Dietetics, Volume 3, Issue 3 (September 2024) – 11 articles

This study aimed to develop the ‘Healthy Eating Index for Older People’ (the index), based on New Zealand dietary guidelines, and measures the validity and reproducibility of a food frequency questionnaire (FFQ) to derive the index scores in older adults. In Auckland, New Zealand, participants (community-dwelling adults aged 65–74 years, [n = 273, 36% male]) completed a 109-item FFQ administered one month apart (FFQ1, FFQ2), with a four-day food record (4-DFR) collected in between. Adherence to the guidelines was scored using the index, comprising a total score (maximum = 100) and two sub-scores: adequacy (maximum = 60) and moderation (maximum = 40). A comparison of FFQ1 and FFQ2 determined reproducibility, and FFQ1 and 4-DFR determined validity. Higher index scores (from FFQ1) were associated with higher intakes of protein, fibre, vitamins and minerals and lower intakes of alcohol and saturated fats (nutrients from 4-DFR) after adjusting for age and sex (all p < 0.001). Total index and sub-indices correlation coefficients ranged from 0.42 to 0.77 (all p < 0.001); weighted kappa values ranged from 0.35 to 0.67; and mean differences were all <10% of FFQ1 for reproducibility and validity. The Bland–Altman analysis showed no bias for the total index score for reproducibility and validity. However, with validation, the sub-index scores became less reliable as food intake increased (p < 0.05). The index applied to the FFQ demonstrated good construct validity and reproducibility. Relative and absolute validity were acceptable, though caution is required when using the absolute sub-index scores. The index is suitable for measuring total diet quality in older New Zealand adults. Full article

Sustainability is an important aspect of all areas of life, including nutrition and dietetic practice. The Sustainability Development Goals are 17 goals set by the United Nations as a guideline on how the global population can be more sustainable moving into the future. Opportunities are available for nutrition and dietetic professionals to be involved in making changes and supporting the SDGs. Yet, there are limited studies exploring Irish dietitians’ perceptions and experiences of sustainability. An online survey consisting of 16 questions exploring familiarity with, as well as personal and professional perceptions of, sustainability was circulated to Irish dietitians by the Irish Nutrition and Dietetic Institute and promoted online through social media platforms (Twitter and Facebook). The survey was open for four weeks (18 October–16 November 2021) and was housed in Qualtrics and analysed using SPSS. A total of 102 Irish dietitians completed the survey (n = 100, 98% female). Most (96.1%) reported that sustainability is very important or important and 81.4% felt that it was very important or important in dietetic practice. Overall, participants were more familiar with environmental sustainability, e.g., widespread availability (79.4%), climate change (89.2%) and some concepts under economic, social, and general sustainability. They were most unfamiliar with agricultural sustainability concepts, e.g., use of food and agricultural policies (36.2% were familiar). This study illustrates the importance that Irish dietitians place on sustainability, aspects they feel confident in and areas for future education and support. Full article

(1) Background: Patient education materials are frequently used by dietitians to support counselling and reinforce key concepts. No studies have examined the quality of dietetic patient education materials for diabetes and common gastrointestinal conditions. (2) Methods: Materials relating to the dietary management of diabetes and gastrointestinal conditions (IBD, IBS, lactose intolerance, coeliac disease and low-FODMAP diets) were evaluated by three dietitian raters. Readability was assessed, and materials with a reading grade level ≤ 7 were considered readable. The PEMAT was used to assess understandability and actionability. Clarity was determined using the CDCCCI. (3) Results: Overall readability scores were satisfactory with a median grade level of 6 (IQR: 5–8). Readability scores did not differ between material types (p = 0.09). The health literacy demand of materials was suboptimal, with a mean understandability score of 65.9 ± 15.1% and an actionability score 49.6% ± 20.8%. Both scores fell below the benchmark of ≥70%. These did not differ between material types (p = 0.06 and p = 0.15, respectively). Clarity scores were below the benchmark of ≥90% (mean score 64.2 ± 14.8%). Only 6.6% of materials achieved a score of ≥90. (4) Conclusions: Improvements to the health literacy demand and clarity of dietetic patient education materials are required. Areas for future improvement have been identified. Full article

Recently, there has been increased scientific and clinical interest in the potential harms associated with ultra-processed foods, including poor mental health, aggression, and antisocial behavior. Research spanning epidemiology, mechanistic pre-clinical work, addiction science, microbiome and exposome science, and human intervention trials has underscored that nutrition is of relevance along the criminal justice continuum. As such, the emerging dietetics research is salient to the thousands of international psychologists and allied mental health professionals that are engaged in justice work, including forensics, prevention, and intervention. In addition, relationships between nutrition and behavior relate to “food crime”, an emergent area unifying criminal justice researchers with psychology, public health, and other interdisciplinary sectors. Food crime scrutinizes the vast harms, including non-communicable diseases and adverse behavioral outcomes, as influenced by the distribution of addictive ultra-processed food products. Here, we examine the emergent research, including biophysiological mechanisms, and evidence indicating that dietary patterns/components intersect with psychosocial vulnerabilities linked with risks of antisocial behavior and justice involvement. Viewed through a prevention lens, the study of nutrition and aggressive behavior should be prioritized, especially if the outcomes emerge as externalities of the global consumption of ultra-processed food. In the context of criminal justice and behavior, there is a need for forensic examination of how industry influence and power structures can undermine matters of food justice. Full article

While homocysteine is produced as an intermediate metabolite during methionine metabolism, increased blood homocysteine levels are associated with various diseases. In a previous cross-sectional study, we reported a significant negative association between the serum concentrations of homocysteine in 227 young women and their dietary fiber intake. In the present study, we examined the relationship between dietary fiber intake from food sources and serum levels of homocysteine and its metabolites. Homocysteine and its metabolites 5-methyltetrahydrofolate (5MTHF), cystathionine, glycine, methionine, and S-adenosyl-methionine were measured using LC-MS/MS. The soluble, insoluble, and total fiber intake from fruits and mushrooms was significantly inversely correlated with the homocysteine concentrations. Furthermore, the soluble, insoluble, and total fiber intake from fruits was significantly positively associated with the serum 5MTHF concentrations, while the fiber intake from mushrooms was positively correlated with the cystathionine concentration and negatively correlated with the methionine and glycine concentrations. These results suggest that ingesting dietary fiber in the form of fruits and mushrooms maintains a low concentration of homocysteine by activating two different homocysteine-scavenging metabolic pathways. Full article

Neurological disorders are increasing globally due to their complex nature, influenced by genetics and environmental factors. Effective treatments remain limited, and early diagnosis is challenging. Recent evidence indicates that metabolic activities play a crucial role in the onset of neural defects. Molecular changes offer new diagnostic markers and dietary targets for disease management. Diets such as MIND, DASH, omega-3 fatty acids, and polyphenols show promise in protecting brain metabolism through their anti-inflammatory properties. Personalized dietary interventions could mitigate neurodegenerative diseases. This review highlights the effects of various dietary interventions, including calorie restriction, fasting, and ketogenic diets, on neurological disorders. Additionally, it emphasizes the nutritional impacts on immunomodulation and the underlying mechanisms, including the influence of gut microbiota on brain function. Dietary interventions could serve as adjunctive therapies in disease management. Full article

Mindful eating is the direct application of mindfulness to eating related issues. This approach has been developed to reduce suffering due to food and body image, to improve the capacity to follow the stimuli of hunger and satiety and to minimize the use of food as psychological compensation. The aim of this review is to analyze the results of clinical trials adopting a mindful eating approach to address cardiometabolic risk factors partly related to dysfunctional eating behavior. The selection of literature included articles published until 31 December 2023. The inclusion criteria were controlled randomized clinical trials, an intervention duration ≥4 weeks and indication of a clinical outcome. Fourteen studies were included. The sample sizes ranged from 18 to 194 participants, and the interventions lasted between 4 and 24 weeks. Their effects on body weight, BMI, waist circumference, serum glucose, glycated hemoglobin and C-reactive protein were assessed using a meta-analysis. Mindful eating was as effective as other recognized types of interventions regarding the clinical outcomes examined, but in many cases, they were more effective in terms of factors which may lead to improvement over a longer period. In particular, our analysis showed that mindful eating effectively reduced suffering related to food and body image. Full article

Neurocognitive deficits in children could be irreversible and detrimental to the overall wellbeing of children. Typically, children with this illness live lives below their mental and intellectual potential. The aim of this paper was to review primary evidence on the association between inflammatory biomarkers on neurocognition in children. Electronic databases such as Scopus, Cochrane Library, and PubMed were systematically searched to include all published data from 2000 to October 2023. The keywords included serum biomarker, cognition, executive function, intellectual ability, brain-derived neurotrophic factor, neurocognitive deficits, tau proteins, and children. A total of 8512 journal publications were obtained, but after the removal of duplicates, commentaries, and review papers, 9 papers were accepted for review. C-reactive protein, brain-derived neurotrophic factor (BDNF) tumor necrosis factor alpha (TNF-α), fibrinogen, plasma leptin, soluble tumor necrosis factor receptor 1 (sTNFR1), and copper were associated with neurocognition in the subjects. This review revealed that there is no research published in sub-Saharan Africa and most of the sample sizes in the studies were small. Full article

Caries is very common in the elderly as there are several aggravating factors, such as a decrease of the ability to self-care and, by extension, insufficient oral hygiene, a carious diet, limited exposure to fluoride, xerostomia, gingival recession, and limited access to dental care. This study aimed to review the dietary risk factors for root caries prevalence in older adults, from socially active people to frail patients. A comprehensive search strategy was used to select studies from PubMed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. Root caries is prevalent in the elderly due to gingival recession and root exposure to the oral environment. Dietary risk factors significantly affect root caries prevalence in older adults, including a high intake of sugars and an alteration of their composition preference in this age group. Caries risk appears more significant in frail, institutionalized patients fed softer food or supplements. Full article

Declines in the mineral content of food have been reported in several countries. This study monitored reported changes in the mineral content of plant foods in Australian food composition databases between 1991 and 2022. Commonly consumed plant foods (n = 130), grouped as fruit, vegetables, legumes, grains, and nuts in raw unprocessed form, were matched between three reference databases from 1991, 2010, and 2022. Absolute and percentage differences in mineral content (iron, zinc, calcium, and magnesium) were calculated. During this 30-year period, 62 matched foods had updated mineral content. Iron content decreased significantly for fruit (48%) and vegetables (20%), although absolute differences were small (0.09–0.14 mg/100 g). Zinc content declined by 15% for fruit (absolute difference 0.03 mg/100 g), but no differences were observed for calcium and magnesium content. Potential reasons for any reported differences could not be explored using food composition data alone, due to biological, agricultural, and/or analytical factors. Nutritionally, these small differences are unlikely to have a major impact on the population’s nutritional status, although efforts to improve fruit and vegetable consumption are encouraged to meet recommendations. Full article

Coenzyme Q₁₀ (CoQ₁₀) is an essential compound for energy production in the mitochondria and the antioxidation of lipid-soluble substances in cells. As it can be biosynthesized in cells, CoQ₁₀ is not an essential nutrient. However, its intake through meals contributes to the maintenance of CoQ₁₀ levels in the body. Therefore, understanding the effects of daily diet on serum CoQ₁₀ levels is crucial. This study investigated the effect of a two-week diet without meat or poultry, which are rich in CoQ₁₀ content, on serum CoQ₁₀ levels of 22 young women aged 20–21 years. Upon restricting the intake of meat and poultry, the participants’ average daily intake of CoQ₁₀ from meals decreased from 2.1 ± 0.6 to 1.1 ± 0.5 mg/day. Simultaneously, the average serum reduced, oxidized, and total CoQ₁₀ levels decreased by 14%, 31%, and 16%, respectively, after the two-week dietary intervention, whereas the reduced serum CoQ₁₀ ratio increased significantly. These results suggest that meat and poultry are significant sources of CoQ₁₀ in the diet. Dietary habits affect serum CoQ₁₀ levels; however, further research is required to determine whether people who follow long-term diets with lower serum CoQ₁₀ levels, such as a healthy reference diet proposed by the EAT-Lancet Commission in addition to vegetarian and vegan diets, need CoQ₁₀ supplementation to maintain health and achieve healthy longevity. Full article