BMC Nutrition最新文献

{"title":"Which dietary patterns fend off nonalcoholic fatty liver disease? A systematic review of observational and interventional studies.","authors":"Farnush Bakhshimoghaddam, Daniel Baez, Neda Dolatkhah, Mahdi Sheikh, Hossein Poustchi, Azita Hekmatdoost, Stanford Dawsey, Farin Kamangar, Christian Abnet, Reza Malekzadeh, Arash Etemadi, Maryam Hashemian","doi":"10.1186/s40795-024-00961-8","DOIUrl":"10.1186/s40795-024-00961-8","url":null,"abstract":"<p><strong>Background: </strong>The global burden of non-alcoholic fatty liver disease (NAFLD) has significantly risen over the past decade. Dietary intake strongly influences its development and should be a component of any prevention and treatment plan strategy. Dietary pattern analysis enables the investigation of the overall diet and permits the consideration of interactions and cumulative effects of dietary components. The current study aimed to systematically review observational studies and intervention trials to determine the associations between various dietary patterns and NAFLD.</p><p><strong>Methods: </strong>The protocol was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, and the Cochrane Library. We included studies that reported a priori dietary pattern (i.e., diet quality scores) or a posteriori method, which identified existing eating patterns (i.e., principal component analysis) in adult participants. Two investigators conducted independent screening, extraction, and quality assessment using the Newcastle‒Ottawa or Jadad scale. A third reviewer resolved conflicts.</p><p><strong>Results: </strong>We identified 27 relevant observational and 16 interventional studies from 16 countries. A Mediterranean or DASH diet might prevent and improve NAFLD, whereas dietary patterns such as Western dietary patterns characterized by high consumption of sweets and animal foods such as red meat and fast food are positively associated with NAFLD. A low-carbohydrate diet effectively prevents and treats NAFLD; however, we need more research on the effects of a low-fat diet and the type of fats.</p><p><strong>Conclusion: </strong>Healthy dietary patterns, mainly plant-based or adjusted macronutrient distributions, such as the adoption of a low-carbohydrate diet, are linked to a reduced risk of NAFLD and could halt its progression. We proposed recommendations for future studies to fill the gap in knowledge regarding the management of NAFLD via dietary modifications.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"153"},"PeriodicalIF":1.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional status as a predictor of 30-day mortality among intensive care unit patients in sub-Saharan Africa: a prospective cohort study.","authors":"Semagn Mekonnen Abate, Bedru Jemal Abafita, Muhiddin Tadesse Barega, Mahlet Berhanu Estifanos, Solomon Nega, Bahru Mantefardo, Abinet Meno","doi":"10.1186/s40795-024-00964-5","DOIUrl":"10.1186/s40795-024-00964-5","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a major public health issue, causing significant mortality and morbidity, especially in developing nations. However, the magnitude and its impact on clinical outcomes in Intensive Care Unit (ICU) patients need to be investigated better in Sub-Saharan Africa, and this study was intended to address these issues.</p><p><strong>Objective: </strong>The objective of this study was to assess the effect of malnutrition on clinical outcomes among ICU patients.</p><p><strong>Method: </strong>A prospective cohort study was conducted among 436 ICU patients, 218 of whom were malnourished. After obtaining ethical approval, malnourished and well-nourished patients were followed for thirty days to examine the effects of nutritional status on clinical outcomes and its determinants. At admission, nutritional screening and evaluation were performed with Subjective Global Assessment (SGA) and Malnutrition Universal Screening Tool (MUST), and during the next thirty days, it was evaluated every seven days with SGA, MUST, and modified Nutrition Risk in Critically Ill (NUTRIC).</p><p><strong>Result: </strong>This study demonstrated that the incidence of 30-day mortality was 47.9%( 95% CI: 43.2 to 52.6). The hazards of death in patients with malnutrition increased by 40% as compared to well-nourished patients (aHR = 1.4, 95% CI: 1.33 to 2.56), and patients with diabetes mellitus had 4 times the hazards of death (aHR = 4.2, 95% CI: 2.12 to 8.28).</p><p><strong>Conclusion: </strong>Malnutrition is prevalent in adult ICU patients and has been linked to a higher 30-day mortality and a more extended ICU stay. MUST, SGA, and NUTRIC, well-validated, practical, cost-effective, and non-invasive techniques for routinely evaluating nutritional status in critically ill patients, were good predictors of mortality.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"154"},"PeriodicalIF":1.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumption of resistant potato starch produces changes in gut microbiota that correlate with improvements in abnormal bowel symptoms: a secondary analysis of a clinical trial.","authors":"Jason R Bush, Michelle J Alfa","doi":"10.1186/s40795-024-00962-7","DOIUrl":"10.1186/s40795-024-00962-7","url":null,"abstract":"<p><strong>Background: </strong>Studies have linked a lack of dietary fibre, including resistant starch (RS), to disease-associated changes in intestinal bacteria. Healthy people often report abnormal bowel symptoms (ABS), including bloating, constipation, abdominal pain, and diarrhea, however, connections between these symptoms and the gut microbiota are poorly understood. Determining correlations between ABS and taxonomic groups may provide predictive value for using prebiotics to mitigate ABS in combination with stool microbiome testing.</p><p><strong>Methods: </strong>Post hoc analysis of a three-arm randomized, double-blind, placebo-controlled clinical trial evaluating the effects of 3.5 g and 7 g resistant potato starch (RPS) doses or placebo was conducted. The study population (n = 70) were healthy adults aged 18-69 years old living in and around Guelph, ON. Participants evaluated their stools using the Bristol Stool Chart and also recorded any ABS daily. The presence of ABS was compared between treatment arms at baseline and changes in ABS were compared within treatment arms over 1- and 4-week periods. Pearson correlation analysis was used to identify significant relationships between changes in ABS and changes in bacterial taxa.</p><p><strong>Results: </strong>Abdominal pain, belching, bloating, constipation, diarrhea, gas, and feeling unwell were reported by participants at low levels at baseline. Neither RPS nor placebo had significant effects on mean ABS scores. However, we identified positive correlations between treatment-dependent changes in symptoms and changes in Granulicatella, Haemophilus, Lachnospira, Olsenella, Papillibacter, Turicibacter, unclassified Enterobacteriaceae, unclassified Fusobacteriaceae, unclassified Pasteurellaceae, and unclassified Gammaproteobacteria. We also identified negative correlations between treatment-dependent changes in symptoms and changes in Anaerotruncus, Dorea, RFN20, Victivallis, unclassified Coriobacteriaceae, and unclassified Oxalobacteraceae. These Pearson correlations were significant after correction for repeated testing. The mean relative abundance of these taxa did not change in response to treatment. Finally, macronutrient intake was unaffected by RPS or placebo treatments.</p><p><strong>Conclusion: </strong>Changes in ABS can be positively or negatively correlated with changes in specific gut microbiota, creating opportunities for personalized microbiome-targeted interventions to resolve ABS.</p><p><strong>Trial registration: </strong>The trial was registered at ClinicalTrials.gov (NCT05242913) on February 16, 2022.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"152"},"PeriodicalIF":1.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between maternal dietary diversity during pregnancy and birth outcomes: evidence from a systematic review and meta-analysis.","authors":"Amare Abera Tareke, Edom Getnet Melak, Bezawit Ketsela Mengistu, Jafar Hussen, Asressie Molla","doi":"10.1186/s40795-024-00960-9","DOIUrl":"10.1186/s40795-024-00960-9","url":null,"abstract":"<p><strong>Background: </strong>Maternal nutrition is a key factor influencing birth and offspring health outcomes in later life. Dietary diversity (DD) is a proxy for the macro/micronutrient adequacy of an individual's diet. There is inadequate comprehensive evidence regarding maternal nutrition during pregnancy, measured through DD and birth outcomes. This study aimed to provide extensive evidence on maternal DD during pregnancy and birth outcomes.</p><p><strong>Methods: </strong>A comprehensive search was performed using PubMed, HINARI, and Google Scholar databases up to January 17, 2024. Studies conducted among pregnant mothers and measuring maternal DD with an evaluation of birth outcomes (low birth weight, small for gestational age, preterm birth), in the global context without design restriction were included. The Newcastle Ottawa Scale and the Cochrane Risk of Bias tool were used to assess the risk of bias. The results are summarized in a table, and odds ratios were pooled where possible. Between-study heterogeneity was evaluated using I² statistics. Potential publication bias was assessed using a funnel plot and Egger's regression test. To explore the robustness, a leave-one-out sensitivity analysis was conducted.</p><p><strong>Results: </strong>Thirty-three studies were used to synthesize narrative evidence (low birth weight: 31, preterm birth: 9, and small for gestational age: 4). In contrast, 24 records for low birth weight, eight for preterm birth, and four for small for gestational age were used to pool the results quantitatively. Of the 31 studies, 17 reported a positive association between maternal DD and infant birth weight, 13 studies reported a neutral association (not statistically significant), and one study reported a negative association. Overall, inadequate DD increased the risk of low birth weight OR = 1.71, 95% CI; (1.24-2.18), with I² of 68.7%. No significant association was observed between maternal DD and preterm birth. Inadequate DD was significantly associated with small for gestational age (OR = 1.32, 95% CI; 1.15-1.49, and I² = 0.0%).</p><p><strong>Conclusion: </strong>Inadequate maternal DD is associated with an increased risk of low birth weight and small for gestational age but not preterm birth, underscoring the importance of promoting adequate DD during pregnancy. To address these issues, it is essential to implement and expand nutritional programs targeted at pregnant women, especially in low-resource settings, to ensure they receive diverse and adequate diets. Further research is needed to address the current limitations and to explore the long-term implications of maternal nutrition on child health. The study was prospectively registered on PROSPERO (registration number CRD42024513197). No funding was received for this study.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"151"},"PeriodicalIF":1.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving dietary diversity and food security among low-income families during financial crisis using cash transfers and mHealth: experience from two selected districts in Sri Lanka.","authors":"Millawage Supun Dilara Wijesinghe, Upeksha Gayani Karawita, Nissanka Achchi Kankanamalage Ayoma Iroshanee Nissanka, Balangoda Muhamdiramlage Indika Gunawardana, Weerasinghe Mudiyanselage Prasad Chathuranga Weerasinghe, Yakupitiyage Asanka Supun, Dilka Rashmi Peiris, Roshan Dela Bandara, Ranjith Batuwanthudawe","doi":"10.1186/s40795-024-00958-3","DOIUrl":"10.1186/s40795-024-00958-3","url":null,"abstract":"<p><strong>Background: </strong>The economic crisis in Sri Lanka worsened food insecurity, with millions facing moderate-to-severe food shortages. This study evaluates the effectiveness of cash transfers combined with mobile health education in enhancing dietary diversity and food security among Sri Lankan households during the crisis.</p><p><strong>Methods: </strong>This quasi-experimental single-group pre-post study involved 1040 eligible individuals selected through stratified random sampling from eligible households of Samurdhi beneficiaries and smallholder farmers. The intervention included a cash transfer of LKR 22,500 and weekly nutrition awareness messages via WhatsApp and SMS complemented by a one-time awareness session. Dietary diversity and food security were assessed using standard validated tools such as the Diet Quality Questionnaire and Food Security Questionnaire.</p><p><strong>Results: </strong>Food insecurity decreased significantly from 89.3% (n = 681) in the pre-test to 76.9% (n = 533) in the post-test, with a 12.4% reduction (95% CI, 8.57 to 16.24, p < 0.05). The Minimum Dietary Diversity for Women improved from 44.5 to 67.8% [23.3% increase (95% CI, 15.89 to 30.63; p < 0.05)]. The mean NCD-Protect and GDR scores increased significantly, indicating a higher adherence to global dietary recommendations, whereas the NCD-risk scores remained unchanged.</p><p><strong>Conclusions: </strong>This study demonstrated that cash transfers combined with mobile phone-based nutritional education significantly improved dietary diversity and food security among low-income families in Sri Lanka during the financial crisis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"150"},"PeriodicalIF":1.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of baseline dietary quality on the efficacy of a dietitian-guided weight reduction program.","authors":"Ying-Cheng Lin, Yen-Chien Chen, Yen-Ju Chen, Hui-Min Hsieh, Yun-Yu Chen, Wen-Hong Wang, Hui-Fen Lang, Yi-Jun Liao, Yen-Chun Peng, Teng-Yu Lee, Sheng-Shun Yang, Yu-Cheng Cheng, Shao-Ciao Luo, Han-Chung Lien","doi":"10.1186/s40795-024-00956-5","DOIUrl":"10.1186/s40795-024-00956-5","url":null,"abstract":"<p><strong>Aim: </strong>This pre-post intervention study aimed to assess the relationship between baseline dietary quality and the efficacy of a dietitian-guided weight reduction program, which has not been thoroughly documented to date.</p><p><strong>Methods: </strong>Ninety-two consecutive obese or overweight patients visiting a tertiary center clinic for weight reduction were enrolled in this study. Participants received a dietitian-guided weight reduction education program aimed at reducing daily caloric intake by 500 kcal and improving adherence to the Mediterranean diet for 3 months. Baseline dietary quality was assessed using the 14-item Taiwanese Mediterranean Diet Adherence Screener (T-MEDAS), where a higher T-MEDAS score reflects greater adherence to the Mediterranean diet. Additional covariates, including dietary behaviors, lifestyle factors, and comorbidities were also recorded. The primary outcome was the percentage of weight reduction at 3 months, analyzed using restricted cubic spline models and generalized estimating equations (GEE) to account for the correlation between weight change and the baseline T-MEDAS scores.</p><p><strong>Results: </strong>Thirty-nine participants were excluded due to major illnesses, use of anti-obesity medications, or loss to follow-up. Among the remaining 53 participants (mean age 41.2 ± 12.8 years, 56.6% female), the average weight reduction was 3.9 ± 3.3% from a baseline weight of 98.5 ± 12.8 kg. Participants who did not achieve a weight reduction of more than 5% had higher baseline T-MEDAS scores compared to those who did (5.4 ± 1.7 vs. 4.1 ± 1.8, p = 0.026). A restricted cubic spline model, adjusted for covariates including age, gender, diabetes mellitus (DM), dyslipidemia, and smoking, revealed a significant inverse relationship between higher baseline T-MEDAS scores and weight loss. After controlling for various confounders, GEE analysis demonstrated that higher baseline T-MEDAS scores were significantly associated with less weight loss (beta: -4.1, 95% CI: -5.6 to -2.6, p < 0.001).</p><p><strong>Conclusions: </strong>Higher baseline dietary quality was associated with reduced effectiveness of a dietitian-guided weight reduction program. This suggests that additional strategies may be required to improve the success of weight loss interventions in individuals with higher baseline dietary quality.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"149"},"PeriodicalIF":1.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dietary intake of iron and heart failure among American adults: data from NHANES 2009-2018.","authors":"Yajie Wang, Jie Yang, Lei Yang, Liang Zheng","doi":"10.1186/s40795-024-00957-4","DOIUrl":"10.1186/s40795-024-00957-4","url":null,"abstract":"<p><p>Patients with heart failure (HF) often experience iron deficiency. Intravenous iron supplementation has been widely used in clinical practice to facilitate the treatment of HF. However, the association between dietary iron intake and HF still needs to be elucidated. This study aimed to evaluate the impact of dietary iron intake on HF in American adults. The data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Iron dietary intake data were obtained from two 24-h dietary recall interviews. We examined baseline data and HF prevalence in different quartile groups of dietary iron intake (Q1-Q4). Two logistic regression models were established to evaluate the impact of Q4 (highest iron consumption) on the risk of HF. The study included 20,853 American adults (age ≥ 20 years). The participants with the highest iron intake (Q4) had the lowest prevalence of HF (Q1: 3.25%, Q2: 2.18%, Q3: 1.92%, Q4: 1.72%; P < 0.001). After adjusting for possible confounding factors, the highest iron intake (Q4) was significantly associated with a reduced risk of HF compared with that of Q1 (odds ratio 0.58, 95% confidence interval 0.41-0.82; P = 0.003). This association remained stable in subgroups of women, current smokers, and Hispanics other than Mexican Americans. This study revealed that the dietary intake of iron was negatively associated with HF in adults without exceeding the tolerable maximum daily intake of 45 mg/day.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"148"},"PeriodicalIF":1.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health outcomes reported by healthcare providers and clients of a community-based medically tailored meal program.","authors":"Jessica M Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S Diaz, Kaitlyn Ann Bartholomew, Julia S Evans, Maria R Johnson, Jeffrey Zhou, Deeksha Ajeya","doi":"10.1186/s40795-024-00955-6","DOIUrl":"10.1186/s40795-024-00955-6","url":null,"abstract":"<p><strong>Background: </strong>Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).</p><p><strong>Methods: </strong>Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' body mass index, systolic blood pressure, and hemoglobin A1C. These health outcomes, measured at program intake and 3-6 months later, were linked with administrative data for 1,959 clients who completed at least two months of MTM services in 2020, 2021, and 2022.</p><p><strong>Results: </strong>Clients exhibited substantial heterogeneity in demographics and health status at intake. Self-reported malnutrition risk decreased significantly over program duration (p < .001). Nearly one-third of clients with poor health reported improvement over time. Over 60% of clients with obesity experienced stable BMI. Clients with hypertension experienced significant improvements in systolic blood pressure (p < .001). Clients with diabetes and available data (n = 45) demonstrated significant reduction in hemoglobin A1C (p = .005).</p><p><strong>Conclusion: </strong>We found evidence that participation in MANNA's MTM program was associated with favorable health outcomes for clients with serious illness and nutritional risk. Community-based organizations can maximize the completeness of their data by focusing on routinely collected internal data like validated health screeners and surveys.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"147"},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data-driven development and validation of a nutrient-based score to measure nutritional balance of meals in the Philippines.","authors":"Fabio Mainardi, Richard G Côté, Nele Kristin Silber, Roko Plestina, Eldridge Ferrer, Imelda Angeles-Agdeppa","doi":"10.1186/s40795-024-00954-7","DOIUrl":"10.1186/s40795-024-00954-7","url":null,"abstract":"<p><strong>Background: </strong>The goal of the present study was to design an easily computable score, based on nutrient composition data instead of food groups, to evaluate the nutritional quality and balance of meals, adapted to the nutritional recommendations for Filipino adults.</p><p><strong>Method: </strong>The score was defined as a weighted average of 9 nutrient scores. Protein, total fat, saturated fat, free sugars were scored as % of energy; calcium, fiber, sodium, vitamin C, magnesium were scored based on the local dietary reference intakes. The scoring algorithm was an adaption of a score previously developed by the authors based on US data. In the present study, the score was applied to 69,923 meals reported by 31,218 adult Filipinos aged 20 to 59 in the 2018 edition of the Philippine Expanded National Nutrition Survey to evaluate its validity and compare against exemplary meals designed as part of 24 h diet plans that meet local dietary guidelines.</p><p><strong>Results: </strong>Meals from these exemplary menu plans, developed by local nutrition experts, scored on average 72.2 ± 13.9 (mean ± standard deviation) while those of survey participants scored 46.1 ± 12.9. Meal scores were significantly associated with the density of positive micronutrients (e.g., Vit A, Vit C) and favourable food groups (e.g. fruits, whole grains) not directly included in the algorithm.</p><p><strong>Conclusion: </strong>The score, between 0 and 100, is a valid tool to assess the nutritional quality of meals consumed by the PH population, accounting for both shortfall and excess nutrients, adjusted for the energy content of the meal. If applied to consumer-facing applications, it could potentially help users to understand which meals are nutritionally balanced.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"146"},"PeriodicalIF":1.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling the potential impact of a tax on fruit juice in South Africa: implications for the primary prevention of type 2 diabetes and health financing.","authors":"Micheal Kofi Boachie, Karen Hofman, Susan Goldstein, Evelyn Thsehla","doi":"10.1186/s40795-024-00941-y","DOIUrl":"10.1186/s40795-024-00941-y","url":null,"abstract":"<p><strong>Background: </strong>South Africa is experiencing a persistent growth in non-communicable diseases. Diabetes is among the top ten causes of mortality, especially among women, which is partly driven by high levels of added sugar consumption and obesity. To reduce obesity rates and the incidence of diabetes, South Africa introduced a tax on sugar sweetened beverages (also known as the Health Promotion Levy (HPL)) in 2018. The tax is applicable to sugar-sweetened beverages but excludes 100% fruit juice. The government is currently considering extending the tax to include fruit juices. This study models the potential health and economic impact of taxing fruit juices at 20% of the retail price of one liter.</p><p><strong>Methods: </strong>To analyze the distributional impact of the tax, this study uses extended cost-effectiveness analysis methodology. Data on price elasticities, healthcare cost, income, fruit juice consumption were sourced from the literature and representative national surveys. The potential impact of the tax on diabetes incidence, prevalence, mortality, and financial benefits were estimated for each income group (lowest, quintile 1 to highest, quintile 5).</p><p><strong>Findings: </strong>We estimate that a 20% tax on fruit juice would avert 156,640 incident cases of type 2 diabetes mellitus over 20 years, with most disease averted occurring among the first- and fifth-income groups. Averted deaths from diabetes would average 2,000 deaths per quintile (for quintiles 1 to 4) and about 2,800 in quintile 5. The improved health resulting from averted incidence and deaths will reduce overall healthcare expenditure by R7.5 billion over 20 years, of which R2.3 billion will occur in the fifth quintile. The South African government will also save about R300 million in subsidizing diabetes-related healthcare cost as a result of prevention; and would raise R8.6 billion in tax revenues per annum. Out-of-pocket expenditure savings will be R303 million and a financial risk protection (money-metric value of insurance) of R4.6 billion over the 20-year period.</p><p><strong>Conclusion: </strong>We conclude that an HPL that significantly raises the retail price of fruit juices would reduce consumption and diabetes-related morbidity and mortality. The tax will also provide significant financial benefits in the form of reduced healthcare costs for both government and households as well as providing financial risk protection to individuals. Health taxes are win-win policies that improve population health and generate revenue for governments to fund public health services delivery and thus improve overall health financing activities of the government. Therefore, population level disease prevention measures such as health taxes are important for achieving universal health coverage.</p>","PeriodicalId":36422,"journal":{"name":"BMC Nutrition","volume":"10 1","pages":"145"},"PeriodicalIF":1.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}