as well as non-nutrients specifically in bread and ready-to-eat breakfast cereals (RTEC), two cereal-based foods which are widely consumed and integral parts of food-based dietary guidelines globally. As a category, most cereals must be processed in some way to enable consumption by humans as we are not equipped to survive exclusively on raw grains. Even thousands of years ago, the processing of cereals was a common practice by humans, turning raw grains into palatable, safe and nutritious foods. Modern processes for cereal-based products are efficient in providing safe and good-quality products to satisfy population needs, as well as helping to meet consumer expectations by providing a range of foods that allows for a varied and balanced diet. Today, RTEC and bread make significant contributions to dietary energy and nutrient requirements and underpin food-based dietary guidance globally. They have been positively linked with intake of dietary fibre, vitamins and minerals, especially when consumed as whole grain.
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