Current status of foodservice nutrition management and effects of welfare facility support for the elderly in Cheongju City

BACKGROUND/OBJECTIVESSouth Korea is representative of countries experiencing rapid societal aging. This study aimed to understand the current status of foodservice nutrition management provided to welfare facilities for the elderly and to understand improvements after support from “the Center for Social Welfare Foodservice Management (CSWFM)” in Cheongju City.SUBJECTS/METHODSThe status of foodservice nutrition management was assessed by dietitians and hired by the CSWFM, who visited 40 welfare facilities (registered members of the CSWFM) for the elderly in Cheongju City. After visiting each facility three times from July to December 2019, the results of inspections on four areas, that is, ‘menu’, ‘meal provision’, ‘cooking’, and ‘distribution’ management for 2nd and 3rd visits (support visits) were compared with results obtained at initial visits.RESULTSBefore support as determined during 1st visits, compliance rates with ‘menu’, ‘meal provision’, ‘cooking’, and ‘distribution’ requirements were 72.1%, 75.5%, 58.3%, and 77.5%, respectively. The mean compliance rate for all 15 items on the questionnaire used was 70.8%. Items with low compliance rates were ‘Is the soup provided by foodservice at the recommended salinity?’ (compliance rate 37.5%) and ‘Is the foodservice cooking conducted by referring to a recipe?’ (42.5%). At the two support visits, mean compliance rates increased significantly (P < 0.01, P < 0.001), mean total score had significantly increased from 71.80 to 90.26 (P < 0.001), and mean soup salinity decreased significantly from 0.82% at 1st visits to 0.68% (P < 0.001) and 0.56% (P < 0.001) at the 1st and second follow-up visits.CONCLUSIONSThese results show that the status of nutrition management at welfare facilities for the elderly was much improved by CSWFM involvement, and indicate the CSWFM should continuously provide nutrition management support to facilities and that finances and opportunities for more welfare facilities for the elderly be expanded.     

The effects of ECE on the benefits of PMRT for breast cancer patients with positive axillary nodes

Background

The purpose of the present study was to retrospectively evaluate the effects of extracapsular extension (ECE) on the benefits of post-mastectomy radiation therapy (PMRT) for groups of patients with varying numbers of positive axillary nodes (1–3, 4–9 and ≥10 positive axillary nodes). Methods: A total of 1220 axillary node-positive patients who had received mastectomy were involved in this study. Patients were grouped as ‘Radio + /ECE + ’, ‘Radio–/ECE + ’, ‘Radio + /ECE–’ or ‘Radio–/ECE–’ according to status of ECE and whether receiving PMRT or not, and were evaluated in terms of local region relapse (LRR) rate. The 5-year and 10-year Kaplan-Meier disease-free survival and overall survival (OS) rates were analyzed. Results: ECE-positive differed from ECE-negative groups with statistical significance for all comparisons in favor of the ECE-negative group: 5-year locoregional failure-free survival (LRFFS) (82.69% vs 91.83%, P < 0.001), 10-year LRFFS (75.39% vs 90.02%, P < 0.001); 5-year OS (52.12% vs 74.46%, P < 0.001), 10-year OS (35.17% vs 67.63%, P < 0.001). There were no significant effects of ECE on the benefits of PMRT for patients with 1–3 (P = 0.5720), ≥10(P = 0.0614) positive axillary nodes. However, for the group of patients with 4–9 positive axillary nodes, ECE status had a significant effect on the benefits of PMRT with respect to 5-year and 10-year LRFFS (P < 0.05). Conclusion: In our study, regardless of the ECE status, PMRT didn''t significantly improve the LRFFS for patients with 1–3 or ≥10 positive axillary nodes. However, for patients with 4–9 positive axillary nodes, ECE could be an important criterion to consider when deciding whether to receive PMRT.     

Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program

BACKGROUND/OBJECTIVESNumerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weight-control efforts, dietary habits, and behavior.SUBJECTS/METHODSA survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs.RESULTSObese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001–0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001–0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001–0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001–0.008).CONCLUSIONSAttending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.     

Association between stress and dietary habits,emotional eating behavior and insomnia of middle-aged men and women in Seoul and Gyeonggi

BACKGROUND/OBJECTIVESThe study was performed to investigate the degree of perceived stress by sex in middle-aged people, and to provide basic data for appropriate nutrition education and interventional measures for middle-aged subjects through comparative analysis of association between stress and dietary habits, emotional eating behavior, and insomnia.SUBJECTS/METHODSA survey was conducted in 670 middle-aged subjects (320 men and 350 women) aged 40–64 years, resided in Seoul and Gyeonggi area. Collected data were analyzed using SPSS WIN 25.0 program.RESULTSPerceived stress in middle-aged subjects was not different by sex. Stress was higher in men with low dietary habits level compared to other groups (P < 0.001), and was higher in women with low and moderate dietary habits level compared to women with high dietary habits level (P < 0.05). Stress in men was higher in the group with emotional eaters (P < 0.05), and the same result was shown in women (P < 0.001). Stress was higher in both men and women with poor sleep quality (P < 0.001). Stress score was positively correlated with emotional dietary behavior and insomnia (P < 0.001) and negatively correlated with dietary habits (P < 0.001).CONCLUSIONSIt is considered that proper nutrition education and interventional measures according to sex are needed for stress control and proper dietary behavior and lifestyle in middle-aged people population, along with projects and policies at the national level.     

Association between sugar-sweetened beverage consumption and depression and suicidal ideation among Korean adults: a cross-sectional study from the 2014 and 2016 Korean National Health and Nutrition Examination Survey (KNHANES)

BACKGROUND/OBJECTIVESSugar-sweetened beverages (SSBs) are regarded as modifiable risk factors for mental health in several populations. Although the consumption of SSBs is steadily increasing in Korea, there is scant evidence regarding the impact of SSB consumption on depression and suicidal ideation. The aim of this study was to investigate the association of SSB consumption with depression and suicidal ideation among adults in Korea.SUBJECTS/METHODSWe used the data for 5,465 participants (2,170 men and 3,295 women) aged ≥ 20 years from the 2014 and 2016 Korea National Health and Nutrition Examination Survey. The subjects were divided into four groups according to SSB consumption using a food frequency questionnaire. Logistic regression analyses were conducted to examine the association of SSB consumption with depression and suicidal ideation, adjusting for sociodemographic, health behavior, and dietary variables.RESULTSParticipants consuming ≥ 1 SSB/day had a significantly higher risk of depression (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.08–2.18; P < 0.001) and suicidal ideation (OR, 2.20; 95% CI, 1.13–4.28; P < 0.001) compared with those in the non-SSB group after adjusting for potential confounding factors.CONCLUSIONSOur results suggest that SSB consumption is positively associated with depression and suicidal ideation in Korean adults.     

Perception of sugar reduction,nutrition education,and frequency of snacking in children by the self-perceived sweet dietary habits of mothers in Busan

BACKGROUND/OBJECTIVESThe aim of this study was to investigate the perception of sugar reduction, nutrition education, and frequency of snacking in children according to the self-perceived dietary preferences for sweet taste by mothers in Busan.SUBJECTS/METHODSA total of 277 mothers were surveyed, and their perceptions of sugar reduction and the frequency of snacking in children were assessed using a questionnaire. The subjects were classified into either a sweet (n = 91) or an unsweet (n = 186) group according to their self-perceived preferences for a sweet taste.RESULTSIn the sweet group, the results for sweet products were sweetened ice (86.8%), confectionery (74.7%), processed milk (73.6%), carbonated beverages (71.4%), and fermented milk (53.9%). In the unsweet group, the results were sweetened ice (88.7%), carbonated beverages (78.5%), processed milk (75.8%), confectionery (69.4%), and fermented milk (50.5%). The necessity of sugar intake reduction was high in both groups (sweet = 89.0%, unsweet = 82.8%). Beverage purchases after identifying the nutrition labeling was significantly lower in the sweet group than in the unsweet group (P < 0.05). The reasons for the beverage purchases instead of water were "habitually" (50.5%) and "like sweet taste" (25.3%) in the sweet group (P < 0.01). Snacking in children was significantly higher in the sweet group based on the increased frequencies of carbonated drinks (P < 0.01), fast food (P < 0.001), candy and chocolate (P < 0.05), crackers (P < 0.01), ramen (P < 0.01), and fish paste/hotdogs (P < 0.01). The frequency of purchase education after identifying the nutrition labeling was significantly lower in the sweet group than in the unsweet group (P < 0.01).CONCLUSIONSThese findings suggest that a perception of sugar reduction and practical nutrition education aimed at reducing the sugar intake are necessary to improve dietary habits.     

Dietary Patterns,Their Nutrients,and Associations with Socio-Demographic and Lifestyle Factors in Older New Zealand Adults

Dietary patterns analyse combinations of foods eaten. This cross-sectional study identified dietary patterns and their nutrients. Associations between dietary patterns and socio-demographic and lifestyle factors were examined in older New Zealand adults. Dietary data (109-item food frequency questionnaire) from the Researching Eating, Activity and Cognitive Health (REACH) study (n = 367, 36% male, mean age = 70 years) were collapsed into 57 food groups. Using principal component analysis, three dietary patterns explained 18% of the variation in diet. Dietary pattern associations with sex, age, employment, living situation, education, deprivation score, physical activity, alcohol, and smoking, along with energy-adjusted nutrient intakes, were investigated using regression analysis. Higher ‘Mediterranean’ dietary pattern scores were associated with being female, higher physical activity, and higher education (p < 0.001, R² = 0.07). Higher ‘Western’ pattern scores were associated with being male, higher alcohol intake, living with others, and secondary education (p < 0.001, R² = 0.16). Higher ‘prudent’ pattern scores were associated with higher physical activity and lower alcohol intake (p < 0.001, R² = 0.15). There were positive associations between beta-carotene equivalents, vitamin E, and folate and ‘Mediterranean’ dietary pattern scores (p < 0.0001, R² ≥ 0.26); energy intake and ‘Western’ scores (p < 0.0001, R² = 0.43); and fibre and carbohydrate and ‘prudent’ scores (p < 0.0001, R² ≥ 0.25). Socio-demographic and lifestyle factors were associated with dietary patterns. Understanding relationships between these characteristics and dietary patterns can assist in health promotion.     

The Paradox of Discrimination,the “Aloha Spirit,” and Symptoms of Depression in Hawai‘i

It remains to be determined whether the “aloha spirit” is a cultural resource that influences psychological well-being in Hawai‘i. Thus, the purpose of this study is to investigate whether the aloha spirit is associated with levels of psychological distress and the risk of depression, while taking into account various risk factors. Data for this study were drawn from an anonymous survey of undergraduate students (N = 1,028) at the University of Hawai‘i. Regression results revealed that having learned the aloha spirit was associated with significantly lower levels (b = −1.76; P < .01) of psychological distress and a reduced odds of depression (OR = .69; P < .01) over and above the effects of perceived discrimination, local identity, levels of ethnic identification, race/ethnicity, immigrant status, duration of residence in Hawai‘i, and other sociodemographic factors. In contrast, everyday discrimination was associated with significantly higher levels (b = 0.41; P < .001) of psychological distress and a greater odds of depression (OR = 1.08; P < .001). Together, these findings highlight the paradox of discrimination and the aloha spirit in Hawai‘i by documenting their distinct relationships with mental health. Overall, this study contributes to medical and public health research on mental health disparities during the transition to adulthood by delving into the social context of daily life in the understudied, multicultural location of Hawai‘i.     

Determinants of Depression in Indonesian Youth: Findings From a Community-based Survey

ObjectivesThis study investigated the determinants of depression in adolescents and young adults.MethodsThe present study analyzed data from the 2018 Indonesia Basic Health Survey (Riset Kesehatan Dasar; RISKESDAS). The study subjects were adolescents (15-17 years old) and young adults (18-24 years old). In total, 64 179 subjects were included. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between youths’ characteristics, risky behavior, chronic disease, parents’ health, and youths’ depression.ResultsThe prevalence of depression was 5.1% in adolescents and 5.6% in young adults. The risk factors for depression in adolescents were being women (adjusted odds ratio [aOR], 3.53; 95% confidence interval [CI], 2.89 to 4.30; p<0.001), an ex-smoker (aOR, 2.99; 95% CI, 2.10 to 4.25; p<0.001), or a current smoker (aOR, 2.60; 95% CI, 1.97 to 3.44; p<0.001); consuming alcohol (aOR, 2.00; 95% CI, 1.33 to 3.01; p=0.001), having a chronic disease (aOR, 2.64; 95% CI, 1.41 to 4.96; p=0.002); maternal depression (aOR, 2.47; 95% CI, 1.97 to 3.09; p<0.001); and paternal depression (aOR, 2.63; 95% CI, 1.98 to 3.50; p<0.001). In young adults, the risk factors were being women (aOR, 2.23; 95% CI, 1.82 to 2.75; p<0.001) or an ex-smoker (aOR, 2.47; 95% CI, 1.67 to 3.67; p<0.001), consuming alcohol (aOR, 2.42; 95% CI, 1.89 to 3.09; p<0.001), maternal depression (aOR, 3.12; 95% CI, 2.54 to 3.84; p<0.001), and paternal depression (aOR, 2.80; 95% CI, 2.17 to 3.63; p<0.001).ConclusionsBeing women, smoking, drinking alcohol, having a chronic disease, and having a parent with depression were crucial factors associated with youth depression. Mental health screening, prevention, and treatment should involve collaboration among primary healthcare, schools, universities, professionals, and families.     

Agrifood consumer competency and organic food purchase intentions according to food-related lifestyle: based on data the 2019 Consumer Behavior Survey for Food

BACKGROUND/OBJECTIVESThe increased consumers’ interests in health and food safety have increased the demand for organic foods. Many studies have been performed on consumers’ purchase intentions for organic foods and their influencing factors, and various studies have shown that the prices of organic foods and the consumers’ willingness to pay are important influencing factors. This study examined the payment value of organic foods and agrifood consumer competency index according to the food-related lifestyles in South Korean consumers.SUBJECTS/METHODSA cross-sectional analysis was performed using the 2019 Consumer Behavior Survey for Food. A total of 6,176 participants aged 19 to 74 years (male: 2,783, female: 3,393) were included in the analysis.RESULTSThree factors were extracted by factor analysis (rational consumption-seeking type, convenience-seeking type, and health, and safety-seeking type) to explain the consumers’ food-related lifestyles. The results of cluster analysis suggested that consumers were classified into 3 food-related lifestyles as the ‘exploratory consumers’ (n = 2,485), ‘safety-seeking consumers’ (n = 1,544), and ‘passive consumers’ (n = 2,147). Exploratory consumers showed a significantly higher willingness to pay for imported organic foods (P < 0.05). Safety-seeking consumers had a significantly higher willingness to pay for domestic organic foods (P < 0.05). For the agrifood consumer competency index, exploratory consumers had the highest score, followed in order by safety-seeking consumers and passive consumers.CONCLUSIONSThese results provide basic data in understanding consumption tendency for organic foods and agrifoods based on food-related lifestyles of South Korean consumers.     

School water,sanitation, and hygiene inequalities: a bane of sustainable development goal six in Nigeria

ObjectivesThe importance of school water, sanitation, and hygiene (WASH) in achieving the Sustainable Development Goal targets 6.1 and 6.2 in developing countries cannot be overemphasized. However, widespread WASH inequalities remain an impediment to achieving the targets by 2030. Hence, this study was conducted to examine current school-WASH disparities among public and private schools in a low-income Nigerian community using mixed methods.MethodsThe cross-sectional survey utilized multi-stage sampling to select 400 students from five public and five private schools in Akinyele, Ibadan. Semi-structured questionnaires and observational checklists were used to obtain data. Inferential statistics were measured at a 95% confidence interval. Independent variables like the students’ sociodemographic characteristics, school type, and available WASH facilities were associated with dependent variables like respondents’ hand hygiene and sanitation practices and WASH-associated knowledge and attitude to examine existing inequalities.ResultsClassifying the available WASH facilities based on the WHO/UNICEF Joint Monitoring Programme, none of the public schools provided any sanitation and hygiene service, while all the private schools provided both services. Furthermore, the private-school students had significantly better WASH knowledge (p<0.001; Ƞ²_p=0.152) and attitude (p<0.001; Ƞ²_p=0.036) compared with the public-school students. Also, a significantly higher portion of public-school students practiced open defecation at school (p<0.001; odds ratio (OR)=7.4; confidence interval (CI)=4.1–13.5) and at home (p<0.001; OR=7.8; CI=3.7–16.7).ConclusionWASH disparities among socioeconomic groups remain a persistent challenge. Sole reliance on the Government to narrow the inequalities has persistently proven unfruitful. There is a need to empower local community stakeholders to facilitate sustainable school-WASH interventions.     

Missed opportunities for hypertension screening: a cross-sectional study,India

ObjectiveTo assess missed opportunities for hypertension screening at health facilities in India and describe systematic differences in these missed opportunities across states and sociodemographic groups.MethodsWe used nationally representative survey data from the 2017–2018 Longitudinal Ageing Study in India to estimate the proportion of adults aged 45 years or older identified with hypertension and who had not been diagnosed with hypertension despite having visited a health facility during the previous 12 months. We estimated age–sex adjusted proportions of missed opportunities to diagnose hypertension, as well as actual and potential proportions of diagnosis, by sociodemographic characteristics and for each state.FindingsAmong those identified as having hypertension, 22.6% (95% confidence interval, CI: 21.3 to 23.8) had not been diagnosed despite having recently visited a health facility. If these opportunities had been realized, the prevalence of diagnosed hypertension would have increased from 54.8% (95% CI: 53.5 to 56.1) to 77.3% (95% CI: 76.2 to 78.5). Missed opportunities for diagnosis were more common among individuals who were poorer (P = 0.001), less educated (P < 0.001), male (P < 0.001), rural (P < 0.001), Hindu (P = 0.001), living alone (P = 0.028) and working (P < 0.001). Missed opportunities for diagnosis were more common at private than at public health facilities (P < 0.001) and varied widely across states (P < 0.001).ConclusionOpportunistic screening for hypertension has the potential to significantly increase detection of the condition and reduce sociodemographic and geographic inequalities in its diagnosis. Such screening could be a first step towards more effective and equitable hypertension treatment and control.     

Association between Food Preferences and Food Habits in a Polish Adolescents’ COVID-19 Experience (PLACE-19) Study

Food preferences are among the most influential factors of food habits in the vulnerable period of adolescence; in addition, gender-dependent differences in food preferences are also observed. The aim of the present study was to analyze differences in food habits between individuals stratified based on their food preferences in a population-based sample of adolescents aged 15–20. The study was conducted within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population in a group of 2419 secondary school students who were randomly chosen to participate in the study using a random quota sampling procedure. The food preferences were determined on the basis of a validated Food Preference Questionnaire (FPQ) (which enables assessing preference of vegetables, fruit, meat/fish, dairy, snacks, and starches), whereas food habits were determined on the basis of the Adolescents’ Food Habits Checklist (AFHC) (which enables assessing food purchase, preparation, and consumption habits). The analysis involved three homogenous clusters (‘low-preferring’, ‘hedonists’, and ‘high-preferring’), which were identified using the k-means algorithm. It was found that for a number of the assessed food purchase, preparation, and consumption habits, there were statistically significant differences between the ‘low-preferring’, ‘hedonists’, and ‘high-preferring’ clusters. Within food purchase habits, the food preference influenced frequency of buying pastries/cakes and frequency of eating takeaway meals for all the respondents, while for female respondents, it influenced also choice of desserts in restaurants, and for male respondents, it influenced choosing a low-fat lunch away from home (p < 0.05). Within food preparation habits, the food preference influenced the fat content in desserts at home, the frequency of eating at least one serving of vegetables/salad with an evening meal, the frequency of spreading butter/margarine on bread thinly, and the frequency of having cream on desserts for all the respondents; meanwhile, for female respondents, it also influenced the frequency of avoiding fried foods and the frequency of including chocolate/biscuits in their packed lunch (p < 0.05). Within food consumption habits, the food preference influenced the frequency of eating a dessert/pudding, eating at least one serving of fruit a day, eating at least one serving of vegetables/salad a day, avoiding sausages/burgers, trying to ensure they eat plenty of fruit and vegetables, and frequency of choosing fruit as a snack for all the respondents; meanwhile, for male respondents, it also influenced the frequency of eating sweet snacks and eating at least three servings of fruit most days (p < 0.05). Taking into account that some improper food habits may be typical for the specific clusters, there is an urgent need to analyze and address them for the purposes of public health and to bear in mind that some of those habits are gender-dependent.     

Disparities in Oral Nutritional Supplement Usage and Dispensing Patterns across Primary Care in Ireland: ONSPres Project

When treating malnutrition, oral nutritional supplements (ONSs) are advised when optimising the diet is insufficient; however, ONS usage and user characteristics have not been previously analysed. A retrospective secondary analysis was performed on dispensed pharmacy claim data for 14,282 anonymised adult patients in primary care in Ireland in 2018. Patient sex, age, residential status, ONS volume (units) and ONS cost (EUR) were analysed. The categories of ‘Moderate’ (<75th centile), ‘High’ (75th–89th centile) and ‘Very High’ ONS users (≥90th centile) were created. The analyses among groups utilised t-tests, Mann–Whitney U tests and chi-squared tests. This cohort was 58.2% female, median age was 76 years, with 18.7% in residential care. The most frequently dispensed ONS type was very-high-energy sip feeds (45% of cohort). Younger males were dispensed more ONSs than females (<65 years: median units, 136 vs. 90; p < 0.01). Patients living independently were dispensed half the volume of those in residential care (112 vs. 240 units; p < 0.01). ‘Moderate’ ONS users were dispensed a yearly median of 84 ONS units (median cost, EUR 153), ‘High’ users were dispensed 420 units (EUR 806) and ‘Very High’ users 892 yearly units (EUR 2402; p < 0.01). Further analyses should focus on elucidating the reasons for high ONS usage in residential care patients and younger males.     

Italians Do It … Less. COVID-19 Lockdown Impact on Sexual Activity: Evidence From a Large Representative Sample of Italian Adults

BackgroundTo explore how sexual activity was impacted by coronavirus disease 2019 (COVID-19) lockdown measures in the general adult population.MethodsA cross-sectional survey was conducted among 6,003 Italian adults aged 18–74 years who were representative of the Italian general population. Study subjects were recruited at the time of the nationwide stay-at-home order (from April 27 to May 3, 2020). We identified characteristics associated with decreased frequency of sex during lockdown, differentiating between cohabiting and non-cohabiting subjects.ResultsOver one-third (35.3%) of Italians reported to have changed their sexual activity during lockdown (8.4% increased and 26.9% decreased). When focusing on cohabitants (N = 3,949, 65.8%), decreased sexual activity (20.7%) was more frequently reported by men (22.3%; compared to women, multivariable odds ratio 1.23; 95% confidence interval, 1.05–1.44), younger subjects (P for trend <0.001), more educated subjects (P for trend = 0.004), subjects living in smaller houses (P for trend = 0.003), and those reporting longer time spent outdoors before the lockdown (P for trend <0.001).ConclusionsCOVID-19 lockdown drastically altered people’s day-to-day life and is likely to have impacted lifestyle habits and behavioral risk factors, including sexual attitudes and practice. This is the first national population-level study exploring changes in sexual life in this COVID-19 era. As we report sexual practice to have been affected by lockdown restrictions, we suggest that the mental health, social, and other determinants of these changes are to be explored beyond imposed social distancing.Key words: COVID-19, lockdown restrictions, sexual activity     

The Role of Maternal Weight in the Hierarchy of Macrosomia Predictors; Overall Effect of Analysis of Three Prediction Indicators

So far it has not been established which maternal features play the most important role in newborn macrosomia. The aim of this study is to provide assessment of a hierarchy of twenty six (26) maternal characteristics in macrosomia prediction. A Polish prospective cohort of women with singleton pregnancy (N = 912) which was recruited in the years 2015–2016 has been studied. Two analyses were performed: for probability of macrosomia > 4000 g (n = 97) (vs. 755 newborns 2500–4000 g); and for birthweight > 90th percentile (n = 99) (vs. 741 newborns 10–90th percentile). A multiple logistic regression was used (with 95% confidence intervals (CI)). A hierarchy of significance of potential predictors was established after summing up of three prediction indicators (NRI, IDI and AUC) calculated for the basic prediction model (maternal age + parity) extended with one (test) predictor. ‘Net reclassification improvement’ (NRI) focuses on the reclassification table describing the number of women in whom an upward or downward shift in the disease probability value occurred after a new factor had been added, including the results for healthy and ill women. ‘Integrated discrimination improvement’ (IDI) shows the difference between the value of mean change in predicted probability between the group of ill and healthy women when a new factor is added to the model. The area under curve (AUC) is a commonly used indicator. Results. The macrosomia risk was the highest for prior macrosomia (AOR = 7.53, 95%CI: 3.15–18.00, p < 0.001). A few maternal characteristics were associated with more than three times higher macrosomia odds ratios, e.g., maternal obesity and gestational age ≥ 38 weeks. A different hierarchy was shown by the prediction study. Compared to the basic prediction model (AUC = 0.564 (0.501–0.627), p = 0.04), AUC increased most when pre-pregnancy weight (kg) was added to the base model (AUC = 0.706 (0.649–0.764), p < 0.001). The values of IDI and NRI were also the highest for the model with maternal weight (IDI = 0.061 (0.039–0.083), p < 0.001), and (NRI = 0.538 (0.33–0.746), p < 0.001). Adding another factor to the base model was connected with significantly weaker prediction, e.g., for gestational age ≥ 38 weeks (AUC = 0.602 (0.543–0.662), p = 0.001), (IDI = 0.009 (0.004; 0.013), p < 0.001), and (NRI = 0.155 (0.073; 0.237), p < 0.001). After summing up the effects of NRI, IDI and AUC, the probability of macrosomia was most strongly improved (in order) by: pre-pregnancy weight, body mass index (BMI), excessive gestational weight gain (GWG) and BMI ≥ 25 kg/m². Maternal height, prior macrosomia, fetal sex-son, and gestational diabetes mellitus (GDM) occupied an intermediate place in the hierarchy. The main conclusions: newer prediction indicators showed that (among 26 features) excessive pre-pregnancy weight/BMI and excessive GWG played a much more important role in macrosomia prediction than other maternal characteristics. These indicators more strongly highlighted the differences between predictors than the results of commonly used odds ratios.     

Blood Chromium Levels and Their Association with Cardiovascular Diseases,Diabetes, and Depression: National Health and Nutrition Examination Survey (NHANES) 2015–2016

Currently, there is no global consensus about the essentiality of dietary chromium. To provide evidence to this debate, an examination of blood chromium levels and common chronic health conditions was undertaken. Using a subsample from the 2015–2016 US National Health and Nutrition Examination Survey (n = 2894; 40 years⁺), chi-square and binary logistic regression analyses were conducted to examine blood chromium levels (0.7–28.0 vs. <0.7 µg/L) and their associations with cardiovascular diseases (CVDs; self-report), diabetes mellitus (DM; glycohemoglobin ≥5.7%), and depression (Patient Health Questionnaire-9 score ≥5), while controlling for socio-demographic (age/sex/income/education/relationship status) and health-related (red blood cell folate/medications/co-morbidities/body mass index (BMI)/substance use) factors. The sample was almost evenly distributed between men and women (n = 1391, 48.1% (men); n = 1503, 51.9% (women)). The prevalence estimates of low blood chromium levels tended to be higher among those with CVDs (47.4–47.6%) and DM (50.0–51.6%). Comparisons between those with low vs. normal blood chromium levels indicate men have increased odds of CVDs (adjusted odds ratio (aOR) = 1.86, 95% confidence interval (CI): 1.22–2.85, p < 0.001) and DM (aOR = 1.93, 95% CI: 1.32–2.83, p < 0.001) and lower odds of depression (aOR = 0.42, 95% CI: 0.22–0.77, p < 0.05). Dietary chromium may be important in the prevention and management of CVDs and DM for men. Continued exploration of chromium’s role in chronic diseases, including differences by biological factors, is needed.     

Western dietary pattern is associated with higher risk of lower lean muscle mass in Korean postmenopausal women: data from the Korea National Health and Nutrition Examination Survey 2008–2011

BACKGROUND/OBJECTIVESIn a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women.SUBJECTS/METHODSThe Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used.RESULTSThe prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass.CONCLUSIONSThe study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.