Early nutritional determinants in cardio-metabolic programming – A prospective randomized controlled dietary intervention study

Western societies have been faced with the fact that overweight, impaired glucose regulation and elevated blood pressure are already prevalent in pediatric populations. This will inevitably mean an increase in later manifestations of cardio-metabolic diseases. The dilemma has been suggested to stem from fetal life and it is surmised that the early nutritional environment plays an important role in the process called programming. The aim of the present study was to characterize early nutritional determinants associating with cardio-metabolic risk factors in fetuses, infants and children. Further, the study was designated to establish whether dietary counseling initiated in early pregnancy can modify this cascade. Healthy mother-child pairs (n=256) participating in a dietary intervention study were followed from early pregnancy to childhood. The intervention included detailed dietary counseling by a nutritionist targeting saturated fat intake in excess of recommendations and fiber consumption below recommendations. Cardio-metabolic programming was studied by characterizing the offspring’s cardio-metabolic risk factors such as over-activation of the autonomic nervous system, elevated blood pressure and adverse metabolic status (e.g. serum high split proinsulin concentration). Fetal cardiac sympathovagal activation was measured during labor. Postnatally, children’s blood pressure was measured at six-month and four-year follow-up visits. Further, infants’ metabolic status was assessed by means of growth and serum biomarkers (32-33 split proinsulin, leptin and adiponectin) at the age of six months. This study proved that fetal cardiac sympathovagal activity was positively associated with maternal pre-pregnancy body mass index indicating adverse cardio-metabolic programming in the offspring. Further, a reduced risk of high split proinsulin in infancy and lower blood pressure in childhood were found in those offspring whose mothers’ weight gain and amount and type of fats in the diet during pregnancy were as recommended. Of note, maternal dietary counseling from early pregnancy onwards could ameliorate the offspring’s metabolic status by reducing the risk of high split proinsulin concentration, although it had no effect on the other cardio-metabolic markers in the offspring. At postnatal period breastfeeding proved to entail benefits in cardio-metabolic programming. Finally, the recommended dietary protein and total fat content in the child’s diet were important nutritional determinants reducing blood pressure at the age of four years. The intrauterine and immediate postnatal period comprise a window of opportunity for interventions aiming to reduce the risk of cardio-metabolic disorders and brings the prospect of achieving health benefits over one generation.

Nutritional and safety assessments of foods and feeds nutritionally improved through biotechnology: Case studies

During the last 2 decades, the public and private sectors have made substantial international research progress toward improving the nutritional value of a wide range of food and feed crops. Nevertheless, significant numbers of people still suffer from the effects of undernutrition. In addition, the nutritional quality of feed is often a limiting factor in livestock production systems, particularly those in developing countries. As newly developed crops with nutritionally improved traits come closer to being available to producers and consumers, we must ensure that scientifically sound and efficient processes are used to assess the safety and nutritional quality of these crops. Such processes will facilitate deploying these crops to those world areas with large numbers of people who need them. This document describes 5 case studies of crops with improved nutritional value. These case studies examine the principles and recommendations published by the Intl. Life Sciences Inst. (ILSI) in 2004 for the safety and nutritional assessment of foods and feeds derived from nutritionally improved crops (ILSI 2004). One overarching conclusion that spans all 5 case studies is that the comparative safety assessment process is a valid approach. Such a process has been endorsed by many publications and organizations, including the 2004 ILSI publication. The type and extent of data that are appropriate for a scientifically sound comparative safety assessment are presented on a case-by-case basis in a manner that takes into account scientific results published since the 2004 ILSI report. This report will appear in the January issue of Comprehensive Reviews in Food Science and Food Safety.

Do patients with osteogenesis imperfecta need individualized nutritional support?

Objective: Information regarding nutrition and body composition in patients diagnosed with osteogenesis imperfecta (OI) is scarce. In the present study, nutritional status, bone mineral density, and biochemical parameters of subjects with Of were evaluated. Methods: Patients with type I OI (n = 13) and type III OI (n = 13) and healthy controls (n = 8) were selected. Nutritional status and bone mineral density were assessed by a 3-d food diary and dual-energy X-ray absorptiometry at the lumbar spine, respectively. Body mass index, serum albumin, calcium, creatinine, cross-linked C-telopeptide, parathyroid hormone, and 25-hydroxivitamin D-3 were also evaluated. Results: Patients with OI had lower bone mineral density (P < 0.05 versus controls). Patients with type III OI had the highest body mass index (P < 0.05 versus patients with type I OI and controls) and the lowest lean body mass (P < 0.05 versus patients with type I OI and controls). In patients with OI, the number of fractures was positively correlated with body mass index (r = 0.581, P = 0.002) and the percentage of body fat (r = 0.451, P = 0.027) and negatively correlated to lean body mass (r = -0.523, P = 0.009). Even when taking dietary supplements, 58% and 12% of subjects with OI did not achieve the calcium and vitamin D recommendations, respectively. Conclusions: Body composition is a risk factor for bone fractures in subjects with OI. Individualized nutritional support is recommended not only to improve body composition but also to potentiate pharmacologic and physical therapies. (C) 2012 Elsevier Inc. All rights reserved.

Meeting the nutritional requirements of hospitalized patients: an interdisciplinary approach to hospital catering

The study served to assure the quality of our catering, to locate problems, and to define further optimization measures at the Bern University Hospital. The main objective was to investigate whether the macronutrient and energy content of the hospital food complies with the nutritional value calculated from recipes as well as with the recommendations issued by the German Nutrition Society (DGE).

Validity and reliability of a measure of Latina mother's nutritional self-efficacy

Background. Not only has obesity played a role in Texas adults but it is also becoming a large issue among low-income Latino children. In Latino children between 2-5 years of age, the Pediatric Nutrition Surveillance data in 1997 found the prevalence of obesity was 12 percent, highest among all ethnic groups. Children learn what and how to eat from their environment. Despite many mothers being working mothers they are still the principal caregivers and source of influence on their toddler's diet. Self-efficacy, a concept created by Albert Bandura, one's belief that one is capable of performing a behavior needed to reach an intended goal, is increasingly becoming important in nutrition and health education. This study is important to understand the degree of impact that a mother's self-efficacy will have on a child's diet. This is useful knowing if influencing a mother's self-efficacy could improve a child's diet to prevent certain public health issues such as obesity and diabetes. The purpose of this study was to examine nutrition self-efficacy of Latina mothers, focusing on sweets and beverage and if their self-efficacy impacted their child's diet. Methods. The data was collected during July-September 2008. Mothers were recruited from two federally qualified San Antonio health centers. In order to qualify, participants had to be Hispanic with children of toddler age. Mothers were informed of incentives available upon completion. The interview consisted of demographic info, a set of five self-efficacy questions repeated at completion, testing reliability and a 24-hour food recall diary asked of the participant's child's diet. Results. There were 225 mothers who participated between both clinics. The Crohnbach alpha scores for the two different times the self-efficacy questions were asked were .44 corresponding to the first time and .49 for the second time. The three most common beverages reported were milk, juice, and water. The mothers who met or gave their child more milk than recommended by the scientific community, 800mg of calcium/3 cups (24oz) set, had a higher self-efficacy score than those who did not meet the standard at all. Mothers who gave their children more juice than the standard recommends, 4-6oz for children 1-6 years of age, had slightly higher self-efficacy scores than mother's who simply met the standard. In general, the lower the mother's self-efficacy, the more sweets they gave their child and vice versa. Conclusion. This study's Kappa values were adequate and this research showed that Latina mothers did in fact have high self-efficacy. In general some of the children's diets did not reflect the current scientific nutrition recommendations. In order to improve self-efficacy and have an impact on children's diets, the scientific community has a responsibility to make recommendations that are easily understood and can be put into practice. The public health community needs to ensure that we encourage those we serve to be more active in their health and educate them about what constitutes good health and nutrition for both themselves and their children.^

Household risk factors and the health and nutritional status of children in rural Honduras

During this cross-sectional study, both quantitative and qualitative research methods were used to elucidate the role that household environment and sanitation play in the nutritional status of children in a rural Honduran community. Anthropometric measurements were taken as measures of nutritional status among children under five years of age, while interviews regarding the household environment were conducted with their primary caregivers. Community participatory activities were conducted with primary caregivers, and results from water quality testing were analyzed for E. coli contamination. Anthropometric results were compared using the 1977 NCHS Growth Charts and the 2006 WHO Child Growth Standard to examine the implications of using the new WHO standard. The references showed generally good or excellent agreement between z-score categories, except among height-for-age classifications for males 24-35.9 months and weight-for-age classifications for males older than 24 months. Comparing the proportion of stunted, underweight, and wasted children, using the WHO standard generally resulted in higher proportions of stunting, lower underweight proportions, and higher overweight proportions. Logistic regression was used to determine which household and sanitation factors most influenced the growth of children. Results suggest only having water from a spring, stream, or other type of surface water as the primary source of drinking water is a significant risk factor for stunting. A protective association was seen between the household wealth index and stunting. Through participatory activities, the community provided insight on health issues important for improving child health. These activities yielded findings to be harnessed as a powerful resource to unify efforts for change. The qualitative findings were triangulated with the quantitative interview and water testing results to provide intervention recommendations for the community and its primary health care clinic. Recommendations include educating the community on best water consumption practices and encouraging the completion of at least some primary education for primary caregivers to improve child health. It is recommended that a community health worker program be developed to support and implement community interventions to improve water use and household sanitation behaviors and to encourage the involvement of the community in targeting and guiding successful interventions. ^

Improving the transitional experience of previously incarcerated women a nutritional needs assessment at a transitional home in Houston, Texas

Transitional homes present a window of opportunity to address the nutrition-related chronic diseases of previously incarcerated women. However, few transitional facilities offer nutrition education programs. This study assesses the nutritional status of 9 previously incarcerated women living at a transitional home in Houston, Texas and makes recommendations for effective nutrition education programs. Data was collected through individual interviews, questionnaires and a 24-hour dietary recall. Participants differed significantly from national nutrition recommendations when comparing BMI values and fruit, vegetable and fiber intake. Qualitative interview themes concerned key barriers to healthful dietary intake such as inadequate food storage and inconvenient cooking environment. Nutrition education programs at transitional homes should focus on healthy meals and snacks that can be quickly prepared and easily stored in small spaces. ^

Nutritional impact on health and performance in intensively reared rabbits

The present work summarizes research related to the definition of nutrient recommendations for feeds used in the intensive production of rabbit's meat. Fibre is the main chemical constituent of rabbit diets that typically contain 320 to 360 and 50 to 90 g/kg of insoluble and soluble fibre, respectively. Instead, the dietary contents of cereal grains (∼120 to 160 g/kg), fat (15 to 25 g/kg) and protein concentrates (150 to 180 g/kg) are usually low with respect to other intensively reared monogastric animals. Cell wall constituents are not well digested in rabbits, but this effect is compensated by its stimulus of gut motility, which leads to an increasing rate of passage of digesta, and allows achieving an elevated dry matter intake. A high feed consumption and an adequate balance in essential nutrients are required to sustain the elevated needs of high-productive rabbits measured either as reproductive yield, milk production or growth rate in the fattening period. Around weaning, pathologies occur in a context of incomplete development of the digestive physiology of young rabbits. The supply of balanced diets has also been related to the prevention of disorders by means of three mechanisms: (i) promoting a lower retention time of the digesta in the digestive tract through feeding fibre sources with optimal chemical and physical characteristics, (ii) restricting feed intake after weaning or (iii) causing a lower flow of easily available substrates into the fermentative area by modifying feed composition (e.g. by lowering protein and starch contents, increasing its digestibility or partially substituting insoluble with soluble fibre), or by delaying age at weaning. The alteration in the gut microbiota composition has been postulated as the possible primary cause of these pathologies.

Influence of nutritional and management practices on productive performance and egg quality of brown egg-laying hens = Influencia de factores nutricionales y de manejo sobre la productividad y calidad del huevo en gallinas ponedoras rubias

El objetivo general de esta Tesis Doctoral fue estudiar la influencia de diversos factores nutricionales y de manejo sobre la productividad y la calidad del huevo en gallinas ponedoras comerciales rubias. Los factores estudiados fueron: 1) Cereal principal y tipo de grasa en la dieta; 2) Nivel de proteína bruta y grasa en la dieta; 3) Nivel energético de la dieta; 4) Peso vivo al inicio del período de puesta. En el experimento 1, la influencia del cereal principal en la dieta y el tipo de grasa suplementada en la dieta sobre los parámetros productivos y la calidad del huevo fue estudiado en 756 gallinas rubias de la estirpe Lohmann desde la sem 22 hasta las 54 de vida. El experimento se realizó mediante un diseño completamente al azar con 9 tratamientos ordenados factorialmente, con 3 cereales bases (maíz, trigo blando y cebada) y 3 tipos de grasa que variaban en su contenido en ácido linoléico (aceite de soja, oleína vegetal mezcla y manteca). Todas las dietas satisfacian las recomendaciones nutricionales para gallinas ponedoras rubias según el NRC (1994) y FEDNA (2008). La unidad experimental fue la jaula para todas las variables. Cada tratamiento fue replicado 4 veces, y la unidad experimental estuvo formada por 21 gallinas alojadas en grupos de 7. Las dietas fueron formuladas con un contenido nutritivo similar, excepto para el ácido linoléico, que varió en función del tipo de cereal y grasa utilizado. Así, dependiendo de la combinación de estos elementos el contenido de este ácido graso varió desde un 0.8% (dieta trigo-manteca) a un 3.4% (dieta maíz-aceite de soja). Este rango de ácido linoléico permitió estimar el nivel mínimo de este nutriente en el pienso que permite maximizar el peso del huevo. Los parámetros productivos y la calidad del huevo se controlaron cada 28 días y el peso de las aves se midió individualmente al inicio y al final del experimento con el objetivo de estudiar la variación en el peso vivo de los animales. No se observaron interacciones entre el tipo de cereal y grasa en la dieta para ninguna de las variables productivas estudiadas. Los tratamientos experimentales no afectaron a las principales variables productivas (porcentaje de puesta, peso del huevo y masa de huevo). Sin embargo, la ganancia de peso fue mayor en gallinas alimentadas con maíz o trigo que las gallinas alimentadas con cebada (243 vs. 238 vs. 202 g, respectivamente; P< 0.05). En el mismo sentido, las gallinas alimentadas con manteca obtuvieron una mayor ganancia de peso que las gallinas alimentadas con aceite de soja u oleína vegetal (251 vs. 221 vs. 210 g, respectivamente; P< 0.05). En cuanto a las variables estudiadas en relación con la calidad del huevo, ninguna de las variables estudiadas se vio afectada por el tratamiento experimental, salvo la pigmentación de la yema. Así, las gallinas alimentadas con maíz como cereal principal obtuvieron una mayor puntuación en relación con la escala de color que las gallinas alimentadas con trigo y con cebada (9.0 vs. 8.3 vs. 8.3, respectivamente; P< 0.001). La pigmentación de la yema también se vio afectada por el tipo de grasa en la dieta, así, las gallinas alimentadas con manteca obtuvieron una mayor puntuación de color en relación con la escala de color que las gallinas alimentadas con aceite de soja u oleína vegetal (8.9 vs. 8.5 vs. 8.2, respectivamente; P< 0.001). La influencia del contenido en ácido linoléico respecto al peso de huevo y masa de huevo fue mayor a medida que el contenido de dicho ácido graso se redujo en la dieta. Así, la influencia de la dieta en los radios peso de huevo/g linoléico ingerido y masa de huevo/g linoléico ingerido fue significativamente mayor a medida que el contenido en dicho ácido graso disminuyo en la dieta (P< 0.001). Los resultados del ensayo indican que las gallinas ponedoras rubias no necesitan más de un 1.0% de ácido linoléico en la dieta para maximizar la producción y el tamaño del huevo. Además, se pudo concluir que los 3 cereales y las 3 grasas utilizadas pueden sustituirse en la dieta sin ningún perjuicio productivo o referente a la calidad del huevo siempre que los requerimientos de los animales sean cubiertos. En el experimento 2, la influencia del nivel de proteína bruta y el contenido de grasa de la dieta sobre los parámetros productivos y la calidad del huevo fue estudiado en 672 gallinas ponedoras rubias de la estirpe Lohmann entre las sem 22 y 50 de vida. El experimento fue conducido mediante un diseño completamente al azar con 8 tratamientos ordenados factorialmente con 4 dietas y 2 pesos vivos distintos al inicio de puesta (1592 vs. 1860g). Tres de esas dietas diferían en el contenido de proteína bruta (16.5%, 17.5% y 18.5%) y tenían un contenido en grasa añadida de 1.8%. La cuarta dieta tenía el nivel proteico más elevado (18.5%) pero fue suplementada con 3.6% de grasa añadida en vez de 1.8%. Cada tratamiento fue replicado 4 veces y la unidad experimental consistió en 21 gallinas alojadas dentro de grupos de 7 animales en 3 jaulas contiguas. Todas las dietas fueron isocalóricas (2750 kcal EMAn/kg) y cubrieron las recomendaciones en aminoácidos para gallinas ponedoras rubias (Arg, Ile, Lys, Met, Thr, Trp, TSAA y Val) según el NRC (1994) y FEDNA (2008). Los efectos de los tratamientos sobre las variables productivas y la calidad de huevo fueron estudiados cada 28 días. La dieta no afecto a ninguna de las variables productivas estudiadas a lo largo del período productivo. Sin embargo, el peso inicial origino que las gallinas pesadas consumieran más (120.6 vs. 113.9 g; P< 0.001), obtuvieran un porcentaje de puesta mayor (92.5 vs. 89.8%; P< 0.01) y un peso del huevo mayor (64.9 vs. 62.4 g; P< 0.001) que las gallinas ligeras. El peso inicial de las gallinas no afecto al IC por kg de huevo ni a la mortalidad, sin embargo, la ganancia de peso fue mayor (289 vs. 233 g; P< 0.01) y el IC por docena de huevos fue mejor (1.52 vs. 1.57; P< 0.01) en las gallinas ligeras que en las gallinas pesadas. En cuanto a la calidad del huevo, la dieta no influyó sobre ninguna de las variables estudiadas. Los resultados del ensayo muestran que las gallinas ponedoras rubias, independientemente de su peso vivo al inicio de la puesta, no necesitan una cantidad de proteína bruta superior a 16.5% para maximizar la producción, asegurando que las dietas cubren los requerimientos en AA indispensables. Asimismo, se puedo concluir que las gallinas con un peso más elevado al inicio de puesta producen más masa de huevo que las gallinas con un peso más bajo debido a que las primeras producen más cantidad de huevos y más pesados. Sin embargo, ambos grupos de peso obtuvieron el mismo IC por kg de huevo y las gallinas más livianas en peso obtuvieron un mejor IC por docena de huevo que las pesadas. En el experimento 3 la influencia de la concentración energética sobre los parámetros productivos y la calidad del huevo fue estudiada en 520 gallinas ponedoras rubias de la estirpe Hy-Line en el período 24-59 sem de vida. Se utilizaron 8 tratamientos ordenados factorialmente con 4 dietas que variaron en el contenido energético (2650, 2750, 2850 y 2950 kcal EMAn/kg) y 2 pesos vivos distintos al inicio del período de puesta (1733 vs. 1606g). Cada tratamiento fue replicado 5 veces y la unidad experimental consistió en una jaula con 13 aves. Todas las dietas se diseñaron para que tuvieran una concentración nutritiva similar por unidad energética. Las variables productivas y de calidad de huevo se estudiaron mediante controles cada 28 días desde el inicio del experimento. No se observaron interacciones entre el nivel energético y el peso inicial del ave para ninguna de las variables estudiadas. Un incremento en la concentración energética de la dieta incrementó la producción de huevos (88.8 % vs. 91.2 % vs. 92.7 % vs. 90.5 %), masa de huevo (56.1 g/d vs. 58.1 g/d vs. 58.8 g/d vs. 58.1 g/d), y eficiencia energética (5.42 vs. 5.39 vs. 5.38 vs. 5.58 kcal EMA/g huevo) de forma lineal y cuadrática (P< 0.05) y afectó significativamente a la ganancia de peso (255 g vs. 300 g vs. 325 g vs. 359 g; P<0.05) . Sin embargo, un incremento en la concentración energética provocó un descenso lineal en el consumo de los animales (115 g vs. 114 g vs. 111 g vs. 110 g; P< 0.001) y un descenso lineal y cuadrático en el IC por kg de huevo (2.05 vs. 1.96 vs. 1.89 vs. 1.89; P< 0.01). En cuanto a la calidad del huevo, un incremento en el contenido energético de la dieta provocó una reducción en la calidad del albumen de forma lineal en forma de reducción de Unidades Haugh (88.4 vs. 87.8 vs. 86.3 vs. 84.7; P< 0.001), asimismo el incremento de energía redujo de forma lineal la proporción relativa de cáscara en el huevo (9.7 vs. 9.6 vs. 9.6 vs. 9.5; P< 0.001). Sin embargo, el incremento energético propició un incremento lineal en la pigmentación de la yema del huevo (7.4 vs. 7.4 vs. 7.6 vs. 7.9; P< 0.001). El peso vivo al inicio de la prueba afecto a las variables productivas y a la calidad del huevo. Así, los huevos procedentes de gallinas pesadas al inicio de puesta tuvieron una mayor proporción de yema (25.7 % vs. 25.3 %; P< 0.001) y menor de albumen (64.7 vs. 65.0; P< 0.01) y cáscara (9.5 vs. 9.6; P< 0.05) respecto de los huevos procedentes de gallinas ligeras. Consecuentemente, el ratio yema:albumen fue mayor (0.40 vs. 0.39; P< 0.001) para las gallinas pesadas. Según los resultados del experimento se pudo concluir que las actuales gallinas ponedoras rubias responden con incrementos en la producción y en la masa del huevo a incrementos en la concentración energética hasta un límite que se sitúa en 2850 kcal EMAn/kg. Asimismo, los resultados obtenidos entre los 2 grupos de peso al inicio de puesta demostraron que las gallinas pesadas al inicio de puesta tienen un mayor consumo y producen huevos más pesados, con el consecuente aumento de la masa del huevo respecto de gallinas más ligeras. Sin embargo, el IC por kg de huevo fue el mismo en ambos grupos de gallinas y el IC por docena de huevo fue mejor en las gallinas ligeras. Asimismo, la eficiencia energética fue mejor en las gallinas ligeras. Abstract The general aim of this PhD Thesis was to study the influence of different nutritional factors and management on the productivity and egg quality of comercial Brown laying hens. The factor studied were: 1) The effect of the main cereal and type of fat of the diet; 2) The effect of crude protein and fat content of the diet; 3) The effect of energy concentration of the diet; 4) The effect of initial body weight of the hens at the onset of lay period. In experiment 1, the influence of the main cereal and type of supplemental fat in the diet on productive performance and egg quality of the eggs was studied in 756 Lohmann brown-egg laying hens from 22 to 54 wk of age. The experiment was conducted as a completely randomized design with 9 treatments arranged factorially with 3 cereals (dented corn, soft wheat, and barley) and 3 types of fat (soy oil, acidulated vegetable soapstocks, and lard). Each treatment was replicated 4 times (21 hens per replicate). All diets were formulated according to NRC (1994) and FEDNA (2008) to have similar nutrient content except for linoleic acid that ranged from 0.8 (wheat-lard diet) to 3.4% (corn-soy bean oil) depending on the combination of cereal and fat source used. This approach will allow to estimate the minimum level of linoleic acid in the diets that maximizes egg weight. Productive performance and egg quality traits were recorded every 28 d and BW of the hens was measured individually at the beginning and at the end of the experiment. No significant interactions between main factors were detected for any of the variables studied. Egg production, egg weight, and egg mass were not affected by dietary treatment. Body weight gain was higher (243 vs. 238 vs. 202 g; P<0.05) for hens fed corn or wheat than for hens fed barley and also for hens fed lard than for hens fed soy oil or acidulated vegetable soapstocks (251 vs. 221 vs. 210 g; P< 0.05). Egg quality was not influenced by dietary treatment except for yolk color that was greater (9.0 vs. 8.3 vs. 8.3; P< 0.001) for hens fed corn than for hens fed wheat or barley and for hens fed lard than for hens fed soy oil or acidulated vegetable soapstocks (8.9 vs. 8.5 vs. 8.2, respectivamente; P< 0.001). The influence of linoleic acid on egg weight and egg mass was higher when the fatty acid was reduced in the diet. Thus, the influence of the diet in egg weight/g linoleic acid intake and egg mass/g linolec acid intake was higher when the amount of this fatty acid decreased in the diet (P< 0.001). It is concluded that brown egg laying hens do not need more than 1.0% of linoleic acid in the diet (1.16 g/hen/d) to maximize egg production and egg size. The 3 cereals and the 3 fat sources tested can replace each other in the diet provided that the linoleic acid requirements to maximize egg size are met. In experiment 2, the influence of CP and fat content of the diet on performance and egg quality traits was studied in 672 Lohmann brown egg-laying hens from 22 to 50 wk of age. The experiment was conducted as a completely randomized design with 8 treatments arranged factorially with 4 diets and 2 initial BW of the hens (1,592 vs. 1,860 g). Three of these diets differed in the CP content (16.5, 17.5, and 18.5%) and included 1.8% added fat. The fourth diet had also 18.5% CP but was supplemented with 3.6% fat instead of 1.8% fat. Each treatment was replicated 4 times and the experimental unit consisted of 21 hens allocated in groups of 7 in 3 adjacent cages. All diets were isocaloric (2,750 kcal AME/kg) and met the recommendations of brown egg-laying hens for digestible Arg, Ile, Lys, Met, Thr, Trp, TSAA, and Val. Productive performance and egg quality were recorded by replicate every 28-d. For the entire experimental period, diet did not affect any of the productive performance traits studied but the heavier hens had higher ADFI (120.6 vs. 113.9g; P< 0.001), egg production (92.5 vs. 89.8%; P< 0.01), and egg weight (64.9 vs. 62.4g; P< 0.001) than the lighter hens. Initial BW did not affect feed conversion per kilogram of eggs or hen mortality but BW gain was higher (289 vs. 233g; P< 0.01) and FCR per dozen of eggs was better (1.52 vs. 1.57; P< 0.01) for the lighter than for the heavier hens. None of the egg quality variables studied was affected by dietary treatment or initial BW of the hens. It is concluded that brown egg-laying hens, irrespective of their initial BW, do not need more than 16.5% CP to maximize egg production provided that the diet meet the requirements for key indispensable amino acids. Heavier hens produce more eggs that are larger than lighter hens but feed efficiency per kilogram of eggs is not affected. In experiment 3, the influence of AMEn concentration of the diet on productive performance and egg quality traits was studied in 520 Hy-Line brown egg-laying hens differing in initial BW from 24 to 59 wks of age. There were 8 treatments arranged factorially with 4 diets varying in energy content (2,650, 2,750, 2,850, and 2,950 kcal AMEn/kg) and 2 initial BW of the hens (1,733 vs. 1,606 g). Each treatment was replicated 5 times (13 hens per replicate) and all diets had similar nutrient content per unit of energy. No interactions between energy content of the diet and initial BW of the hens were detected for any trait. An increase in energy concentration of the diet increased (linear, P< 0.05; quadratic P< 0.05) egg production (88.8 % vs. 91.2 % vs. 92.7 % vs. 90.5 %), egg mass (56.1 g/d vs. 58.1 g/d vs. 58.8 g/d vs. 58.1 g/d), energy efficiency (5.42 vs. 5.39 vs. 5.38 vs. 5.58 kcal AMEn/g of egg), and BW gain (255 g vs. 300 g vs. 325 g vs. 359 g; P<0.05) but decreased ADFI (115 g vs. 114 g vs. 111 g vs. 110 g; P< linear, P< 0.001) and FCR per kg of eggs (2.05 vs. 1.96 vs. 1.89 vs. 1.89; linear, P< 0.01; quadratic P< 0.01). An increase in energy content of the diet reduced Haugh units (88.4 vs. 87.8 vs. 86.3 vs. 84.7; P< 0.01) and the proportion of shell in the egg (9.7 vs. 9.6 vs. 9.6 vs. 9.5; P< 0.001). Feed intake (114.6 vs. 111.1 g/hen per day), AMEn intake (321 vs. 311 kcal/hen per day), egg weight (64.2 vs. 63.0 g), and egg mass (58.5 vs. 57.0 g) were higher for the heavier than for the lighter hens (P<0.01) but FCR per kg of eggs and energy efficiency were not affected. Eggs from the heavier hens had higher proportion of yolk (25.7 % vs. 25.3 %; P< 0.001) and lower of albumen (64.7 vs. 65.0; P< 0.01) and shell (9.5 vs. 9.6; P< 0.05) than eggs from the lighter hens. Consequently, the yolk to albumen ratio was higher (0.40 vs. 0.39; P< 0.001) for the heavier hens. It is concluded that brown egg-laying hens respond with increases in egg production and egg mass, to increases in AMEn concentration of the diet up to 2,850 kcal/kg. Heavy hens had higher feed intake and produced heavier eggs and more egg mass than light hens. However, energy efficiency was better for the lighter hens.

Estudio de las dinámicas de pérdida de peso corporal en los programas de ejercicio físico y nutrición = Study of the dynamics of body weight loss in exercise and nutritional programs

Introducción. La obesidad puede definirse como una enfermedad metabólica crónica de origen multifactorial, lo que provoca trastornos o problemas físicos y psicológicos a la persona, con patologías asociadas que limitan la esperanza de vida y deterioran la calidad de la misma, siendo determinante para sus áreas sociales y laborales. Este trastorno metabólico crónico se caracteriza por una acumulación excesiva de energía en el cuerpo en forma de grasa, lo que lleva a un aumento de peso con respecto al valor esperado por sexo, edad y altura. La gestión y el tratamiento de la obesidad tienen objetivos más amplios que la pérdida de peso e incluyen la reducción del riesgo y la mejora de la salud. Estos pueden ser alcanzados por la pérdida modesta de peso (es decir, 10.5% del peso corporal inicial), la mejora del contenido nutricional de la dieta y un modesto incremento en la actividad física y condición física. La dieta es uno de los métodos más populares para perder peso corporal. El ejercicio es otra alternativa para perder peso corporal. El aumento de ejercicio provoca un desequilibrio cuando se mantiene la ingesta calórica. También tiene ventajas, como la mejora del tono muscular, la capacidad cardiovascular, fuerza y flexibilidad, aumenta el metabolismo basal y mejora el sistema inmunológico. Objetivos. El objetivo de esta tesis es contribuir en un estudio de intervención para aclarar la evolución del peso corporal durante una intervención de dieta y ejercicio. Para ello, se evaluaron los efectos de la edad, sexo, índice de masa corporal inicial y el tipo de tratamiento en las tendencias de pérdida de peso. Otro objetivo de la tesis era crear un modelo de regresión lineal múltiple capaz de predecir la pérdida de peso corporal después del periodo de intervención. Y, por último, determinar el efecto sobre la composición corporal (peso corporal, índice de masa corporal, la masa grasa, y la masa libre de grasa) de las diferentes intervenciones basadas en ejercicios (fuerza, resistencia, resistencia combinada con fuerza, y las recomendaciones de actividad física (grupo control)) en combinación con dieta de adultos con sobrepeso y obesidad, después de la intervención, así como los cambios de la composición corporal 3 años más tarde. Diseño de la investigación. Los datos empleados en el análisis de esta tesis son parte del proyecto “Programas de Nutrición y Actividad Física para el tratamiento de la obesidad” (PRONAF). El proyecto PRONAF es un estudio clínico sobre programas de nutrición y actividad física para el sobrepeso y la obesidad, desarrollado en España durante varios años de intervención. Fue diseñado, en parte, para comparar diferentes tipos de intervención, con el objetivo de evaluar su impacto en las dinámicas de pérdida de peso, en personas con sobrepeso y obesidad. Como diseño experimental, el estudio se basó en una restricción calórica, a la que, en algunos casos, se le añadió un protocolo de entrenamiento (fuerza, resistencia, o combinado, en igualdad de volumen e intensidad). Las principales variables para la investigación que comprende esta tesis fueron: el peso corporal y la composición corporal (masa grasa y masa libre de grasa). Conclusiones. En esta tesis, para los programas de pérdida de peso en personas con sobrepeso y obesidad con un 25-30% de la restricción calórica, el peso corporal se redujo significativamente en ambos sexos, sin tener en cuenta la edad y el tipo de tratamiento seguido. Según los resultados del estudio, la pérdida de peso realizada por un individuo (hombre o mujer) durante los seis meses puede ser representada por cualquiera de las cinco funciones (lineal, potencial, exponencial, logarítmica y cuadrática) en ambos sexos, siendo la cuadrática la que tiende a representarlo mejor. Además, se puede concluir que la pérdida de peso corporal se ve afectada por el índice de masa corporal inicial y el sexo, siendo mayor para las personas obesas que para las de sobrepeso, que muestran diferencias entre sexos sólo en la condición de sobrepeso. Además, es posible calcular el peso corporal final de cualquier participante involucrado en una intervención utilizando la metodología del proyecto PRONAF sólo conociendo sus variables iniciales de composición corporal. Además, los cuatro tipos de tratamientos tuvieron resultados similares en cambios en la composición corporal al final del período de intervención, con la única excepción de la masa libre de grasa, siendo los grupos de entrenamiento los que la mantuvieron durante la restricción calórica. Por otro lado, sólo el grupo combinado logra mantener la reducción de la masa grasa (%) 3 años después del final de la intervención. ABSTRACT Introduction. Obesity can be defined as a chronic metabolic disease from a multifactorial origin, which leads to physical and psychological impacts to the person, with associated pathologies that limit the life expectancy and deteriorate the quality of it, being determinant for the social and labor areas of the person. This chronic metabolic disorder is characterized by an excessive accumulation of energy in the body as fat, leading to increased weight relative to the value expected by sex, age and height. The management and treatment of obesity have wider objectives than weight loss alone and include risk reduction and health improvement. These may be achieved by modest weight loss (i.e. 5–10% of initial body weight), improved nutritional content of the diet and modest increases in physical activity and fitness. Weight loss through diet is one of the most popular approaches to lose body weight. Exercise is another alternative to lose body weight. The increase of exercise causes an imbalance when the caloric intake is maintained. It also has advantages such as improved muscle tone, cardiovascular fitness, strength and flexibility, increases the basal metabolism and improves immune system. Objectives. The aim of this thesis is to contribute with an interventional study to clarify the evolution of the body weight during a diet and exercise intervention. For this, the effects of age, sex, initial body mass index and type of treatment on weight loss tendencies were evaluated. Another objective of the thesis was to create a multiple linear regression model able to predict the body weight loss after the intervention period. And, finally, to determine the effect upon body composition (body weight, body mass index, fat mass, and fat-free mass of different exercise-based interventions (strength, endurance, combined endurance and strength, and physical activity recommendations group (control group)) combined with diet in overweight and obese adults, after intervention as well as body composition changes 3 years later. Research Design. The data used in the analysis of this thesis are part of the project "Programs of Nutrition and Physical Activity for the treatment of obesity" (PRONAF). The PRONAF project is a clinical trial program about nutrition and physical activity for overweight and obesity, developed in Spain for several years of intervention. It was designed, in part, to compare different types of intervention, in order to assess their impact on the dynamics of weight loss in overweight and obese people. As experimental design, the study was based on caloric restriction, which, in some cases, added a training protocol (strength, endurance, or combined in equal volume and intensity). The main research variables comprising this thesis were: body weight and body composition outcomes (fat mass and fat-free mass). Conclusions. In this thesis, for weight loss programs in overweight and obese people with 25-30% of caloric restriction, the body weight was significantly decreased in both sexes, regardless the age and type of followed treatment. According to the results of the study, the weight loss performed by an individual (male or female) during six months can be represented by any of the five functions (linear, power law, exponential, logarithmic and quadratic) in both sexes, being the quadratic one which tends to represent it better. In addition, it can be concluded that the body weight loss is affected by the initial body mass index and sex condition, being greater for the obese people than for the overweight one, showing differences between sexes only in the overweight condition. Moreover, it is possible to calculate the final body weight of any participant engaged in an intervention using the PRONAF Project methodology only knowing their initial body composition variables. Furthermore, the four types of treatments had similar results on body composition changes at the end of the intervention period, with the only exception of fat-free mass, being the training groups the ones that maintained it during the caloric restriction. On the other hand, only the combined group achieved to maintain the fat mass (%) reduced 3 years after the end of the intervention.

Global standard for the composition of infant formula: Recommendations of an ESPGHAN coordinated international expert group

The Codex Alimentarius Commission of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) develops food standards, guidelines and related texts for protecting consumer health and ensuring fair trade practices globally. The major part of the world's population lives in more than 160 countries that are members of the Codex Alimentarius. The Codex Standard on Infant Formula was adopted in 1981 based on scientific knowledge available in the 1970s and is currently being revised. As part of this process, the Codex Committee on Nutrition and Foods for Special Dietary Uses asked the ESPGHAN Committee on Nutrition to initiate a consultation process with the international scientific community to provide a proposal on nutrient levels in infant formulae, based on scientific analysis and taking into account existing scientific reports on the subject. ESPGHAN accepted the request and, in collaboration with its sister societies in the Federation of International Societies on Pediatric Gastroenterology, Hepatology and Nutrition, invited highly qualified experts in the area of infant nutrition to form an International Expert Group (IEG) to review the issues raised. The group arrived at recommendations on the compositional requirements for a global infant formula standard which are reported here.

Dietary analysis and nutritional behaviour in people with and without age-related macular disease

Background and Aims: Consumption of antioxidant nutrients can reduce the risk of progression of age-related macular degeneration (AMD) - the leading cause of visual impairment in adults over the age of 50 years in the UK. Lutein and zeaxanthin (L&Z) are of particular interest because they are selectively absorbed by the central retina. The objectives of this study were to analyse the dietary intake of a group of AMD patients, assess their ability to prepare and cook healthy food, and to make comparisons with people not affected by AMD. Methods: 158 participants with AMD were recruited via the UK charity The Macular Society, and fifty participants without AMD were recruited from optometric practice. A telephone interview was conducted by trained workers where participants completed a 24 hour food diary, and answered questions about cooking and shopping capabilities. Results: In the AMD group, the average L&Z intake was low in for both males and females. Those able to cook a hot meal consumed significantly more L&Z than those who were not able. Most participants were not consuming the recommended dietary allowance of fibre, calcium, vitamin D and E, and calorific intake was also lower than recommendations for their age-group. The non-AMD group consumed more kilocalories and more nutrients than the AMD group, but the L&Z intake was similar to those with AMD. The main factor that influenced participant’s food choices was personal preference. Conclusion: For an ‘informed’ population, many AMD participants were under-consuming nutrients considered to be useful for their condition. Participants without AMD were more likely to reach recommended daily allowance values for energy and a range of nutrients. It is therefore essential to design more effective dietary education and dissemination methods for people with, and at risk of, AMD.

Designing Lifestyle-specific Food Policies Based on Nutritional Requirements and Ecological Footprints.

Expanded understanding of the trends and determinants of food consumption is needed to reduce the ecological impacts of the contemporary agro-food system while also being attentive to broader issues pertaining to health and the environment. Incorporating these additional aspects and formulating meaningful dietary recommendations is a major challenge. This article seeks to highlight differences in ecological footprint (EF) by activity level for various so-cial groups to meet suggested physiological requirements by nutritionists versus actual food consumption. The study is based on a combination of healthy diet requirements (as expressed by national guidelines) and a survey of a repre-sentative sample of 1,013 Hungarian adults using a bottom-up approach for calculating EFs. Students and women with small children have a higher than average food-related EF due to their higher nutritional needs. At the same time, the elderly are characterized by lower footprints. Perhaps most interesting is our finding that people with seden-tary forms of employment have higher food footprints than those with jobs that require physical labor. We offer rec-ommendations for food-policy planning based on encouraging dietary changes for individuals, differentiated by the nature of their work. The research suggests that dietary policy that improves health often has environmental benefits.

The impact of cooking methods on the nutritional quality and safety of chicken breaded nuggets

The impact of cooking methods (industrial pre-frying, deep-fat frying and baking) on the nutritional quality and safety of chicken breaded nugget samples from supermarket and commercial brands was evaluated. The changes in the quality characteristics (nutritional composition, fatty acids profile, cholesterol and salt) of the fried food and frying oil, after ten consecutive frying operations, were evaluated. The total fat content of nuggets varied between 10.9 and 22.7 g per 100 g of edible portion and the salt content ranged from 0.873 to 1.63 g per 100 g. Taking into account one portion of nuggets, the daily intake of salt can reach 49%, which can have a significant impact on the health of those who regularly consume this type of food, especially considering the prevalence of hypertension around the world. The analysed chicken breaded nuggets are rich in unsaturated fatty acids, which have been related with potential health benefits, namely regarding cardiovascular diseases. The cholesterol content of baked samples was two times higher when compared with the fried ones. The trans fatty acids and polar compounds contents of the frying oil used for frying significantly increased, but the values were still away from the maximum recommended by legal entities for its rejection. From a nutritional point of view, it is possible to conclude that the applied cooking methods can significantly influence the nutritional quality and safety of the analysed chicken breaded nuggets. This study will contribute to important knowledge on how the applied cooking methods can change the nutritional quality and safety of foods, namely of chicken nuggets, and can be very useful for dietary recommendations and nutritional assessment.

Sociodemographic factors influencing adherence to antenatal iron supplementation recommendations among pregnant women in Malawi: Analysis of data from the 2010 Malawi Demographic and Health Survey

Background and Aim: Maternal morbidity and mortality statistics remain unacceptably high in Malawi. Prominent among the risk factors in the country is anaemia in pregnancy, which generally results from nutritional inadequacy (particularly iron deficiency) and malaria, among other factors. This warrants concerted efforts to increase iron intake among reproductive-age women. This study, among women in Malawi, examined factors determining intake of supplemental iron for at least 90 days during pregnancy. Methods: A weighted sample of 10,750 women (46.7%), from the 23,020 respondents of the 2010 Malawi Demographic and Health Survey (MDHS), were utilized for the study. Univariate, bivariate, and regression techniques were employed. While univariate analysis revealed the percent distributions of all variables, bivariate analysis was used to examine the relationships between individual independent variables and adherence to iron supplementation. Chi-square tests of independence were conducted for categorical variables, with the significance level set at P < 0.05. Two binary logistic regression models were used to evaluate the net effect of independent variables on iron supplementation adherence. Results: Thirty-seven percent of the women adhered to the iron supplementation recommendations during pregnancy. Multivariate analysis indicated that younger age, urban residence, higher education, higher wealth status, and attending antenatal care during the first trimester were significantly associated with increased odds of taking iron supplementation for 90 days or more during pregnancy (P < 0.01). Conclusions: The results indicate low adherence to the World Health Organization’s iron supplementation recommendations among pregnant women in Malawi, and this contributes to negative health outcomes for both mothers and children. Focusing on education interventions that target populations with low rates of iron supplement intake, including campaigns to increase the number of women who attend antenatal care clinics in the first trimester, are recommended to increase adherence to iron supplementation recommendations.