Correction: Bogusz, A.; Górnicka, M. Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study. Healthcare 2024, 12, 673.

The authors would like to make the following corrections to the publication, dealing with references #25 and #42 [...].

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study.

Endometriosis is a chronic gynecological disease characterized by ectopic endometrial tissue outside the uterus that can cause chronic pain, dysmenorrhea, fatigue, and infertility. The aim of this study was to assess diet quality and nutritional knowledge of women with endometriosis. A questionnaire was used to collect data on lifestyle, dietary habits and nutritional knowledge from 90 women. More than 80% of women with endometriosis (82.2%) confirmed that diet and lifestyle are related to the progression of endometriosis. After being diagnosed with endometriosis, 77.3% of respondents reported a change in their dietary habits and made various changes to their diet by increasing or eliminating the consumption of certain foods. The majority declared reducing pro-inflammatory products, increasing anti-inflammatory foods, including the consumption of vegetables and fruits, avoiding white/or red/or processed meat, and avoiding sweets. Nevertheless, diet quality as assessed by the pro-healthy diet index (pHDI-10) and the Mediterranean Diet Score (MDS) showed a low intensity of consumption of pro-healthy food (average pHDI-10 value 31.4%; MDS 7.55/14 points, p = 0.0001). Women with endometriosis reported lower than recommended consumption of fruits, vegetables, dairy products and whole grains. A higher percentage of healthy controls had a "good" level of nutritional knowledge than women with endometriosis. The results of our study highlight the need to improve diet quality and nutritional knowledge among women with endometriosis as well as developing targeted dietary recommendations to help improve well-being and reduce the pain symptoms of endometriosis.

Healthy and sustainable school meals - proposal for a new quality index SMI-LE.

INTRODUCTION AND OBJECTIVE: Provision of healthy and high-quality school meals is an important solution to improve children's health and well-being. Moreover, the meals provided at schools should not only meet dietary guidelines but also questions of sustainability. The aim of the study was to develop a new index to assess the quality of school meal menus, specifically their accordance with actual regulations, dietary guidelines and some sustainability goals. MATERIAL AND METHODS: The School Meal Index-Lunch Evaluation (SMI-LE) is an originally created index to evaluate the quality of 5-day school menus. The general idea is to reflect the healthy and sustainability issues that should be present in school canteens according to WHO and EU recommendations. The index was tested in a real-life situation and fifty 5-day school menus available online from primary schools located in different regions of Poland, in rural and urban areas, were assessed with SMI-LE. RESULTS: The median value of SMI-LE equaled 52 /140 points. Most of the analyzed menus (72%) were classified as 'Medium' quality according to SMI-LE. The menus classified as 'Low' were characterized by the lowest energy value, the lowest content of calcium, magnesium, iron, potassium, and folates, while the highest of sodium. Menus from the 'Good' category had the highest nutritional value, as well as the lowest sodium content. CONCLUSIONS: A novel tool to has been provided for measuring the quality of school meals that addresses health and sustainability issues. It responds to the need for new indices that would consider changes in dietary guidelines and increasing knowledge about the impact of food systems on the environment.

Changes in Plasma Carotenoid Concentrations during the AntioxObesity Weight Reduction Program among Adults with Excessive Body Weight.

Plasma carotenoid concentrations are associated with antioxidant defense which might be disturbed in people with excessive body weight (EBW). This study aimed at evaluating the effect of a 6-week weight reduction program on plasma concentration of ß-carotene, lycopene, and lutein/zeaxanthin in adults with EBW. A total of 130 adults were recruited for the study; 75 completed the program. Data on food consumption were collected with a 3-day recording method and a semi-quantitative FFQ. Body height, body weight (BW), waist circumference (WC), fat mass (FM), fat-free mass (FFM), abdominal subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) were measured. Lipid profile, ß-carotene, lycopene, and lutein/zeaxanthin were analyzed in blood. The AntioxObesity program resulted in a significant reduction in BW, WC, FM, SAT, and VAT. The mean plasma concentrations of ß-carotene, lycopene, and lutein/zeaxanthin increased significantly after intervention. A reduction in FM above 4 kg significantly increased the concentration of ß-carotene, lutein/zeaxanthin, and total carotenoids. An increase in carotenoid levels correlated with FM reduction, as fruit and vegetable intake remained unchanged. However, this effect may vary due to gender, HDL-cholesterol, body fat content, and obesity status in the weight loss process.

Dietary Vitamin E Isoforms Intake: Development of a New Tool to Assess Tocopherols and Tocotrienols Intake in Adults.

Due to the documented health benefits of tocopherols and tocotrienols as bioactive compounds, it seems important to assess their intake. The aim of this study was to develop a new tool and its application for assessment of tocopherol and tocotrienol intake in adults. Dietary data were collected by semiquantitative FFQ (VitE-FFQ) and by a 1-day dietary record in a group of 447 subjects. The database of the US Department of Agriculture (USDA) was used to calculate the individual isoforms of vitamin E and develop the tool-VIT_E.CAL. The assessment of measuring agreement between the two methods was conducted by analysis of the correlations and Bland-Altman plots. The average α-tocopherol intake was 11.3 mg/day for the data obtained using the FFQ method and 12.8 mg/day for the results obtained using the 1-day dietary record. Depending on the adopted recommendation, only 40-57% of the subjects had adequate vitamin E intake. The intake of α-tocopherol did not exceed the UL value in any of the respondents. The dominant forms of vitamin E in the diet of the studied group were α- and γ- forms (55% and 38% of the total sum) among tocopherols and ß- and γ- forms (49% and 24% of the total sum) among tocotrienols. VIT_E.CAL allows us to calculate not only the total amount of vitamin E but also its eight isoforms. It can be a useful tool to assess individual and group intake of various forms of vitamin E in the diet. The use of VIT_E.CAL enables the proper assessment of vitamin E (as α-tocopherol and not α-tocopherol equivalent) in the diet of Poles, and most likely also in the European diet. The obtained results indicate the need to take into account the content of individual forms of vitamin E in food/diet, which will allow for a reliable assessment of its consumption. It also seems necessary to standardize the nomenclature regarding the name of vitamin E and its use for correct nutritional assessment.

Plasma Carotenoids and Polyphenols and Their Association with MetS: The Need for Nutritional Interventions.

Metabolic syndrome (MetS) is characterized by increased pro-oxidative stress and a chronic inflammation state and their consequent alterations. Several studies have highlighted the protective effect of carotenoids and polyphenols in MetS patients. This study aimed to evaluate the plasma level of selected carotenoids and polyphenols and to determine their relationship with MetS severity, MetS components, and inflammatory markers in Polish adults with metabolic disorders. It was designed as a cross-sectional study. The final study group comprised 275 adults, including 158 women and 117 men. Data were collected on the frequency of consumption of selected food groups. Anthropometric measurements and blood samples were taken to determine the concentration of carotenoids, polyphenols, and indicators (parameters) of metabolic disorders. Plasma concentrations of selected carotenoids and polyphenols were low in adults with MetS. The highest concentrations of carotenoids and polyphenols in the blood were observed for lutein and phenolic acids (including gallic and p-coumaric acids). Nevertheless, a correlation was found between the individual bioactive compounds and MetS components. In terms of the lipid profile, our study showed that the plasma of the selected carotenoids and polyphenols positively correlated with HDL cholesterol (zeaxanthin; total carotenoids), LDL cholesterol (chlorogenic acid), triglycerides (lycopene), and the total cholesterol (kaempferol). We found that the level of CRP as a marker of inflammation negatively correlated with the concentration of zeaxanthin. In our study group, no relationship was found between the dietary antioxidant intensity and the variables studied, which may be attributed to the low frequency of consumption of the sources of bioactive compounds, such as carotenoids and polyphenols, but also to the metabolic disorders. Further research is needed to determine whether these associations are causally related to the metabolic syndrome or are a result of the pathologies of the syndrome or improper diet with a low intake of vegetables and fruit.

Associations between Dietary Patterns, Anthropometric and Cardiometabolic Indices and the Number of MetS Components in Polish Adults with Metabolic Disorders.

Diet-therapy of metabolic syndrome (MetS) is of great importance due to significant health and social consequences. The aim of this study was (1) to determine dietary patterns (DPs), and (2) to search for associations between defined DPs, anthropometric and cardiometabolic indices, and the number of MetS components in Polish adults with metabolic disorders. The study was designed as a cross-sectional. The study group was 276 adults. Data about the frequency of consumption of selected food groups were collected. Anthropometric measurements: body height (H), body weight (BW), waist (WC), and hip (HC), as well as body composition, were taken. Blood samples were obtained for measurements of glucose and lipids. The obtained biochemical and anthropometric parameters were used to calculate the anthropometric and metabolic dysfunction indices. Three dietary patterns were identified in our study group: Western, Prudent and Low Food. Results of logistic regression analysis indicated rare consumption of fish as a predictor of risk of more severe forms of MetS. The possibility of using body roundness index (BRI) for fast diagnosis of cardiometabolic risk was found. In the management of MetS, the development of strategies to reduce the risk of more severe forms of MetS should be focused on increasing fish consumption and other prohealthy food.

The Role of Dietary Fats in the Development and Treatment of Endometriosis.

Endometriosis is an estrogen-dependent disease in women of childbearing age that affects approximately 5-15% of the female population. The etiology of endometriosis is complex, multifaceted, and not fully understood. In endometriosis, which is an estrogen-related chronic inflammatory condition, estrogen plays a major role in endometrial cellular growth. High estrogen levels could be another risk factor for developing endometriosis. The aim of this review is to update knowledge on the impact of dietary fats on the development of endometriosis and chronic inflammation in women with endometriosis and diet therapy. Dietary fat may be linked with the progression and development of endometriosis, but studies have been contradictory due to various issues including sample size, different study designs, and different methodological aspects. Results have shown that the risk of endometriosis may increase with a higher consumption of products rich in saturated fats, especially palmitic acid and trans-unsaturated fatty acids. Monounsaturated fats and omega-3 polyunsaturated fatty acids may likely be connected with a lower risk of developing endometriosis and with reductions in the severity of disease. Monounsaturated fats, omega-3 polyunsaturated fatty acids, and a suitable eicosapentaenoic acid to arachidonic acid ratio can be used in diet therapy to improve quality of life by reducing pain and inflammation. Further research is needed in order to fully understand the influence of dietary fats on the risk of development of this disease.

Tocopherols and Tocotrienols-Bioactive Dietary Compounds; What Is Certain, What Is Doubt?

Tocopherols and tocotrienols are natural compounds of plant origin, available in the nature. They are supplied in various amounts in a diet, mainly from vegetable oils, some oilseeds, and nuts. The main forms in the diet are α- and γ-tocopherol, due to the highest content in food products. Nevertheless, α-tocopherol is the main form of vitamin E with the highest tissue concentration. The α- forms of both tocopherols and tocotrienols are considered as the most metabolically active. Currently, research results indicate also a greater antioxidant potential of tocotrienols than tocopherols. Moreover, the biological role of vitamin E metabolites have received increasing interest. The aim of this review is to update the knowledge of tocopherol and tocotrienol bioactivity, with a particular focus on their bioavailability, distribution, and metabolism determinants in humans. Almost one hundred years after the start of research on α-tocopherol, its biological properties are still under investigation. For several decades, researchers' interest in the biological importance of other forms of vitamin E has also been growing. Some of the functions, for instance the antioxidant functions of α- and γ-tocopherols, have been confirmed in humans, while others, such as the relationship with metabolic disorders, are still under investigation. Some studies, which analyzed the biological role and mechanisms of tocopherols and tocotrienols over the past few years described new and even unexpected cellular and molecular properties that will be the subject of future research.

Long-term effect of one-time nutritional education in school on nutritional knowledge of early school-aged children.

BACKGROUND: In the group of school-aged children nutritional education (NE) enables an early development of healthy eating habits, which can be transferred to the adult life. OBJECTIVE: The aim of the study was to assess the long-term effect of a one-time nutritional education, including also culinary workshops, on the level of nutritional knowledge (NK) of early school-aged children as well as to analyse the nutritional content of the children's books. MATERIAL AND METHODS: The study was conducted among second- and third-grade pupils from a primary school in Warsaw (n=76). The level of NK was determined using the same, self-administrated questionnaire at each of the three stages of the study. RESULTS: The level of NK was assumed as very good in 47% of respondents before the education, in 91% immediately after the education, and in 74% six months after it. Out of all 23.0 points (max.) on average 18.1 points were obtained at the first stage, 21.1 points at the second stage and 19.7 points at the third stage (p<0.001). Immediately after the NE and six months after it the level of NK increased significantly (comparing to the first stage) especially on these topics: the daily water requirements and the recommendations on physical activity (p<0.001 for both questions). CONCLUSIONS: The results of the study confirmed the effectiveness of a one-time nutritional education on the level of nutritional knowledge. Moreover, results show that in the research group nutritional knowledge about importance of physical activity, adequate nutrition, eating varicoloured vegetables and fruits, screen time limits and distinguishing between healthy and unhealthy products was satisfactory, even at the baseline, but in the main source of fats in a diet, the role of milk products, the effect of having too little water in a diet and the sugar content in food children's knowledge was not enough.

Patterns of Avoiding Nutrition Mistakes in Metropolitan Adolescents Are Associated with Sex, Nutrition Knowledge, Physical Activity, and Family Environment.

A comprehensive approach to the identification of the relationship between behaviors limiting nutrition mistakes, nutrition knowledge, and physical activity in the context of the family environment has not yet been widely explored. We aim to identify patterns of avoiding nutrition mistakes in high school students from Warsaw, Poland, and to assess their associations with nutrition knowledge (NK), physical activity (PA), body mass index (BMI), demographic, and family environment characteristics. A cross-sectional study involving 616 high school students, aged 16-19, was conducted. The data were collected by distributing questionnaires. The k-means method was used for cluster analysis, and logistic regression was used to assess the adherence to identified patterns. We identified three patterns: Prudent Ones (45%), Inconsequent (39%), and Rebels (16%). About 70% of adolescents had insufficient NK. The adherence to the Rebels pattern was lower by 85 % in girls, by 68% in students with younger siblings, and was about 4.0-times higher in children of mothers with primary education, 2.4 times higher in students with insufficient NK, and 1.9-times higher in students living in a family with more than 4 persons. The groups of adolescents with feature characteristics of the Rebels and Inconsequent are possible targets for intervention and require further in-depth research to explain their lack of attempts to avoid nutrition mistakes. The results clearly indicate the necessity of including metropolitan teenage boys in effective nutritional education for the rationalization of their dietary behavior.

Dietary Supplements during COVID-19 Outbreak. Results of Google Trends Analysis Supported by PLifeCOVID-19 Online Studies.

The use of dietary supplements (DSs) has been steadily increasing all over the world and additionally, the sales of DSs have dynamical increased in the wake of coronavirus disease 2019 (COVID-19) in most of the countries. We investigated DSs phenomenon in 2020 through (1) exploration of Google searches worldwide and in Poland (with Google Trends (GT) tool), and (2) analyses of results of PLifeCOVID-19 Online Studies conducted during the first and second wave of the pandemic. The conducted GT analysis and cross-sectional studies revealed that during the COVID-19 outbreak in March 2020, the interest in immune-related compounds and foods like vitamins C and D, zinc, omega-3, garlic, ginger, or turmeric, as well as their consumption increased. Improving immunity was the main reason behind the supplementation and changes in consumption of pro-healthy foods. GT analysis has shown these interests were positively correlated with the interest in COVID-19, but adversely with cumulative cases or deaths. Respondents tended to start supplementation during the first COVID-19 wave rather than the second one. Except for the role of vitamins D and C, zinc, and selenium in patients with deficiencies of those nutrients, there are no clear and convincing studies that support the role of DSs use in COVID-19 prevention and treatment in healthy, well-nourished individuals. Moreover, as the risk of elevated intake of some nutrients due to the popularity of DSs exists, effective education of consumers in rationale use of DSs and health-protecting behaviors against COVID-19 should be developed.

Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. Report from the ABC of Healthy Eating Study.

Today, the time spent actively is increasingly being replaced by screen-based media, although in some teenagers, a high level of physical activity (PA) and longer time spent in front of a screen (screen time, ST) may coexist as a mixed behavioral pattern. This study aimed to examine the association of the pattern created as activity (low/high ST with high PA) and inactivity patterns (low/high ST with low PA) with overweight, central obesity, and muscle strength in Polish teenagers taking into consideration socioeconomic and demographic factors. Cross-sectional data were collected from elementary school children (n = 1567), aged 11-13 years. Height, weight, waist circumference, and handgrip strength were measured. Body mass index (BMI) was calculated as the overweight measure, and the waist-to-height ratio (WHtR) was calculated as the central obesity measure. Data on ST, PA, socioeconomic status, demographics, and nutrition knowledge were collected by a questionnaire. Activity-inactivity patterns were defined by an a priori approach. Multivariate logistic regression modelling was applied. The most active pattern (lowST-highPA) was found in 17% of the total sample. Teenagers with the most inactive pattern (highST-lowPA) had over four times higher chance of general overweight. No association between WHtR ≥0.5 and highST-highPA pattern was found. Higher muscle strength (>1 SD) was associated only with high physical activity. Urban residence or lower socioeconomic status increased adherence to the most inactive pattern. From a public health perspective, implementing interventions promoting active patterns in 11-13-year-old teenagers is important for obesity prevention and enhanced physical fitness, especially in girls, teenagers living in urban areas, and from families with lower socio-economic status.

Dietary and Lifestyle Changes During COVID-19 and the Subsequent Lockdowns among Polish Adults: A Cross-Sectional Online Survey PLifeCOVID-19 Study.

The present study aimed to identify patterns of dietary changes during the COVID-19 pandemic and their associations with sociodemographics, body mass index (BMI) before pandemic, and lifestyle changes in Polish adults and to examine the effects of lockdowns on dietary-lifestyle changes. This study used a cross-sectional online survey to collect data. The k-means algorithm was used to determine of patterns of dietary changes, and logistic regression analyses were performed. During the study period, 43% of respondents decreased physical activity (PA), 49%-increased screen time, and 34%-increased food consumption. Among the three dietary changes patterns, two opposite patterns were found: Prohealthy (28% participants) and Unhealthy (19% participants).The adherence to the Prohealthy pattern was negatively associated with age, but positively with being overweight (aOR 1.31) or obese before pandemic (aOR 1.64). Residing in a macroeconomic region with GDP > 100% decreased adherence to the Prohealthy (aOR 0.73) but increased adherence to the Unhealthy pattern (aOR 1.47). Adults over 40 years old, those living with children, unemployed, those living in a region with a higher GDP, and those not consuming homemade meals could be more exposed to unhealthy behaviors. From a public health perspective, enhancing the message "to be active" during the compulsory isolation period should be prioritized.

Analysis of Association between Breastfeeding and Vegetable or Fruit Intake in Later Childhood in a Population-Based Observational Study.

Vegetable and fruit consumption in childhood remains below recommendations in many countries. As the intake of fruit and/or vegetables during childhood in a few studies was associated with breastfeeding, it may be suggested as a serious interfering factor while analyzing the association between breastfeeding and its long-term health effects. Thus, it may be important for creation and implementation of effective public health programs. The aim of this study was to evaluate the association between breastfeeding and consumption of fruit or vegetables in later childhood. The study was conducted within the Project "ABC of Healthy Eating-ABC of Kids and Parents" among a representative sample of 703 pairs of mothers and children aged 7-12 years in Poland. A systematic purposive-quota selection according to gender, age, place of residence, and region of Poland was applied. The study was conducted by interviewers in the respondents' homes in 2017. Logistic regression analysis was conducted, and models adjusted for children's age, BMI centile and gender, maternal education, employment status, and economic situation, as well as for EU-28 average Gross Domestic Product (GDP) region. Almost 86% of children were ever breastfed. Vegetables for breakfast, second breakfast, dinner, supper, and between meals were consumed by 23.9%, 18.6%, 47.4%, 26.7%, and 4.0% of children, whereas fruit was consumed by 13.9%, 46.1%, 7.7%, 12.9%, and 59.7% of children, respectively. Breastfeeding for a period of 4-6 months increased the chance of vegetable consumption for breakfast in the whole group (aOR 3.80, 95%CI 1.90-7.59, p ≤ 0.001) and particularly in girls (aOR 4.60, 95%CI 1.43-14.75, p ≤ 0.01) when compared to boys (aOR 3.17, 95%CI 1.32-7.63, p ≤ 0.01). Longer duration of breastfeeding (over 12 months) increased the chance of vegetable consumption for dinner in the total group (aOR 2.36, 95%CI 1.30-4.26, p ≤ 0.01) and particularly in girls (aOR 3.04, 95%CI 1.24-7.46, p ≤ 0.01) when compared to boys (aOR 2.20, 95%CI 1.01-4.95, p ≤ 0.05). We showed a positive association between breastfeeding and vegetable consumption for breakfast and dinner among children aged 7-12 years. These associations were gender-specific (stronger among girls) and were not diminished by socio-demographic factors.

Skipping Breakfast and a Meal at School: Its Correlates in Adiposity Context. Report from the ABC of Healthy Eating Study of Polish Teenagers.

Little is known on skipping breakfast and a meal at school, especially considered together. The study identified nutrition knowledge-related, lifestyle (including diet quality, physical activity, and screen time) and socioeconomic correlates of skipping breakfast and a meal at school, considered together or alone and assessed the association of skipping these meals with adiposity markers in Polish teenagers. The sample consisted of 1566 fourth and fifth grade elementary school students (11-13 years). The study was designed as a cross-sectional study. Data related to the consumption of selected food items and meals, physical activity, screen time, sociodemographic factors, and nutrition knowledge (all self-reported) were collected (in 2015-2016) with a short form of a food frequency questionnaire. Respondents reported the usual consumption of breakfast (number of days/week) and a meal or any food eaten at school (number of school days/week) labelled as 'a meal at school'. The measurements of body weight, height, and waist circumference were taken. BMI-for-age ≥25 kg/m2 was considered as a marker of overweight/obesity (general adiposity), while waist-to-height ratio ≥0.5 as a marker of central obesity (central adiposity). A multivariate logistic regression was applied to verify the association between variables. A total of 17.4% of teenagers frequently skipped breakfast (4-7 days/week), 12.9% frequently skipped a meal at school (3-5 school days/week), while 43.6% skipped both of these meals a few times a week. Predictors of skipping breakfast and/or a meal at school were female gender, age over 12 years, urban residence, lower family affluence, lower nutrition knowledge, higher screen time, and lower physical activity. In comparison to "never-skippers," "frequent breakfast skippers" were more likely to be overweight/obese (odds ratio, OR 1.89; 95% confidence interval, 95%CI 1.38, 2.58) and centrally obese (OR 1.63; 95%CI 1.09, 2.44), while skippers a few times a week of both of these meals were more likely to be overweight/obese (OR 1.37; 95%CI 1.06, 1.78). Concluding, we estimated that a large percentage of Polish teenagers (approx. 44%) usually skipped both breakfast and a meal at school a few times a week. Similar predictors of skipping breakfast and predictors of skipping a meal at school were identified. Special attention should be paid to promoting shortening screen time and increasing physical activity and teenagers' nutrition knowledge which are relatively easily modifiable correlates. The study shows that skipping both of these meals a few times a week was associated with general adiposity and also strengthens previous evidence showing the association of frequent skipping breakfast with general and central adiposity.

Changes in Sedentary and Active Lifestyle, Diet Quality and Body Composition Nine Months after an Education Program in Polish Students Aged 11⁻12 Years: Report from the ABC of Healthy Eating Study.

The sustainability of education focused on improving the dietary and lifestyle behaviours of teenagers has not been extensively studied. The aim of this study was to determine the sustainability of diet-related and lifestyle-related school-based education on sedentary and active lifestyle, diet quality and body composition of Polish pre-teenagers in a medium-term follow-up study. An education-based intervention study was carried out on 464 students aged 11⁻12 years (educated/control group: 319/145). Anthropometric measurements were taken and body mass index (BMI) and waist-to-height ratios (WHtR) were calculated, both at the baseline and after nine months. Dietary data from a short-form food frequency questionnaire (SF-FFQ4PolishChildren) were collected. Two measures of lifestyle (screen time, physical activity) and two diet quality scores (pro-healthy, pHDI, and non-healthy, nHDI) were established. After nine months, in the educated group (vs. control) a significantly higher increase was found in nutrition knowledge score (mean difference of the change: 1.8 points) with a significantly higher decrease in physical activity (mean difference of the change: -0.20 points), nHDI (-2.3% points), the z-WHtR (-0.18 SD), and the z-waist circumference (-0.13 SD). Logistic regression modelling with an adjustment for confounders revealed that after nine months in the educated group (referent: control), the chance of adherence to a nutrition knowledge score of at least the median was over 2 times higher, and that of the nHDI category of at least the median was significantly lower (by 35%). In conclusion, diet-related and lifestyle-related school-based education from an almost one-year perspective can reduce central adiposity in pre-teenagers, despite a decrease in physical activity and the tendency to increase screen time. Central adiposity reduction can be attributed to the improvement of nutrition knowledge in pre-teenagers subjected to the provided education and to stopping the increase in unhealthy dietary habits.

α-Tocopherol Protects the Heart, Muscles, and Testes from Lipid Peroxidation in Growing Male Rats Subjected to Physical Efforts.

The effect of α-tocopherol supplementation on adaptation to training is still equivocal. The aim of the study was to determine the effect of training and α-tocopherol supplementation on α-tocopherol and thiobarbituric acid reactive substance (TBARS) concentration in the rat liver, heart, muscles, and testes. Male Wistar rats (n = 32) were divided into four groups (nonsupplemented, not trained-C; nonsupplemented, trained-CT; supplemented, not trained-E; supplemented and trained-ET). During the 14-day experimental period, 2 mg/d of vitamin E as α-tocopherol acetate was administered to the animals (groups E and ET). Rats in the training group (CT and ET) were subjected to 15 minutes of treadmill running each day. The α-tocopherol levels in rat tissues were assessed using high-performance liquid chromatography (HPLC). Lipid peroxides were determined by TBARS spectrophotometric method. α-Tocopherol had a significant impact on α-tocopherol concentration in all tissues. Training increased the α-tocopherol concentration in the heart and muscles but reduced it in the liver. Training also caused increased lipid peroxidation in the muscles, heart, and testes; but a higher α-tocopherol content in tissues reduced the TBARS level. The main finding of the study is that impaired α-tocopherol status and its adequate intake is needed to maintain optimal status to prevent damage to the skeletal and cardiac muscles as well as the testes in growing individuals.

Weight loss program is associated with decrease α-tocopherol status in obese adults.

BACKGROUND & AIMS: Studies on changes in plasma α-tocopherol levels during body fat reduction in obese persons are not clear. The aim of the present study was to assess factors associated with α-tocopherol status in obese people and to examine changes in α-tocopherol status after a 6-week AntioxObesity weight loss program. METHODS: The study was conducted in 60 overweight or obese adults, aged 18-54 years old. Food intake data were collected using the 3-day record method and a semi-quantitative food-frequency questionnaire. Anthropometric measurements included: height (H), body weight, waist circumference (WC) and hip circumference (HC), body composition: fat mass (FM) and fat-free mass (FFM), subcutaneous fat (SF) and visceral fat (VF). Lipid profile, α-tocopherol concentration, glutathione peroxidase (GPx) activity, total antioxidant capacity (TAC) in plasma and superoxide dismutase (SOD) activity in erythrocytes were determined. RESULTS: Energy, fat, and carbohydrate intakes decreased significantly in all subjects (P < 0.001). Body weight, WC, body mass index (BMI), waist-to height ratio (WHtR), and FM, VF and SF decreased significantly during the 6 weeks in all subjects. Plasma α-tocopherol significantly decreased during the program (P = 0.006). No changes were observed for SOD activity, but GPx activity and TAC decreased significantly (P = 0.001; P = 0,023, respectively). Plasma α-tocopherol concentration after 6 weeks of the AntioxObesity program was strongly associated with baseline plasma α-tocopherol, changes in TC, VF and FM. Low α-tocopherol status (<20 µmol/L) was found in 78% of the women and 68% of the men, after 6 weeks of the AntioxObesity program. Men were characterized by a greater decrease in weight, BMI, WC, FM, VF, SF and TAC compared to women. CONCLUSIONS: A 6-week weight loss program lowered α-tocopherol status in overweight and obese people. Low baseline α-tocopherol status and adiposity in obese adults negatively affected α-tocopherol status after 6 weeks weight loss program. These results, coupled with excessive weight and low α-tocopherol intake, led to the finding that there was an increased risk of oxidative stress diseases in adults on a reduced diet. Long-term dietary restriction program for obese patients should be monitored to avoid α-tocopherol deficiency, and take into account higher dietary α-tocopherol requirements for obese people.

Adherence to nutrition guidelines in patients with cardiovascular diseases (CVD) as a secondary prevention

Background: The appropriate nutrition is an important component of the secondary prevention of cardiovascular diseases (CVD) Objectives: The aim of the study was to investigate if the patients with cardiovascular disease were informed of the role of appropriate nutrition in prevention or received nutrition guidelines and to assess the dietary intake compared to recommendations for patients with cardiovascular disease who received or not nutrition guidelines Material and Methods: The study was conducted among patients with cardiovascular disease (n = 127) of cardiological hospital clinic, aged 62 ± 11. The questionnaire was used to obtain personal and anthropometric details, information if patients had received nutrition guidelines. The method of 3-day food records was used for dietary assessment Results: 20% of subjects had not received nutrition guidelines and almost 40% of subjects did not recognize the nutrition effect on cardiovascular disease development. Compared to the diets of the subjects who had not received nutrition guidelines, the diets of those who had received them were of significantly lower intake of: energy from saturated fatty acids (15%, p = 0.006), cholesterol (21%, p = 0.012) and higher intake (14-26%) of potassium (p = 0,003), sodium (p = 0.013), phosphorus (p = 0.044), magnesium (p = 0.003), iron (p = 0.005), copper (p = 0.001), zinc (p = 0.046). Among the patients who had received nutrition guidelines, percentage of the subjects whose intake of nutrients was consistent with recommendations was higher Conclusions: Not all subjects had received nutrition guidelines. Diets of those who had received them were more balanced, but in neither group nutrition guidelines were complied with