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JMIR Formative Research May 2024China's older population is facing serious health challenges, including malnutrition and multiple chronic conditions. There is a critical need for tailored food...
BACKGROUND
China's older population is facing serious health challenges, including malnutrition and multiple chronic conditions. There is a critical need for tailored food recommendation systems. Knowledge graph-based food recommendations offer considerable promise in delivering personalized nutritional support. However, the integration of disease-based nutritional principles and preference-related requirements needs to be optimized in current recommendation processes.
OBJECTIVE
This study aims to develop a knowledge graph-based personalized meal recommendation system for community-dwelling older adults and to conduct preliminary effectiveness testing.
METHODS
We developed ElCombo, a personalized meal recommendation system driven by user profiles and food knowledge graphs. User profiles were established from a survey of 96 community-dwelling older adults. Food knowledge graphs were supported by data from websites of Chinese cuisine recipes and eating history, consisting of 5 entity classes: dishes, ingredients, category of ingredients, nutrients, and diseases, along with their attributes and interrelations. A personalized meal recommendation algorithm was then developed to synthesize this information to generate packaged meals as outputs, considering disease-related nutritional constraints and personal dietary preferences. Furthermore, a validation study using a real-world data set collected from 96 community-dwelling older adults was conducted to assess ElCombo's effectiveness in modifying their dietary habits over a 1-month intervention, using simulated data for impact analysis.
RESULTS
Our recommendation system, ElCombo, was evaluated by comparing the dietary diversity and diet quality of its recommended meals with those of the autonomous choices of 96 eligible community-dwelling older adults. Participants were grouped based on whether they had a recorded eating history, with 34 (35%) having and 62 (65%) lacking such data. Simulation experiments based on retrospective data over a 30-day evaluation revealed that ElCombo's meal recommendations consistently had significantly higher diet quality and dietary diversity compared to the older adults' own selections (P<.001). In addition, case studies of 2 older adults, 1 with and 1 without prior eating records, showcased ElCombo's ability to fulfill complex nutritional requirements associated with multiple morbidities, personalized to each individual's health profile and dietary requirements.
CONCLUSIONS
ElCombo has shown enhanced potential for improving dietary quality and diversity among community-dwelling older adults in simulation tests. The evaluation metrics suggest that the food choices supported by the personalized meal recommendation system surpass autonomous selections. Future research will focus on validating and refining ElCombo's performance in real-world settings, emphasizing the robust management of complex health data. The system's scalability and adaptability pinpoint its potential for making a meaningful impact on the nutritional health of older adults.
PubMed: 38814702
DOI: 10.2196/52170 -
The Lancet Regional Health. Southeast... Jun 2024The World Health Organization has recently updated the guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in infants and... (Review)
Review
The World Health Organization has recently updated the guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in infants and children under 5 years. Apart from differences with regard to the nutritional framework that defines the quantity of energy required as Ready-to-Use Therapeutic Food (RUTF) for the outpatient treatment of severe wasting and/or nutritional oedema, there are also important gaps in the practical guidance. Instead of the recommended energy intake of 150-185 kcal/kg/day, our alternative calculations indicate the requirement to be only 105-120 kcal/kg/day. If true, the implementation of such caloric overfeeding can have adverse consequences. Gaps in practical guidance also need to be addressed, including the timing of transition to home-based diets, maximal duration of therapeutic feeding, especially in non-responders (∼50% in South Asia), and the role of augmented home foods as the primary therapeutic food option.
PubMed: 38807646
DOI: 10.1016/j.lansea.2024.100419 -
Ecology and Evolution May 2024Nutritional limitation is a common phenomenon in nature that leads to trade-offs among processes competing for limited resources. These trade-offs are mediated by...
Nutritional limitation is a common phenomenon in nature that leads to trade-offs among processes competing for limited resources. These trade-offs are mediated by changes in physiological traits such as growth factors and circulating lipids. However, studies addressing the sex-specific effect of nutritional deficiency on these physiological variables are limited in birds. We used dietary restriction to mimic the depletion of resources to various degrees and investigated sex-specific effects on circulating levels of insulin-like growth factor 1 (IGF-1) and triglycerides in Japanese quails () subjected to ad libitum, 20%, 30% or 40% restriction of their daily requirement, for 2 weeks. We also explored the association of both physiological variables with body mass and egg production. While dietary restriction showed no effects on circulating IGF-1, this hormone exhibited a marked sexual difference, with females having 64.7% higher IGF-1 levels than males. Dietary restriction significantly reduced plasma triglyceride levels in both sexes. Females showed more than six-fold higher triglyceride levels than males. Triglyceride levels were positively associated with body mass in females while showed not association in males. Overall, our findings revealed sex-specific expression of physiological variables under dietary restriction conditions, which coincide with body size.
PubMed: 38799393
DOI: 10.1002/ece3.11405 -
Frontiers in Medicine 2024Malnutrition among intensive care unit (ICU) patients is associated with a higher risk of mortality and prolonged hospitalization. However, the influence of malnutrition...
BACKGROUND AND AIM
Malnutrition among intensive care unit (ICU) patients is associated with a higher risk of mortality and prolonged hospitalization. However, the influence of malnutrition on severe outcomes of ICU patients with coronavirus disease 2019 (COVID-19) is unclear. By evaluating the effect of malnutrition on the outcomes of COVID-19 in the ICU in older adult patients, this study will contribute to new knowledge of assessing the nutritional status and recovery of these patients.
METHODS
In the current single center prospective study, 310 critically ill COVID-19 patients with an age range of ≥65 years were recruited. Data on demographic characteristics, laboratory parameters, comorbidities, medications, and types of mechanical ventilation were collected in the first 24 h of ICU admission. Malnutrition was defined based on the two-step approach of the Global Leadership Initiative on Malnutrition (GLIM) scale at baseline. During the 45 days after the baseline, we collected data on delirium incidence, mortality, invasive mechanical ventilation (IMV) requirement, length of ICU and hospital admission, and re-hospitalization.
RESULTS
In this study, the prevalence of malnutrition was 63.4% among critically ill COVID-19 patients. During the 45-day follow-up, 190 (61.3%) COVID-19 deaths were recorded among the baseline 310 patients. After controlling for potential confounders, malnutrition was associated with an increased risk of delirium so malnourished COVID-19 patients had a significantly 35% higher risk of delirium than those without malnutrition (HR: 1.35, 95% CI: 1.01-1.83). Such a significant association was not for COVID-19 mortality and IMV requirement. In addition, malnutrition was associated with a significantly 84% greater odds of prolonged ICU admission (OR: 1.84, 95% CI: 1.09-3.10). No significant association was seen between malnutrition and re-hospitalization and also prolonged hospital admission.
CONCLUSION
Malnutrition was associated with an increased risk of delirium and prolonged ICU admission among critically ill older adult COVID-19 patients. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.
PubMed: 38799151
DOI: 10.3389/fmed.2024.1259320 -
Plants (Basel, Switzerland) May 2024Ensuring global food security in the face of climate change is critical to human survival. With a predicted human population of 9.6 billion in 2050 and the demand for... (Review)
Review
Ensuring global food security in the face of climate change is critical to human survival. With a predicted human population of 9.6 billion in 2050 and the demand for food supplies expected to increase by 60% globally, but with a parallel potential reduction in crop production for wheat by 6.0%, rice by 3.2%, maize by 7.4%, and soybean by 3.1% by the end of the century, maintaining future food security will be a challenge. One potential solution is new climate-smart varieties created using the breadth of diversity inherent in crop wild relatives (CWRs). Yet CWRs are threatened, with 16-35% regarded as threatened and a significantly higher percentage suffering genetic erosion. Additionally, they are under-conserved, 95% requiring additional ex situ collections and less than 1% being actively conserved in situ; they also often grow naturally in disturbed habitats limiting standard conservation measures. The urgent requirement for active CWR conservation is widely recognized in the global policy context (Convention on Biological Diversity post-2020 Global Biodiversity Framework, UN Sustainable Development Goals, the FAO Second Global Plan of Action for PGRFA, and the FAO Framework for Action on Biodiversity for Food and Agriculture) and breeders highlight that the lack of CWR diversity is unnecessarily limiting crop improvement. CWRs are not spread evenly across the globe; they are focused in hotspots and the hottest region for CWR diversity is in West Asia and North Africa (WANA). The region has about 40% of global priority taxa and the top 17 countries with maximum numbers of CWR taxa per unit area are all in WANA. Therefore, improved CWR active conservation in WANA is not only a regional but a critical global priority. To assist in the achievement of this goal, we will review the following topics for CWRs in the WANA region: (1) conservation status, (2) community-based conservation, (3) threat status, (4) diversity use, (5) CURE-CWR hub: (ICARDA Centre of Excellence), and (6) recommendations for research priorities. The implementation of the recommendations is likely to significantly improve CWRs in situ and ex situ conservation and will potentially at least double the availability of the full breadth of CWR diversity found in WANA to breeders, and so enhance regional and global food and nutritional security.
PubMed: 38794414
DOI: 10.3390/plants13101343 -
Life (Basel, Switzerland) Apr 2024This narrative review comprehensively examines the impact of oxidative stress on military personnel, highlighting the crucial role of physical exercise and tailored... (Review)
Review
This narrative review comprehensively examines the impact of oxidative stress on military personnel, highlighting the crucial role of physical exercise and tailored diets, particularly the ketogenic diet, in minimizing this stress. Through a meticulous analysis of the recent literature, the study emphasizes how regular physical exercise not only enhances cardiovascular, cognitive, and musculoskeletal health but is also essential in neutralizing the effects of oxidative stress, thereby improving endurance and performance during long-term missions. Furthermore, the implementation of the ketogenic diet provides an efficient and consistent energy source through ketone bodies, tailored to the specific energy requirements of military activities, and significantly contributes to the reduction in reactive oxygen species production, thus protecting against cellular deterioration under extreme stress. The study also underlines the importance of integrating advanced technologies, such as wearable devices and smart sensors that allow for the precise and real-time monitoring of oxidative stress and physiological responses, thus facilitating the customization of training and nutritional regimes. Observations from this review emphasize significant variability among individuals in responses to oxidative stress, highlighting the need for a personalized approach in formulating intervention strategies. It is crucial to develop and implement well-monitored, personalized supplementation protocols to ensure that each member of the military personnel receives a regimen tailored to their specific needs, thereby maximizing the effectiveness of measures to combat oxidative stress. This analysis makes a valuable contribution to the specialized literature, proposing a detailed framework for addressing oxidative stress in the armed forces and opening new directions for future research with the aim of optimizing clinical practices and improving the health and performance of military personnel under stress and specific challenges of the military field.
PubMed: 38792589
DOI: 10.3390/life14050567 -
Foods (Basel, Switzerland) May 2024Research regarding meat analogues is mostly based on formulation and process development. Information concerning their safety, shelf life, and long-term nutritional and... (Review)
Review
Research regarding meat analogues is mostly based on formulation and process development. Information concerning their safety, shelf life, and long-term nutritional and health effects is limited. This article reviews the existing literature and analyzes potential hazards introduced or modified throughout the processing chain of plant-based meat analogues via extrusion processing, encompassing nutritional, microbiological, chemical, and allergen aspects. It was found that the nutritional value of plant-based raw materials and proteins extracted thereof increases along the processing chain. However, the nutritional value of plant-based meat analogues is lower than that of e.g., animal-based products. Consequently, higher quantities of these products might be needed to achieve a nutritional profile similar to e.g., meat. This could lead to an increased ingestion of undigestible proteins and dietary fiber. Although dietary fibers are known to have many positive health benefits, they present a hazard since their consumption at high concentrations might lead to gastrointestinal reactions. Even though there is plenty of ongoing research on this topic, it is still not clear how the sole absorption of metabolites derived from plant-based products compared with animal-based products ultimately affects human health. Allergens were identified as a hazard since plant-based proteins can induce an allergic reaction, are known to have cross-reactivities with other allergens and cannot be eliminated during the processing of meat analogues. Microbiological hazards, especially the occurrence of spore- and non-spore-forming bacteria, do not represent a particular case if requirements and regulations are met. Lastly, it was concluded that there are still many unknown variables and open questions regarding potential hazards possibly present in meat analogues, including processing-related compounds such as n-nitrosamines, acrylamide, and heterocyclic aromatic amino acids.
PubMed: 38790841
DOI: 10.3390/foods13101541 -
Foods (Basel, Switzerland) May 2024Camellia seed oil (CSO), as a nutrient-rich edible oil, is widely used in foods, cosmetics, and other fields. In this work, the extraction, deacidification,...
Camellia seed oil (CSO), as a nutrient-rich edible oil, is widely used in foods, cosmetics, and other fields. In this work, the extraction, deacidification, decolorization, and deodorization processes of CSO were respectively optimized for meeting injectable oil standards. The results showed that the CSO extraction rate reached the highest level of 94% at optimized conditions (ultrasonic time, 31.2 min; reaction pH, 9.2; and reaction time, 3.5 h). The physicochemical indexes of CSO and 10 other vegetable oils were evaluated by the principal component analysis method, and the overall scores of vegetable oils were ranked as camellia seed oil > olive oil > rice oil > peanut oil > sesame oil > corn oil > soybean oil > sunflower oil > rapeseed oil > walnut oil > flaxseed oil. The physicochemical indicators of CSO were the most ideal among the 11 vegetable oils, which means that CSO is suitable as an injectable oil. Through the optimized processes of the deacidification, decolorization, and deodorization, the CSO acid value was reduced to 0.0515 mg KOH/g, the decolorization rate reached a maximum of 93.86%, and the OD was 0.015, meeting the requirement (≤0.045 of OD) of injectable oil. After the deodorization process, these parameters of the refractive index, acid value, saponification value, iodine value, absorbance, unsaponifiable, moisture and volatiles, fatty acid composition, and heavy metal limits all met the pharmacopoeia standards of injectable oil in many countries and regions. The possibility of CSO as an injectable oil was first verified through refining-process optimization and nutritional index analysis, providing an important technical reference for the high-value utilization of vegetable oil.
PubMed: 38790730
DOI: 10.3390/foods13101430 -
Heliyon May 2024Millets are rich in nutritional and bioactive compounds, including polyphenols and flavonoids, and have the potential to combat malnutrition and various diseases.... (Review)
Review
Millets are rich in nutritional and bioactive compounds, including polyphenols and flavonoids, and have the potential to combat malnutrition and various diseases. However, extracting these bioactive compounds can be challenging, as conventional methods are energy-intensive and can lead to thermal degradation. Green-assisted techniques have emerged as promising methods for sustainable and efficient extraction. This review explores recent trends in employing green-assisted techniques for extracting bioactive compounds from millets, and potential applications in the food and pharmaceutical industries. The objective is to evaluate and comprehend the parameters involved in different extraction methods, including energy efficiency, extraction yield, and the preservation of compound quality. The potential synergies achieved by integrating multiple extraction methods, and optimizing extraction efficiency for millet applications are also discussed. Among several, Ultrasound and Microwave-assisted extraction stand out for their rapidity, although there is a need for further research in the context of minor millets. Enzyme-assisted extraction, with its low energy input and ability to handle complex matrices, holds significant potential. Pulsed electric field-assisted extraction, despite being a non-thermal approach, requires further optimization for millet-specific applications, are few highlights. The review emphasizes the importance of considering specific compound characteristics, extraction efficiency, purity requirements, and operational costs when selecting an ideal technique. Ongoing research aims to optimize novel extraction processes for millets and their byproducts, offering promising applications in the development of millet-based nutraceutical food products. Therefore, the current study benefits researchers and industries to advance extraction research and develop efficient, sustainable, and scalable techniques to extract bioactive compounds from millets.
PubMed: 38784533
DOI: 10.1016/j.heliyon.2024.e30921 -
Frontiers in Nutrition 2024Autoimmune diseases (ADs) represent a heterogeneous group of conditions affecting 5-10% of the global population. In recent decades, hematopoietic stem cell transplant... (Review)
Review
Autoimmune diseases (ADs) represent a heterogeneous group of conditions affecting 5-10% of the global population. In recent decades, hematopoietic stem cell transplant (HSCT), mainly autologous, has been successfully adopted to treat patients affected by severe/refractory ADs. In this context malnutrition has a detrimental impact on relapse, mortality, infection rate, engraftment, long-term survival, and prolongation of hospitalization. However, in this population, the management of nutrition should be improved since nutritional assessment is partially performed in routine clinical practice. A panel of nurses and physicians from the European Society for Blood and Marrow Transplantation (EBMT) reviewed all available evidence based on current literature and expert practices from centers with extensive experience in HSCT for ADs, on the nutritional management of ADs patients during HSCT procedure. In this context, adequate nutritional status predicts a better response to treatment and improves quality of life. Herein, a systematic and comprehensive monitoring of nutritional status before, during and after HSCT, with adequate nutritional support in the case of ADs patients, in addition to assessing the dietary requirements associated with HSCT has been covered. Moreover, given the singularity of each AD, the underlying disease should be considered for an appropriate approach. The management and evaluation of nutritional status must be carried out by a multidisciplinary team to assess the needs, monitor the effectiveness of each intervention, and prevent complications, especially in complex situations as patients affected by ADs.
PubMed: 38784130
DOI: 10.3389/fnut.2024.1394518