Differences of skin carotenoids and adherence to the Mediterranean Diet pattern in adults from Southern Italy and Dominican Republic.

BACKGROUND: The measurement of the skin carotenoids using the Veggie Meter® has emerged as a rapid objective method for assessing fruit and vegetable intake, highly recommended by the Mediterranean Diet (MD), which represents one of the healthiest dietary patterns, worldwide. This study aimed to examine differences in skin carotenoid content and degree of adherence to the MD pattern between two adult populations from Southern Italy and the Dominican Republic. METHODS: This cross-sectional study enrolled a total of 995 adults, 601 subjects from Italy and 394 from the Dominican Republic. All participants underwent anthropometric measurements and skin carotenoid assessment by Veggie Meter®. Adherence to the MD and lifestyle were evaluated using the Mediterranean Diet Adherence Screener (MEDAS) and the Mediterranean Lifestyle Index (MEDLIFE) questionnaires. Correlations between the skin carotenoid and MEDAS score were estimated using Pearson's correlation coefficient. Multiple linear regression models were created to determine variables that affect skin carotenoid score for both populations. RESULTS: Mean total skin carotenoids were higher in the Italian compared to the Dominican Republic population (342.4 ± 92.4 vs 282.9 ± 90.3; p < 0.005) regardless of sex (women: 318.5 ± 88.9 vs 277.3 ± 91.9, p < 0.005 and men: 371.7 ± 88.3 vs 289.5 ± 88.1, p < 0.005), and remaining statistically significant after age-adjustment of the Dominican Republic sample. Using the MEDAS questionnaire, we found a higher MD adherence score in the Italian than in the Dominican Republic population also after age-adjusting data (7.8 ± 2.1 vs 6.2 ± 3.7; p < 0.005) and even when categorized by sex (Italian vs age-adjusted Dominican Republic women: 7.9 ± 2.1 vs 6.3 ± 2.6; Italian vs age-adjusted Dominican Republic men: 7.7 ± 2.2 vs 6.0 ± 4.7; p < 0.005). Using the MEDLIFE test, total Italians presented a lower score with respect to the age-adjusted Dominican Republic population (3.2 ± 1.2 vs 3.4 ± 1.4; p < 0.05). In multiple regression analysis, skin carotenoids were associated with sex and negatively associated with BMI in the Italian population (sex: ß: 54.95; 95% CI: 40.11, 69.78; p < 0.0001; BMI: ß: - 1.60; 95% CI: - 2.98,0.86; p = 0.03), while they resulted associated with age and sex in the Dominican Republic population (age: ß: 2.76; 95% CI: 1.92, 3.56; p < 0.001; sex: ß: 23.29; 95% CI: 5.93, 40.64; p = 0.009). Interestingly, skin carotenoids were positively correlated with MEDAS score in both populations (Italy: r = 0.03, p < 0.0001, Dominican Republic: r = 0.16, p = 0.002). CONCLUSIONS: This study provides the assessment of the adherence to the MD and skin carotenoid content in adults living in Southern Italy and the Dominican Republic, showing a higher MD adherence score and a skin carotenoid content in inhabitants from the Mediterranean region. Our findings highlight the need to globally encourage fruit and vegetable intake, particularly in non-Mediterranean area.

Consumo de frutas, verduras y legumbres en adultos de Santiago Oriente, Chile: ¿Ha influido el confinamiento por COVID-19?

RESUMEN El confinamiento por la pandemia del COVID-19 pudo impactar negativamente los hábitos alimentarios en Chile, principalmente debido al menor acceso a alimentos y los efectos psicológicos del encierro, cambiando patrones de consumo de frutas, verduras y legumbres. El objetivo del estudio fue comparar la frecuencia y cantidad consumida de frutas, verduras y legumbres y el cumplimiento de las guías alimentarias para estos alimentos en adultos residentes del sector oriente de Santiago, antes y durante el confinamiento. Se realizó mediante una encuesta digital de frecuencia de consumo y participaron 1.351 residentes de las comunas en confinamiento pertenecientes al sector oriente, mayores de 18 años y ambos sexos. En los resultados se observó una disminución en la frecuencia y cantidad consumida de frutas y verduras y un aumento en la frecuencia y cantidad de legumbres consumidas durante el confinamiento. El cumplimiento de la guía alimentaria de legumbres aumentó, para las frutas disminuyó y para las verduras se mantuvo. El confinamiento afectó negativamente el consumo de frutas, mantuvo el de verduras y el consumo de legumbres aumentó pero sigue siendo insuficiente. Los efectos del confinamiento en la alimentación podrían agravar la situación epidemiológica de los chilenos.

ABSTRACT Confinement due to COVID-19 pandemic could have a negative impact on eating habits in Chile, mainly due to decreased food access, the psychological effects of confinement, and the changing patterns of fruit, vegetable and legume consumption. The objective of the study was to compare frequency and quantity of fruits, vegetables and legumes consumed by adults from the eastern sector of Santiago de Chile before and during confinement, as well as compliance with dietary guidelines for these foods. 1.351 subjects over 18 years old, of both sexes and residents of localities in confinement within the eastern sector of Santiago answered a digital food frequency questionnaire. Results showed a decrease in the frequency and quantity of fruits and vegetables consumed and an increase in the frequency and quantity of legumes consumed during confinement. Compliance with the dietary guideline for legumes increased, it decreased for fruits and was unchanged for vegetables. Confinement negatively affected consumption of fruits, did not alter that of vegetables, and legume consumption increased, yet is still insufficient. The effects of confinement on food habits could aggravate the epidemiological situation of Chileans.

Influence of pre-schooler and parent nutrition education on carotenoid levels of Mexican-heritage children.

OBJECTIVE: To determine the mediating effect of direct preschool and parent nutrition education on changes in skin carotenoids scores over 2 years in children of Mexican heritage. DESIGN: In a quasi-experimental, community-based study, two school districts were randomly assigned to either a comparison group (parent workshops unrelated to nutrition) or a childhood obesity prevention intervention group which included nutrition education at family nights for parents and at school for children. Changes in skin carotenoid intensity scores (diffCAROT, year 2015 minus 2013) were measured in children as a proxy for fruit and vegetable consumption using Resonance Raman Spectroscopy. SETTING: Two rural, low-income, school districts from a county in California's Central Valley. PARTICIPANTS: 316 Mexican heritage families with children aged 3-8 years. RESULTS: Intervention group children improved over 2 years in skin carotenoid scores relative to comparison group children (diffCAROT mean +1419 (sd 9540) v. -3473 (sd 9272), P = 0·0001). Parent attendance at nutrition education classes partially mediated the intervention effect on diffCAROT (P = 0·02). Controlling for child's age and other covariates, participation in preschool during the study had a significant positive effect on diffCAROT among intervention children compared with controls (P < 0·03), whereas no significant difference by group was observed among those not enrolled in preschool or already enrolled in elementary school. CONCLUSIONS: Programmes that combine direct parent and preschool nutrition education may be effective in low-income Mexican heritage families to improve children's intake of fruit and vegetables.

Promoting fruit, vegetable and simple water consumption among mothers and teachers of preschool children: An Intervention Mapping initiative.

For preschool children, mothers and teachers are the principal models and promoters of fruit, vegetable and simple water consumption at home and school, respectively. However, the daily intake of these food and drink items falls below recommended standards among Mexican adults, posing a high risk of non-communicable diseases such as overweight and obesity across all age groups in the country. The objective of this article is to describe the design, implementation and evaluation of an educational initiative conducted in a Mexican locality with the aim of promoting the consumption of fruits, vegetables (FVs) and simple water (SW) among preschoolers through the influence of their mothers and teachers. We used the Intervention Mapping methodology with qualitative and quantitative components. Mothers attended eight theoretical and practical sessions and two school meetings, while teachers were offered two workshops. Our results revealed positive changes among both groups: participants took greater interest in healthy nutrition, increased their purchase, preparation and intake of FVs and SW and promoted their consumption. This confirms that it is possible to achieve favorable changes in eating habits among those who participate in educational initiatives in Mexico.

Adequate and excessive food consumption in Suriname: a multiethnic middle-income country.

OBJECTIVES: To explore food consumption among different sex, age, ethnic, urban, education and income groups in Suriname. METHODS: Data from a cross-sectional population study (n = 5748; 15-64 year) were used. Food consumption was defined adequate if (1) fruit and vegetable intake was conformable to WHO recommendations, (2) mostly vegetable oil was used, and (3) whole-wheat products were used ≥ 3 days/week. Food consumption was defined excessive if 3 out of the following 5 items scored positive: consumption of (1) snack, (2) sweet, (3) fast food, or (4) soft drink ≥ 3 days/week, or (5) salt was always added while preparing a hot meal. RESULTS: 6.4% (95% CI 5.8-7.1) had an adequate and 21.9% (95% CI 20.9-23.0) an excessive food consumption pattern, with differences among ethnic groups (p < 0.05). Adequate consumption increased, while excessive consumption decreased with increasing age (p < 0.05). Both adequate and excessive consumption increased with higher degree of urbanization, level of education and income (p < 0.05). Except for level of education for adequate consumption, all characteristics remained in both models with adequate and excessive consumption as outcome (p < 0.09). CONCLUSIONS: Our study suggests interventions to promote adequate food consumption in general and to limit excessive food consumption mainly focused on youngsters and those living in urbanized areas of higher socioeconomic status.

Learning to like vegetables during breastfeeding: a randomized clinical trial of lactating mothers and infants.

Background: What lactating mothers eat flavors breast milk and, in turn, modifies their infants' acceptance of similarly flavored foods.Objective: We sought to determine the effects of the timing and duration of eating a variety of vegetables during breastfeeding on the liking of vegetables in both members of the dyad.Design: We conducted a randomized controlled study of 97 mother-infant dyads. Lactating mothers drank vegetable, beet, celery, and carrot juices for 1 mo beginning at 0.5, 1.5, or 2.5 mo postpartum or for 3 mo beginning at 0.5 mo postpartum. The control group drank equal volumes of water and avoided drinking the juices. Mothers rated the tastes of the juices and self-reported dietary intakes at each monthly visit (0.5-4.5 mo). After weaning, when 7.9 mo of age, infants' acceptance of plain, carrot-flavor (exposed flavor), and broccoli-flavor (nonexposed flavor) cereals was assessed on separate days.Results: The timing of exposure affected the acceptance of the carrot flavor that did not generalize to the novel broccoli flavor. A relatively brief experience (1 mo) with vegetable flavors in mothers' milk, starting at 0.5 mo postpartum, was sufficient to shift the hedonic tone, which resulted in a faster rate of eating carrot-flavored cereal than that in infants who were exposed during subsequent months or not at all. One month of exposure had a greater effect than 3 mo of exposure or no exposure. Regardless of when exposure occurred, infants were less likely to display facial expressions of distaste initially when eating the carrot cereal. Over time, mothers liked the tastes of carrot, beet, and celery juices more, but no changes in dietary intake of vegetables were observed.Conclusions: Early life may be an optimum time for both infants and their mothers to learn to like the taste of healthy foods. More research is needed to facilitate the liking and eating of these foods by mothers, which will, in turn, increase the likelihood of their feeding these foods to their children. This trial was registered at clinicaltrials.gov as NCT01667549.

The role of emotional states in fruit and vegetable consumption in Brazilian adults / O papel dos estados emocionais no consumo de frutas e vegetais em adultos brasileiros

Abstract The objective was to investigate the association between emotional states with adequate fruit and vegetable consumption (FVC). This is a population-based cross-sectional study with 1,100 adults from a medium-sized city in Southern Brazil. Adequate FVC was defined as concomitant intake ≥ 3 fruits and ≥ 5 tablespoons of vegetables per day. Exposures were self-perception of nervousness/stress and minor psychiatric disorders (MPD). Data analysis used logistic regression. After controlling for demographic, socioeconomic and behavioral variables, adults reporting lack of nervousness/stress were twice more likely to report adequate FVC than those who reported it. Similarly, those reporting not having MPD symptoms were 52% more likely to have adequate FVC than those who did not. These effects increased and remained significant among women.

Resumo O objetivo foi verificar a associação entre a autopercepção do estado emocional com o consumo adequado de frutas, verduras e legumes (FVL). Este é um estudo transversal de base populacional com uma amostra probabilística de 1100 adultos residentes na zona urbana de um município de médio porte do Brasil. Considerou-se como consumo adequado uma ingestão ≥ 3 frutas concomitante com ≥ 5 colheres de verduras/legumes ao dia. O estado emocional foi avaliado através da autopercepção do nervosismo/stress e distúrbios psiquiátricos menores (DPM). Potenciais fatores de confundimento incluíam variáveis demográficas, socioeconômicas e comportamentais. Foram observadas associações significativas entre a autopercepção de nervosismo/stress e DPM com o consumo adequado de FVL. Após o controle de fatores de confusão, adultos relatando ausência de nervosismo/stress possuíam uma chance de apresentar um consumo adequado duas vezes maior do que aqueles relatando nervosismo/stress. Similarmente, participantes com ausência de distúrbios psiquiátricos possuíam uma chance de consumo adequado FVL 52% mais elevada quando comparados àqueles que relataram presença desses sintomas. Quando estratificada por gênero, esse efeito aumentou e manteve-se com significância estatística apenas entre as mulheres.

Food environment and family support in relation to fruit and vegetable intake in pregnant women

The aim of the study was to investigate predictor factors related to self-perceived food environment, food practices, and family support and fruit and vegetable intake during pregnancy. A cross-sectional study was conducted among 282 pregnant women at the second trimester of pregnancy living in the city of Ribeirão Preto, Brazil. A food frequency questionnaire, and two 24-hour dietary recalls were obtained, and the Multiple Source Method was used to estimate the usual intake. Self-perceived food environment, food practice and family support were assessed by structured questionnaires. Logistic regression models adjusted for education, age, socioeconomic class, and BMI by gestational age were used to evaluate the relationship between self-perceived food environment, food practice and family support and fruit and vegetable intake. No association between self-perceived food environment and fruit and vegetable intake was found. However, the women who reported a greater number of meals per day (OR 1.95 (95% CI = 1.06; 3.56), p = 0.03), those who believed they consumed enough fruit and vegetable (3.71 (2.23; 6.20), p < 0.001), and who reported to have family support for a healthy diet (3.16 (1.78; 5.60), p < 0.001), were more likely to consume greater amounts of these foods. Our data suggests that the family support and a higher number of meals per day might be relevant to achieve a higher fruit and vegetable intake among pregnant women(AU)

A relação entre o ambiente alimentar e o suporte familiar e o consumo de frutas, verduras e legumes em gestantes. O objetivo do presente estudo foi investigar fatores preditores relacionados à percepção do ambiente alimentar, práticas alimentares e suporte familiar e o consumo de frutas, verduras e legumes durante a gestação. Trata-se de um estudo transversal, conduzido entre 282 gestantes residentes em Ribeirão Preto, SP, Brasil, durante o segundo trimestre gestacional. O consumo alimentar foi avaliado por meio de um questionário de frequência alimentar e dois recordatórios de 24 horas. Para estimar o consumo usual de alimentos foi utilizado o Multiple Source Method. A percepção do ambiente alimentar, práticas alimentares e suporte familiar foram avaliados por meio de um questionário estruturado. Modelos de regressão logística ajustados por escolaridade, idade, classe social e IMC por idade gestacional foram utilizados para avaliar a relação entre a percepção do ambiente alimentar, práticas alimentares e suporte familiar com o consumo de frutas, verduras e legumes. Nenhuma relação foi encontrada entre a percepção do ambiente alimentar e o consumo de frutas, verduras e legumes. Por outro lado, as gestantes que relataram um maior número de refeições ao dia (OR 1,95 (95%IC = 1,06; 3,56), p = 0,03), aquelas que consideravam que consumiam uma quantidade suficiente de frutas, verduras e legumes (3,71 (2,23; 6,20), p < 0,001), e aquelas que relataram suporte familiar para ter uma alimentação saudável (3,16 (1,78; 5,60), p < 0,001), apresentaram maior chance de consumir uma maior quantidade destes alimentos. Os resultados sugerem que o suporte familiar e um maior número de refeições sejam relevantes para o alcance do maior consumo de frutas, verduras e legumes entre gestantes(AU)

Consumo de frutas e hortaliças por idosos de baixa renda na cidade de São Paulo / Fruit and vegetable intake among low income elderly in the city of São Paulo, Southeastern Brazil

OBJETIVO: Estimar os fatores socioeconômicos e sociodemográficos associados ao consumo diário de cinco porções de frutas e hortaliças por idosos residentes em áreas de baixa renda, identificando as principais frutas e hortaliças que compõem a dieta desta população. MÉTODOS: Estudo transversal de base populacional com 2.066 idosos (>60 anos) de baixa renda residentes na cidade de São Paulo, SP, em 2003-2005. Para a avaliação do consumo de frutas e hortaliças foi aplicado questionário de freqüência alimentar. As respostas foram transformadas em consumo diário e comparadas às recomendações da Organização Mundial da Saúde (consumo de cinco ou mais porções diárias). A relação entre consumo recomendado de frutas e hortaliças e variáveis socioeconômicas foi avaliada mediante modelos de regressão logística. RESULTADOS: Dos participantes, 60,5 por cento eram mulheres e 39,5 por cento homens. Cerca de um terço dos idosos (n=723; 35,0 por cento) não consumia diariamente nenhum tipo de fruta ou hortaliça e 19,8 por cento relataram consumo diário de cinco ou mais porções de frutas e hortaliças. Este consumo esteve positivamente associado à renda e à escolaridade. CONCLUSÕES: O consumo de frutas e hortaliças de idosos de baixa renda do município de São Paulo mostrou-se insuficiente em relação às recomendações da Organização Mundial da Saúde e está associado a condições socioeconômicas desfavoráveis.

OBJECTIVE: To estimate the socioeconomic and sociodemographic factors associated with the daily intake of five servings of fruit and vegetables by elderly individuals living in low income areas, identifying the main fruits and vegetables which compose the diet of this population. METHODS: This is a cross-sectional population-based study with 2,066 low income elderly individuals (>60 years) living in the city of São Paulo, Southeastern Brazil, in 2003-2005. To assess the fruit and vegetable intake a Food Frequency Questionnaire was administered. The answers were transformed into daily intake and compared with the recommendations of the World Health Organization (five or more servings per day). The relationship between recommended fruit and vegetable intake and socioeconomic variables was analyzed using logistic regression models. RESULTS: Of the participants, 60.5 percent were women and 39.5 percent were men. Approximately one third of the elders (n=723; 35.0 percent) did not consume any kind of fruit or vegetable on a daily basis and 19.8 percent reported a daily intake of five or more servings of fruits and vegetables. This intake was positively associated with income and years of schooling. CONCLUSIONS: The fruit and vegetable intake of low income elderly individuals in the city of São Paulo was insufficient according to the recommendations of the World Health Organization and is associated with unfavorable socioeconomic conditions.