Influencing Factors for Sustainable Dietary Transformation—A Case Study of German Food Consumption

In a case study of Germany, we examine current food consumption along the three pillars of sustainability to evaluate external factors that influence consumers’ dietary decisions. We investigate to what extent diets meet nutritional requirements (social factor), the diets’ environmental impact (ecological factor), and the food prices’ influence on purchasing behavior (economic factor). For this, we compare two dietary recommendations (plant-based, omnivorous) with the status quo, and we examine different consumption styles (conventional, organic produce). Additionally, we evaluate 1446 prices of food items from three store types (organic store, supermarket, and discounter). With this, we are able to evaluate and compare 30 different food baskets along their health, environmental, and economic impact. Results show that purchasing decisions are only slightly influenced by health-related factors. Furthermore, few consumers align their diet with low environmental impact. In contrast, a large share of consumers opt for cheap foods, regardless of health and environmental consequences. We find that price is, arguably, the main factor in food choices from a sustainability standpoint. Action should be taken by policy makers to financially incentivize consumers in favor of healthy and environmentally friendly diets. Otherwise, the status quo further drives especially underprivileged consumers towards unhealthy and environmentally damaging consumption.

Development of the Healthy Eating Food Index (HEFI)-2019 measuring adherence to Canada's Food Guide 2019 recommendations on healthy food choices

The release of Canada’s Food Guide (CFG) in 2019 by Health Canada prompted the development of indices to measure adherence to these updated dietary recommendations for Canadians. This study describes the development and scoring standards of the Healthy Eating Food Index (HEFI)-2019, which is intended to measure alignment of eating patterns with CFG-2019 recommendations on food choices among Canadians aged 2 years and older. Alignment with the intent of each key recommendation in the CFG-2019 was the primary principle guiding the development of the HEFI-2019. Additional considerations included previously published indices, data on Canadians’ dietary intakes from the 2015 Canadian Community Health Survey (CCHS) – Nutrition, and expert judgement. The HEFI-2019 includes 10 components: Vegetables and fruits (20 points), Whole-grain foods (5 points), Grain foods ratio (5 points), Protein foods (5 points), Plant-based protein foods (5 points), Beverages (10 points), Fatty acids ratio (5 points), Saturated fats (5 points), Free sugars (10 points), and Sodium (10 points). All components are expressed as ratios (e.g., proportions of total foods, total beverages, or total energy). The HEFI-2019 score has a maximum of 80 points. Potential uses of the HEFI-2019 include research as well as monitoring and surveillance of food choices in population-based surveys. Novelty: ● The Healthy Eating Food Index-2019 was developed to measure adherence to the 2019 Canada's Food Guide recommendations on healthy food choices. ● The HEFI-2019 includes 10 components, of which 5 are based on foods, 1 on beverages and 4 on nutrients, for a total of 80 points.

Prescription, Compliance, and Burden Associated with Salt-Restricted Diets in Heart Failure Patients: Results from the French National OFICSel Observatory

(1) Background: There is much debate about the use of salt-restricted diet for managing heart failure (HF). Dietary guidelines are inconsistent and lack evidence. (2) Method: The OFICSel observatory collected data about adults hospitalised for HF. The data, collected using study-specific surveys, were used to describe HF management, including diets, from the cardiologists’ and patients’ perspectives. Cardiologists provided the patients’ clinical, biological, echocardiography, and treatment data, while the patients provided dietary, medical history, sociodemographic, morphometric, quality of life, and burden data (burden scale in restricted diets (BIRD) questionnaire). The differences between the diet recommended by the cardiologist, understood by the patient, and the estimated salt intake (by the patient) and diet burden were assessed. (3) Results: Between March and June 2017, 300 cardiologists enrolled 2822 patients. Most patients (90%) were recommended diets with <6 g of salt/day. Mean daily salt consumption was 4.7 g (standard deviation (SD): 2.4). Only 33% of patients complied with their recommended diet, 34% over-complied, and 19% under-complied (14% unknown). Dietary restrictions in HF patients were associated with increased burden (mean BIRD score of 8.1/48 [SD: 8.8]). (4) Conclusion: Healthcare professionals do not always follow dietary recommendations, and their patients do not always understand and comply with diets recommended. Restrictive diets in HF patients are associated with increased burden. An evidence-based approach to developing and recommending HF-specific diets is required.

Hyperuricemia: Features of the Diet

The association of hyperuricemia (HU) with cardiovascular disease (CVD), diabetes, metabolic syndrome, and kidney disease has been demonstrated in numerous studies. НU is the main pathogenetic factor in the development of gout and is associated with an increase in overall and cardiovascular mortality. НU is included in the list of factors determining cardiovascular risk. According to epidemiological studies, there is a high prevalence of HU in the world and its increase in recent decades. A number of factors have been identified that contribute to the increased risk of НU. Non-modifiable factors include gender, age, genetic factors, and modifiable factors include diet and lifestyle. Nutritional unbalances, increased life expectancy, increased prevalence of obesity, and increased use of drugs (especially diuretics) are seen as contributing factors to the rise in НU. The review was carried out to summarize the available information on the effect of dietary habits, individual foods and nutrients on serum uric acid (SUA) levels and the risk of developing HU. The review presents the results of scientific studies demonstrating the relationship of НU with the consumption of foods rich in purines (offal, red meat, fish, seafood, legumes), alcohol consumption, drinks sweetened with fructose, coffee, dairy products, vegetables and fruits. Diet correction is an important and necessary step in the prevention and treatment of НU. The article reviews the basic principles of dietary management in HU and provides dietary recommendations for patients. For effective prevention and treatment of НU, a mandatory correction of the diet is required.

Livelihood functions of fisher households under a cold-water production environment of Kashmir, Jammu and Kashmir, India

This study comprehensively investigated the livelihood security scenario of fisher households (FHs) employing the CARE framework with little modifications, in Kashmir, India. Primary data for this study was collected from selected FHs, and a regression function was fitted to quantify the determinants of livelihood security. The findings revealed that fishing has been their dominant livelihood option. The landholding owned by the households was meagre enough to carry out farming or domesticate animals on commercial lines. Poor capital endowments place them at less livelihood security level; however, the respondents with diversified income have a relatively higher index value for livelihood. The regression estimates indicated that barring social and natural capital, all forms of capital have a significant role to play in securing their livelihood. Poor livelihood security, coupled with less income flow, has made their survival vulnerable to various distresses and health disorders, including the prevalence of Infant & Maternal Mortality. Their dietary intake was undesirably less than their dietary recommendations. The COVID-19 pandemic was perceived as a shock to their livelihood security. Further, public investment, which is pertinent for the growth of the fisheries sector, has shown a discouraging trend. The study concluded with a few policy suggestions for securing the livelihood of the fisher community.

Intakes of nutrients and food categories in Canadian children and adolescents across levels of sugars intake: Cross-sectional analyses of the Canadian Community Health Survey 2015 Public Use Microdata File

Dietary recommendations to reduce sugars consumption may influence choices of sugars-containing foods and affect the intake of key micronutrients. We compared intakes of nutrients and food sources stratified by quintiles of total sugars in Canadian children (2-8y) and adolescents (9-13y, 14-18y) using 24-hour dietary recalls from the 2015 Canadian Community Health Survey-Nutrition. Energy intakes did not differ across quintiles of sugars intake. Those with lower sugars intakes (Q1/Q3) generally had higher protein, fat, sodium, niacin, folate and zinc and lower vitamin C compared to those with the highest sugars intakes (Q5). Q1 also had lower potassium but higher saturated fat compared to Q5. Further, Q1 generally had higher protein, fats and niacin compared to Q3, while children in Q3 had higher potassium and riboflavin and older adolescents had higher calcium and fibre. Q5 had highest intakes of multiple sugar-containing food categories (e.g. fruit, confectionary, milks, cakes/pies/pastries), with higher sugars-sweetened beverages in adolescents. Q3 had higher fruit, milks and fruit juice compared to Q1 and lower sugars/syrups/preserves, confectionary, and fruit juices compared to Q5. Certain nutrient-dense food sources of sugars (fruit, milks) may help increase key nutrients (potassium, calcium, fibre) in older adolescents with low sugars intakes. However, in those with the highest sugars intakes, nutrient-poor foods may displace nutrient-dense foods. Novelty: • Canadian children and adolescents with lower sugars intake have better intakes of some nutrients • Energy intakes did not differ across sugars intake • Older adolescents with mean intakes of total sugars had better intakes of some key nutrients (potassium, calcium, fibre)

Precision Nutrition Model Predicts Glucose Control of Overweight Females following the Consumption of Potatoes High in Resistant Starch

Individual glycemic responses following dietary intake result from complex physiological processes, and can be influenced by physical properties of foods, such as increased resistant starch (RS) from starch retrogradation. Predictive equations are needed to provide personalized dietary recommendations to reduce chronic disease development. Therefore, a precision nutrition model predicting the postprandial glucose response (PPGR) in overweight women following the consumption of potatoes was formulated. Thirty overweight women participated in this randomized crossover trial. Participants consumed 250 g of hot (9.2 g RS) or cold (13.7 g RS) potatoes on two separate occasions. Baseline characteristics included demographics, 10-day dietary records, body composition, and the relative abundance (RA) and α-diversity of gut microbiota. Elastic net regression using 5-fold cross-validation predicted PPGR after potato intake. Most participants (70%) had a favorable PPGR to the cold potato. The model explained 32.2% of the variance in PPGR with the equation: 547.65 × (0 [if cold, high-RS potato], ×1, if hot, low-RS potato]) + (BMI [kg/m2] × 40.66)—(insoluble fiber [g] × 49.35) + (Bacteroides [RA] × 8.69)—(Faecalibacterium [RA] × 73.49)—(Parabacteroides [RA] × 42.08) + (α-diversity × 110.87) + 292.52. This model improves the understanding of baseline characteristics that explain interpersonal variation in PPGR following potato intake and offers a tool to optimize dietary recommendations for a commonly consumed food.

The methodology of food design. Part 2. Digital nutritiology in personal food

Atherosclerosis (the main cause of a wide range of cardiovascular diseases) and other multifactorial diseases depend on several nutrition factors, defined in general by lifestyle that directly and constantly affects the human body. The modern level of science and technology development is able to form a diet, taking into account all personal characteristics in such a way that makes nutrition an effective preventive measure against diseases in order to keep a person healthy. The purpose of this article is to define and study all the limitations (the scope of its coverage in the scientific literature) that arose in the process of research aimed to formation of an integrated personal approach to designing of nutrition to prevent atherosclerosis. The object of the study was scientific literature, which is available in open source and free access databases: PubMed, ScienceDirect, eLIBRARY.RU, www.fips.ru, Patentscope. The language of search is Russian and English, search depth is 12 years. In the course of the research two food design concepts were found that affect process of digitalization in the food sector: the concept “FoodTech” (food technology) and digital nutritiology. It was established that in Russia only one company — LLC “City Supermarket” (Moscow), that works with the brand “Azbuka Vkusa” — acts in the sphere of “FoodTech” on the Russian market. This company selects personalized food, taking into account the results of personal nutrigenetic tests, in cooperation with LLC “Genotech” (Moscow). There is a need to use biological information, statistical information processing (nutrigenetic studies, nutrigenomic research) and machine-aided data processing (machine learning) for further generation of automatic algorithm that compiles personal recommendations. The relevance of generation of a national domestic database on chemical composition of food products (presented in the market) to simplify the preparation of individual personal diets is observed. We underline the necessity to use the test-organisms, i. e. dorio fish / zebrafish (Danio rerio) and nematodes (Caenorhabditis elegans)), which were used to determine the activity of candidate substances — the biologically active substances that feature antiatherosclerotic properties. In the future the authors plan to conduct a nutrigenomic and nutrigenetic study, using digital achievements. To collect information about consumers, it is necessary to apply digital devices, and use biological informatics to process the results; after that it is necessary to generate the algorithm for automatic selection of personalized dietary recommendations.

Transient Ischemic Attack

The transient ischemic attack is a neurological emergency which is a clinical view of focal cerebral, retinal, or spinal dysfunction that lasts less than an hour, without any detectable acute infarction in neurological imaging methods. TIA is a serious warning for ischemic stroke, and this risk is particularly high in the first 48 hours. Following TIAs, approximately 10-15% of patients undergo stroke in 90 days and about half of these patients suffer a stroke in the first two days. Neuroimaging and laboratory studies should be performed quickly to reveal the etiology and to reduce the risk of stroke that may develop in patients present with TIA. Therapeutic and preventive interventions should be started as soon as possible. With early diagnosis and treatment, the risk of a 90-day stroke in these patients can be reduced by 80%. In addition to antiplatelet and anticoagulant treatments, aggressive control of blood pressure, regulation of blood sugar, statin, dietary recommendations, exercise, and managing the other underlying specific conditions should be started quickly.