Dietetics, Volume 1, Issue 3 (December 2022) – 8 articles

The present study aimed to clarify the differences in nutritional intake in relation to the consumption of local food products and dietary patterns between two rural Kenyan regions, Kitui and Vihiga, where different ethnic groups live in different agro-ecological zones. A participant observation study with weighted dietary records was conducted in August 2019. Enumerators stayed in each targeted household for approximately one week and measured the ingredients and dishes. We compared the dietary intake of farm women in charge of meal preparation (n = 21) between the two regions and examined the contribution of each dish to the intake and the degree of home production for each food item. The results showed no difference in energy intake, but vitamin B₂, B₁₂, and C intakes were significantly higher in Vihiga, influenced by their consuming small fish and a variety of homegrown leafy vegetables. The people in Kitui consumed large quantities of homegrown pigeon peas, largely contributing to their nutritional intake. Dietary patterns were similar; common staple foods and tea with sugar accounted for about 40% of energy and protein intakes and fruit consumption was low. There was no difference in foods purchased frequently. These results suggested that promoting locally available fruits and vegetables would contribute to a sustainable supply of adequate micronutrients. Further studies are required to develop strategies to promote healthy dietary habits and improve health status. Full article

Due to its anti-inflammatory and antioxidant capacity and, by inference, its involvement in the myelin stealth attainment, oral nutrient supplementation (ONS) with saffron has recently been investigated as a complementary treatment in multiple sclerosis (MS). The purpose of the present study was to systematically review the literature for randomized controlled trials (RCTs) comparing saffron supplementation to placebo, or other interventions, in patients with an MS diagnosis. PubMed, CENTRAL, and clinicaltrials.gov were searched for relevant completed or ongoing RCTs. The Cochrane’s RoB tool 2.0 was used, and a qualitative synthesis without meta-analysis (SWiM) was performed. In total, five parallel, double-, or triple-blind RCTs were identified, fulfilling the study’s criteria, and were included in the SWiM. Intervention duration ranged from four weeks to a year. The summary RoB revealed some concerns, or even high risk for overall bias. The included RCTs failed to report particularities of their interventions (exact composition, active compound, safety assays, etc.) and adverse events. The SWiM revealed that according to the results of single trials, inflammation markers (TNF-a and IL-17) were reduced, and MS-specific biomarkers (MMP-9 and TIMP-1) and cognition were improved after saffron ONS, although definite conclusions regarding saffron efficacy with regard to these outcomes cannot be drawn. Two RCTs reported improvement in the redox status of patients receiving saffron, whereas, with regard to depression, the findings were conflicting. Overall, ONS with saffron compounds may prove beneficial in improving antioxidant defense and oxidative stress in patients with MS; however, the evidence appears scattered, heterogenous, and inadequate in terms of making any suggestions regarding the direction of effect of other outcomes. Trials of better design and MS-specific outcomes are required. Full article

Female athletes who endure physical strain on the same bone area are prone to stress fractures. Preventing these improves their quality of life. Blood vitamin B2 (V.B2) and E (V.E) levels influence blood homocysteine (Hcy) levels, which, when elevated, increase the risk of stress fractures. We aimed to determine the effects of V.B2 and V.E supplementation on plasma Hcy concentrations in these athletes carrying the C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR). This study is a before–after study in 16 female athletes. It was divided into three intervention periods of V.B2 (28 mg/day), V.E (60 mg/day), and V.B2 + V.E intake, and each period was 14 days. Blood samples were collected before and after each period, and plasma Hcy concentration and each blood vitamin concentration were measured. Plasma Hcy concentration significantly decreased in all periods, but the maximum lowering effect was obtained when V.B2 and V.E were used in combination. The administration of V.B2 might have lowered the plasma Hcy level by maximizing the catalytic activity of MTHFR; V.E might have suppressed cell oxidation, increasing the efficiency of folate in lowering the plasma Hcy level. We propose the combined intake of V.B2 and V.E as effective nutrients to reduce plasma Hcy concentrations in female athletes with MTHFR polymorphisms. Full article

(1) Background: The quality of dietetic care is crucial to improve patient outcomes. The aim of this study was to measure the current practices regarding the provision of nutrition care in type 2 diabetes mellitus (T2DM) among dietitians in Malaysia. (2) Methods: A 49-item online survey was distributed via Malaysian Dietitians’ Association and Ministry of Health Malaysia social media platforms. Self-reported dietetic practices in the management of T2DM were evaluated against practice guidelines. (3) Results: A total of 173 dietitians completed the survey, with a response rate of 62%. Three-quarters of dietitians in the public sector consulted patients within two to three weeks or more than four weeks versus less than two weeks (86.3%) among private dietitians (p-value < 0.001). More than 95% of private dietitians spent 31–60 min or more than 60 min on new cases versus 71% among public dietitians (p-value < 0.001). Group counseling was only practiced among public dietitians (36.0%). Different practice settings led to the current findings. A limited use of behavioral counseling theories and strategies was observed among dietitians from both sectors. Limited adherence to nutrition-related recommendations (62.8%) and lack of readiness for diet/lifestyle changes (45.5%) were the key challenges faced by dietitians when managing T2DM. (4) Conclusions: The survey indicates that there is a need for the development of comprehensive training to increase the utilization of behavioral counselling. Practice setting is an element to consider when designing training. Full article

Colorectal cancer (CRC) is an abnormal growth that occurs in the rectum or rectal portion. In 2020, an anticipated 104,610 new cases of colon illness and 43,340 new cases of rectal abnormal growth were expected in the United States. Red and processed meat, body bloatedness, belly fatness, and binge drinking expands the occurrence of colorectal disease. Dietary fibres contribute to faecal bulking, but they are break down by gut bacteria and produce metabolites such as short-chain fatty acids (SCFAs). SCFAs are chemical compounds that are mostly made up of acetate, propionate, and butyrate. Acetate and butyrate help to control mucus production and discharge, and thus, protect the gut mucosa. Reduced mucus secretion/increased bacterial catabolism, and fermentation of amino acids resulted in an increase of potentially detrimental metabolites such as branched-chain fatty acids, ammonia, amines, and N-nitroso complex components. Vital roles of fibres include reduction in the time that carcinogens encounter the intestinal lumen and promotion of healthy gut microbiota as well as modification of the host metabolism. The present review focuses on a brief introduction to various dietary fibres and specialised metabolites that can possess beneficial effect on CRC, as well as presenting our current, detailed understanding of various dietary fibres along with their potential effects on gut microbiota and its association with the colon cancer. A comprehensive discussion is also included, advocating the dietary fibre-enriched diet. Full article

Male fertility is declining and affects approximately one in seven couples. Reasons for this are multi-factorial and the subject of on-going research, though environmental contaminants (such xenoestrogens) are believed to be contributory factors. Semen parameters can be improved through a healthy diet and nutritional supplementation has also been shown to improve semen parameters, clinical pregnancy and live birth rates significantly. Despite this, in medical care dietary modification beyond alcohol reduction is rarely recommended. The aim of this review was to consider the psychosocial impacts of infertility in males whilst assessing other nutritional and lifestyle interventions that can be used in personalized nutrition care. More tailored nutrition care needs to consider this and the taboo surrounding the male infertility experience. A systematic approach was used. Three electronic databases (CINAHL, Medline and Academic Search Complete) were searched using predetermined Boolean search terms and identified 125 papers for review. Hand searches were undertaken to ensure recent evidence was included. Duplicates were removed and predefined inclusion and exclusion criteria were applied. Narrative synthesis was used for review and to develop preconceptual guidelines. Review data indicates dietary modification or supplementation with antioxidants such as vitamin C, vitamin E, coenzyme Q10, selenium, carnitine and zinc have been shown to improve markers of male fertility and reduce markers of seminal oxidative damage. Also, a Mediterranean style diet is also associated with higher quality sperm counts. Weight loss is beneficial in terms of normalizing endocrine profiles but at present it is not possible to determine if this is the effect of weight loss alone, or the combined effect of weight loss alongside other dietary improvement. Further research is therefore needed to understand the role of the many potential confounding factors. Despite this, infertility is emotionally challenging for men and nutrition, and personalised nutrition and lifestyle therapies have potential to support men trying to conceive. Pre-conceptual nutrition and lifestyle guidelines for men have been developed from this review and the use should be considered as the basis for more tailored nutrition care in practice. Full article

(1) Background: The internet is a popular information source; however, research evaluating online nutrition-related dementia information is limited. This review characterised content, quality, and accuracy of online dementia-specific nutrition resources for dementia prevention and treatment. (2) Methods: JBI methodology for scoping reviews guided the study. Searches used Google search engine with terms related to dementia and nutrition. Webpages from government, organisational and commercial sources were included; blogs, social media and media sources were excluded. DISCERN tool evaluated content quality; accuracy was assessed against ESPEN and WHO guidelines. Differences in mean DISCERN scores were calculated using ANOVA. (3) Results: 105 webpages from eight countries were included. Webpages were mainly from organisational sources (n = 65) and covered nutrition-related prevention (n = 52) including diet–disease relationships (n = 81). Fewer webpages provided information on dementia related eating issues. The total mean DISCERN score (SD) was 50 ± 8, indicating overall good quality. All government webpages provided accurate information. Commercial webpages had some inaccuracy (ESPEN: 3% mixed, 3% inaccurate; WHO: 3% mixed, 3% inaccurate). (4) Conclusions: Information was of reasonable quality and mostly accurate. Further information on dementia-related eating issues is needed. Future research could address readability, understandability and actionability and examine other sources, such as social media, blogs or forums. Full article

Little is known about the attitudes and perceptions towards dietary sugars in Canadian adults. The objective of this study was to use rule-developing experimentation (RDE) to identify consumer mindsets related to dietary sugars in 18–50-year-old Canadians. Following an isomorphic permuted experimental design, participants (n = 269) each rated a unique set of 24 scenarios, each consisting of a distinct mixture of two to four messages about dietary sugars on a 5-point scale. A regression model was created for each respondent, identifying the value that each respondent attributed to each of the 16 messages. K-means clustering revealed three distinct mindset groups as follows: “Sugars Beliefs” (MS1), “Trend Analysts” (MS2), and “Health Seekers” (MS3). In conclusion, this study found that RDE is a useful methodological approach for evaluating how consumers think about dietary sugars and revealed mindset-specific messages that matter most to people who differ in their attitudes toward sugars. Full article