Agroforestry diversity,indigenous food consumption and nutritional outcomes in Sauria Paharia tribal women of Jharkhand,India

Like several indigenous populations, Sauria Paharias, a vulnerable indigenous tribal group residing in a biodiverse environment of Jharkhand, India, have high levels of undernutrition. We assessed agroforestry and dietary diversity, food consumption especially indigenous food (IF) intake and nutritional status of Sauria Paharia women through a cross‐sectional study conducted in 18 villages of Godda district, Jharkhand. Household level information was elicited through household surveys including a dietary survey and a food frequency questionnaire. Twenty‐four‐hour dietary recalls (24 HDR) and anthropometric assessments were taken on one randomly selected woman per household. An index, Food Accessed Diversity Index (FADI) created to measure agroforestry diversity, showed a low mean score of 0.21 ± 0.15 and range: 0, 0.85. Fifty‐nine percent of women consumed any IF during 24 HDR. Median minimum dietary diversity score for women (MDD‐W) was 3 (acceptable score ≥5). More than 96% of women had intakes below estimated average requirements for all nutrients studied (energy; vitamins A, C, thiamine, riboflavin, niacin, pyridoxine; folate; iron; calcium and zinc) except protein; 41% women were underweight. IF consumption was independently associated with calcium and vitamin A intake. Decision trees developed for micronutrient consumption at different levels of MDD‐W score and IF consumption scenarios revealed 1.3 to 2.9 times higher consumption of micronutrients among women with MDD‐W ≥ 3 or 4. Strategies like agricultural extension programmes promoting indigenous varieties and nutrition education for increasing dietary diversity with IFs have potential to address undernutrition in Sauria Paharia women.     

Effects of dietary counselling on micronutrient intakes in pregnant women in Finland

The intake of some micronutrients is still a public health challenge for pregnant women in Finland. This study examined the effects of dietary counselling on micronutrient intakes among pregnant women at increased risk of gestational diabetes mellitus in Finland. This study utilised data from was a cluster‐randomised controlled trial (n = 399), which aimed to prevent gestational diabetes. In the intervention group, the dietary counselling was carried out at four routine visits to maternity care and focused on dietary fat, fibre and saccharose intake. A validated 181‐item food frequency questionnaire was used for evaluating the participants'' food consumption and nutrient intakes. The differences in changes in micronutrient intakes from baseline (pre‐pregnancy) to 36–37 weeks'' gestation were compared between the intervention and the usual care groups using multilevel mixed‐effects linear regression models, adjusted for confounders. Based on the multiple‐adjusted model, the counselling increased the intake of niacin equivalent (coefficient 0.50, 95% confidence interval [CI] 0.03–0.97), vitamin D (0.24, CI 0.05–0.43), vitamin E (0.46, CI 0.26–0.66) and magnesium (5.05, CI 0.39–9.70) and maintained the intake of folate (6.50, CI 1.44–11.56), from early pregnancy to 36 to 37 weeks'' gestation. Except for folate and vitamin D, the mean intake of the micronutrients from food was adequate in both groups at baseline and the follow‐up. In conclusion, the dietary counselling improved the intake of several vitamins and minerals from food during pregnancy. Supplementation on folate and vitamin D is still needed during pregnancy.     

备孕人群膳食叶酸营养状况横断面调查

目的调查上海市备孕人群膳食叶酸摄入量、膳食叶酸来源和血液叶酸水平,并评估上海市备孕人群的叶酸营养状况。方法采取横断面整群抽样的方法对在上海市闵行区妇幼保健院孕前门诊接受孕前检查的备孕夫妇进行调查。采用连续3 d 24 h膳食回顾法和食物频率表法对研究人群的膳食状况进行调查。应用《孕前膳食营养素补充剂调查表》调查研究对象近3个月的叶酸等营养素补充剂使用情况。采集空腹静脉EDTA抗凝全血和非抗凝血各5 mL,通过化学发光微粒子免疫法检测血清叶酸浓度及红细胞叶酸浓度。结果共纳入研究对象535例,女性276例（51.6%）、男性259例,平均年龄（29.4±4.1)岁。研究人群平均膳食叶酸摄入量为296.3 μg·d-1,503例（94.0%）低于推荐摄入量,女性和男性的平均膳食叶酸摄入量分别为 267.2和327.3 μg·d-1。血清叶酸水平中位数为5.8 ng·mL-1,血清叶酸缺乏率16.3%;红细胞叶酸水平中位数为214.6 ng·mL-1,红细胞叶酸缺乏率为87.3%。女性血清叶酸浓度（7.0 ng·mL-1 vs 4.8 ng·mL-1）及红细胞叶酸浓度（231.2 ng·mL-1 vs 193.7 ng·mL-1）显著高于男性（P＜0.001）。结论上海地区备孕人群中,绝大多数人群处于红细胞叶酸缺乏的状况,膳食叶酸摄入量低于推荐值。     

Diet quality among pregnant women in the Navajo Birth Cohort Study

Proper nutrition during pregnancy is vital to maternal health and fetal development and may be challenging for Navajo Nation residents because access to affordable and healthy foods is limited. It has been several decades since reported diet quality during pregnancy was examined on Navajo Nation. We present the first study to estimate iodine intake and use the Healthy Eating Index (HEI‐2015) to assess maternal diet quality among pregnant women in the Navajo Birth Cohort Study (NBCS). Based on dietary intake data derived from food frequency questionnaires, overall estimated micronutrient intake has remained similar since the last assessment in 1981, with potential improvements evident for folate and niacin. A high proportion of women (>50%) had micronutrient intakes from dietary sources below the Estimated Average Requirements during pregnancy. The median urinary iodine concentration for NBCS women (90.8 μg/L; 95% CI [80, 103.5]) was less than adequate and lower than concentrations reported for pregnant women that participated in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014. Overall, average diet quality of NBCS women estimated using the HEI‐2015 (62.4; 95% CI [60.7, 64.0]) was similar to that reported for women of child‐bearing age and pregnant women in NHANES. Although, NBCS women had diets high in added sugar, with sugar‐sweetened beverages as the primary contributors. Our study provides updated insights on maternal diet quality that can inform health and nutrition initiatives in Navajo communities emphasizing nutrition education and access to prenatal vitamins and calcium, iodine, and vitamin E dense foods.     

Nutrient intakes and impact of fortified breakfast cereals in schoolchildren.

OBJECTIVE: To report micronutrient intakes in Northern Ireland schoolchildren, and to establish the contribution of fortified breakfast cereal to overall nutrient intakes and achievement of current dietary recommendations. DESIGN: Analysis of dietary intakes and physical characteristics of participants in a randomly selected 2% population sample of 1015 schoolchildren aged 12 and 15 years in Northern Ireland during the 1990/1 school year. MAIN OUTCOME MEASURES: Dietary intakes, physical characteristics, and their association with consumption of fortified breakfast cereal. RESULTS: Mean micronutrient intakes were generally adequate with the exception of low intakes of folate (boys and girls) and iron (girls). Fortified breakfast cereals, consumed by a high proportion (94% boys; 83% girls) of the sample, were associated with higher daily intakes of most micronutrients and fibre and with a macronutrient profile consistent with current nutritional recommendations. Appreciable proportions of subjects who did not consume fortified breakfast cereals had daily intakes that fell below the lower reference nutrient intake for riboflavin, niacin, folate, vitamin B-12, and iron (girls). CONCLUSIONS: The results demonstrate the potential of fortification in contributing to micronutrient intakes of schoolchildren, particularly where requirements are high, or for those on marginal diets of low nutritional quality.     

Nutrient intakes and impact of fortified breakfast cereals in schoolchildren

OBJECTIVE: To report micronutrient intakes in Northern Ireland schoolchildren, and to establish the contribution of fortified breakfast cereal to overall nutrient intakes and achievement of current dietary recommendations. DESIGN: Analysis of dietary intakes and physical characteristics of participants in a randomly selected 2% population sample of 1015 schoolchildren aged 12 and 15 years in Northern Ireland during the 1990/1 school year. MAIN OUTCOME MEASURES: Dietary intakes, physical characteristics, and their association with consumption of fortified breakfast cereal. RESULTS: Mean micronutrient intakes were generally adequate with the exception of low intakes of folate (boys and girls) and iron (girls). Fortified breakfast cereals, consumed by a high proportion (94% boys; 83% girls) of the sample, were associated with higher daily intakes of most micronutrients and fibre and with a macronutrient profile consistent with current nutritional recommendations. Appreciable proportions of subjects who did not consume fortified breakfast cereals had daily intakes that fell below the lower reference nutrient intake for riboflavin, niacin, folate, vitamin B-12, and iron (girls). CONCLUSIONS: The results demonstrate the potential of fortification in contributing to micronutrient intakes of schoolchildren, particularly where requirements are high, or for those on marginal diets of low nutritional quality.     

Dietary guideline adherence during preconception and pregnancy: A systematic review

The aim of this study is to determine the level of adherence to dietary guidelines among men and women during preconception, and pregnant women, and factors associated with adherence. Searches were conducted in CINAHL, AMED, EMBASE, and Maternity and Infant Care from inception to March 2018. Observational studies assessing the primary outcome (adherence to dietary guidelines and/or nutritional recommendations) and/or secondary outcome (factors associated with adherence) were eligible. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross‐sectional studies. Men or women (aged ≥18 years) who identified as trying/intending to conceive or were pregnant. Eighteen studies were included. The quality of studies was fair (44%) to good (56%). Most studies indicated preconceptual and pregnant women do not meet recommendations for vegetable, cereal grain, or folate intake. Pregnant women did not meet iron or calcium intake requirements in 91% and 55% of included studies, respectively, and also exceeded fat intake recommendations in 55% of included studies. Higher level education was associated with improved guideline adherence in pregnant women, whereas older age and non‐smoking status were associated with greater guideline adherence in preconceptual and pregnant women. The findings of this review suggest that preconceptual and pregnant women may not be meeting the minimum requirements stipulated in dietary guidelines and/or nutritional recommendations. This could have potential adverse consequences for pregnancy and birth outcomes and the health of the offspring. Major knowledge gaps identified in this review, which warrant further investigation, are the dietary intakes of men during preconception, and the predictors of guideline adherence.     

Safety of a fat-reduced diet: the Dietary Intervention Study in Children (DISC)

OBJECTIVE: To assess the relationship between energy intake from fat and anthropometric, biochemical, and dietary measures of nutritional adequacy and safety. DESIGN: Three-year longitudinal study of children participating in a randomized controlled trial; intervention and usual care group data pooled to assess effects of self-reported fat intake; longitudinal regression analyses of measurements at baseline, year 1, and year 3. PARTICIPANTS: Six hundred sixty-three children (362 boys and 301 girls), 8 to 10 years of age at baseline, with elevated low-density lipoprotein cholesterol, who are participants of the Dietary Intervention Study in Children. MEASURES: Energy intake from fat assessed from three 24-hour recalls at each time point was the independent variable. Outcomes were anthropometric measures (height, weight, body mass index, and sum of skinfolds), nutritional biochemical determinations (serum ferritin, zinc, retinol, albumin, beta-carotene, and vitamin E, red blood cell folate, and hemoglobin), and dietary micronutrients (vitamins A, C, E, thiamin, riboflavin, niacin, vitamins B-6, B-12, folate, calcium, iron, zinc, magnesium, and phosphorus). RESULTS: Lower fat intake was not related to anthropometric measures or serum zinc, retinol, albumin, beta-carotene, or vitamin E. Lower fat intake was related to: 1) higher levels of red blood cell folate and hemoglobin, with a trend toward higher serum ferritin; 2) higher intakes of folate, vitamin C, and vitamin A, with a trend toward higher iron intake; 3) lower intakes of calcium, zinc, magnesium, phosphorus, vitamin B-12, thiamin, niacin, and riboflavin; 4) increased risk of consuming less than two-thirds of the Recommended Dietary Allowances for calcium in girls at baseline, and zinc and vitamin E in boys and girls at all visits. CONCLUSIONS: Lower fat intakes during puberty are nutritionally adequate for growth and for maintenance of normal levels of nutritional biochemical measures, and are associated with beneficial effects on blood folate and hemoglobin. Although lower fat diets were related to lower self-reported intakes of several nutrients, no adverse effects were observed on blood biochemical measures of nutritional status. Current public health recommendations for moderately lower fat intakes in children during puberty may be followed safely.     

Zinc in the Fetus and Newborn

ABSTRACT. The growing fetus and infant are at risk of becoming deficient of zinc, an adequate supply of which is essential for normal growth and development. Mild maternal zinc depletion was strongly associated with intrauterine growth retardation. Low levels of zinc in maternal plasma and poor placental perfusion reduced the materno-fetal transfer of zinc. Mean maternal dietary intake of zinc was 60% recommended daily allowance and mothers of small-for-gestational-age (SGA) babies consumed significantly less zinc than mothers of appropriate-for-gestational-age babies. In addition, iron/folate supplements, which are often routinely prescribed during pregnancy, despite dietary intakes of iron and folate being adequate, significantly decreased the oral bio-availability of zinc in pregnant women. Zinc supplementation may be beneficial to women at risk of delivering SGA babies. Zinc requirements and interactions are also important to consider when designing mineral supplements for preterm babies, infant formulae and food fortification in developing countries.     

Dietary aspects of pregnant women in rural areas of Northern India

The aim of this article is to document the current dietary profile of pregnant women in rural areas of Delhi. In order to explore the diet the combination of quantitative (24-h recall method) and qualitative methods (food frequency method) were used. The mean intake of macronutrients and micronutrients, namely, iron, folic acid and Vitamin C which play an important role in the pathophysiology of nutritional anaemia during pregnancy was calculated from the foodstuffs, using Nutritive Value of Indian Foods. The preferences and avoidance of various foods by the pregnant women were also elicited. The data were analysed using Epi Info 3.4. The intake of calories, protein, iron, folic acid and Vitamin C was found to be less than the recommended dietary allowance in 100%, 91.2%, 98.2%, 99.1% and 65.8% of pregnant women respectively. Folic acid intakes were significantly lower in younger, primiparous and poorly educated women from low-income families. Vitamin C intake was lower among non-Hindus only. The overall data suggested the presence of food gap rather than isolated deficiency of any particular nutrient.     

Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort

Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer‐administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single‐nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (～70%) and calcium (～80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d^?1. Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women.     

Contribution of snacks to dietary intakes of young children in the United States

Nutritional quality of children's diets is a public health priority in the fight against childhood obesity and chronic diseases. The main purpose of this study was to determine contribution of snacks to energy and nutrient intakes and to identify leading snack food sources of energy, total fat, and added sugars amongst young children in the United States. Using the 2005–2012 NHANES data, dietary intakes of 2‐ to 5‐year‐old children were analysed from a parent‐reported 24‐hour dietary recall (n = 3,429). Snacking occasions were aggregated to determine the proportion of total food/beverage intake obtained from snacks, estimate energy, and nutrient intakes, and identify the leading snack food sources of energy, added sugars, and total fat. Nearly all children consumed a snack on the reported day (62% morning, 84% afternoon, and 72% evening). Snacks accounted for 28% of total energy intake, 32% of carbohydrates, 39% of added sugars, and 26% of total fat and dietary fiber intakes for the day. Snacking occasions accounted for 46.6% of all beverages consumed on the reported day. Snacks and sweets food category (i.e., cookies and pastries) were the leading sources of energy (44%), total fat (52%), and added sugars (53%) consumed during snacking occasions. Sweetened beverages (e.g., fruit and sport drinks) contributed 1‐quarter of all added sugars obtained from snacks. Snacks contribute considerable amount of energy and nutrients to young children's diets, with a heavy reliance on energy‐dense foods and beverages. Targeted interventions are needed to improve the nutritional quality of snacks consumed by young children.     

Assessing statistical similarity in dietary intakes of women of reproductive age in Bangladesh

Women of reproductive age (WRA) need adequate nutrient intakes to sustain a healthy pregnancy, support fetal growth, and breastfeed after childbirth. However, data on women''s dietary intake in low‐ and middle‐income countries (LMICs) are limited, and assessment of differences between dietary intakes of pregnant or lactating women compared with that of nonpregnant, nonlactating (NPNL) women is untested. Using single, multiple‐pass 24‐h dietary recall data from a sample of WRA residing in rural Bangladesh, we examined women''s dietary intakes for energy, protein, calcium, iron, vitamin A, and dietary diversity for three groups: NPNL (n = 2,903), pregnant (n = 197), and lactating women (n = 944). We used equivalence testing to examine similarity in adjusted intakes for pregnant versus NPNL women and lactating versus NPNL women with a predetermined equivalence threshold based on recommendations specific for each reproductive stage. On average, both pregnant and lactating women had insufficient intakes for all dietary measures. Although statistically significant differences were observed between pregnant and NPNL women for energy intake and dietary diversity and between lactating and NPNL women for energy and protein intake, the magnitudes of these differences were too small to reject equivalence. Statistical similarity was also evident in all micronutrients and dietary diversity for both two‐group comparisons. Understanding statistical differences and similarities between dietary measures of women in distinct reproductive stages has important implications for the relevance, appropriateness, and evaluation of maternal diet‐enhancing interventions in LMICs, especially during pregnancy and lactation, when demand for macronutrients and micronutrients is elevated.     

Nutrient intakes and dietary patterns of young children by dietary fat intakes

OBJECTIVE: To determine whether low fat intake is associated with increased risk of nutritional inadequacy in children 2 to 8 years old and to identify eating patterns associated with differences in fat intake. STUDY DESIGN: Using 2 days of recall from the Continuing Survey of Food Intake by Individuals (CSFII), 1994 to 1996, we classified 2802 children into quartiles of energy intake from fat (<29%, 29% to 31.9% [defined as moderate fat], 32% to 34.9%, and > or =35%) and compared nutrient intakes, the proportion of children at risk for inadequate intakes, Food Pyramid servings, and fat content per serving across quartiles. RESULTS: More children in quartile 2 were at risk for inadequate intakes of vitamin E, calcium, and zinc than children in higher quartiles (P <.0001); more children in quartiles 3 and 4 were at risk for inadequate intakes of vitamins A and C and folate (P <.001). Fruit intake decreased across quartiles (P <.0001); whereas vegetable, meat, and fat-based condiment intakes increased (P <.0001). Fat per serving of grain, vegetables, dairy, and meat increased across quartiles (P <.0001). CONCLUSIONS: Moderate-fat diets were not consistently associated with an increased proportion of children at risk for nutritional inadequacy, and higher-fat diets were not consistently protective against inadequacy. Dietary fat could be reduced by judicious selection of lower-fat foods without compromising nutritional adequacy.     

Combining food‐based dietary recommendations using Optifood with zinc‐fortified water potentially improves nutrient adequacy among 4‐ to 6‐year‐old children in Kisumu West district,Kenya

Children in developing countries often face multiple micronutrient deficiencies. Introduction of zinc‐fortified water can increase zinc intake, but additional recommendations are required to address overall diet nutrient adequacy. We developed and tested food‐based recommendations (FBRs) that included zinc‐fortified water for children aged between 4 and 6 years from rural Kenya to achieve the best possible nutrient adequacy. Dietary intakes of 60 children aged 4–6 years, from Kisumu West district, Kenya, were assessed using a quantitative multipass 24‐hr recall. Linear programming model parameters were derived, including a list of foods consumed, median serving sizes, and distribution of frequency of consumption. By using the Optifood linear programming tool, we developed FBRs for diets including zinc‐fortified water. FBRs with nutrient levels achieving ≥70% recommended nutrient intake (RNI) of the World Health Organization/Food and Agriculture Organization of the United Nations RNI for most of the 12 considered nutrients were selected as the final recommendations for the children. With no FBRs and no zinc‐fortified water, percent RNI coverage range was between 40% and 76% for zinc, improving to 66–101% after introduction of zinc‐fortified water. The final set of FBRs achieved nutrient adequacy for all nutrients except for vitamin A (25% RNI) and folate (68% RNI). Introduction of zinc‐fortified water combined with FBRs will likely improve the nutrient adequacy of diets consumed by children in Kenya but needs to be complemented with alternative interventions to ensure dietary adequacy.     

Increased prevalence of constipation in pre-school children is attributable to under-consumption of plant foods: A community-based study

Aim: To evaluate consumption of foods rich in dietary fibre and its relation to the prevalence of constipation in pre‐school children. Methods: In total, 368 children aged 3–5 years were randomly selected from kindergartens in Hong Kong. Constipation was confirmed by Rome‐criteria. Children with normal bowel habits served as non‐constipated controls. Consumption of vegetables, fruits, whole‐grain cereals and fluid were determined using a 3‐day food record. Results: A total of 28.8% children were reported to have constipation. Median dietary fibre intake of constipated children was significantly lower than non‐constipated children (3.4 g/d (inter‐quartile range (IQR): 2.3–4.6 g/d) vs. 3.8 g/d (IQR: 2.7–4.9 g/d); P = 0.044) corresponding to 40% reference dietary fibre intake. Constipated children also had significantly lower intakes of vitamin C (P = 0.041), folate (P = 0.043) and magnesium (P = 0.002). Fruit intake and total plant foods intake were significantly lower in the constipated than non‐constipated children: (61 g/d (IQR: 23.8–115 g/d) vs. 78 g/d (IQR: 41.7–144.6 g/d); P = 0.047) and (142.5 g/d (IQR: 73.7–214.7 g/d) vs. 161.1 g/d (IQR: 98.3–233.3 g/d); P = 0.034), respectively. Total fluid intake did not differ between groups but milk intake among the constipated children was marginally higher than the non‐constipated children (P = 0.055) Conclusion: Insufficient dietary fibre intake is common in Hong Kong pre‐school children. Constipated children had significantly lower intakes of dietary fibre and micronutrients including vitamin C, folate and magnesium than non‐constipated counterparts which was attributable to under‐consumption of plant foods. However, milk intake was marginally higher in the constipated children. More public education is necessary for parents to help develop healthy dietary habit and bowel habit in early life in order to prevent childhood constipation.     

Effect of enhanced homestead food production and aquaculture on dietary intakes of women and children in rural Cambodia: A cluster randomized controlled trial

The Cambodian diet is low in nutrient‐dense animal‐source foods. Enhanced homestead food production (EHFP) and aquaculture, which increase availability of nutrient‐dense foods, are promising interventions to improve dietary intake. This study examined the effect of EHFP with or without aquaculture on dietary intake and prevalence of inadequate intake of select nutrients among women and children living in rural Cambodia, compared to controls. In a registered, cluster randomized controlled trial in Prey Veng, Cambodia, 10 households in each of 90 villages (n = 900) were randomized by village to receive EHFP, EHFP plus aquaculture, or control. After 22‐month intervention, 24‐hr dietary recalls (24HRs) were collected from mothers aged 18–50 years (n = 429) and their children aged 6 months–7 years (n = 421), reported by their mothers. Usual intake distributions (generated using 24HRs and repeat 24HRs on a subsample) were used to estimate prevalence of inadequate intake. Compared to controls, women in the EHFP group had significantly higher zinc (+1.0 mg/d) and Vitamin A (+139 retinol activity equivalents/d) intakes, and women in the EHFP plus aquaculture group had significantly higher iron (+2.7 mg/d), Vitamin A (+191 retinol activity equivalents/d), and riboflavin (+0.17 mg/d) intakes. Women in the EHFP plus aquaculture group also had significantly lower prevalence of inadequate iron (?7%, at 10% bioavailability), Vitamin A (?19%), and riboflavin (?17%) intakes, compared to controls. No significant differences in intakes or nutrient adequacy were observed among children or between EHFP and EHFP plus aquaculture groups. The biological importance of the small differences in nutrient intakes among women remains to be established.     

Nutritional management of the gluten-free diet in young people with celiac disease in The Netherlands

BACKGROUND: For young people with celiac disease, adherence to the gluten-free diet may be difficult to achieve and gluten restriction may lead to insufficient nutrient intake and unbalanced food intake resulting in overweight. In The Netherlands, no nutritional information is available. Therefore, we evaluated the nutritional management and nutritional state in young celiac patients. METHODS: The Dutch Celiac Society invited all its members aged 12 to 25 years to complete a food record and a questionnaire. Nutrient intakes were compared with the recommendations and the intake in the general population. Total immunoglobin A, endomysial antibody, tissue transglutaminase and IgA gliadin were determined, and height and weight were assessed. RESULTS: Strict dietary compliance was reported by 75%. The fiber and iron intakes were significantly lower, and the saturated fat intake significantly higher than recommended but comparable with the general population. Most of the patients (61%) found the diet easy to follow. Regular medical controls were reported by 86% but regular dietary controls by only 7% of the patients. Mean and SD scores for height and body mass index were -0.3 +/- 1.1 and -0.3 +/- 0.8, respectively. CONCLUSIONS: The dietary compliance in this group is high, the nutritional state is adequate, but the nutrient intake is not. Better medical and dietary support is necessary to prevent long-term complications and to achieve an ongoing satisfying management in this group of young patients with a chronic disorder.     

Effect of tailored dietary guidance for pregnant women on nutritional status: A double‐cohort study

This double cohort study aimed to evaluate the effect of tailored dietary guidance for pregnant women on dietary intake, nutritional status, and infant birth weight. Healthy pregnant women were recruited at an antenatal clinic during two phases over 2 years. The historical controls were analyzed a year prior to the intervention group. In both groups, data were collected at 19–26 gestational weeks (baseline) and at 34–37 gestational weeks (outcome measurement). The intervention included the following: (a) assessments of maternal dietary nutritional intake using the brief self‐administered diet history questionnaire, (b) individual feedback based on the assessments of maternal nutritional status, (c) tailored guidance for a healthy diet, (d) original cooking recipes, and (e) goal sharing. Mann–Whitney U test was used to compare the outcome data between the groups. Of the 378 eligible women, 309 women had follow‐up questionnaire data. Blood samples were obtained from 202 women. Despite a lack of improvement in reported dietary intake, plasma eicosapentaenoic acid (p = .002), docosahexaenoic acid (p < .001), arachidonic acid (p < .001), and dihomo‐gamma‐linolenic acid (p < .001) concentrations as well as maternal weight gain (p = .019) were significantly higher in the intervention group. However, serum folate (p = .031) concentration was significantly lower in the intervention group, and there were no significant differences between the groups in 25‐hydroxy vitamin D levels, blood count, average birth weight, and rate of low birth weight infants. Assessment‐based tailored guidance individualized to maternal dietary intake might partially contribute to improved nutrition in pregnant women.