The Public Health Impact of Major Depression: A Call for Interdisciplinary Prevention Efforts

Major depression is a consequential public health problem in the United States. Depression has long been recognized as an important target of intervention in psychology and psychiatry, but these fields have focused efforts primarily on treatment rather than prevention. Although effective preventive interventions targeting high-risk groups have been developed, they have thus far had poor reach and sustainability in the community. The development of sustainable preventive interventions that have the potential to impact population health represents a critical goal for the field. To this end, a research agenda incorporating the perspectives of both mental health disciplines and public health is proposed as a guide for future depression prevention research. Increased interdisciplinary collaboration between mental health disciplines and public health is recommended to develop, enact, and evaluate multilevel preventive interventions aimed at reducing the population health burden of major depression.     

A Review of Cutoffs for Nutritional Biomarkers

The nutritional status of an individual or population needs to be assessed through valid and reliable biomarkers. Cutoffs generally have an underlying relation to health status and are one of the important quantitative criteria against which biomarker outputs are compared. For this reason, cutoffs are integral for surveys, surveillance, screening, interventions, monitoring, and evaluation. Despite their importance, nutritional biomarker cutoffs have not been adequately addressed in the literature. Furthermore, the field has not reached a consensus on which cutoff to use for each biomarker, and different cutoffs are often used for the same biomarkers in published studies. This review provides a comprehensive overview of cutoffs related to nutritional biomarkers and highlights some of the high-priority research gaps and challenges of using micronutrient case studies.     

社区老年人群营养状况综合性评价方法及其应用

[目的]建立一种简便、快速、经济、有效、实用的社区老年人综合性营养状况评价方法。[方法]采用新拟定的问卷评分法以及传统评价方法（人体测量、实验室检测、膳食调查、临床检查）5种方法对182名老年人分别进行调查。将问卷评分法所得结果与传统评价方法所得结果进行比较分析，对问卷评分法的有效性和可靠性进行评价。[结果]①对问卷评分法测得的分值与传统评价方法测得的营养指标进行相关性分析表明，除膳食脂肪摄入量外，余均存在正相关关系；以传统方法综合评价结果为“金标准”，问卷评分法以17分为临界分割点时，其实际应用的灵敏度为92-31％、特异度为88．89％、阳性预测值为88．89％、阴性预测值为98．71％；问卷评分法以分值17、24分为两个临界分割点，将被评价者营养状况分成3种状态：〈17分为营养不良；17～〈24分为存在营养不良危险；≥24分营养状况良好。经过比较，3种状态下主要营养指标差别均有显著性（P〈0．05）。②问卷评分法各项目所得分值与总分值相关分析表明，内在一致度系数a为0．92；30名样本人群采用问卷评分法前后两次调查评分结果无差异，P〉0．05，其Kappa值为0．82。[结论]新的问卷评分法是一种简便、快速、经济、实用、有效、可靠的综合性营养状况评价方法。     

A Historical Review of Changes in Nutrition Standards of USDA Child Meal Programs Relative to Research Findings on the Nutritional Adequacy of Program Meals and the Diet and Nutritional Health of Participants: Implications for Future Research and the Summer Food Service Program

Background: The USDA child meal programs (CMPs) (National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) were established in 1946 (NSLP) and 1975 (SBP and SFSP) to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. Objective: The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Methods: Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. Results: NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003). Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in vegetable servings. Conclusions: There is critical need for policy change that would enable updates to the SFSP nutrition standards to match those of the NSLP and SBP. In addition, strategies are needed to facilitate development of CMP menus that meet current nutrition standards. Finally, rigorously designed studies are needed to understand the direct impact of CMP participation on child diet and health, particularly the SFSP for which there is limited published data.     

Nutritional Interventions for Treating Cancer-Related Fatigue: A Qualitative Review

Cancer-related fatigue (CRF) is a debilitating syndrome that persists for many cancer survivors for years after treatment. Symptoms include early and persistent fatigue, functional decline, depression, and cognitive difficulties. Inflammation, assessed using pro-inflammatory biomarkers, is increased in cancer survivors with fatigue and treatments for fatigue are often aimed at reducing inflammation. Additionally, cancer and its treatment lead to nutritional complications, changes in body composition, and nutritional deficiencies that potentially weaken the cancer survivor and impact CRF. We conducted a qualitative review of clinical trials that assessed nutritional interventions for preventing and treating CRF. Further studies were examined that used nutritional interventions to address inflammation and fatigue, due to the dearth of nutrition research directly related to CRF. Dietary intake prior to, during, and after cancer treatment appears to affect fatigue levels. Increased protein intake may help preserve lean mass and body composition. Dietary patterns that reduce inflammation, such as the Mediterranean diet and other plant-based diets, appear tolerable to cancer survivors and may reduce fatigue. Supplementation with ginseng, ginger, or probiotics may improve cancer survivors’ energy levels. Nutritional interventions, alone or in combination with other interventions should be considered as therapy for fatigue in cancer survivors.     

Community Engagement in Research: Frameworks for Education and Peer Review

Community engagement in research may enhance a community''s ability to address its own health needs and health disparities issues while ensuring that researchers understand community priorities. However, there are researchers with limited understanding of and experience with effective methods of engaging communities. Furthermore, limited guidance is available for peer-review panels on evaluating proposals for research that engages communities.The National Institutes of Health Director''s Council of Public Representatives developed a community engagement framework that includes values, strategies to operationalize each value, and potential outcomes of their use, as well as a peer-review framework for evaluating research that engages communities.Use of these frameworks for educating researchers to create and sustain authentic community–academic partnerships will increase accountability and equality between the partners.THE SIGNIFICANT RENAISSANCE of community engagement in research stems from demands by community leaders, policymakers, and funders for meaningful community involvement to address health problems facing communities. The published peer-reviewed literature and numerous reports point to the many potential benefits of community engagement in research.^1–16 According to the Institute of Medicine, for example, community-based participatory research increases community understanding of the issues under study and enhances researchers'' ability to understand community priorities, the importance of addressing community priorities, and the need for culturally sensitive communications and research approaches.¹⁷Several models for community engagement in research exist, including community-based participatory research,^18,19 empowerment evaluation,^20,21 participatory or community action research,²² and participatory rapid appraisal.²³ Some confusion exists about the definition of community engagement in research, however, because many researchers use the terms interchangeably.Researchers conducting community engagement in research need appropriate education and training not typically offered by traditional doctoral and master''s level curricula. The field clearly needs long-term programs that integrate the knowledge and skills of experienced community and researcher partners in high-quality participatory research to build the capacity of young and traditionally trained researchers and scientists interested in pursuing community engagement in research.²⁴Funding agencies often find it difficult to assess participatory research proposals, especially if they use traditional review criteria that are not necessarily applicable to participatory research.²⁵ A 2004 review²⁶ points out that when reviewers in typical study sections are not familiar with community-based participatory research or are even skeptical about the approach''s merits, investigators find it challenging to obtain funding for their community-based participatory research projects through conventional peer-review mechanisms.Many funders include members of the lay public in their peer-review panels to evaluate proposals from the patient''s or family member''s perspective.^27,28 Lay public reviewers help scientists understand the impact of the research on the community and help them make appropriate funding recommendations that address the needs and concerns of patients, health care providers, and family members.²⁹ However, many scientists are concerned that lay peer reviewers do not have the scientific expertise required to offer an appropriate evaluation.^30,31 A survey of the National Cancer Institute of Canada''s scientific grant review panel members found that not all scientists value lay contributions and many lay members feel insecure about the importance of their contributions.³²Because of these barriers, community engagement in research is probably underused. The National Institutes of Health (NIH) Director''s Council of Public Representatives (COPR), a federal advisory committee to the NIH director, addressed these issues and produced this article to advance community engagement in research. We describe approaches that funders and educational institutions can use to develop community engagement in research training programs and peer-review processes that can expand the community engagement in research field.     

Global Climate Implications for Homelessness: A Scoping Review

Homelessness is a persistent global challenge with significant health impacts on those affected. Homeless people are by definition the most exposed to weather conditions and the social and economic problems caused by extreme weather and climate change and variability. This systematic review was designed to synthesize the academic literature that addresses the health and social implications of global climate change for homelessness. The question examined in this systematic scoping review is the following: What is the current state of knowledge in the scientific literature on the health and social implications of global climate change for homelessness? A systematic scoping review method was used to identify and synthesize the peer-reviewed literature relevant to this question. The databases searched were PsycINFO, Medline, Scopus, and Google Scholar. Of the 26 papers identified in this review, 20 employed original data analyses with conclusions largely inferred from cross-sectional associations. Themes included the potential influence of climate change on homelessness prevalence, climate impacts that exacerbate specific vulnerabilities of homeless populations (e.g., chronic illness, exposure, stigmatization), and health and social outcomes. Service use and design implications were also addressed. Given the scale of the impacts of climate change on homelessness, the literature on this topic poses promising directions but is under-developed in its current state to adequately inform risk mitigation and response planning. A systems framework is proposed here to inform future research and service design.     

Consequences of the COVID-19 Syndemic for Nutritional Health: A Systematic Review

Confinement at home, quarantine, and social distancing are some measures adopted worldwide to prevent the spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2), which has been generating an important alteration in the routines and qualities of life of people. The impact on health is still being evaluated, and consequences in the nutritional field are not entirely clear. The study objective was to evaluate the current evidence about the impact that preventive measures of physical contact restriction causes in healthy nutrition. A systematic review was carried out according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” PRISMA Group and Cochrane method for rapid systematic reviews. Searching was performed in six electronic databases and evaluated articles published between 2010 and 2020, including among their participants adult subjects who had been exposed to the preventive measures of physical contact restriction. Seven studies met the selection criteria and reported an overall increase in food consumption, weight, Body Mass Index (BMI), and a change in eating style. Findings suggest that healthy nutrition is affected by preventive measures to restrict physical contact as a result of the COVID-19 syndemic.     

Evaluating the Nutritional Properties of Food: A Scoping Review

There are many methods or indicators used for evaluating the nutritional value of foods; however, it is difficult to accurately reflect the comprehensive nutritional value of a food with a single indicator, and a systematic evaluation system is lacking. In this article, we systematically summarize the common evaluation methods and indicators of the nutritional value of foods. The purpose of this review was to establish an evaluation procedure for nutritional properties of foodstuffs and to help scientists choose more direct and economical evaluation methods according to food types or relevant indicators. The procedure involves the selection of a three-level evaluation method that covers the whole spectrum of a food’s nutritional characteristics. It is applicable to scientific research in the fields of agricultural science, food science, nutrition, and so on.     

Global Regulatory Review Needed for Cochlear Implants: A Call for FDA Leadership

Maternal and Child Health Journal - Using the United States Food and Drug Administration (FDA) as example, we argue that regulatory agencies worldwide should review their guidance on cochlear...     

Perioperative Nutritional Support: A Review of Current Literature

Since the beginning of the practice of surgery, the reduction of postoperative complications and early recovery have been two of the fundamental pillars that have driven the improvement of surgical techniques and perioperative management. Despite great advances in these fields, the rationalization of antibiotic prophylaxis, and other important innovations, postoperative recovery (especially in elderly patients, oncological pathology or digestive or head and neck surgery) is tortuous. This can be explained by several reasons, among which, malnutrition has a major role. Perioperative nutritional support, included within the ERAS (Enhanced Recovery After Surgery) protocol, has proven to be a main element and a critical step to achieve better surgical results. Starting with the preoperative nutritional assessment and treatment in elective surgery, we can improve nutritional status using oral supplements and immunomodulatory formulas. If we add early nutritional support in the postoperative scenario, we are able to significantly reduce infectious complications, need for intensive care unit (ICU) and hospital stay, costs, and mortality. Throughout this review, we will review the latest developments and the available literature.     

Exercise and Nutritional Intervention for Physical Function of the Prefrail: A Systematic Review and Meta-Analysis

ObjectivesThe aim is to inspect the effects of exercise and nutritional intervention on prefrail older adults' physical function.DesignSystematic review and meta-analysis registered with PROSPERO (registration number: CRD42021261197).Setting and ParticipantsRandomized controlled trials involving prefrail older adults who received exercise and/or nutritional interventions.MethodsOvid MEDLINE, EMBASE, Cochrane Central Registry of Controlled Trials (CENTRAL), Web of Science, Clinical Trials, and PubMed were searched from inception to September 1, 2021. Primary outcomes were physical function, including physical performance, mobility, and grip strength. The short physical performance battery score and chair sit-to-stand test were used to assess the physical performance. Timed up and go and gait speed were applied to assess the mobility. Secondary outcomes were frailty status, weight, body mass index, Barthel index, and quality of life (Euro quality of life 5 dimension index values).ResultsWe included 16 randomized controlled trials comprising 1199 prefrail older adults (intervention group, n = 593; control group, n = 606). Exercise and nutritional interventions significantly improved the short physical performance battery score [n = 5, mean difference 0.81, 95% confidence interval (CI) 0.21?1.42, I² = 62%], handgrip strength (n = 7, mean difference 1.52, 95% CI 0.70?2.34, I² = 6%), and gait speed (n = 4, standard weighted mean difference ?1.06, 95% CI -1.87 to ?0.25, I² = 89%). There were no significant differences among the chair sit-to-stand test, timed up and go, weight, body mass index, and Barthel index.Conclusions and ImplicationsOur systematic review and meta-analysis shows that the receipt of exercise and nutritional intervention significantly improved physical function in prefrail older adults.     

Community Partnerships: Review of Selected Models and Evaluation of Two Case Studies

Risks for cardiovascular diseases (CVDs) are established early in life with behavior patterns associated with diet and physical activity. Establishing healthy behavior patterns among children, and providing the environmental supports necessary to maintain them, has the potential to reduce future risks for chronic diseases. This paper reviews the literature on collaborative partnerships formed to address similar issues.The authors describe the evaluation of school and community partnerships facilitated by the Kansas LEAN School Intervention Project, which had the mission of reducing risks for chronic diseases, including CVDs and some cancers, among children. A multiple case study design was used with collaborative partnerships in two communities in Kansas.The results suggest that the partnerships facilitated important changes in the schools and communities. We discuss challenges and opportunities in the evaluation of school and community partnerships for health.     

Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns

Adverse food reactions include immune-mediated food allergies and non-immune-mediated intolerances. However, this distinction and the involvement of different pathogenetic mechanisms are often confused. Furthermore, there is a discrepancy between the perceived vs. actual prevalence of immune-mediated food allergies and non-immune reactions to food that are extremely common. The risk of an inappropriate approach to their correct identification can lead to inappropriate diets with severe nutritional deficiencies. This narrative review provides an outline of the pathophysiologic and clinical features of immune and non-immune adverse reactions to food—along with general diagnostic and therapeutic strategies. Special emphasis is placed on specific nutritional concerns for each of these conditions from the combined point of view of gastroenterology and immunology, in an attempt to offer a useful tool to practicing physicians in discriminating these diverging disease entities and planning their correct management. We conclude that a correct diagnostic approach and dietary control of both immune- and non-immune-mediated food-induced diseases might minimize the nutritional gaps in these patients, thus helping to improve their quality of life and reduce the economic costs of their management.     

Energy Requirements and Nutritional Strategies for Male Soccer Players: A Review and Suggestions for Practice

Soccer is a high intensity intermittent sport, featuring critical events completed at high/maximal intensity which is superimposed onto an aerobic base of lower intensity activities and rest. Due to these varying energic demands and the duration of competition the need for optimal nutritional strategies to offset and delay fatigue are paramount. Over the last 50 years, several investigations have been reported on aspects of soccer be they nutrition-focused or those concerning the demands of the sport. Emanating from these scientific papers, observations have been made on the likely factors which result in the fatigue during match-play. Factors such as muscle glycogen depletion and hypoglycaemia are discussed. Studies on the energy demands of soccer have employed a variety of methodologies which are briefly reviewed and vary between the use of heart rate telemetry to the use of global positioning systems (GPS). Moving on from observations of the energy demands of the sport leads to the major focus of this review which highlights key nutritional strategies to support the preparation and recovery of male soccer players to enhance performance, or at least to enable players to perform adequately. This review examines relevant methodologies in assessing training and competitive energy costs as well as the concomitant energy intakes demanded for successful performance outcomes. In order to bring an applied aspect to the overall findings from areas discussed, some practical ideas of feeding strategies are presented.     

Application of Magnetic Resonance Imaging in the Evaluation of Nutritional Status: A Literature Review with Focus on Dialysis Patients

Magnetic resonance imaging (MRI) is indispensable in clinical medicine for the morphological and tomographic evaluation of many parenchymal organs. With varied imaging methods, diverse biological information, such as the perfusion volume and measurements of metabolic products, can be obtained. In addition to conventional MRI for morphological assessment, diffusion-weighted MRI/diffusion tensor imaging is used to evaluate white matter structures in the brain; arterial spin labeling is used for cerebral blood flow evaluation; magnetic resonance elastography for fatty liver and cirrhosis evaluation; magnetic resonance spectroscopy for evaluation of metabolites in specific regions of the brain; and blood oxygenation level-dependent imaging for neurological exploration of eating behavior, obesity, and food perception. This range of applications will continue to expand in the future. Nutritional science is a multidisciplinary and all-inclusive field of research; therefore, there are many different applications of MRI. We present a literature review of MRI techniques that can be used to evaluate the nutritional status, particularly in patients on dialysis. We used MEDLINE as the information source, conducted a keyword search in PubMed, and found that, as a nutritional evaluation method, MRI has been used frequently to comprehensively and quantitatively evaluate muscle mass for the determination of body composition.