NAFLD: Diet and metabolic syndrome

Associations between dietary intake and the presence of the metabolic syndrome in patients with non-alcoholic fatty liver disease

Georgoulis et al., JHND Early View

Background

Although dietary habits have been associated with the likelihood of the metabolic syndrome (MetS) in the general population, similar associations in non-alcoholic fatty liver disease (NAFLD) patients have not been explored. The aim of this cross-sectional study was to assess the presence of the MetS and to explore its potential association with dietary habits in a sample of NAFLD patients.

Methods

Seventy-three adult patients with recent NAFLD diagnosis based on elevated liver enzyme levels and evidence of hepatic steatosis on ultrasound were enrolled. Participants’ habitual food consumption was retrospectively assessed through a food frequency questionnaire and adherence to the Mediterranean diet (MD) was assessed via the Mediterranean Diet Score (MedDietScore). The presence of the MetS was defined as the concomitant presence of at least three of its individual components, according to the criteria proposed by a recent joint statement of several major organisations.

Results

The MetS was present in 46.5% of the sample, with increased waist circumference values and decreased high-density lipoprotein cholesterol levels being the most prevalent disorders (63% and 88.7%, respectively). Consumption of refined grains [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.00–1.05] and red meat and products (OR = 1.10, 95% CI = 1.01–1.21) were positively associated with the presence of the MetS, whereas the consumption of whole grains (OR = 0.92, 95% CI = 0.84–0.99) and MedDietScore (OR = 0.87, 95% CI = 0.76–0.99) were negatively associated, after adjusting for participants’ age, sex, daily energy intake and time spent in sedentary activities.

Conclusions

Low refined grain and red meat intake, high whole grain intake and high adherence to the MD were associated with lower odds of the MetS in NAFLD patients.

Picky eating and weight in childhood

Picky eating and child weight status development: a longitudinal study

Antoniou et al., JHND Early View

Background

Children’s picky eating behaviour has been linked both to being overweight and underweight. However, the role of parenting practices in this relationship has rarely been investigated. The present study aimed to clarify the direction of the association between picky eating and weight status and to examine the moderating role of food parenting practices.

Methods

The present study comprised a longitudinal study on the effects of picky eating on child weight status within the KOALA Birth Cohort Study, the Netherlands. Mothers and their children were included in the analyses. Children’s picky eating behaviour and food parenting practices were assessed at baseline (child age 5 years). Their weight status was assessed repeatedly until age 9 years. Mixed effects linear and logistic regressions were used to compare picky eaters (n = 403) and non-picky eaters (n = 621) on changes in weight status over the years.

Results

At baseline of age 5 years, picky eaters were slightly shorter, more often underweight and less often overweight than non-picky eaters, whereas energy intake in relation to body weight (kJ kg−1) was similar. Picky eaters with a normal weight at baseline had no increased risk of becoming underweight during follow-up until age 9 years, and were less likely to become overweight compared to non-picky eaters. There were no interactions with food parenting practices. The parents of picky eaters more often reported pressuring their child to eat and restrict unhealthy food intake compared to parents of non-picky eaters.

Conclusions

The association between picky eating and child weight status was not influenced by parenting practices.

June issue now available!

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Issue 28(3) of the Journal of Human Nutrition and Dietetics is out now. For full issue details click here.

The articles in the issue are:

Clinical Nutrition

Serum 25-hydroxy vitamin D concentrations are more deficient/insufficient in peritoneal dialysis than haemodialysis patients in a sunny climate. Hanna et al.

Public Health Nutrition and Epidemiology

Consumer behaviour towards vegetables: a study on domestic processing of broccoli and carrots by Dutch households. Bongoni et al.

Cardiovascular risk and lifestyle habits of consumers of a phytosterol-enriched yogurt in a real-life setting. Paillard et al.

Cereal, fruit and vegetable fibre intake and the risk of the metabolic syndrome: a prospective study in the Tehran Lipid and Glucose Study. Hosseinpour-Niazi et al.

The diets of school-aged Aboriginal youths in Canada: a systematic review of the literature. Gates et al.

Traditional food patterns are associated with better diet quality and improved dietary adequacy in Aboriginal peoples in the Northwest Territories, Canada. Sheehy et al.,

Nutritional Science

Effects of a green tea extract, Polyphenon E, on systemic biomarkers of growth factor signalling in women with hormone receptor-negative breast cancer. Crew et al.

Glycaemic responses of staple South Asian foods alone and combined with curried chicken as a mixed meal. George et al.

Performance of an anthropometric assessment method as a predictor of low birthweight and being small for gestational age. Carvhallo Padilha et al.

Dietetic and Professional Practice

Dietitians’ perceptions of communicating with preadolescent, overweight children in the consultation setting: the potential for e-resources. Raaff et al.

JHND continues drive for higher quality

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Almost a year ago I published the above editorial in the Journal of Human Nutrition and Dietetics. My basic message was that the journal was going through a significant change, with faster turnaround times, a more responsive editorial team, an international editorial board and a push towards publication of only the highest quality submissions. Associated with these changes, things were become noticeably tougher for authors, with around 1 in 4 papers receiving a reject without review decision and acceptance rates falling to just 20%.

For the journal this was a high-risk strategy. JHND has always had a core market, with the majority of authors contributing from the UK and being largely drawn from the dietetics and clinical nutrition fields. In adopting a tougher stance which is designed to push up journal impact and create a top international journal, there was the risk that this core market could become alienated. This was not something that we wanted to happen as JHND remains the journal of the British Dietetic Association and has a clear responsibility to publish material that is appropriate to that audience and which includes that audience among the contributing audience. In this respect we have played a role in promoting research to UK dietitians and participated in the 2014 BDA Research Symposium, publishing the abstracts from that meeting.

Fears about losing our core market appear to be unfounded however and compared to this time in 2014 manuscript submissions to the journal have increased by more than 10% and we have handled 25% more manuscripts so far in 2015 than in the equivalent period in 2013. International submissions are more commonplace than in the past with 7 out of 8 manuscript submissions now coming from outside the UK.

Increasing the number of manuscripts submitted to the journal has important knock-on effects. Firstly it increases the pool of good papers that the editors can select from, which is great news. We are aiming to increase the quality of published articles, so a bigger pool is helpful. There is a negative side to this though. The journal has a limited page budget, despite being online only, which means that we can only publish approximately 75 articles per year. This means that in addition to the quality of manuscripts we have to consider priority for publication based on interest to readers and the likelihood of future citation. Consequently more authors are likely to receive rejection decisions accompanied by apparently favourable reviewer reports. The journal is also accruing a backlog of papers that have been published on Early View, but are not yet formally published. At the moment there is a lag of around a year between acceptance and final publication which, as Editor, I find unacceptable. To deal with this situation against a background of rising submissions, there is a further need to be selective.

We have recently made a decision to further limit acceptance rates for the journal to around 10%. This is primarily designed to further increase the quality of what we publish, but will also help us clear the backlog of papers. If you have recently been invited to review manuscripts for the journal you may have noticed a change in the decision page, which we have simplified. The old system was rather cumbersome and we now ask reviewers to clearly indicate whether they recommend acceptance, minor revision, major revision or rejection (we had many shades of grey in the past). Reviewers are also asked to indicate whether they consider papers to be in the top 10% or top 25% of those that they have reviewed recently. This helps our senior editorial team with decision-making.

Over the next six months we hope to publish many more high quality papers and are lining up some invited review articles from leading researchers across our range of disciplines. JHND continues to make great progress towards the aspiration to be a highly ranked international journal in the nutrition and dietetics field.

Children’s portion sizes are associated with maternal perceptions of weight and hunger

The relationship between mother to child calories served and maternal perception of hunger

Stromberg and Janicke JHND Early View

Background

Research has examined self-serving portions in adults and children and has shown that larger portion size is related to more calories consumed. The present study examines factors that may influence the portion sizes a mother serves her child at a mealtime.

Methods

The present observational study included a community-based sample of 29 mother–child dyads. Dyads attended a 1-h session in which they shared a meal together. A buffet of food was provided and the mother was asked to serve her child and herself. The amount of food served and consumed by the child was recorded. Main independent variables of interest included maternal body mass index (BMI), child BMI Z-score, and maternal perception of personal and child hunger. The primary dependent variable was the total calories the mother served her child. Regression models and a moderated mediation were used to examine the relation between variables.

Results

Calories served to the child was positively associated with calories consumed by the child. Maternal perception of her own hunger was related to her perception of her child’s hunger. Furthermore, maternal perception of child hunger explained the relationship between maternal perception of personal hunger and total calories served to the child, although only for obese mothers.

Conclusions

Mothers may be serving their children larger portion sizes based on their personal weight and their perception of their child’s hunger. To help children obtain or maintain a healthy weight, obesity prevention and intervention programmes should help mothers serve more appropriate serving sizes to their children.

Psychosocial predictors of adherence to a gluten-free diet

Prediction of adherence to a gluten-free diet using protection motivation theory among adults with coeliac disease

Dowd et al., JHND Early View

Background

Coeliac disease is a chronic autoimmune disease that requires strict adherence to a gluten-free diet. However, strict adherence to a gluten-free diet is difficult, with findings from a recent review suggesting that up to 42% of individuals with coeliac disease do not eat a strict gluten-free diet.

Methods

The present study aimed to examine psychosocial predictors of adherence (purposeful and accidental) to a gluten-free diet among adults with coeliac disease over a 1-month period. In this longitudinal study, 212 North American adults with coeliac disease completed online questionnaires at two time points, baseline and 1 month later.

Results

The results revealed that intentions partially mediated the effects of symptom severity, self-regulatory efficacy, planning and knowledge on purposeful gluten consumption. Intentions did not mediate the effects of severity, response cost, self-regulatory efficacy, planning and knowledge for accidental gluten consumption but, interestingly, self-regulatory efficacy directly predicted fewer accidental incidents of gluten-consumption.

Conclusions

These findings delineate the differential psychological processes in understanding accidental and purposeful gluten consumption among adults with coeliac disease and emphasise the importance of bolstering self-regulatory efficacy beliefs to prevent accidental and purposeful consumption of gluten.

Risk of undernutrition in the elderly

Dietary intake in the dependent elderly: evaluation of the risk of nutritional deficit

Fernández-Barrés et al., JHND Early View

Background

Malnutrition is a frequent problem in elderly dependent patients and their prognosis is adversely affected. Assessment of food consumption and adequacy of energy and nutrient intake of dependent elderly is needed to plan any selected actions for this population.

Methods

The study comprised a multicentre cross-sectional study of 190 users (≥65 years) of a home care programme provided by primary care centers in Tarragona (Spain), at nutritional risk (Mini Nutritional Assessment: 17–23.5 points). Food consumption was assessed using a semiquantitative validated food frequency questionnaire. Energy intake was compared with the Spanish dietary reference intake (DRI) and nutritional intakes with the DRI of the American Institute of Medicine.

Results

Mean (SD) age was 85.0 (7.2) years (67.5% female). The food items consumed were varied but lower than the recommended portions for cereals, fruits, vegetables and legumes. Energy intake was 7454.2 (1553.9 kJ day–1) [1781.6 (371.4) kcal day–1] (97.7% of recommended dietary allowance; RDA) and protein intake was 1.0 (0.4) g kg–1 of weight (121.4% of RDA). Proteins provided 13.3%, carbohydrates provided 39.9% and fats provided 45.8% of energy intake. The intakes of calcium, vitamin D, vitamin E and folates were less than two-thirds of the RDA and their probability of inadequate intake was >85%.

Conclusions

Dietary intakes of elderly dependent patients at nutritional risk were well balanced. In general, energy and protein intakes meet the recommendations. The diet was high in energy density, low in complex carbohydrates, high in simple carbohydrates and excessive in fats. The dependent elderly had inadequate intake of micronutrients often related to fragility, such as calcium, vitamin D, vitamin E and folates.