Knowledge, attitude, and practices of restaurant and foodservice personnel in food allergy. A systematic review and meta-analysis.

Background: Currently, there may be 240-250 million people worldwide affected by food allergies. Dining out can be challenging for individuals with food allergies who rely on restaurant and food service staff to properly prepare allergen-free meals. For this reason, the personnel working in restaurants and other food services play a significant role in managing the risks faced by customers with food allergies. Objectives: A systematic review and meta-analysis was conducted to assess the existing evidence concerning the knowledge, attitudes, and practices related to food allergies among restaurant and foodservice personnel. Methods: To identify, characterize, and synthesize published research on the prevalence of positive responses regarding knowledge, attitudes, and practices related to food allergies among restaurant and food service personnel, international recommendations for systematic reviews and PRISMA guidelines were followed. The search was conducted between January 2012 and January 2022, utilizing the electronic databases PubMed, Web of Science, Scopus, and the Cochrane Library. Selection and data extraction were carried out following predefined protocols, and constructs based on reported outcomes were generated and subsequently analyzed in the meta-analysis. Trials were evaluated using the Cochrane tool for risk of bias. The results are presented using summary tables, forest plots, and box plots, showcasing the combined proportion of constructs obtained from independent surveys conducted without control groups. These constructs were then grouped into categories as an organizational framework and analyzed to determine their distribution among quintiles, aiming to provide a detailed overview of data variability. This strategy allowed us to demonstrate how results from the analyzed categories were distributed. Results: The algorithm identified 23 relevant studies, primarily originating from the United States and Europe. The main observed variability was related to the evaluated populations and the instruments used. A total of 28 constructs were identified, with 10 related to knowledge, 9 to attitudes, and 9 to practices. A proportion meta-analysis was conducted to determine the prevalence of positive responses within these three study categories. The results obtained reveal that, in the knowledge category, quintiles 4 and 5 exhibit strong knowledge on the subject (over 84 %). In contrast, starting from quintile 2, the majority of participants shows a positive attitude toward catering to consumers with food allergies (over 85 %). However, after examining the practices category, responses belonging to quintile 5 reflect a low level of risk, while in the other quintiles, behaviors with a higher potential risk for consumers with food allergies are identified. Conclusions: The knowledge, attitudes, and practices of personnel in the food service sector are crucial due to the increasing prevalence of food allergies today, as well as the growing frequency of eating out. Knowledge is the most extensively studied category, showing generally acceptable but still insufficient levels in some areas. Positive attitudes are expressed towards individuals disclosing allergic conditions, yet they do not necessarily correlate with high levels of knowledge. The identified practices do not ensure the safety of the dish served to the customer. There is limited awareness regarding the importance of preventing acute allergic reactions at the time of food consumption. Restaurants and food services should train all staff involved in customer service, implement protocols aimed at preventing allergic reactions during food service, and establish guidelines for handling a customer experiencing an acute reaction.The limitations of this research are related to the heterogeneity present in the synthesized results, urging caution when interpreting the overall estimate of the combined effect, as the findings may not be applicable to all populations or study settings. Indeed, more studies are needed to enhance result precision and provide more specific recommendations for catering to allergic customers in restaurants and food services.

Increased Serum Al Levels in Hemodialysis Patients Kept Enhanced during a 2-Year Prospective Study.

The regulation of mineral homeostasis is altered in hemodialysis patients with renal insufficiency, producing increased risk for secondary diseases like cardiovascular ones. We hypothesized that risen serum aluminum (Al) concentration in hemodialysis patients kept enhanced during a 2-year longitudinal study is associated with enhanced cardiovascular risk and influenced by medical treatments. This study reports the prospective monitoring of serum Al levels in six-monthly samplings over 2 years in 116 hemodialysis patients and a control group of 50 healthy adults. The influence of other factors like sex, age, kidney transplant, disease etiology, and drug consumption was also considered. At each sampling, serum Al levels were significantly higher in the patients than in the healthy controls (P < 0.05). Levels in the patient group were statistically significantly lower at the third and fourth versus first and second samplings, which may be related to Al accumulation in tissues. Increased Al levels in patients were positively and significantly related to serum calcium (Ca) and uric acid levels. Serum Al concentrations were significantly lower in patients receiving vasodilators and diuretics. Higher serum Al levels in hemodialyzed patients administered with phosphate binders or anti-hyperkalemics are attributable to their usual Al salt content. The consumption of antianemic drugs increases Al absorption by forming more bioavailable complexes with the compounds in these drugs. In conclusion, this is the first study to indicate that cardiovascular problems associated with elevated serum Al levels in hemodialysis patients may be in part mitigated by administrating vasodilators and diuretics, which reduce these levels.

Evaluación de Nutrire(R): una herramienta on-line para realizar estudios de evaluación del estado nutricional / Evaluation of Nutrire(R): An On-Line Tool for Carrying Out Evaluation Studies to Assess Nutritional Status

Introducción: Nutrire(R) es un programa informático, fruto de tres proyectos de innovación docente de la Universidad de Granada (España), que permite la valoración del estado nutricional mediante a partir de parámetros antropométricos, dietéticos y bioquímicos. Objetivo: El objetivo de este trabajo es presentar los resultados obtenidos de la evaluación global del programa por alumnos y egresados para poder analizar sus puntos fuertes y débiles que sirvan con posterioridad para realizar las modificaciones oportunas. Material y Métodos: Se ha realizado una encuesta anónima a 128 alumnos de 3 titulaciones de grado y 1 de postgrado de la Universidad de Granada. Se incluye 6 preguntas sobre navegabilidad y diseño y 5 sobre contenidos académicos del programa. Asimismo, se han entrevistado a 20 egresados que lo han utilizado en su actividad profesional. Resultados: La puntuación media obtenida en los alumnos fue de 4,1 sobre 5. Como aspectos positivos destacan: facilidad de uso, incorporación de fotografías de alimentos para elegir el tamaño de ración/ porción. Como aspectos de mejora señalan: incorporar más fotos de alimentos, el poder instalar el programa para su uso en un ordenador. Según los egresados, el principal punto fuerte es tener reunido en un solo programa los tres aspectos de la evaluación del estado nutricional. Como puntos débiles señalan la falta de algún nutriente, como los azucares, en la base de datos nutricional. Conclusión: Nutrire(R) es un programa de fácil utilización, muy bien valorada por los alumnos y por los egresados para realizar estudios de evaluación del estado nutricional

Introduction: Nutrire(R) is a computer programme, a product of three innovation teaching projects of the University of Granada (Spain), designed to carry out the assessment of the nutritional status by anthropometric, dietetic and biochemical parameters. Objectives: The main aim of this study is to present its overall results and to analyze its strengths and weaknesses and to carry out the modifications to improve the programme. Material and Method: An anonymous survey was carried out on 128 students from three different degrees and one the Master’s degree. The survey included 6 questions on navigability and design and 5 about the academic content of the programme. Twenty post-graduates who had used the programme in their professional life were also interviewed. Results and Discussion: The average marking of the students was 4.1 out of 5. The main positive aspects which stood out were the ease of use of the computer programme, and the inclusion of photographs of foodstuffs which facilitated the choice of size of portion when evaluating a diet. Negative aspects that were commented on were the necessity to include more photos of foodstuffs, and the impossibility of using the programme without the internet. According to the post-graduates the main benefit of the programme is to have the three principal aspects of the assessment of the nutritional status. The weak points commented on are that the table showing the composition of the foodstuffs does not give information on simple sugars. Conclusion: Nutrire(R) is an easy tool to use and highly valued by both under-graduates and graduates to evaluate nutritional status

Effect of Physical Activity, Nutritional Education, and Consumption of Extra Virgin Olive Oil on Lipid, Physiological, and Anthropometric Profiles in a Pediatric Population.

BACKGROUND: The aim of this study was to determine the effects of nutritional education and vigorous physical activity on health-related parameters. METHODS: The sample group consisted of 134 children from 5 rurally located schools. Participants were divided between 5 different experimental groups: control group (CG), physical activity group (PA), nutritional education group (NE), combined intervention group (PA+NE), and a combined intervention group with additional substitution of normally used oil for extra virgin olive oil (EVOO; PA+NE+EVOO). The intervention consisted of 60 minute sessions of physical activity held twice a week as well as nutritional education sessions held over 6 months. RESULTS: Students in the groups receiving physical activity reduced their fat percentage and increased their muscle mass post intervention. At posttest the lipid profile improved in all intervention groups. The proportion of macronutrients and dietary cholesterol improved in the groups receiving nutritional education. The posttest comparison showed significantly lower fat percentage, sum of skinfolds and waist circumference in NE relative to CG and PA relative to CG. Diastolic blood pressure and glycaemia were significantly lower in PA+NE+EVOO relative to CG. CONCLUSION: A school-based program consisting of nutritional education or nutritional education plus a physical activity program showed a positive effect on health-related parameters in children.

Evaluación del impacto del ayuno en Ramadán en el estilo de vida y salud / Evaluating the impact of the Ramadan fasting on the life style and health

Fundamentos: Durante el Ramadán, los individuos de confesión islámica se abstienen de comer y beber desde la salida del sol hasta su puesta. El objetivo fundamental de este estudio es evaluar cómo influye el precepto del Ramadán en los hábitos alimenticios de las personas, su sueño, actividad física, actividad u ocupación diarios y también determinar cómo varía la incidencia y la frecuencia de ciertos síntomas y patologías. Material y métodos: Se procedió a un estudio transversal en el cual se realizó un cuestionario a 200 personas de las que se encontraron ayunando en el mes de Ramadán del 2013. El cuestionario constó de cinco partes y trató sobre los hábitos alimenticios, los hábitos de sueño de estas personas, su actividad diaria y actividad física, también de cómo varia la incidencia de patologías y de sintomatologías. Resultados: Ante una inadecuada higiene de vida, el Ramadán cambia radicalmente los hábitos alimenticios de las personas, influye en sus adicciones, altera la naturaleza de su sueño, baja el ritmo de su ocupación diaria y de su actividad física. Afecta al estado de ánimo de las personas y aumenta su irritabilidad (42%). Aumenta la frecuencia de padecer dolor de cabeza (49%) y náuseas (34%). Altera la memoria (17%) y la concentración en algunas personas (18%). Aumenta a su vez la incidencia de padecer indigestiones, acidez gástrica y molestias digestivas (40%), estreñimiento (36%), flatulencia y dispepsia (36%), induce también una bajada de la temperatura corporal (49%) y provoca una sequedad bucal en casi todos los individuos (73%). Las molestias dentales (30%) y la halitosis (39%) son otras de las consecuencias del Ramadán. Conclusiones: Amortiguar este gran impacto que tiene el Ramadán sobre la salud de las personas seria primordial informar, prevenir y mejorar al máximo la higiene de vida por motivo de este periodo sería la solución (AU)

Background: During Ramadan individuals abstain totally from drinking and eating from sunrise to sunset. The principal objective of this study is to evaluate how the precept of Ramadan influences food habits, sleeping, physical activities, and daily routines and occupations, and determine the variety and frequency of some symptoms and pathologies. Methods: A data was collected by questioning 200 volunteers muslims in the period of Ramadan. They indicated they were fasting. The questionnaire asked about the food habits of these individuals, their sleeping patterns, daily and physical activities, and the variety of pathologies and symptomologies. Results: Due to an inadequate hygiene of life, Ramadan fasting can change radically food habits, influences addictions, alters the nature of sleeping, reduces the rhythm of daily occupation and physical activities; influences the state of mind and rises irritation (42%), increases the frequency of headache (49%) and nauseas (34%); alters the memory (17%) and the concentration (18%) , increases the occurrence of ingestion illnesses, gastric acidity and digestive problems (40%), constipation (36%) , flatulency and dyspepsia (36%) , decreases the corporal temperature (49%) and provokes mouth dryness in almost all individuals (73%). Dental troubles (30%) and halitosis (39%) are some of Ramadan consequences. Conclusions: So often the great impact of Ramadan may have on the health is primordial. Inform, prevent, educate and enhance to the maximum the life hygiene during this period is the solution (AU)

Results of a 7-week school-based physical activity and nutrition pilot program on health-related parameters in primary school children in southern Spain.

The goal of this study was to determine the effect of nutrition education combined with sessions of vigorous extracurricular physical activity (VEPA) on the improvement of health related parameters in children in primary education. The sample group consisted of 54 children in the fifth year of primary education divided into two groups: an intervention group (IG) of 25 students and a control group (CG) of 29 students. The intervention lasted 7 weeks and consisted of 13 sessions of VEPA combined with sessions of nutritional education that were attended by the students in the IG as well as their parents. During the intervention the IG showed a decrease in the body fat percentage, total cholesterol, cholesterol linked to low- density lipoproteins and blood pressure, together with an increase in cholesterol linked to high-density lipoproteins, and an improvement in the maximum oxygen uptake and dietary intake profile compared with the CG, which showed an increase in the percentage of fats and no significant changes (p < .05) in other parameters. The results of this study provide evidence that a 7-week program of nutritional education and vigorous short-duration physical activity can improve health related parameters in children.

Evaluación del estado nutricional en niñosy jóvenes escolarizados en Granada / Assessment of the nutritional state in children and adolescent students of Granada

El objetivo de este estudio ha sido analizar el índice de masa corporal (IMC), el grado de actividad física y valorar el estado nutricional de niños y jóvenes escolarizados en Granada. Para ello se realizó un estudio nutricional en una muestra formada por 77 sujetos, 37 niños (16 varones y 21 mujeres) con una media de edad de 11.46 ± 0.55 años y 40 jóvenes (20 varones y 20 mujeres) con una media de edad de 15.8 ± 0.75 años, mediante un registro dietético de 3 días. Además se evaluó el IMC y el grado de actividad o sedentarismo realizando encuestas personales. Los resultados nos muestran como el aporte calórico de los macronutrientes fue desequilibrado: alto de lípidos (36.11%) y prótidos (16.78%) y bajo de hidratos de carbono (47.09%). Con respecto a los micronutrientes, las dietas evaluadas fueron, en general, adecuadas, excepto en el caso de la vitamina E, ácido fólico, potasio y calcio para todos los grupos; magnesio para todos los grupos a excepción del grupo de niños género femenino; y hierro para el grupo de jóvenes género femenino, donde se observan deficiencias. El IMC medio está dentro de los valores de normopeso, sin embargo un alto porcentaje de los sujetos estudiados tienen unos IMC superiores a los establecidos como normopeso. El número de sujetos activos va disminuyendo con la edad, independientemente del género. Analizando los resultados parece conveniente realizar algún tipo de intervención nutricional y de actividad física para prevenir posibles trastornos como es el caso de la obesidad (AU)

The objective of this study was to analyze the Body Mass Index (BMI), physical activity, and to assess the nutritional state of children and adolescent students of Granada. The nutritional assessment was developed in a sample of 77 subjects, 37 children (16 boys and 21 girls) aged 11.46 ± 0.55 years and 40 adolescents (20 boys and y 20 girls) aged 15.8 ± 0.75 years, by means of a 3 day dietetic recording. BMI has been also studied, as well as the grade of physical activity or sedentary pattern by means of personal interviews. The results show calorie support of macronutrients was misbalanced, high in lipids (36.11%) and proteins (16.78%), and low in carbohydrates (47.09%). In respect to micronutrients, evaluated diets were, in general, adequate, except in the case of E vitamin, Folic Acid, Potassium, and Calcium for all the groups; Magnesium for all the groups except children girls; and Iron for the adolescent girls. Mean BMI is within the values of normal weight, although a high percentage of the studied subjects sows higher values of BMI than the considered as normal. The number of subjects physically active is decreasing with age independently of gender. Should be important to carry out an intervention in nutritional pattern as well as in physical activity to prevent disorders as obesity (AU)

An extra-virgin olive oil rich in polyphenolic compounds has antioxidant effects in OF1 mice.

Extra-virgin olive oil (OO) is becoming more important in daily diets due to its beneficial effects on health, most of which are because of its antioxidant content. We studied the antioxidant activity and mechanisms of an extra-virgin OO that is rich in phenolics on pancreatic islets and liver in control mice (CTL) fed a nonpurified diet and in mice supplemented with 50 microL/d sunflower oil (SO) or 50 microL/d extra-virgin OO for 4 d. Plasma hydroxytyrosol concentration was determined by HPLC-diode array detector. Plasma antioxidant capacity, enzymatic activities, and lipid peroxidation were measured by spectrophotometry. Islet function was studied by measuring insulin release. Islet cell gene expression was examined using quantitative RT-PCR. The plasma hydroxytyrosol concentration was greater in OO mice than in CTL or SO mice (P < 0.05) and was greater in SO mice than in CTL mice. The ratio of reduced:oxidized glutathione and the antioxidant capacity in plasma was greater in OO mice than in CTL or SO mice (P < 0.05) and higher in SO mice than in CTL mice. Glucose-stimulated insulin secretion was greater in OO mice than in CTL or SO mice (P < 0.05) and was also higher in SO mice than in CTL mice. Protection against liver cell and beta cell membrane lipid peroxidation was greater in OO mice than in CTL or SO mice (P < 0.05) and was greater in SO mice than in CTL mice. Catalase (CAT) expression in the islet of Langerhans was higher in OO mice than in CTL mice and SO mice (P < 0.05). The CAT and glutathione peroxidase 1 activities in the islet of Langerhans were 25% greater in OO mice than in CTL mice and higher than in SO mice (P < 0.05) and they were greater in SO mice than in CTL mice. These results indicate that, in metabolic tissues, protection by extra-virgin OO against oxidative stress occurs primarily through a direct antioxidant effect as well as through an indirect mechanism that involves greater expression and activity of certain enzymes with antioxidant activities.

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