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Low riboflavin intake is associated with cardiometabolic risks in Korean women

Background and Objectives: Metabolic syndrome is a leading global public health concern. Nutritional approaches are important for preventing and managing cardiometabolic risks, including metabolic syndrome. The aim of this study was to examine the potential association between riboflavin intake and cardiometabolic risks according to sex among Koreans. Methods and Study Design: We used data from the Korea National Health and Nutrition Examination Survey 2015-2016, a nationwide cross-sectional survey that assesses the health and nutritional status of the Korean population. A total of 6,062 individuals aged ≥19 years were included. The nutrition survey was performed using 24-h dietary recall. Results: A significant association was observed between low riboflavin intake with only increased HDL-cholesterol (OR 1.362, 95% CI 1.017-1.824, p=0.038) among metabolic syndrome and its components in men, whereas insufficient riboflavin intake was positively associated with hypertension (OR 1.352, 95% CI 1.085-1.685, p=0.007), diabetes (OR 1.493, 95% CI 1.137-1.959, p=0.004) and metabolic syndrome (OR 1.289, 95% CI 1.014-1.640, p=0.038) in women after adjusting for the other covariates. For post-menopausal women, central obesity was also correlated with insufficient riboflavin intake (OR 1.315, 95% CI 1.019-1.696, p=0.035). Conclusions: Insufficient riboflavin intake may contribute to development of cardiometabolic disorder, particularly in women. It was also found that riboflavin may have different influences on its risks in women according to menopausal status. This study highlighted the importance of public policies targeted at these sex-specific groups for reducing cardiometabolic risks.

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Subcutaneous and visceral fat volumes measured by MRI and their relationships with nutrient intakes among adults

Background and Objectives: Types and amounts of nutrients may influence the volume of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). This study targeted to investigate the relationship between SAT and VAT volumes and macro- and micronutrients intake among adults. Methods and Study Design: Data were collected via a private face-to-face interview, in which diet history was obtained using validated quantitative food frequency questionnaire. The different fat volumes were assessed using magnetic resonance imaging (MRI) scanning. Results: Participants with the lowest VAT volume had the highest intake of saturated fats, monounsaturated fatty acids and omega-3 and omega-6 fatty acids (p＜0.05). VAT volume was significantly associated with the highest level of total energy and energy from carbohydrate consumption among participants while significantly associated with the lowest energy intake from fat among participants (p=0.013). There was a significant relationship with the highest consumption of total carbohydrate, soluble fiber, and insoluble fiber and VAT volume (p＜0.05). Participants in the highest VAT volume had significantly the highest intake of vitamin A, β- carotene, and copper. Conclusions: This study underscores the importance of quantifying depot-specific body fat and highlights the unique responsiveness of various fat depots to dietary intake.

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Food-based recommendations for Minangkabau women of reproductive age with dyslipidemia

Background and Objectives: Considering the impact of unfavorable dietary practices on inadequate nutrient intake, this cross-sectional study aimed to explore dietary practices, including problem nutrients, and develop local food-based recommendations (FBRs) to improve the intake of problem nutrients among women of reproductive age (WoRA) with dyslipidemia in Minangkabau, Indonesia. Methods and Study Design: The study was conducted in the Padang township inhabited mostly by the Minangkabau tribe. Accordingly, 74 WoRA with dyslipidemia completed the study. Two replicate 24-h recalls and a 5-day food record were used to assess food consumption patterns. Then, linear programming (LP) analysis using three modules of the WHO Optifood software was employed to identify problem nutrients and develop FBRs. Results: Median (5th and 95th percentiles) weekly consumption frequencies for grain; meat, fish, and eggs; and added fat were 18 (14-27), 11 (6-16), and 15 (7-30), while those for fruits and vegetables were 2 (0-11) and 7 (2-16), respectively. Based on the aforementioned food pattern, PUFA (both n-3 and n-6 fatty acids), dietary fiber, iron, and zinc were identified as typical problem nutrients. The final FBR emphasized on incorporating locally available nutrient-dense foods, as well as food groups and sub-groups, which would improve the intake of problem nutrients. Conclusions: Minangkabau WoRA have dietary practices that predispose them to dyslipidemia. Moreover, the LP approach is a sensitive tool for identifying nutrient-dense foods that could potentially improve problem nutrient intake, as well as those that need to be limited in the final FBR.

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Duration of periconceptional folic acid supplementation and risk of gestational diabetes mellitus

Background and Objectives: Increased consumption of folic acid is prevalent, raising concerns about possible adverse effects. This prospective study aimed to explore the associations between the duration of folic acid supplementation and the risk of gestational diabetes mellitus (GDM) in Chinese women. Methods and Study Design: A total of 326 pregnant women were prospectively included for detailed information on folic acid supplementation during pre-pregnancy and early pregnancy, lipid profiles at 16-18 weeks, and subsequent GDM diagnosis at 24-28 weeks. Associations among folic acid supplementation, lipid profiles, and risk of GDM were analyzed using linear and logistic regression models, adjusting for potential confounders. Results: The incidence of GDM in participants was 10.1%. We observed a U-shape relation between duration of folic acid supplementation and risk of GDM. Women who did not take folic acid and took folic acid for ＞90 days had a higher incidence of GDM compared to those who took folic acid for ≤60 days. Moreover, lipid profiles were positively correlated with duration of folic acid supplementation and risk of GDM. After adjusting for demographic characters, energy and nutrients intakes and lipid profiles, the adjusted OR of GDM comparing taking folic acid for ＞90 days with taking folic acid for ≤60 days was 3.45 (95% CI: 1.01, 11.8). Conclusions: This prospective study indicate a positive association among prolonged folic acid supplementation, lipid profiles in the second trimester, and risk of GDM. Future studies are warranted to verify the causal relationship and underlying mechanisms.

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Socioeconomic disparity in the diet quality of pregnant women in Northwest China

Background and Objectives: Few studies have described the socioeconomic disparity of dietary quality in Northwest China. The present study aimed to evaluate the diet quality of pregnant women in Shaanxi province of Northwest China by using the Diet Balance Index for Pregnancy (DBI-P) and explored the relationships with socioeconomic status (SES). Methods and Study Design: A cross-sectional analysis of data from 7,630 women who were pregnant during 2012-2013 was performed. Dietary intake during the whole pregnancy was assessed by FFQ within 12 months (median, 3 months; 10th-90th percentile, 0-7 months) after delivery. Diet quality evaluated by the DBI-P was related to socioeconomic factors. Results: Most women had insufficient consumption of vegetables (72.27%), dairy (89.58%), meat (82.07%), fish and shrimp (92.23%), eggs (62.54%), and dietary variety (97.92%). 67.76% of women had excessive intake of grains, and 87.77% and 69.79% of participants had surplus consumption of edible oil and salt respectively. Women with higher education, occupation and household wealth index (HWI) consumed more vegetables, fruit, dairy, soybean and nuts, meat, fish and shrimp, eggs, edible oil, alcohol and dietary variety but less grains and salt. After adjusting for confounders, education, occupation and HWI were negatively associated with the level of inadequate dietary intake. Conversely, individuals with medium HWI had higher level of excessive dietary intake compared to low HWI groups. Conclusions: The diet quality of pregnant women in Northwest China was associated with SES. Socioeconomic disparities in diet quality should be considered when planning nutrition interventions for pregnant women.

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Breast milk selenocystine as a biomarker for selenium intake in lactating women at differential geographical deficiency risk in China

Background and Objectives: A reliable biomarker for optimal selenium (Se) intake in lactating women is not currently available. Methods and Study Design: Daily dietary Se intake in lactating women was calculated from a 24-hour meal record survey for over 3 days. Se levels in plasma and breast milk were measured through inductively coupled plasma mass spectrometry. Plasma selenoprotein P 1 levels and glutathione peroxidase 3 activity were measured using an enzyme-linked immunosorbent assay. Ultra-performance liquid chromatography-tandem mass spectrometry was used to analyze proteinaceous Se species in enzymatically digested breast milk. Results: Dietary Se intakes of lactating women from Liangshan, Beijing, and Enshi were 41.6±21.2 ng/d, 51.1±22.6 ng/d, and 615±178 ng/d, respectively (p＜0.05). The Se levels in the blood and breast milk were significantly associated with the dietary Se intake (p＜0.05). The proteinaceous Se species in breast milk were SeMet and SeCys2. The levels of SeMet in the lactating women from Liangshan, Beijing, and Enshi were 3.31±2.44 ng Se/mL, 7.34±3.70 ng Se/mL, and 8.99±9.64 ng Se/mL, while that of SeCys2 were 13.7±12.0ng Se/mL, 35.6±20.9ng Se/mL, and 57.4±13.2ng Se/mL, respectively. Notably, the concentration of SeCys2, the metabolite of unstable SeCys, reached a saturation platform, whereas no similar phenomenon were found for the total Se SeMet from Secontaining proteins. Conclusions: SeCys2 in breast milk is a potential biomarker for determining the optimal Se intake in lactating women.

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Composition requirements of follow-up formula for 6-12-month-old infants: recommendations of a Chinese expert group

Background and Objectives: The Chinese national standard of formula for 6-12-month-old infants (GB 10767- 2010) requires review and revision because it does not correspond to current scientific knowledge and data. The aim of this paper was to summarize the formula composition recommended for 6-12-month-old infants by a Chinese expert group. Methods and Study Design: Formula composition recommendations for 6-12-month-old infants were devised by a Chinese expert group based on a detailed systematic review, which included nutrient intake, nutrient content of Chinese women's breast milk, and the latest adequate intake and tolerable upper intake levels, also referencing the Codex Alimentarius recommendations and those of other countries and considering the practice in products on the market. Results: Compared with current standards, it was recommended that most compositional requirements be modified, including decreasing the maximum energy density from 85 to 75 kcal/100 mL, decreasing the protein content in milk-based formula from 2.9-5.0 g/100 kcal to 1.8-3.5 g/100 kcal, increasing the minimum content of lipids from 2.9 g/100 kcal to 3.5 g/100 kcal, providing the maximum amount of vitamins and minerals (including vitamin E, vitamin K, thiamin, riboflavin, vitamin B_6, vitamin B_(12), niacin, folic acid, pantothenic acid, vitamin C, biotin, magnesium, calcium, phosphorus, and iodine), and changing the content of optional components such as taurine, docosahexaenoic acid, and arachidonic acid. Conclusions: These nutrient standard modifications based on recent evidence are expected to enhance feeding practices and further guarantee the health of 6-12-month-old infants in China.

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Iodine nutritional status and prevalence of goitre among school going children: a cross-sectional study to assess progress towards universal salt iodization in Tikamgarh district of Madhya Pradesh

Background and Objectives: Iodine deficiency disorders (IDD) has been a major public health challenge for the Indian subcontinent over many years. Our study was conducted in Tikamgarh district of Madhya Pradesh, an iodine deficiency disorders-endemic district, with the objective to estimate total goitre rate and iodine nutrition status. Methods and Study Design: A cross-sectional study with 30 cluster sampling was conducted between June to July 2016 among school-going children in the age group of 6-12 years. Ninety children from each school (30x90=2700) were selected for the assessment of Goitre. Total 540 salt samples and 270 urine samples were collected to estimate salt iodine content from their house-hold and urine iodine excretion (UIE) respectively. A total of 150 households and 30 shopkeepers were interviewed to understand the awareness level for salt iodization. Results: Goitre rate in Tikamgarh district was 1.9% with prevalence of grade I & II was 1.7% and 0.2% respectively. The median UIE level was 200 mcg/L. The 20% the population had iodine deficiency, 28.9% population had adequate iodine nutrition and 51.1% population had either more than adequate level of iodine. The 72.4% of the population consume adequately iodized salt (≥15 ppm). Conclusions: Our study concludes that Tikamgarh district is non-endemic for IDDs against the earlier classification as an IDD-endemic district. About 20% population has 'iodine deficiency' and approximately 51.1% population has 'more than adequate iodine intake'. We recommend stringent programme monitoring, undertake periodic assessment of IDD and explore manifestations of excess iodine intake (≥300 mcg/L) such as Iodine-induced hyperthyroidism in future.

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Food frequency questionnaire reproducibility for middle-aged and elderly Japanese

Background and Objectives: The aim of this study was to examine the reproducibility of a self-administered food frequency questionnaire (FFQ) originally developed for the Japan Public Health Center-Based Prospective Study (JPHC study) and modified for use in the Next Generation (JPHC-NEXT) study. Methods and Study Design: Participants included 98 men and 142 women aged 40-74 years from the five areas included in the JPHC-NEXT protocol. In November 2012, participants were recruited and asked to complete the first nutrition survey. The second nutrition survey was completed after 1 year. Results: We estimated daily energy as well as 53 nutrient and 29 food group intakes using the FFQ. To assess reproducibility, we calculated Spearman correlation coefficients between both FFQs, which showed mostly intermediate-to-high values. Median (range) correlation coefficients and quartile distribution in the same and adjacent categories for energy-adjusted nutrient intakes were 0.55 (0.42-0.84) and 84.7% (76.5%-98.0%) in men and 0.54 (0.35-0.80) and 84.5% (76.1%-94.4%) in women. The respective values for energy-adjusted food group intakes in men and women were also mostly intermediate to high: 0.54 (0.39-0.79) and 83.7% (75.5%-90.8%) in men and 0.57 (0.40-0.83) and 84.5% (77.5%-93.7%) in women. Conclusions: The FFQ developed for the JPHC-NEXT study has reasonable reproducibility. Because this FFQ has also been validated in a previous study, it can be considered a useful dietary assessment tool to examine associations between dietary consumption and lifestyle-related diseases.

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Increased coffee, tea, or other sugar-sweetened beverage consumption in adolescents is associated with less satisfactory dietary quality, body fatness and serum uric acid profiles over the past 18 years in Taiwan

Background and Objectives: Taiwan has a high density of convenience stores and beverage shops, which makes sugar-sweetened beverages (SSBs) very accessible to teenagers. This study examined the changes and the association between SSBs and biomarkers and nutrient intake, for teenagers over the course of 18 years using a national representative sample. Methods and Study Design: This cross-sectional study used data from the Nutrition and Health Survey in Taiwan (NAHSIT). Complete data for teenagers aged 13 to 19 years including a 24-hour dietary recall, anthropometric and clinical measurements, and SSBs from two periods were analyzed (1993-1996: N=1820; 2010-2011: N=2513). SAS callable SUDAAN was used for statistical analysis, adjusting for the sampling scheme. Log transformation was used for non-normal variables before linear models were used. Coffee or tea and SSB (excluding tea or coffee) consumers were categorized as non-drinkers, low (below), or high (above) consumers based on median intake during 1993-1996. Results: Intake of coffee or tea increased significantly in the 18 years of this study (p＜0.01), whereas intake of SSBs (excluding coffee or tea) decreased significantly (p＜0.05). Intake was significantly higher among second survey and those with high total energy intakes (p＜0.01). For both coffee/tea and SSB, the high-intake groups had higher serum uric acid and intake of carbohydrates (p＜0.05), lower intake of protein and phosphorus and lower dietary diversity score (p＜0.05). Conclusions: Consumption of coffee or tea increased in adolescents during the 18 years. High intakes of SSB, coffee or tea was associated with high serum uric acid values and worse dietary quality.