Lack of Association between Inadequate Micronutrient Intake and Prognosis in Outpatients with Heart Failure

Inadequate nutrient intake can lead to worse outcomes in patients with heart failure (HF). This prospective cohort study aimed to assess the prevalence of inadequate micronutrient intake and their association with prognosis in 121 adult and elderly outpatients with HF. Habitual micronutrient intake was evaluated using 24-h dietary recalls (minimum 2 and maximum 6). Participants were grouped into moderate (n = 67) and high (n = 54) micronutrient deficiency groups, according to the individual assessment of each micronutrient intake. Patients’ sociodemographic, clinical, and anthropometric data and clinical outcomes (hospitalization and mortality) within 24 months were collected. Overall and event-free survival rates were calculated using Kaplan–Meier estimates, and curves were compared using the log-rank test. The death risk rate (hazard ratio (HR)) was calculated using Cox’s univariate model. The rate of inadequate intake was 100% for vitamins B1 and D and above 80% for vitamins B2, B9, and E, calcium, magnesium, and copper. No differences in overall survival and event-free survival were observed between groups of HF outpatients with moderate and high micronutrient deficiencies (HR = 0.94 (CI = 0.36–2.48), p = 0.91, and HR = 1.63 (CI = 0.68–3.92), p = 0.26, respectively), as well as when the inadequacy of each micronutrient intake was evaluated alone (all p > 0.05). In conclusion, a high prevalence of inadequate micronutrient intake was observed in outpatients with HF. Inadequate micronutrient intake was not associated with hospitalization and mortality in this group of patients.     

Association between Serum Copper Status and Working Memory in Schoolchildren

Trace elements such as copper are essential micronutrients. Traditionally, copper has been studied in the context of micronutrient deficiencies. Recent studies in both animals and humans, however, have revealed that elevated blood copper can also have adverse effects on cognitive function since free copper can cross the blood-brain barrier and subsequently impose oxidative stress to neuronal cells. However, most of these human studies were conducted in adult populations with and without cognitive decline, and there are few studies on the effect of excess copper on cognitive function in children. This project seeks to look at the effects of elevated copper levels on cognitive development in a population of school age children (ages 10–14 years with mean age of 12.03 years and standard deviation (SD) of 0.44) from Jintan, China. Briefly, serum copper levels and working memory test scores were collected from a sample of 826 children with a mean serum copper level of 98.10 (SD 0.75). Copper level was considered as a categorical variable (taking the first group as those with as ≤84.3 μg/dL, the second group as >84.3 and ≤110.4 μg/dL, and the third group as >110.4 μg/dL with the cut-off values defined by the first and third quartiles of the sample). Results showed a significant association between high copper levels (>110.4 μg/dL) and poorer working memory in boys but this association was not seen in lower copper levels in either sex. These results suggests that in school age children, like in adults, elevated copper levels have the potential to adversely affect cognition.     

Micronutrient Intake in Healthy Toddlers: A Multinational Perspective

Adequate nutrient intake during early childhood is of particular importance for optimal growth and future health. However, cross-national comparative research on nutrient intake of toddlers is still limited. We conducted a literature review to examine the nutrient intake in healthy toddlers from some of the world’s most populous nations currently on different stages of socioeconomic development: Brazil, Germany, Russia and the United States. We aimed to identify national surveys reporting mean intakes of the following nutrients: vitamins A, D, E, folate, calcium, iron and zinc. To calculate the prevalence of inadequate nutrient intake, we used a modified version of the Estimated Average Requirement cut-point method. Overall, five studies with 6756 toddlers were eligible for inclusion in this review. In countries where data were available, a prevalence of inadequate intake higher than 20% was found for vitamins A, D, E and calcium. In Germany, folate intake also appeared to be inadequate. The results of our review indicate that inadequate micronutrient intake in toddlers might be a global challenge affecting also affluent countries. However, to explore the full scope of this important public health issue joint efforts of researchers worldwide are needed to combine existing data and fill in data gaps.     

Change in Micronutrient Intake among People with Relapsing-Remitting Multiple Sclerosis Adapting the Swank and Wahls Diets: An Analysis of Weighed Food Records

The low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets have shown promise for MS symptoms; however, due to their restriction of specific foods, inadequate intake of micronutrients is concerning. Therefore, as part of a randomized trial, weighed food records were collected on three consecutive days and were used to evaluate the intake of micronutrients among people with relapsing remitting MS adapting these diets. After randomization to either the Swank or Wahls diets, diet education and support was provided by registered dietitians at baseline and throughout the first 12 weeks of the intervention. Usual intake of each micronutrient was estimated and then evaluated with the EAR-cut point method. At 12 weeks, the Swank group had significant reductions in the proportion with inadequate intake from food for vitamins C, D, and E, while the Wahls group had significant reductions for magnesium and vitamins A, C, D, and E. However, the proportion with inadequate intake significantly increased for calcium, thiamin, and vitamin B₁₂ in the Wahls group and for vitamin A in the Swank group. Inclusion of intake from supplements reduced the proportion with inadequate intake for all micronutrients except calcium among the Wahls group but increased the proportion with excessive intake for vitamin D and niacin among both groups and magnesium among the Swank group. Both diets, especially when including intake from supplements, are associated with reduced inadequate intake compared to the normal diet of people with relapsing remitting MS.     

Comparison of Micronutrient Intervention Strategies in Ghana and Benin to Cover Micronutrient Needs: Simulation of Bene-Fits and Risks in Women of Reproductive Age

Overlapping micronutrient interventions might increase the risk of excessive micronutrient intake, with potentially adverse health effects. To evaluate how strategies currently implemented in Benin and Ghana contribute to micronutrient intake in women of reproductive age (WRA), and to assess the risk for excess intakes, scenarios of basic rural and urban diets were built, and different on-going interventions were added. We estimated micronutrient intakes for all different scenarios. Four types of intervention were included in the scenarios: fortification, biofortification, supplementation and use of locally available nutrient-rich foods. Basic diets contributed poorly to daily micronutrient intake in WRA. Fortification of oil and salt were essential to reach daily requirements for vitamin A and iodine, while fortified flour contributed less. Biofortified products could make an important contribution to the coverage of vitamin A needs, while they were not sufficient to cover the needs of WRA. Iron and folic acid supplementation was a major contributor in the intake of iron and folate, but only in pregnant and lactating women. Risk of excess were found for three micronutrients (vitamin A, folic acid and niacin) in specific contexts, with excess only coming from voluntary fortified food, supplementation and the simultaneous overlap of several interventions. Better regulation and control of fortification and targeting of supplementation could avoid excess intakes.     

Probiotic Supplementation and Micronutrient Status in Healthy Subjects: A Systematic Review of Clinical Trials

Micronutrient deficiencies are a worldwide public health concern. Emerging evidence supports the ability of probiotics to enhance micronutrient status, which could aid in the prevention of non-communicable disease-associated malnutrition. This systematic review evaluated evidence of the efficacy of probiotic supplementation to improve micronutrient status in healthy subjects. The authors searched for published English language peer-reviewed journal articles in PubMed, Scopus, Embase, and Google Scholar databases from inception to July 2020 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of eligible studies was assessed using the Revised Cochrane Risk-of-Bias tool (RoB)2 and Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS-I tool). Fourteen original studies out of 2790 met the inclusion criteria. The results indicated that, despite varying degrees of efficacy, the intake of certain probiotics in healthy subjects was associated with a positive impact on the status of certain micronutrients (vitamin B12, calcium, folate, iron and zinc). A limitation was that studies were widely heterogeneous in terms of participant age, probiotic strain, species, dosage, intervention duration, and form of administration. Additional clinical trials are warranted to determine the most effective strains of probiotics, doses and durations of interventions.     

Micronutrient,Antioxidant, and Oxidative Stress Status in Children With Severe Cerebral Palsy

Background: Markers indicative of micronutrient and antioxidant status in children with cerebral palsy (CP) were explored due to these children's well‐documented issues with food intake and the limited biochemical literature. Materials and Methods: Children aged 4 to 12 years with marked CP (n = 24) and controls (n = 24) were recruited. The CP group represented orally (O) or enterally fed (E) children. Concentrations of red cell folate (RCF), magnesium, superoxide dismutase (SOD), glutathione reductase, and peroxidase were measured, as well as serum methylmalonic acid and vitamin C. Plasma hemoglobin, C‐reactive protein, α‐tocopherol, cholesterol, zinc, protein carbonyls, and total antioxidant capacity were also quantified. Results: Data are reported as mean (SD) and z scores where values differ with age. Many similarities existed, but zinc z scores were reduced in O (–1.10 [0.83]) vs controls (–0.54 [0.54]) (P < .05), as well as for glutathione reductase in O (10.15 [1.69]) vs E (12.22 [2.41]) and controls (11.51 [1.67]) (P < .05). RCF was greatly increased in E (1422 [70]) vs O (843 [80]) and controls (820 [43]) (P < .001). SOD was decreased in E (24.3 [1.4]) vs controls (27.0 [2.8]) (P < .05). Conclusion: Considering their vast impact on physiology, micronutrients should be routinely monitored in orally fed children with swallowing disorders and dietary limitations. Excessive intakes, particularly long term in enterally fed children, should also be monitored in view of their potential for competitive inhibition, particularly at high levels.     

Do diets high in sugars compromise micronutrient intakes? Micronutrient intakes in the Dietary and Nutritional Survey of British Adults according to dietary concentration of ‘added’, ‘non-milk extrinsic’ or ‘total’ sugars

Objective : It has been claimed that dietary sugars, particularly added and non-milk extrinsic sugars, are 'empty calories', displacing micronutrients from the diet. Evidence for this hypothesis was examined using data from the Dietary and Nutritional Survey of British Adults (Gregory et al ., 1990). Method : Men and women aged 16–64 years were classified into quintiles (fifths) of the distribution of food energy from added sugars, non-milk extrinsic sugars (NMES) and total sugars. Micronutrient intakes were compared across quintiles for each type of sugars energy. Results : Many nutrients showed a non-linear relationship with sugars energy (whether added, NME or total), with the highest nutrient intakes among average consumers. The most marginal nutrient (in comparison to dietary reference values) was iron among women; no group achieved the RNI for iron, regardless of sugar level or type. Calcium intakes were below the RNI among women in the first quintile (all types of sugars), although under-reporting may have led to underestimations of intake in this group. Intakes of several nutrients fell in the 4th and 5th quintiles (all types), but remained adequate in comparison to the RNI (except for iron and folate in women). There were positive relationships between extrinsic and total sugars, and vitamin C, which reflected fruit juice consumption. Diets high in added and NME sugars tended to be of lower nutrient density, but any deficit in nutrient intake was contingent on a low energy intake, which was untypical. Conclusions : These data suggest that NME sugar intakes providing up to about 17% of food energy did not compromise micronutrient intakes in these British adults. Specific advice may be needed to counteract low nutrient intakes (e.g. iron intake in women), particularly where energy intake is restricted.     

The Relationship between Learning Style Preferences and Memory Strategy use in Adults

Deficits in working memory are pervasive, resistant to remediation and significantly impact a persons ability to perform activities of daily living. Internal strategies are effective for improving working memory. Learning style preferences may influence the use of various internal working memory strategies. This study compares the use of internal working memory strategies among four different learning style preferences; converger, diverger, assimilator and accommodator. A non-experimental group design was used to compare the use of internal working memory strategies and learning style preferences among 110 adults. There were some significant differences in the types of strategies used according to learning style preferences. Knowing the learning style preference of clients may help occupational therapists better tailor cognitive rehabilitation treatments to meet the client's needs.     

Comparison of Remedial and Compensatory Approaches in Memory Dysfunction: A Comprehensive Literature Review

ABSTRACT

Memory is a cognitive process of information storage and retrieval that is essential to performing daily functional activities efficiently. Occupational therapists regularly help individuals with memory impairment to manage their memory deficits. The purpose of this paper was to review the main memory strategies and instructional methods used to improve or manage memory. Studies were identified by searching for the relevant literature published between 1980 and 2007 through the use of several databases with the inclusion criteria that the study must identify at least one specific memory rehabilitation method with an outcome measure representative of the specific method. The reviewed studies included three reviews, 10 randomized control trials, 17 quasi-experimental studies, and five single subjects’ designs. The results suggest that there is empirical evidence to support the effectiveness of certain remedial and compensatory memory rehabilitation methods with healthy populations, but weaker evidence can be identified for the memory-impaired populations. In general, remedial methods are effective in lab settings with primarily healthy populations, yet effectiveness in daily activities is less clear. Compensatory methods are generally more efficient than remedial ones and more easily generalized to daily activities, even with memory-impaired populations.     

The Critical Role of Working Memory in Academic Achievement

Far too many culinary arts educators are unaware of the critical role that working memory plays in student’s ability to perform cognitive and academic tasks, such as reading, note taking, and studying for tests (memorization). In this article, we provide research that suggests working memory may be uniquely responsible for the difficulties faced by culinary students in the kitchen and classroom. This literature review not only defines working memory but describes its functionality based on the work of key researchers in the field and gives practical recommendations to apply this knowledge in culinary arts education. The vital role that working memory plays in teaching and learning should give teachers great pause and make them re-examine their approach to instructional design to enhance the academic achievement potential of culinary students.     

Nutritional Risk,Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic

Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.     

Age-Related Cognitive Decline May Be Moderated by Frequency of Specific Food Products Consumption

Our study aimed to evaluate whether the type of food products and the frequency of their consumption are associated with cognitive functioning in younger and older adults. The impact of diets that are high in added sugars and saturated fat on cognitive functioning, especially on memory, was at the center of our interest. Participants in the study were 204 healthy adults (aged 20–55) who performed a multitasking cognitive test and completed dietary and psychological questionnaires. Stepwise regression analysis with age and food consumption patterns as predictors, and the cognitive task performance as a dependent variable, revealed that cognitive task performance worsened with age. However, we found that the frequency of consuming different types of foods (healthy versus unhealthy dietary patterns) moderates the effects of age on cognitive functioning. Red meat and animal fat consumption were negatively correlated with cognitive performance, and this relation was dependent on the age of our participants. Conversely, white meat and fish consumption were positively related to memory. Different indices of dietary patterns (both positive and negative) were stronger predictors of cognitive performance in the older adult group. We interpret our results as evidence that diet may be a protective (or worsening) factor in age-related cognitive decline.     

Castration Differentially Affects Spatial Working and Reference Memory in Male Rats

A male advantage for spatial learning and memory tasks is well documented among humans and rodents. A possible physiological cause for this male advantage is activational effects of androgens among males. The spatial memory of eight castrated and eight sham-castrated adult male rats was compared using a working-reference memory version of the eight-arm radial arm maze followed by a reference memory version of the Morris water maze. After maze testing, blood was collected from each rat, and testosterone levels were determined using radioimmunoassay. In the radial arm maze, castrates committed significantly more working memory errors and significantly fewer reference memory errors than did shams. In the water maze, no statistically significant differences were found for acquisition or retention. There was a trend for shams with higher testosterone levels to have better retention in the water maze, but this seemed to be due to higher levels of perseverance rather than better reference memory. Castration may have affected performance in the radial arm maze and not in the water maze because the radial arm maze was a more difficult task or because the water maze was aversively motivated while the radial arm maze was appetitively motivated. Our results indicate that androgens improve working memory and may impair reference memory, but the effects of androgens on reference memory seem to be task dependent.     

Micronutrient Deficiencies and Anemia in Children with Inflammatory Bowel Disease

Children with inflammatory bowel disease (IBD) are at risk of developing nutrition deficiencies, particularly because of reduced intake, restrictive diets, malabsorption, and excessive nutrient loss. The aim of this study was to determine the prevalence and predictors of anemia and micronutrient deficiencies at diagnosis and one year follow up in children and adolescents with inflammatory bowel disease (IBD). Children and young adults diagnosed with IBD before the age of 17 years between 2012 and 2018 were included. Laboratory measurements including serum levels of iron, ferritin, zinc, vitamin D, vitamin A, vitamin E, selenium, copper, vitamin B12, and red blood cell (RBC) folate at diagnosis and one-year follow-up were documented as part of the Manitoba Longitudinal Pediatric Inflammatory Bowel Disease (MALPID) Cohort. A total of 165 patients with IBD were included, 87 (53%) with Crohn’s disease (CD) and 78 (47%) with ulcerative colitis (UC). The prevalence of deficiencies in our cohort at diagnosis and one year follow-up, respectively, were iron (56% and 27%), ferritin (39% and 27%), zinc (10% and 6%), vitamin D (22% and 13%), vitamin A (25% and 25%), vitamin E (5% and 4%), selenium (10 and 7%), copper (17% and 27%), vitamin B12 (2% and 5%), and Red blood cell (RBC) folate (1% and 17%). Anemia was present in 57% and 25% at diagnosis and follow up respectively. In CD patients, age of diagnosis (15y–younger than 18y) was a predictor of moderate to severe anemia and albumin levels (<33 g/L) were protective against anemia. Many children with IBD suffer from anemia and micronutrient deficiencies at diagnosis and some fail to recover after one year despite being in clinical remission.     

Feasibility of Online Nutrition Education in the Workplace: Working Toward Healthy Lifestyles

Objective

Determination of feasibility of online nutrition education in the federal workplace.

Association between Creativity and Memory with Cardiorespiratory Fitness and Lifestyle among Chilean Schoolchildren

The objective was to investigate the association between creativity and memory with cardiorespiratory fitness (CRF; i.e., CFR classification and V˙O_2max); lifestyle parameters (i.e., physical activity (PA), sleep duration, screen time (ST), and food habits); and anthropometric measures (i.e., body mass index (BMI), waist circumference (WC)) among Chilean schoolchildren. A total of 248 schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated in the cross-sectional study. Creativity, memory, concentration, and selective attention and lifestyle (PA, ST, sleep duration, and Mediterranean diet (MD) adherence) were measured using a standard questionnaire. CRF (measured by the 20 m shuttle run test and expressed as maximum oxygen consumption (V˙O_2max) and anthropometric measures (BMI and WC) were also included. Creativity showed a positive association with V˙O_2max (mL/kg/min) (β; 0.209, 95% CI; 0.02–0.40, p = p < 0.05) and MD Adherence (score) (β; 0.206, 95% CI; 0.01; 0.74, p = p < 0.05). Long-term memory reported a positive association with CRF (β; 1.076, 95% CI; 0.02–2.13, p = p < 0.05). An increase in CRF levels, together with healthy food habits and normal nutritional status, should be a target for community- and school-based interventions to promote cognitive development in creativity and memory among schoolchildren.     

锌及复合微量营养素的营养干预对学龄前儿童认知功能的影响

相同年龄段（６～７岁）学龄前儿童２８０名，男、女各半，分为锌组（Ｚｎ组）、锌加复合微量营养素组（ＺｎＭ组）和单纯补充微量营养素组（Ｍ组），每组８０人，另外４０名儿童为对照组，采用双盲法进行营养干预实验，实验周期为１０周。结果显示，重庆市城区学龄前儿童近８０％处于边缘性锌缺乏状态，一半以上儿童血铅超过０．４８３μｍｏｌ／Ｌ的安全标准，经过１０周营养干预后，发现每日补充１６ｍｇ锌的同时再添加多种复合微量营养素能有效增加儿童血锌含量、降低血铅水平，同时明显增强儿童的认知功能，而单纯补锌效果并不理想。本研究儿童认知功能的改善可能与体内良好的锌营养状况、铅负荷减少有关。