Journal of Nutrition and Metabolism The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Validity of Nutritional Screening Tools for Hospitalized Children Sun, 14 Sep 2014 09:18:05 +0000 Background. Malnutrition in hospitalized children can be prevented if children with risk of malnutrition are identified. Every hospital is recommended to have a standard nutritional screening tool. Numerous simple screening tools have been developed, namely Paediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), and Screening Tool for Risk on Nutritional Status and Growth (STRONG-kids). None has been accepted as a universal tool. Our study aims to determine the best screening tools compared to Subjective Global Nutrition Assessment (SGNA), an assessment tool which is more complex as our gold standard. Methods. This diagnostic study involved 116 patients aged 1–15 years. Three screening tools and SGNA were examined to each subject. Statistical analysis was used to determine sensitivity, specificity, and likelihood ratio (LR) by results from screening tools divided into low and moderate-high risk of malnutrition compared to results from SGNA divided into no and moderate-severe malnutrition. Results. PYMS showed superior agreement to SGNA resulting in sensitivity 95.32%, specificity 76.92%, positive LR 4.13, and negative LR 0.061. STAMP resulted in sensitivity, specificity, positive LR, and negative LR, respectively, as 100%, 11.54%, 1.13, and 0 and STRONG-kids resulted in 100%, 7.7%, 1.083, and 0. Conclusion. PYMS was the most reliable screening tool. Nathania Wonoputri, Julistio T. B. Djais, and Ina Rosalina Copyright © 2014 Nathania Wonoputri et al. All rights reserved. Moringa oleifera Supplemented Diets Prevented Nickel-Induced Nephrotoxicity in Wistar Rats Thu, 11 Sep 2014 12:08:57 +0000 Background. The Moringa oleifera plant has been implicated for several therapeutic potentials. Objective. To evaluate whether addition of M. oleifera to diet has protective effect against nickel-induced nephrotoxicity in rats. Methodology. Male Wistar rats were assigned into six groups of five. The rats were given oral exposure to 20 mg/kg nickel sulphate (NiSO4) in normal saline and sustained on either normal diet or diets supplemented with Moringa oleifera at different concentrations for 21 days. 24 hours after cessation of treatments, all animals were sacrificed under slight anesthesia. The blood and kidney samples were collected for biochemical and histopathology analyses, respectively. Results. NiSO4 exposure reduced the kidney-to-body weight ratio in rats and caused significant elevation in the levels of plasma creatinine, urea, and potassium. Also, the plasma level of sodium was decreased by NiSO4 exposure. However, addition of M. oleifera to diets averted the nickel-induced alteration to the level of creatinine and urea. The histopathology revealed damaged renal tubules and glomerular walls caused by NiSO4 exposure. In contrast, the damages were ameliorated by the M. oleifera supplemented diets. Conclusion. The addition of M. oleifera to diet afforded significant protection against nickel-induced nephrotoxicity. O. S. Adeyemi and T. C. Elebiyo Copyright © 2014 O. S. Adeyemi and T. C. Elebiyo. All rights reserved. Effect of a Mediterranean Diet Intervention on Dietary Glycemic Load and Dietary Glycemic Index: The PREDIMED Study Thu, 11 Sep 2014 08:46:37 +0000 Objective. To compare the one year effect of two dietary interventions with MeDiet on GL and GI in the PREDIMED trial. Methods. Participants were older subjects at high risk for cardiovascular disease. This analysis included 2866 nondiabetic subjects. Diet was assessed with a validated 137-item food frequency questionnaire (FFQ). The GI of each FFQ item was assigned by a 5-step methodology using the International Tables of GI and GL Values. Generalized linear models were fitted to assess the relationship between the intervention group and dietary GL and GI at one year of follow-up, using control group as reference. Results. Multivariate-adjusted models showed an inverse association between GL and MeDiet + extra virgin olive oil (EVOO) group: β = −8.52 (95% CI: −10.83 to −6.20) and MeDiet + Nuts group: β = −10.34 (95% CI: −12.69 to −8.00), when comparing with control group. Regarding GI, β = −0.93 (95% CI: −1.38 to −0.49) for MeDiet + EVOO, β = −1.06 (95% CI: −1.51 to −0.62) for MeDiet + Nuts when comparing with control group. Conclusion. Dietary intervention with MeDiet supplemented with EVOO or nuts lowers dietary GL and GI. Ana Isabel Rodríguez-Rejón, Itandehui Castro-Quezada, Cristina Ruano-Rodríguez, María Dolores Ruiz-López, Almudena Sánchez-Villegas, Estefanía Toledo, Reyes Artacho, Ramón Estruch, Jordi Salas-Salvadó, María Isabel Covas, Dolores Corella, Enrique Gómez-Gracia, José Lapetra, Xavier Pintó, Fernando Arós, Miquel Fiol, Rosa María Lamuela-Raventós, Valentina Ruiz-Gutierrez, Helmut Schröder, Emilio Ros, Miguel Ángel Martínez-González, and Lluis Serra-Majem Copyright © 2014 Ana Isabel Rodríguez-Rejón et al. All rights reserved. HO-1 Upregulation Attenuates Adipocyte Dysfunction, Obesity, and Isoprostane Levels in Mice Fed High Fructose Diets Tue, 09 Sep 2014 12:04:02 +0000 Background. Fructose metabolism is an unregulated metabolic pathway and excessive fructose consumption is known to activate ROS. HO-1 is a potent antioxidant gene that plays a key role in decreasing ROS and isoprostanes. We examined whether the fructose-mediated increase in adipocyte dysfunction involves an increase in isoprostanes and that pharmacological induction of HO-1 would decrease both isoprostane levels and adipogenesis. Methods and Results. We examined the effect of fructose, on adipogenesis in human MSCs in the presence and absence of CoPP, an inducer of HO-1. Fructose increased adipogenesis and the number of large lipid droplets while decreasing the number of small lipid droplets (). Levels of heme and isoprostane in fructose treated MSC-derived adipocytes were increased. CoPP reversed these effects and markedly increased HO-1 and the Wnt signaling pathway. The high fructose diet increased heme levels in adipose tissue and increased circulating isoprostane levels ( versus control). Fructose diets decreased HO-1 and adiponectin levels in adipose tissue. Induction of HO-1 by CoPP decreased isoprostane synthesis ( versus fructose). Conclusion. Fructose treatment resulted in increased isoprostane production and adipocyte dysfunction, which was reversed by the increased expression of HO-1. Zeid Khitan, Mohit Harsh, Komal Sodhi, Joseph I. Shapiro, and Nader G. Abraham Copyright © 2014 Zeid Khitan et al. All rights reserved. Trigonella Foenum-Graecum Seeds Lowers Postprandial Blood Glucose in Overweight and Obese Individuals Wed, 03 Sep 2014 06:50:10 +0000 This study determined the effects of fenugreek on postprandial plasma glucose (PPG) and satiety among overweight and obese individuals. Fourteen subjects were studied in the morning after overnight fasts on four separate occasions. Glycaemic responses elicited by 50 g carbohydrate portions of white bread and jam with or without 5.5 g of fenugreek and fried rice with or without 5.5 g fenugreek were determined over 2 h. The primary endpoint was the incremental area under the plasma glucose response curve (IAUC). Adding fenugreek to both foods significantly reduced the IAUC compared to the food alone: white bread and jam, 180 ± 22 versus 271 ± 23 mmol × min/L (P = 0.001); fried rice, 176 ± 20 versus 249 ± 25 mmol × min/L (P = 0.001). Fenugreek also significantly reduced the area under the satiety curve for white bread with jam (134 ± 27 versus 232 ± 33 mm × hr, P = 0.01) and fried rice (280 ± 37 versus 379 ± 36 mm × hr, P = 0.01). It is concluded that fenugreek significantly decreased the PPG response and increased satiety among overweight and obese individuals. Sathyasurya Daniel Robert, Aziz Al-Safi Ismail, and Wan Ishak Wan Rosli Copyright © 2014 Sathyasurya Daniel Robert et al. All rights reserved. Accuracy of Self-Reported Physical Activity Levels in Obese Adolescents Tue, 26 Aug 2014 12:17:04 +0000 Introduction. Self-reported measures of habitual physical activity rely completely on the respondent’s ability to provide accurate information on their own physical activity behaviours. Our aim was to investigate if obese adolescents could accurately report their physical activity levels (PAL) using self-reported diaries. Methods. Total energy expenditure (TEE) was measured using doubly labelled water (DLW) and resting energy expenditure (REE) was measured via indirect calorimetry. Activity energy expenditure (AEE) and PAL values were derived from measured TEE and REE. Self-reported, four-day activity diaries were used to calculate daily MET values and averaged to give an estimated PAL value (ePAL). Results. Twenty-two obese adolescents, mean age years, mean BMI  kg/m2, completed the study. No significant differences between mean measured and estimated PAL values were observed ( versus , ). Bland Altman analysis illustrated a significant relationship (, ) between the two methods; thus the bias was not consistent across a range of physical activity levels, with the more inactive overreporting their physical activity. Conclusion. At an individual level, obese adolescents are unlikely to be able to provide an accurate estimation of their own activity. Sarah A. Elliott, Kimberley A. Baxter, Peter S. W. Davies, and Helen Truby Copyright © 2014 Sarah A. Elliott et al. All rights reserved. The Relationship between the Neighborhood Safety and Nutritional Status of Children in Baghdad City, Iraq Sun, 24 Aug 2014 11:44:27 +0000 Introduction. The neighborhoods where the children live play an important role in their development physically and mentally. The objective of this study was to assess the relationship between neighborhood safety and child nutritional status in Baghdad city, Iraq. Methods. A cross-sectional study was carried out in Baghdad city, Iraq, among 400 primary school children from 4 schools. BMI-for-age Z score was used to assess the nutritional status of the children. Newly developed questionnaires on neighborhood safety were distributed to the parents to answer them. Results. In this study, males were more predominant than females with 215 participants compared to 185 females. A total of 49% were normal weight, 38.8% either overweight or obese, and only 12.2% underweight. There was a significant relationship between father education, father and mother working status, family income, and children nutritional status (, 0.009, <0.001, 0.37), respectively. The association between neighborhood safety variables and child nutritional status was significant except for worrying about child safety and thinking of leaving the neighborhood (, 0.084), respectively. Conclusion. Nutritional status of school children continues to be a public health issue in Iraq especially Baghdad city. There was a significant association between neighborhood safety and children nutritional status. Hasanain Faisal Ghazi, Zaleha Md. Isa, Shamsul Azhar Shah, Mohammed A. Abdal Qader, Tiba Nezar Hasan, and AL-abed Ali AL-abed Copyright © 2014 Hasanain Faisal Ghazi et al. All rights reserved. Vitamin D Supplementation in Australia: Implications for the Development of Supplementation Guidelines Tue, 19 Aug 2014 08:32:22 +0000 High rates of vitamin D deficiency and testing have been reported in Australia, yet there are few reports regarding vitamin D supplement use. Australian wholesale sales data was obtained for vitamin D supplements for the period 2000–2011. There has been a threefold increase in supplement sales over the past decade, whereby over A$94 million supplements containing vitamin D in Australia were sold during the year 2010. There were eighty-nine manufacturers that produce a variety of 195 vitamin D products. The amount of vitamin D in these products varies considerably, from 40 to 1000 IU per unit, although supplements containing only vitamin D had the highest amount of vitamin D. There was a trend for sales to increase in winter months. Given the potential public health benefits of vitamin D, there is an urgent need for a better understanding of supplementation use and for the development of supplementation. Kellie Bilinski and Peter Talbot Copyright © 2014 Kellie Bilinski and Peter Talbot. All rights reserved. Low-Salt Intake during Mating or Gestation in Rats Is Associated with Low Birth and Survival Rates of Babies Thu, 14 Aug 2014 13:24:00 +0000 We investigated the influence of maternal salt restriction during mating or gestation on birth rate and offspring growth in Dahl salt-sensitive rats (DS). DS were divided into 5 groups: DS fed a low-salt (0.3% NaCl, w/w) (DS-low) or high-salt (4% NaCl, w/w) diet (DS-high) during mating and DS-high or DS-low during gestation, and DS fed regular chow (0.75% NaCl, w/w) (DS-regular) throughout mating and gestation. During the unspecified periods, the rats were given regular chow. DS-low during mating delivered fewer infants than high-salt mothers (). The birth rate on regular chow was 87%. Six out of 11 DS-low rats during pregnancy produced pups while the rats fed a high-salt diet all delivered pups (). The pup survival rate was 67% for high-salt mothers during mating and 54% for mothers on a low-salt diet. The pup survival rate was 95% for mothers on a high-salt diet during pregnancy and 64% for mothers on a low-salt diet (). Seven out of 8 DS-regular rats during mating delivered 59 neonates. However, 66% of the neonates survived. A low-salt diet during mating or pregnancy lowers birth rate and the neonates from low-salt mothers during pregnancy were more likely to die than those from high-salt mothers. Ranna Chou, Anna Hara, DongDong Du, Namiko Shimizu, Hiroe Sakuyama, and Yoshio Uehara Copyright © 2014 Ranna Chou et al. All rights reserved. A Modern Cohort of Duodenal Obstruction Patients: Predictors of Delayed Transition to Full Enteral Nutrition Thu, 14 Aug 2014 13:06:55 +0000 Background. A common site for neonatal intestinal obstruction is the duodenum. Delayed establishment of enteral nutritional autonomy continues to challenge surgeons and, since early institution of nutritional support is critical in postoperative newborns, identification of patients likely to require alternative nutritional support may improve their outcomes. Therefore, we aimed to investigate risk factors leading to delayed establishment of full enteral nutrition in these patients. Methods. 87 patients who were surgically treated for intrinsic duodenal obstructions from 1998 to 2012 were reviewed. Variables were tested as potential risk factors. Median time to full enteral nutrition was estimated using the Kaplan-Meier method. Independent risk factors of delayed transition were identified using the multivariate Cox proportional hazards regression model. Results. Median time to transition to full enteral nutrition was 12 days (interquartile range: 9–17 days). Multivariate Cox analysis identified three significant risk factors for delayed enteral nutrition: gestational age (GA) ≤ 35 weeks (), congenital heart disease (CHD) (), and malrotation (). Conclusions. CHD and Prematurity are most commonly associated with delayed transition to full enteral nutrition. Thus, in these patients, supportive nutrition should strongly be considered pending enteral nutritional autonomy. Sigrid Bairdain, David C. Yu, Chueh Lien, Faraz Ali Khan, Bhavana Pathak, Matthew J. Grabowski, David Zurakowski, and Bradley C. Linden Copyright © 2014 Sigrid Bairdain et al. All rights reserved. Anthropometry and Dietary Intake before and during a Competition in Mountain Runners Thu, 07 Aug 2014 07:19:33 +0000 Mountain running is a non-Olympic sport consisting of uphill or up- and downhill races at moderate-to-high altitude. Special nutritional requirements are anticipated, but no nutritional data of mountain runners are available. In three studies, physique of elite and recreational athletes (), maximum oxygen uptake (), and prerace and race day dietary intake () were measured (mean ± SD). Mean oxygen uptake was  mL/kg/min. Energy and carbohydrate intake before a race ( km,  m HD) was  kcal/d ( MJ/d) and  g/d ( g/kg/d) in German national team members. Fluid intake was calculated as  mL/d. During the race, athletes consumed  kcal and  mL of fluids. Substrate intake per hour was calculated as  g of carbohydrates and  g of proteins. In conclusion, anthropometric and oxygen uptake characteristics of mountain runners were similar to those reported for elite distance runners. Carbohydrate intake before and during the race was below recommendations for endurance athletes. This is of concern when considering the increased reliance on carbohydrates at altitude. Anja Carlsohn and Wolfram Müller Copyright © 2014 Anja Carlsohn and Wolfram Müller. All rights reserved. Effects of Astrocaryum aculeatum Meyer (Tucumã) on Diet-Induced Dyslipidemic Rats Sun, 03 Aug 2014 12:00:30 +0000 An in vivo study was conducted to assess the effects of the consumption of Astrocaryum aculeatum Amazon Meyer (tucumã) in the treatment of diet-induced dyslipidemia in sedentary and exercised Wistar rats. With an average weight of 350 grams, 40 male rats were divided into 4 subgroups of 10. The sedentary control group (SCG) was fed with commercial feed, while the sedentary treatment group (STG) was fed with a ration of tucumã. In addition to the sedentary groups, two exercise groups were formed. The Exercised control group (ECG) was fed with commercial food and the exercised treatment group (ETG) was fed with a ration of tucumã. Body weight gain and food intake were monitored during the experiment. Plasma was analyzed for cholesterol, triglycerides, HDL-C, LDL-C, VLDL, total protein, glucose, insulin, and leptin concentrations. Our results show that the ECG group tended to consume more food, while the groups that were fed with tucumã pulp (STG and ETG) presented a greater tendency to gain body mass. ECG group showed a tendency towards a higher concentration of cholesterol in plasma, while STG and ETG presented higher absolute values for triglycerides and VLDL. No hypolipiemic effect was observed related to tucuma ingestion. Geórgia Craveiro Holanda Malveira Maia, Mozer da Silva Campos, Janice Barros-Monteiro, Juan Eduardo Lucas Castillo, Murilo Soares Faleiros, Rejane Souza de Aquino Sales, Denise Moraes Lopes Galeno, Edson Lira, Francisca das Chagas do Amaral Souza, Carmen Ortiz, Luisa Morales, and Rosany Piccolotto Carvalho Copyright © 2014 Geórgia Craveiro Holanda Malveira Maia et al. All rights reserved. Reliability of a Fully Automated Interpretation of γ-H2AX Foci in Lymphocytes of Moderately Trained Subjects under Resting Conditions Thu, 24 Jul 2014 00:00:00 +0000 Background. Analysis of -H2AX foci is a promising approach to evaluate exercise-induced DNA damage. However, baseline levels and day-to-day variability of -H2AX foci have not been investigated in healthy subjects at rest. Methods. Blood was taken from eight moderately trained healthy males (29 ± 3 yrs, 1.84 ± 0.03 m, and 85 ± 6 kg) at two separate days (M1/M2) after 24-hour exercise cessation. Number of -H2AX foci per 100 lymphocytes (N), number of foci per affected lymphocyte (NAL), percentage of affected lymphocytes (PAL), and diameter (D) of -H2AX foci were analyzed (mean ± SD). Differences between M1 and M2 were analyzed using paired -tests ( = 0.05). Day-to-day variability was evaluated by calculating the coefficients of variation (CV%), bias, and limits of agreement (LoA). Results. There were no statistically significant differences between M1 (N: 7.6 ± 4.4, NAL: 1.2 ± 0.2, PAL: 5.9 ± 2.6%, and D: 0.63 ± 0.07) and M2 (N: 8.4 ± 4.6, NAL: 1.3 ± 0.1, PAL: 6.9 ± 4.2%, and D: 0.66 ± 0.06). CV was calculated to be 98.5% (N), 88.9% (PAL), 11.3% (NAL), and 8.0% (D). Bias (LoA) was 0.75 (−15.2/13.7), −0.02 (−0.36/0.33), −1.0 (−11.9/9.9), and −0.04 (−0.16/0.09), respectively. Conclusions. Background level in healthy subjects is approximately 0.07 to 0.09 -H2AX foci/cell. NAL and D are reliable measures. Juliane Heydenreich, Christoph Otto, Frank Mayer, and Anja Carlsohn Copyright © 2014 Juliane Heydenreich et al. All rights reserved. Subclinical Iodine Deficiency among Pregnant Women in Haramaya District, Eastern Ethiopia: A Community-Based Study Thu, 17 Jul 2014 00:00:00 +0000 Background. Iodine deficiency in pregnancy is a worldwide problem. This study aimed to assess prevalence and predictors of subclinical iodine deficiency among pregnant women in Haramaya district, eastern Ethiopia. Methods. A cross-sectional, community-based study was conducted on 435 pregnant women existing in ten randomly selected rural kebeles (kebele is the smallest administrative unit in Ethiopia). Data on the study subjects’ background characteristics, dietary habits, and gynecological/obstetric histories were collected via a structured questionnaire. UIC of <150 μg/L defined subclinical iodine deficiency. Data were analyzed by Stata 11. A multivariable logistic regression was used to identify the predictors of subclinical iodine deficiency. Results. The median urinary iodine concentration (MUIC) was 58.1 μg/L and 82.8% of the women who had subclinical iodine deficiency. The risk of subclinical iodine deficiency was reduced by the use of iodized salt (AOR = 0.13) and by intake of milk twice a month or more (AOR = 0.50), but it was increased by maternal illiteracy (AOR = 3.52). Conclusion. Iodine nutritional status of the pregnant women was poor. This shows that women and their children are exposed to iodine deficiency and its adverse effects. Thus, they need urgent supplementation with iodine and improved access to and intake of iodized salt and milk during pregnancy. Haji Kedir, Yemane Berhane, and Alemayehu Worku Copyright © 2014 Haji Kedir et al. All rights reserved. Exercise and Dietary-Mediated Reductions in Postprandial Lipemia Sun, 29 Jun 2014 09:01:16 +0000 Postprandial hyperlipemia produces long-term derangements in lipid/lipoprotein metabolism, vascular endothelial dysfunction, hypercoagulability, and sympathetic hyperactivity which are strongly linked to atherogenesis. The purpose of this review is to (1) provide a qualitative analysis of the available literature examining the dysregulation of postprandial lipid metabolism in the presence of obesity, (2) inspect the role of adiposity distribution and sex on postprandial lipid metabolism, and (3) examine the role of energy deficit (exercise- and/or energy restriction-mediated), isoenergetic low-carbohydrate diets, and omega-3 (n-3) fatty acid supplementation on postprandial lipid metabolism. We conclude from the literature that central adiposity primarily accounts for sex-related differences in postprandial lipemia and that aerobic exercise attenuates this response in obese or lean men and women to a similar extent through potentially unique mechanisms. In contrast, energy restriction produces only mild reductions in postprandial lipemia suggesting that exercise may be superior to energy restriction alone as a strategy for lowering postprandial lipemia. However, isoenergetic very low-carbohydrate diets and n-3 fatty acid supplementation reduce postprandial lipemia indicating that macronutrient manipulations reduce postprandial lipemia in the absence of energy restriction. Therefore, interactions between exercise/energy restriction and alterations in macronutrient content remain top priorities for the field to identify optimal behavioral treatments to reduce postprandial lipemia. Eric P. Plaisance and Gordon Fisher Copyright © 2014 Eric P. Plaisance and Gordon Fisher. All rights reserved. Study of Body Composition and Metabolic Parameters in HIV-1 Male Patients Tue, 10 Jun 2014 00:00:00 +0000 Background. HIV patients on highly active antiretroviral therapy (HAART) containing protease inhibitors (PIs) had been often associated with lipodystrophy. However, there are only few studies on association of nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTI and NNRTI) with lipodystrophy. Study Design. One hundred and one HIV male patients were categorised into ART naïve (), zidovudine (), stavudine (), tenofovir (), and PIs () based HAART. Their clinicoepidemiological data had been entered in preformed pro forma. The body composition, using TANITA machine and metabolic parameters like lipid profile, blood sugars was analysed. Results. Clinically, lipoatrophy of face was most prevalent in HIV patients on stavudine (15 patients, 83.3%) and PIs (20 patients, 83.3%) based HAART. The mean BMI among study population was in normal range. Excess visceral fat was most prevalent among patients on PIs, 4 patients (16.7%). The waist-hip ratio was significantly higher in PIs () based HAART. There was no significant difference among different study populations in terms of BMI (), body water (), body fat (), bone mass (), and muscle mass (). Hypertriglyceridiemia was found in stavudine, tenofovir, and protease inhibitors regimens. Low levels of high density lipoprotein (HDL) was found zidovudine, stavudine, and PIs regimens. Fasting and postprandial hyperglycaemia was found PIs and impaired glucose tolerance in stavudine regimen. Conclusion. Patients on PIs were associated with truncal obesity and lipoatrophy of face, along with dyslipidemia and hyperglycaemia. Stavudine based regimen is associated with hypertriglyceridiemia and low HDL along with lipoatrophy of face. Gurudath Gundurao Sreekantamurthy, N Biplab Singh, Th Bhimo Singh, Th Suraj Singh, and Karam Romeo Singh Copyright © 2014 Gurudath Gundurao Sreekantamurthy et al. All rights reserved. Effect on Blood Pressure of Daily Lemon Ingestion and Walking Thu, 10 Apr 2014 17:52:46 +0000 Background. Recent studies suggest that the daily intake of lemon (Citrus limon) has a good effect on health, but this has not been confirmed in humans. In our previous studies, it was observed that people who are conscious of their health performed more lemon intake and exercise. An analysis that took this into account was required. Methodology. For 101 middle-aged women in an island area in Hiroshima, Japan, a record of lemon ingestion efforts and the number of steps walked was carried out for five months. The change rates (Δ%) of the physical measurements, blood test, blood pressure, and pulse wave measured value during the observation period were calculated, and correlations with lemon intake and the number of steps walked were considered. As a result, it was suggested that daily lemon intake and walking are effective for high blood pressure because both showed significant negative correlation to systolic blood pressure Δ%. Conclusions. As a result of multiple linear regression analysis, it was possible that lemon ingestion is involved more greatly with the blood citric acid concentration Δ% and the number of steps with blood pressure Δ%, and it was surmised that the number of steps and lemon ingestion are related to blood pressure improvement by different action mechanisms. Yoji Kato, Tokio Domoto, Masanori Hiramitsu, Takao Katagiri, Kimiko Sato, Yukiko Miyake, Satomi Aoi, Katsuhide Ishihara, Hiromi Ikeda, Namiko Umei, Atsusi Takigawa, and Toshihide Harada Copyright © 2014 Yoji Kato et al. All rights reserved. Nutrigenomics: Definitions and Advances of This New Science Tue, 25 Mar 2014 12:31:47 +0000 The search for knowledge regarding healthy/adequate food has increased in the last decades among the world population, researchers, nutritionists, and health professionals. Since ancient times, humans have known that environment and food can interfere with an individual’s health condition, and have used food and plants as medicines. With the advance of science, especially after the conclusion of the Human Genome Project (HGP), scientists started questioning if the interaction between genes and food bioactive compounds could positively or negatively influence an individual’s health. In order to assess this interaction between genes and nutrients, the term “Nutrigenomics” was created. Hence, Nutrigenomics corresponds to the use of biochemistry, physiology, nutrition, genomics, proteomics, metabolomics, transcriptomics, and epigenomics to seek and explain the existing reciprocal interactions between genes and nutrients at a molecular level. The discovery of these interactions (gene-nutrient) will aid the prescription of customized diets according to each individual’s genotype. Thus, it will be possible to mitigate the symptoms of existing diseases or to prevent future illnesses, especially in the area of Nontransmissible Chronic Diseases (NTCDs), which are currently considered an important world public health problem. N. M. R. Sales, P. B. Pelegrini, and M. C. Goersch Copyright © 2014 N. M. R. Sales et al. All rights reserved. Nutritional Knowledge and Attitudes of Adolescent Swimmers in Trinidad and Tobago Tue, 11 Feb 2014 09:38:06 +0000 Purpose. To investigate the level of nutrition knowledge and attitude of adolescent male and female swimmers training competitively in Trinidad and Tobago. Methodology. A self-administered questionnaire, which consisted of 21 nutrition knowledge and 11 attitude statements, was utilized to assess the level of nutrition knowledge and attitude of adolescent swimmers. For the assessment of nutrition knowledge, correct answers were given a score of “1” and incorrect answers were given a score of “0.” For the evaluation of attitude towards nutrition, a score ranging from 1 to 5 was assigned to each response; “5” was given to the most positive response, and “1” was given to the most negative. Data were analyzed using SPSS version 21.0. Results. Two hundred and twenty swimmers with a mean age of completed the questionnaire. The mean nutrition knowledge score was and mean attitude score was . Nutrition knowledge was positively and significantly related to the number of reported nutrition sources (, ). Nutrition knowledge was positively and significantly related to the attitude (, ). Conclusions and Implication. Athletes lack nutrition knowledge but have a positive attitude towards nutrition, which may indicate receptiveness to future nutrition education. Marquitta C. Webb and Safiya E. Beckford Copyright © 2014 Marquitta C. Webb and Safiya E. Beckford. All rights reserved. Evaluation of Beneficial Metabolic Effects of Berries in High-Fat Fed C57BL/6J Mice Tue, 14 Jan 2014 11:05:41 +0000 Objective. The aim of the study was to screen eight species of berries for their ability to prevent obesity and metabolic abnormalities associated with type 2 diabetes. Methods. C57BL/6J mice were assigned the following diets for 13 weeks: low-fat diet, high-fat diet or high-fat diet supplemented (20%) with lingonberry, blackcurrant, bilberry, raspberry, açai, crowberry, prune or blackberry. Results. The groups receiving a high-fat diet supplemented with lingonberries, blackcurrants, raspberries or bilberries gained less weight and had lower fasting insulin levels than the control group receiving high-fat diet without berries. Lingonberries, and also blackcurrants and bilberries, significantly decreased body fat content, hepatic lipid accumulation, and plasma levels of the inflammatory marker PAI-1, as well as mediated positive effects on glucose homeostasis. The group receiving açai displayed increased weight gain and developed large, steatotic livers. Quercetin glycosides were detected in the lingonberry and the blackcurrant diets. Conclusion. Lingonberries were shown to fully or partially prevent the detrimental metabolic effects induced by high-fat diet. Blackcurrants and bilberries had similar properties, but to a lower degree. We propose that the beneficial metabolic effects of lingonberries could be useful in preventing obesity and related disorders. Lovisa Heyman, Ulrika Axling, Narda Blanco, Olov Sterner, Cecilia Holm, and Karin Berger Copyright © 2014 Lovisa Heyman et al. All rights reserved. Nutrition Therapy in the Transition between Hospital and Home: An Investigation of Barriers Sun, 29 Dec 2013 14:10:22 +0000 Aims and Objectives. This study aimed to investigate barriers for nutrition therapy in the transition between hospital and home and hereby to identify areas for potential improvements. Background. Though the focus on nutritional risk is improving in hospital, there seems to be less effort to maintain or even improve nutritional status after discharge and during the rehabilitation period. Design. Qualitative focus group interviews. Methods. Semistructured focus group interviews with experienced multiprofessional staff from hospital, home care, nursing homes, and general practise. The study was done in the county of Aalborg with about 280.000 inhabitants regarding homecare and general practise as well as Aalborg University Hospital, Denmark. Results. Interviews were generated with 41 professionals from hospital, general practise, and home care. Barriers identified between settings included the following aspects: economic, organisation, and education. The impression of professionals was that few patients are discharged with nutrition therapy, compared to who could benefit from nutrition therapy after discharge. Most often, reasons were a short in-hospital stay and lack of knowledge and interest. Moreover, lack of clinical guidelines throughout all settings, time consumption, lack of transparency regarding economy and workflows, and lack of assistance from experts regarding complicated nutritional problems were identified. Conclusions. Many barriers were found in hospital as well as in the community and general practise. These were most often practical as well as organizational. Improvements of clinical guidelines and instructions and improvement of knowledge and communication at all levels are needed. Relevance to Clinical Practise. This study emphasizes that responsibility needs to be taken for patients whom are still at nutritional risk at discharge, and even before hospitalization. Nurses and doctors in and outside hospital are in need of improved knowledge, standard care plans, and instructions. Mette Holst and Henrik Højgaard Rasmussen Copyright © 2013 Mette Holst and Henrik Højgaard Rasmussen. All rights reserved. Hyperleptinemia, Adiposity, and Risk of Metabolic Syndrome in Older Adults Thu, 26 Dec 2013 13:34:21 +0000 Background. Abdominal adiposity and serum leptin increase with age as does risk of metabolic syndrome. This study investigates the prospective association between leptin and metabolic syndrome risk in relation to adiposity and cytokines. Methods. The Health, Aging, and Body Composition study is a prospective cohort of older adults aged 70 to 79 years. Baseline measurements included leptin, cytokines, BMI, total percent fat, and visceral and subcutaneous fat. Multivariate logistic regression was used to determine the association between leptin and metabolic syndrome (defined per NCEP ATP III) incidence after 6 years of follow-up among 1,120 men and women. Results. Leptin predicted metabolic syndrome in men ( for trend = 0.0002) and women ( for trend = 0.0001). In women, risk of metabolic syndrome increased with higher levels of leptin (compared with quintile 1, quintile 2 RR = 3.29, CI = 1.36, 7.95; quintile 3 RR = 3.25, CI = 1.33, 7.93; quintile 4 RR = 5.21, CI = 2.16, 12.56; and quintile 5 RR = 7.97, CI = 3.30, 19.24) after adjusting for potential confounders. Leptin remained independently associated with metabolic syndrome risk after additional adjustment for adiposity, cytokines, and CRP. Among men, this association was no longer significant after controlling for adiposity. Conclusion. Among older women, elevated concentrations of leptin may increase the risk of metabolic syndrome independent of adiposity and cytokines. Suruchi Mishra, Tamara B. Harris, Trisha Hue, Iva Miljkovic, Suzanne Satterfield, Nathalie de Rekeneire, Mira Mehta, and Nadine R. Sahyoun Copyright © 2013 Suruchi Mishra et al. All rights reserved. The Effect of a Maternal Double Megadose of Vitamin A Supplement on Serum Levels of Retinol in Children Aged under Six Months Tue, 24 Dec 2013 15:07:46 +0000 Objective. To measure concentrations of serum retinol in children after the use of maternal vitamin A double megadose supplements. Design. Randomized controlled clinical trial. Setting. The study was conducted at two maternity hospitals in the city of Recife, in the northeast region of Brazil between August 2007 and June 2009. Subjects and Methods. 276 children/mothers were recruited after birth and the women received a 200,000 IU capsule of vitamin A. After ten days they were randomly assigned to two treatment groups. One group received a second 200.000 IU capsule, while the other received a placebo. The concentrations of retinol in the serum of the children from each group were measured at 2, 4, and 6 months. Results. 173 children completed the study. There was no difference between the two treatment groups (). The mean base retinol level was lower than that at four and six months (). Conclusions. The maternal double megadose supplement had no additional effect on the serum retinol levels of the children, although concentrations of retinol in the children rose in the first six months of life. This trial is registered with NCT00742937. Carmina Silva dos Santos, Ilma Kruze, Taciana Fernandes, Luciana Marques Andreto, José Natal Figueiroa, and Alcides da Silva Diniz Copyright © 2013 Carmina Silva dos Santos et al. All rights reserved. Assistance for the Prescription of Nutritional Support Must Be Required in Nonexperienced Nutritional Teams Tue, 17 Dec 2013 10:32:46 +0000 The aim of the study was to determine the current practices of nutritional support among hospitalized patients in nonspecialized hospital departments. Materials and Methods. During an observation period of 2 months, a surgeon and a gastroenterologist designated in each of the two departments concerned, not “specialized” in nutritional assistance, have treated patients in which nutritional support seemed necessary. Assessing the degree of malnutrition of the patient, the therapeutic decision and the type of product prescribed by the doctors were secondarily compared to the proposals of a structured computer program according to the criteria and standards established by the institutions currently recognized. Results. The study included 120 patients bearing a surgical disease in 86.7% of cases and 10% of medical cases. 50% of the patients had cancer. Nutritional status was correctly evaluated in 38.3% by the initial doctors’ diagnosis—consistent with the software’s evaluation. The strategy of nutrition was concordant with the proposals of the software in 79.2% of cases. Conclusions. Despite an erroneous assessment of the nutritional status in more than two-thirds of cases the strategy of nutritional management was correct in 80% of cases. Malnutrition and its consequences can be prevented in nonexperienced nutritional teams by adequate nutritional support strategies coming from modern techniques including computerized programs. Mehdi Ouaïssi, Philippe Grandval, Diane Mege, Anamaria Nedelcu, Gaëlle Hautefeuille, Frédéric Vanhoeve, Bernard Sastre, Igor Sielezneff, and Jacques di Costanzo Copyright © 2013 Mehdi Ouaïssi et al. All rights reserved. Cut-Off Values of Visceral Adiposity to Predict NAFLD in Brazilian Obese Adolescents Sat, 07 Dec 2013 12:18:12 +0000 Objectives. The present study aimed at determining cut-off points of visceral fat to predict NAFLD and analyzed metabolic disorders of obese adolescents. Methods. Cross-sectional study involved 165 obese adolescents ranged in age from 15 to 19 years. Glycemia, hepatic transaminases, lipid profile, and insulin resistance were analyzed. Visceral and subcutaneous fat were measured by ultrasound and body composition by plesthysmography. Results. The NAFLD adolescents had significantly higher values for body mass, BMI-for-age, BMI, total fat, waist circumference, and visceral fat when compared with non-NAFLD obese adolescents in both genders. Moreover, there were significant positive correlations between visceral fat with the variables BMI-for-age (), TG (), AST (), ALT (), WC (), and visceral/subcutaneous ratio () for NAFLD group. Total fat, triglycerides, and visceral fat were the independent predictors to NAFLD. Analysis of the ROC curves revealed cut-off points of visceral fat of 4.47 cm for girls and 4.21 cm for boys. Conclusions. The results may suggest that abdominal ultrasonography procedure may be a safe alternative method of assessing visceral adiposity aiming to be considered to the development of preventive and treatment strategies in obese individuals. This clinial trial is registered with (NCT01358773). Ana Paula Grotti Clemente, Bárbara Dal Molin Netto, Aline di Piano Ganen, Lian Tock, Danielle Arisa Caranti, Marco Túlio de Mello, Sergio Tufik, and Ana R. Dâmaso Copyright © 2013 Ana Paula Grotti Clemente et al. All rights reserved. Dietary Diversity and Meal Frequency Practices among Infant and Young Children Aged 6–23 Months in Ethiopia: A Secondary Analysis of Ethiopian Demographic and Health Survey 2011 Sun, 24 Nov 2013 10:12:18 +0000 Background. Appropriate complementary feeding practice is essential for growth and development of children. This study aimed to assess dietary diversity and meal frequency practice of infants and young children in Ethiopia. Methods. Data collected in the Ethiopian Demographic and Health Survey (EDHS) from December 2010 to June 2011 were used for this study. Data collected were extracted, arranged, recoded, and analyzed by using SPSS version 17. A total of 2836 children aged 6–23 months were used for final analysis. Both bivariate and multivariate analysis were done to identify predictors of feeding practices. Result. Children with adequate dietary diversity score and meal frequency were 10.8% and 44.7%, respectively. Children born from the richest households showed better dietary diversity score (OR = 0.256). Number of children whose age less than five years was important predictor of dietary diversity (OR = 0.690). Mothers who had exposure to media were more likely to give adequate meal frequency to their children (OR = 0.707). Conclusion. Dietary diversity and meal frequency practices were inadequate in Ethiopia. Wealth quintile, exposure to media, and number of children were affecting feeding practices. Improving economic status, a habit of eating together, and exposure to media are important to improve infant feeding practices in Ethiopia. Melkam Aemro, Molla Mesele, Zelalem Birhanu, and Azeb Atenafu Copyright © 2013 Melkam Aemro et al. All rights reserved. Pivotal Role of Mediterranean Dietary Regimen in the Increase of Serum Magnesium Concentration in Patients with Coronary Artery Disease Thu, 07 Nov 2013 10:25:36 +0000 Background. Recent studies confirmed cardioprotective role of intravenous magnesium for the prevention of cardiac events, but effect of dietary intake of this mineral via recommended dietary regimens on control and inhibition of coronary artery disease (CAD) risk factors has been questioned. The aim of the present study was to determine effect of Mediterranean dietary approach on serum magnesium concentration among Iranian patients with CAD. Method. Baseline characteristics and clinical data of 102 consecutive patients with the diagnosis of CAD and candidates for isolated coronary artery bypass surgery were entered into the study. Laboratory parameters especially serum magnesium concentration were measured after 12–14 h of overnight fasting and before operation. Nutritional status was assessed by food frequency questionnaire and the diet score was calculated on the basis of Mediterranean diet quality index (Med-DQI). Results. No significant differences were found in the concentrations of albumin, last fasting blood sugar, last creatinine, and lipid profiles between the groups with Mediterranean dietary score < 5 and the group with higher dietary score; however, serum magnesium concentration in the first group was higher than that in the group with higher dietary score. Linear multivariate regression analysis showed that the lower Mediterranean dietary score was a predictor for serum magnesium concentration after adjusting for confounders. Conclusion. Taking Mediterranean dietary regimen can be associated with increased level of serum magnesium concentration, and thus this regimen can be cardioprotective because of its effects on serum magnesium. Nimah Bahreini, Mojgan Gharipour, Hossein Khosravi-Boroujeni, Hojjat Rouhi-Boroujeni, Afshin Shiranian, Amin Salehi-Abargouei, and GholamReza Sharifzadeh Copyright © 2013 Nimah Bahreini et al. All rights reserved. Clinical Spectrum of Propionic Acidaemia Thu, 31 Oct 2013 11:36:26 +0000 Objectives. To evaluate the clinical features, physical findings, diagnosis, and laboratory parameters of the patients with propionic acidaemia (PA). Methods. The records of diagnosed cases of propionic acidaemia were reviewed, retrospectively. Results. Twenty-six patients with PA had 133 admissions. The majority (85%) of the patients exhibited clinical manifestations in the 1st week of life. Regarding clinical features, lethargy, fever, poor feeding, vomiting, dehydration, muscular hypotonia, respiratory symptoms, encephalopathy, disturbance of tone and reflexes, and malnutrition were observed in 51–92% admissions. Metabolic crises, respiratory diseases, hyperammonaemia, metabolic acidosis, hypoalbuminaemia, and hypocalcaemia were observed in 30–96% admissions. Pancytopenia, ketonuria, hypoproteinemia, hypoglycaemia, and mildly disturbed liver enzymes were found in 12–41% admissions. Generalised brain oedema was detected in 17% and cerebral atrophy in 25% admissions. Gender-wise odd ratio analysis showed value of 1.9 for lethargy, 1.99 for respiratory diseases, 0.55 for anaemia, and 1.82 for hypocalcaemia. Conclusion. Propionic acidaemia usually presents with wide spectrum of clinical features and disturbances of laboratory parameters in early neonatal age. It is associated with significant complications which deteriorate the patients’ quality of life. Perhaps with early diagnosis of the disease and in time intervention, these may be preventable. Muhammad Rafique Copyright © 2013 Muhammad Rafique. All rights reserved. Immobilization Technologies in Probiotic Food Production Mon, 28 Oct 2013 08:11:09 +0000 Various supports and immobilization/encapsulation techniques have been proposed and tested for application in functional food production. In the present review, the use of probiotic microorganisms for the production of novel foods is discussed, while the benefits and criteria of using probiotic cultures are analyzed. Subsequently, immobilization/encapsulation applications in the food industry aiming at the prolongation of cell viability are described together with an evaluation of their potential future impact, which is also highlighted and assessed. Gregoria Mitropoulou, Viktor Nedovic, Arun Goyal, and Yiannis Kourkoutas Copyright © 2013 Gregoria Mitropoulou et al. All rights reserved. Impact of a Traditional Dietary Supplement with Coconut Milk and Soya Milk on the Lipid Profile in Normal Free Living Subjects Thu, 24 Oct 2013 14:48:09 +0000 Background. The effects of coconut fat and soya fat on serum lipids are controversial. This study was designed to investigate the lipid effects of coconut milk and soya milk supplementation on the lipid profile of free living healthy subjects. Methods. Sixty (60) healthy volunteers aged 18–57 years were given coconut milk porridge (CMP) for 5 days of the week for 8 weeks, followed by a 2-week washout period, subsequent to which they received isoenergetic soya milk porridge (SMP) for 8 weeks. Results. The LDL (low density lipoprotein) levels decreased with CMP and reached statistical significance in the total study population and in the >130 baseline LDL group. The HDL (high density lipoprotein) levels rose significantly with CMP supplementation (). Conclusions. We conclude that coconut fat in the form of CM does not cause a detrimental effect on the lipid profile in the general population and in fact is beneficial due to the decrease in LDL and rise in HDL. SMP will be of benefit only in those whose baseline LDL levels are elevated. R. A. I. Ekanayaka, N. K. Ekanayaka, B. Perera, and P. G. S. M. De Silva Copyright © 2013 R. A. I. Ekanayaka et al. All rights reserved.