Promotion of legume intake-Israeli dietitians' knowledge, beliefs and practices.

BACKGROUND: The health and environmental benefits of legume consumption are reflected in dietary guidelines worldwide. However, legume intake fails to meet recommendations. Dietitians' legume counseling practices can impact consumption patterns. This cross-sectional study assessed Israeli dietitians' knowledge, attitudes, perceptions and practices regarding legume counseling and identified pertinent barriers and facilitators. METHODS: An electronic survey among Israeli dietitians (n = 309) was performed. Multivariable logistic regression assessed associations between recommending legumes with participants' socio-demographic and professional characteristics, knowledge, perceptions, attitudes toward legume counseling and personal legume intake. RESULTS: Almost half (47.4%) of the participants recommended that 76% or more of their patients increase legume intake. Factors that were associated with recommending legumes were perceptions of fewer barriers to consumption [adjusted OR (aOR) 1.92 (95% CI 1.24-2.96)] and positive attitudes toward legume counseling pertaining to its importance [aOR 1.95 (95% CI 1.12-3.4)]. Negatively associated factors were a low level of personal legume consumption [aOR 0.38 (95% CI 0.15-0.94)] and working in hospitals [aOR 0.43 (95% CI 0.19-0.98)]. CONCLUSIONS: Israeli dietitians' recommendations for legume consumption were well below current guidelines. These findings indicate the need for a tailored intervention for nutrition professionals to increase the frequency of legume counseling and overall consumption.

From food waste to functional component: Cashew apple pomace.

Globally, large numbers of people suffer from undernourishment and food insecurity, while a third of food produced is lost or wasted. The widely cultivated cashew nut produces large quantities of waste in early processing. It grows on an edible peduncle called the cashew apple which contains many essential nutrients. An estimated 36.9 million tons of cashew apples are produced annually, but only small amounts are used to make juice. The remainder is considered production waste. This review presents the potential of cashew apple pomace as a food ingredient and examines the effects of incorporation on chemical composition, physical properties and sensory evaluation. Inclusion in optimized amounts into food products is a strategy proven to produce palatable results with high acceptability. Transforming this manufacturing by-product into a functional food component will have economic benefits, improve resource-utilization, promote sustainability and potentially increase the nutritional value of foods.

Non-Dairy Animal Protein Consumption Is Positively Associated with Overweight and Obesity in Israeli Adolescents.

Protein consumption apparently plays a role in weight control. This cross-sectional study examined the association of protein consumption in Israeli adolescents with overweight/obesity. 7th−12th grade students participating in a national school-based survey (2015−2016) completed self-administered questionnaires, including a food frequency questionnaire, and height and weight measurements (n = 3443, 48% males, 15.2 ± 1.6 years). WHO growth standards served to define weight status. Intakes of total protein and protein source were calculated. Multivariable logistic regression analyses evaluated associations with overweight/obesity (BMI z-score ≥ 1), adjusting for possible covariates. Total protein intake (median (IQR)) was 62.5 (45.5, 85.7) g/d, accounting for 12.0 (10.5, 13.6) percent of daily energy. Of participants, 31.4% were overweight/obese. In multivariable models, overweight/obesity was positively associated with incremental increases of 10 g/d in total protein intake (OR = 1.07, 95% CI: 1.02−1.12, p < 0.01), total animal protein intake (OR = 1.05, 95% CI: 1.01−1.10, p = 0.026), and non-dairy animal protein intake (OR = 1.06, 95% CI: 1.01−1.11, p = 0.029). No associations were found with plant or dairy protein intake. These associations remained when protein intake was reported as a percentage of daily energy and when overweight and obesity were analyzed individually. High daily protein intakes, principally from non-dairy animal sources, were positively associated with overweight/obesity in adolescents. Additional studies are needed to establish causality of these findings.

The impact of Option B+ on mother-to-child transmission of HIV in Africa: A systematic review.

OBJECTIVE: In 2015, the WHO released new guidelines to reduce mother-to-child transmission (MTCT) of HIV. The recommendations, known as Option B+, included initiation of lifelong highly active antiretroviral therapy regardless of CD4 count for all HIV-positive pregnant and breastfeeding mothers. For infants, exclusive breastfeeding for 6 months and antiviral therapy were sanctioned. Targets of <5% transmission in breastfeeding populations and <2% in non-breastfeeding populations were set. This review evaluated the impact of Option B+ on MTCT in African countries. METHODS: Using the PRISMA guidelines, a systematic search of PubMed and Google Scholar databases was conducted to identify relevant studies published between 2015 and 2021. All studies meeting inclusion criteria were evaluated. RESULTS: Of the 687 references screened, 22 studies from 11 countries (Cameroon, Ethiopia, Lesotho, Malawi, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe) met inclusion criteria. Six studies reported MTCT rates of <2%, 16 studies reported rates of 2-5% and two studies (Uganda and Zambia) reported 6% or more. Rates varied within the same study at different time points postpartum and amongst studies from the same country. Overall, reported MTCT rates appear to be close to WHO targets. However, diverse study designs, selection bias, extensive loss to follow-up and undocumented adherence rates to Option B+ protocols may significantly underestimate MTCT rates of HIV in Africa. CONCLUSIONS: Standardised protocols for impact evaluation must be established to provide evidenced-based data on the efficacy of Option B+ in Africa.

Milk and dairy consumption is positively associated with height in adolescents: results from the Israeli National Youth Health and Nutrition Survey.

PURPOSE: Milk consumption is associated with increased height primarily in early childhood. However, in adolescents, data are scarce with inconsistent results. Since height is a proxy for overall health and well-being, this study evaluated the association of dairy intake with height in adolescents. METHODS: Students in 7th-12th grades, participating in the 2015-2016 Israeli Health and Nutrition Youth Survey, a school-based cross-sectional study, completed self-administered questionnaires, including a semi-quantitative food frequency questionnaire (n = 3529, 48% males, 15.2 ± 1.6 years). Anthropometric measurements were also performed. Dairy servings were calculated as the calcium equivalent of 1 cup of milk, and consumption was divided into four categories from very low (< 1 serving/day) to high (3 + servings/day). BMI- and Height-for-age z scores (HAZs) were calculated according to WHO growth standard; relatively short stature (RSS) was defined as HAZ < - 0.7 SD (< 25th percentile). Multivariable linear and logistic regression analyses were performed to evaluate the association of dairy intake with HAZ and prevalence of RSS, respectively. RESULTS: Median consumption of dairy products was 2 servings/day, 1.4 from unsweetened products (milk, cheese and yogurt). Controlling for age, sex, BMI-z-score and socioeconomic status, each increment of unsweetened dairy intake was associated with on average 0.04 higher HAZ (equivalent to 0.3-0.4 cm, p < 0.05), and with reduced risk for RSS: OR 0.90, 95%CI: 0.84, 0.97, p < 0.01. No such associations were found with sweetened dairy products. CONCLUSION: Consumption of unsweetened dairy products (3-4 servings/day) appears to contribute to achieving growth potential in adolescents. Intervention studies are necessary to determine the causal relationship between dairy intake and linear growth.

Prevalence and sex-specific patterns of metabolic syndrome in rural Uganda.

BACKGROUND AND AIMS: In sub-Saharan Africa, infectious diseases are still the leading causes of mortality; however, this may soon be surpassed by non-communicable illnesses, namely hypertension, diabetes and cardiovascular disease. This study determined the prevalence and patterns of metabolic syndrome and cardio-risk factors in men and women in rural Uganda. METHODS: A household-based, cross-sectional survey was carried out following the WHO STEP-wise approach to surveillance. It included demographic and lifestyle questionnaires, anthropometric measurements and biochemical analyses. Of the 200 randomly recruited participants, 183 successfully completed two steps of the study and 161 provided blood samples. RESULTS: Data were collected from 183 adults, aged 18-69 years; 62% were female. Based on the National Cholesterol Education Program-Adult Treatment Panel-III criteria, the prevalence of metabolic syndrome was 19.1% (95% CI 14.0 to 22.5). Elevated fasting plasma glucose was observed in 14.2% (95% CI 9.1 to 19.3) of participants, hypertriglyceridaemia in 16.9% (95% CI 12.1 to 23.1); hypertension in 36.1% (95% CI 29.0 to 43.0) and 52.5% (95% CI 45.2 to 59.6) had low HDL (high-density lipoprotein) cholesterol. Abdominal obesity was found in 24.6% (95% CI 18.8 to 31.4) of participants. Sex disparities were significant for several risk factors. Females had significantly higher prevalence of abdominal obesity (38.6% vs 1.5% in males, p=0.001) and twice the rates of low HDL (65.8% vs 30.4%, p=0.001). Men tended to have higher but not significant rates of hypertension (42.0% vs 32.5%) and smoked significantly more than women (49.3% vs 21.1%, p<0.001). Alcohol consumption was also higher in men (55.1% vs 18.4%, p<0.001) and quantities consumed were approximately three times greater than in females (p<0.001). CONCLUSION: Metabolic syndrome exists at worrying rates in the rural Ugandan population. Sex disparities are evident in risk factor prevalence, reflecting physiological variables and deeply entrenched cultural and lifestyle norms.

Rapid Weight Loss Among Adolescents Participating In Competitive Judo.

Athletes competing in individual sports such as judo are categorized by weight. Before competitions, weight cutting is common. This cross-sectional study was designed to characterize and determine the prevalence of rapid weight loss (RWL) among adolescent judo competitors. Male athletes aged 12- to 17-years old (N = 108) were recruited from local judo teams. Each participant completed a validated questionnaire regarding RWL practices. Anthropometric measurements were also performed. Average age was 14.6 ± 1.6 years and all participants were of normal body mass index (BMI). RWL was practiced by 80% of the athletes before competition, beginning at an average age of 12.5 ± 2.2 years with the highest prevalence (~94%) in the oldest group of judoka (16-17.9 years). Precompetition weight loss duration was 8 ± 5.4 days, with an average weight reduction of 1.5 ± 1.1 kg. The number of weight loss efforts per athlete in the past season was 2.8 ± 2.2. RWL was achieved by increased physical activity (82.6%), skipped meals (56.3%), or fasting at least once (47%). Two-thirds of the athletes indicated that their coaches were the most influential figure in their decision to lose weight before competition. RWL is highly prevalent in adolescent judo competitors. The methods used by these athletes can potentially lead to significant health risks including compromised nutritional status, diminished physical performance and impaired growth and development. It is of great importance to insure that those who guide young adults in weight loss for competitive sports have the knowledge and understanding to make safe recommendations and appropriate decisions regarding achieving specific weight goals.

Hypocholesterolemic effects of nutraceuticals produced from the red microalga Porphyridium sp in rats.

Red microalgae contain functional sulfated polysaccharides (containing dietary fibers), polyunsaturated fatty acids, zeaxanthin, vitamins, minerals, and proteins. Studies in rat models support the therapeutic properties of algal biomass and isolated polysaccharides. Algal products incorporated into rat diets were found to significantly improve total serum cholesterol, serum triglycerides, hepatic cholesterol levels, HDL/LDL ratios and increased fecal excretion of neutral sterols and bile acids. Morphological and metabolic changes were induced by consumption of algal products. These results suggest that red microalgae can be used as potent hypocholesterolemic agents, and they support the potential use of red microalgae as novel nutraceuticals.