RESUMEN

Dietary diversity is a crucial component of healthy eating patterns because it ensures nutritional adequacy. Yet, concerns have been raised about the potential risks of its increase, which may reflect excessive consumption of unhealthy foods and higher obesity or cardiometabolic risk, particularly in high-income countries. However, the links between dietary diversity and different health outcomes remain inconclusive because of methodological differences in assessing dietary diversity. Numerous studies, mostly cross-sectional, have assessed dietary diversity using different indicators usually based only on the number of foods or food groups consumed. In this perspective, we emphasize that dietary diversity is a multidimensional concept encompassing the number of foods in the diet (food coverage) but also their relative proportions (food evenness) and the nutritional dissimilarity of foods consumed over time (food complementarity). Consequently, a comprehensive assessment of dietary diversity reflecting all its dimensions, both between and within-food groups, is needed to determine the optimal level of complementarity between and within-food groups required to improve health and diet quality. Moreover, given the prevailing context of abundant highly processed and energy-dense foods in high-income countries, promoting dietary diversity should prioritize nutrient-dense food groups. Until recently, within-food group diversity has received limited attention in research and public health recommendations. Still, it may play a role in improving diet quality and long-term health. This perspective aims to clarify the concept of dietary diversity and suggest research avenues that should be explored to better understand its associations with nutritional adequacy and health among adults in high-income countries.

Asunto(s)

RESUMEN

Very low energy diets (VLEDs) contain <800 kcal/day and typically comprise formulated meal replacement products with adequate protein and micronutrients. Food-based VLEDs are an alternative approach, but it is uncertain whether they can provide adequate nutrition within an 800 kcal/day restriction. This analysis aimed to assess the nutritional adequacy of food-based VLEDs compared with formula VLEDs. A systematized literature review was conducted to identify balanced food-based VLEDs by searching five scientific databases from inception to 23 March 2023 and online sources between 1 and 7 May 2023. Ultimately, nine diets were analyzed for nutritional content and compared with Codex Alimentarius standards for formula foods, and Australian estimated average requirement and adequate intake (AI) for adults 19-50 years. Optifast® was used as a comparator. None of the VLEDs met all nutritional benchmarks. Three food-based diets had nutrient profiles similar to formula VLEDs, with one being adequate for all nutrients except thiamine, magnesium and zinc in men and iron in women. All VLEDs, including Optifast®, did not meet AI for dietary fiber, except one. In general, food-based VLEDs offered more fiber than Optifast®. In conclusion, food-based VLEDs were inadequate in certain micronutrients but offered more dietary fiber than formula VLEDs. These nutritional deficits do not preclude food-based VLEDs from being recommended, provided they are addressed.

Asunto(s)

RESUMEN

Background: Breakfast meals provide essential nutrients and energy to children and adolescents. Based on recommendations from the International Breakfast Research Initiative (IBRI), the Breakfast Quality Score (BQS) was developed to assess breakfast nutritional value among the French adult population. However, its application to children remains unexplored. Objective: This study aimed to evaluate the BQS in assessing the nutritional quality of breakfasts consumed by French children aged 4-17 years. Methods: A total of 4,015 breakfasts, obtained from dietary recalls provided by 1,448 children participating in the French representative dietary survey (INCA3), were analyzed. As for adults, the performance of the BQS was tested through correlations with other nutritional indicators and comparison of nutrients and dietary components between tertiles of scores. The study examined the regularity of breakfast consumption and compared the BQS of children's breakfasts across socio-demographic modalities and breakfast categories distinguished by their primary grain component. Additionally, a predictive modeling using Partial Least Squares (PLS) regression identified influential INCA3 food groups. Results: The majority of children consumed solid breakfasts regularly. Socio-professional category, household income and food insecurity influenced BQS, revealing contradictory disparities. Ready-to-eat cereal (RTEC) breakfasts had the highest BQS (73.5% for children and 73.1% for adolescent), while biscuits and viennoiseries scored the lowest (52% for children and 49.1% for adolescent). PLS highlighted RTECs, milk, and hot beverages (mainly containing chocolate milk) as being positively associated with BQS, while sweet beverages and viennoiseries were negatively associated. Conclusion: The study demonstrates the effectiveness of the BQS in assessing children's breakfast quality, with RTEC breakfasts showing the highest nutritional value. The findings provide insights into factors influencing breakfast nutritional quality and underscore the importance of promoting healthier breakfast choices among all children.

RESUMEN

In 2019, the EAT-Lancet Commission proposed a Planetary Health Diet (PHD) to address challenges toward sustainable and healthy diets. However, its suitability within the Dutch context and a comparison with the Dutch Dietary Guidelines (DDG) needs investigation. Our study aimed to compare the PHD with DDG in terms of food groups, servings, nutritional content, and adequacy in adults. We modeled two theoretical diets, the PHD (PHD-NL) and another based on the DDG (DDG-NL), using the Dutch National Food Consumption Survey (FCS-2016) and Dutch Food Composition Database to calculate the nutritional content and compared it with the Dutch Dietary Reference Values (DRVs). The PHD included higher quantities of vegetables, fish, legumes, and nuts, while the DDG suggested more significant amounts of cereals, tubers, starchy vegetables, dairy, and red meat. We observed differences in macronutrient distribution; while both diets lacked sufficient vitamin D, calcium content was lower in the PHD-NL. The PHD-NL had higher levels of fiber, vegetable protein, unsaturated fats, and non-heme iron, while vitamins B2, B6, B12, and calcium were lower than the DDG-NL diet. The PHD-NL has nutritional adequacy in the Dutch context, except for vitamin D and calcium, although it is essential to be cautious with iron because of the bioavailability of non-heme iron in plant-based diets. These findings have implications for the adoption of a sustainable diet according to nutritional requirements, population health status, and sociocultural context, as well as compliance with specific dietary behaviors of populations.

Asunto(s)

RESUMEN

This cross-sectional study, conducted on 4003 participants aged between 18 and 45, aims to contribute to orthorexia nervosa (ON) research by examining the relationship between ON, body image and nutritional adequacy. The Orthorexia Nervosa-11 scale (ORTO-11) and body perception scale were applied to individuals, and food consumption records were taken with a 24-hour dietary recall method. The study found that more individuals with orthorexia nervosa (ON) considered themselves overweight compared to non-ON individuals. Evaluating diet quality, the mean adequacy ratio was significantly higher in ON individuals. Nutrient adequacy ratios for total fiber, magnesium, zinc, thiamine, folic acid, and vitamin C were higher, while those for carbohydrate and iron were lower in ON individuals. Additionally, increasing the number of snacks, protein, and total fiber adequacy decreased the ORTO-11 score. Distorted body image perception may be a risk factor for ON, but healthy eating fixation does not lead to nutrient inadequacy unless it involves progressive food restriction.

RESUMEN

Meals comprising a staple grain, a main, and side dishes (SMS meals) promote good dietary intake, yet limited studies have examined their multifactorial relationship with dietary intake. We investigated how demographic characteristics, lifestyle, and dietary habits affect the relationship between SMS meal frequency and nutrient intake adequacy. This cross-sectional study analyzed survey data from 331 Japanese adults (208 men and 123 women) aged 30-69 years in February 2019. SMS meal frequency was evaluated according to respondents' answers to how many days a week they consumed ≥2 daily SMS meals. Dietary intake was evaluated using the brief self-administered diet history questionnaire. Differences in nutrient intake adequacy among groups according to SMS meal frequency were determined using multiple logistic regression. Less frequent SMS meals correlated with a lower intake of protein, water-soluble vitamins, and certain minerals, with more individuals falling below the estimated average requirement for nutrient intake. However, no relationship was found between SMS meal frequency and nutrient intake concerning tentative dietary goals for preventing lifestyle-related diseases. Our findings indicate that adopting SMS meals could achieve adequate intake of some nutrients and enhance overall diet quality among Japanese adults.

Asunto(s)

RESUMEN

In 2019, the EAT-Lancet Commission introduced the Planetary Health Diet (PHD), a guide for creating 2500 kcal/day country-specific sustainable diets that promote health while reducing the environmental impact associated with food systems. The PHD was previously adapted to the Italian food context, resulting in the EAT-IT dietary pattern. However, this adaptation revealed several challenges in terms of nutritional adequacy, feasibility, and environmental impact. This study reports on strategies to improve the previous pattern and align it more closely with the Mediterranean Diet, resulting in the MED_EAT-IT pattern. The study also explores feasible strategies for adapting this pattern to different energy targets, enhancing its scalability and promoting personalized approaches. For the optimization of this pattern, a specific calculation tool was developed to introduce variation to the pattern, considering realistic and feasible serving sizes and frequency of consumption. This tool integrates a defined food ontology, food composition data, and two environmental impact metrics (Carbon and Water Footprint). To optimize nutritional adequacy, several adaptations of the amount within the different food groups were made, for instance by increasing cereals and animal source by 25.5% kcal/day and 36.2% kcal/day respectively compared to EAT-IT. The resulting 2500 kcal/die pattern meets all nutritional requirements except for vitamin D and does not hamper the possibility to limit environmental impact (Carbon Footprint increased only by 12.2% but Water Footprint decreased by 6.3%). Lower energy targets were achieved by modulating amounts of the different food groups to ensure nutritional adequacy. The strategies and tools proposed here could aid in optimizing dietary plans, evaluating their potential for environmental impact reduction, and identifying issues that could hinder their adoption. Furthermore, the analyses carried out pave the way for the potential future development of new or improved foods that may contribute to the optimization of nutritional and environmental impact of diets.

RESUMEN

According to the latest data, Spain (19.4%) and Portugal (21.8%) are the two European countries with the highest percentage of older adults. Concerns about diet quality are increasing, especially among institutionalized older people, who are at the greatest risk of malnutrition. To assess the adequacy of dietary intake of 186 older adults (>65 y) institutionalized in public nursing homes (NH) in Galicia (Northwest Spain) and the Porto district (Northern Portugal), a cross-sectional study has been carried out. The double-weighing method and a country-specific food composition database were employed for nutritional assessment. Nutritional adequacy was assessed based on the recommendations of the EFSA and WHO. Caloric intake in Spanish NHs was higher than in Portuguese facilities; 20.3% and 35.8% of Spanish and Portuguese residents, respectively, had a protein intake below the EFSA recommendation, and 46.2% and 44.9% of residents in Portugal and Spain, respectively, had lipid intakes below the reference intake range. Further, 45.5% of the residents in Portugal and 66.9% in Spain had a carbohydrate intake within the recommended range. Salt intake was higher than the recommendation for 67.0% and 32.3% of the residents in Spain and Portugal, respectively. This study supports the notion that institutionalized older adults are prone to significant nutritional inadequacies.

Asunto(s)

RESUMEN

OBJECTIVE: This study aims at comparing two Italian case studies in relation to schoolchildren's plate waste and its implications, in terms of nutritional loss, economic cost and carbon footprint. DESIGN: Plate waste was collected through an aggregate selective weighting method for 39 d. SETTING: Children from the first to the fifth grade from four primary schools, two in each case study (Parma and Lucca), were involved. RESULTS: With respect to the served food, in Parma, the plate waste percentage was lower than in Lucca (P < 0·001). Fruit and side dishes were highly wasted, mostly in Lucca (>50 %). The energy loss of the lunch meals accounted for 26 % (Parma) and 36 % (Lucca). Among nutrients, dietary fibre, folate and vitamin C, Ca and K were lost at most (26-45 %). Overall, after adjusting for plate waste data, most of the lunch menus fell below the national recommendations for energy (50 %, Parma; 79 %, Lucca) and nutrients, particularly for fat (85 %, Parma; 89 %, Lucca). Plate waste was responsible for 19 % (Parma) and 28 % (Lucca) of the carbon footprint associated with the food supplied by the catering service, with starchy food being the most important contributor (52 %, Parma; 47 %, Lucca). Overall, the average cost of plate waste was 1·8 €/kg (Parma) and 2·7 €/kg (Lucca), accounting respectively for 4 % and 10 % of the meal full price. CONCLUSION: A re-planning of the school meals service organisation and priorities is needed to decrease the inefficiency of the current system and reduce food waste and its negative consequences.

Asunto(s)

RESUMEN

OBJECTIVES: The main aim of this study was to describe nutrition provision in Australian and New Zealand (ANZ) pediatric intensive care units (PICUs), including mode of nutrition and adequacy of enteral nutrition (EN) to PICU day 28. Secondary aims were to determine the proportion of children undergoing dietetics assessment, the average time to this intervention, and the methods for estimation of energy and protein requirements. METHODS: This observational study was conducted in all ANZ tertiary-affiliated specialist PICUs. All children ≤18 y of age admitted to the PICU over a 2-wk period and remaining for ≥48 h were included. Data were collected on days 1 to 7, 14, 21, and 28 (unless discharged prior). Data points included oral intake, EN and parenteral nutrition support, estimated energy and protein adequacy, and dietetics assessment details. RESULTS: We enrolled 141 children, of which 79 were boys (56%) and 84 were <2 y of age (60%). Thirty children (73%) received solely EN on day 7 with documented energy and protein targets for 22 (73%). Of these children, 14 (64%) received <75% of their estimated requirements. A dietetics assessment was provided to 80 children (57%), and was significantly higher in those remaining in the PICU beyond the median length of stay (41% in patients staying ≤4.6 d versus 72% in those staying >4.6 d; P < 0.001). CONCLUSIONS: This prospective study of nutrition provision across ANZ PICUs identified important areas for improvement, particularly in EN adequacy and nutrition assessment. Further research to optimize nutrition provision in this setting is urgently needed.

Asunto(s)

RESUMEN

Veganism, a way of eating that forbids goods produced from animals, is rising in acceptance around the globe. This thorough analysis investigates how a vegan diet affects fetal growth during pregnancy, highlighting the need to maintain ideal maternal nutrition. The idea of "early life programming" emphasizes how a pregnant woman's lifestyle impacts her unborn child's health. Nutrient consumption during pregnancy makes it essential to have a healthy eating routine. While a carefully thought-out vegan diet may contain all the essential nutrients, some micronutrients need special attention, which may call for supplementation. The study delves into significant findings concerning nutritional adequacy and challenges in the discussion section, highlighting nutrients like calcium, iron, omega-3 fatty acids, vitamin D, and protein. It emphasizes medical professionals' need to monitor and assist vegan expectant mothers in meeting their nutritional needs. The analysis also examines the intricate connection between a mother's health and the outcomes of vegan pregnancies, such as decreased rates of gestational diabetes and hypertension. Examining fetal growth and development further highlights the complexity of this process, as do the contradicting data on birth weights. Furthermore, early data suggest that infants born to vegan moms may benefit cognitively, but further studies are required to prove a causal relationship. In addressing ethical and environmental issues in the review's conclusion, it is acknowledged that these aspects impact pregnant women's food decisions. Given the rising popularity of veganism, it is crucial to offer trustworthy advice to expectant women who are thinking about or already following a vegan diet.

RESUMEN

PURPOSE: Introducing healthy and sustainable diets early in life can promote lifelong healthy dietary patterns with a low environmental impact. Therefore, we aimed to estimate the environmental and nutritional consequences of a dietary change for 2-year-old children in Norway towards healthier dietary patterns. METHODS: Environmental impacts of the current habitual diet among 2-year-olds (n = 1413) were estimated for six impact categories and compared with scenario diets based on the Norwegian food-based dietary guidelines (FBDG) and the EAT-Lancet Commission reference diet. Last, we evaluated the nutritional adequacy of the diets against the Norwegian nutrition recommendations for children aged 2-5 years. The current diet was assessed by an FFQ. RESULTS: Environmental impacts of the current habitual diet were up to two times higher than those of the scenario diets. Compared with the current diet, impacts from the FBDG scenario diet were reduced by 35% for water use and 18% for terrestrial acidification, whereas impacts from the EAT-Lancet scenario diet were reduced by 51% for water use, 57% for terrestrial acidification, 36% for global warming potential and 27% for freshwater eutrophication. Milk and dairy products were the main contributors to environmental impacts in both the current diet and the FBDG scenario diet. The scenario diets were nutritionally adequate and improved the dietary quality among Norwegian 2-year-olds. CONCLUSION: Compared to current diets among young children, more plant-based dietary patterns in line with national FBDG or the EAT-Lancet Commission reference diet can improve the nutritional adequacy of diets and simultaneously reduce environmental impacts.

Asunto(s)

RESUMEN

[This corrects the article DOI: 10.3389/fnut.2022.1056205.].

RESUMEN

INTRODUCTION: Australian healthy food baskets are typically modelled off the Government Guidelines for healthy eating. However, these baskets have not been updated recently, nor has there been a Mediterranean Diet basket developed for an Australian population despite research suggesting high adherence is possible and subsequent health benefits observed. Food baskets typically only present the nutrition profile or the cost of a basket, seldom both. METHODS: Baskets were developed based on the Australian Guide to Healthy Eating, The Mediterranean Diet and typical Australian dietary intake (Western Diet). Four reference families were created based on data from Australian censuses and population statistics. Seven-day meal plans for reference families were entered into Foodworks software and aimed to meet 100% of nutrition and energy requirements. Basket costs were calculated from Coles Australia online. RESULTS: The AGHE basket met all NRVs except for VLCN3 for the 7-year-old male (73% adequate intake). The Mediterranean Diet met all NRVs except zinc (44-year-old male) ranging from 98 to 257% of the RDI. The Western Diet failed to meet NRVs for numerous nutrients. The MedDiet baskets were generally cheaper ($78 for a one-person household to $285 for a four-person household) than AGHE and Western Diet. DISCUSSION: Meeting nutrition requirements over seven days for zinc can be challenging for males. Fortified products provide an opportunity to improve nutrient profile; however, nutrient intake should equilibrate over time. Further, cost saving strategies can increase affordability. This research suggests a MedDiet is not more costly than a typical Western Diet or healthy AGHE diet.

Asunto(s)

RESUMEN

PURPOSE: Modified Nutrition Risk in the Critically Ill (NUTRIC) score (mNUTRIC score) have been validated as screening tool for quantifying risk of adverse outcome critically ill patients admitted to the intensive care units (ICUs). The aim of this study was to evaluate the prognostic value of mNUTRIC score to assess outcomes in this population. MATERIALS AND METHODS: This prospective, observational study was conducted on adult patients admitted to the general ICUs of two university affiliated hospital in northwest of Iran. The association between the mNUTRIC score and outcomes was assessed using the univariate and multivariate binary logistic regression. The performance of mNUTRIC score to predict outcomes was assessed using the receiver operating characteristic (ROC)-curve. RESULTS: In total 445 ICU patients were enrolled. Based on mNUTRIC score, 62 (13.9%) and 383 (86.1%) individuals were identified at high and low nutritional risk, respectively. The area under the curve (AUC) for predicting ICU mortality, using vasopressor, duration of vasopressor, and mechanical ventilation (MV) duration were (AUC: 0.973, 95% CI: 0.954-0.986, P < 0.001), (AUC: 0.807, 95% CI: 0.767-0.843, P < 0.001), (AUC: 0.726, 95% CI: 0.680-0.769, P < 0.001) and (AUC: 0.710, 95% CI: 0.666-0.752, P < 0.001), respectively. CONCLUSIONS: An excellent and good predictive performance of the mNUTRIC score was found regarding ICU mortality and using vasopressor, respectively. However, this predictive was fair for MV and vasopressor duration and poor for ICU and hospital length of stay.

Asunto(s)

RESUMEN

Adopting eco-friendly diets will demand the consumption of more plant-based protein food sources such as legumes. However, assessing the impact of such a dietary shift on the dietary and nutritional intake of traditionally omnivorous populations is needed. The objective of this study was to assess the impact of substituting a traditional omnivorous-based lunch for a vegetarian, legume-based meal on the daily dietary and nutritional intake in a group of omnivorous adults in the city of Porto, Portugal. Nineteen, non-vegetarian, healthy young adults consumed a vegetarian, legume-based meal from Monday to Friday, for 8 consecutive weeks. Socio-demographic data, health status, lifestyle-related information and anthropometric parameters were recorded. Three-day food records were used to collect food intake at baseline and week 8. European Food Safety Authority and World Health Organization reference values were used to assess nutritional inadequacies. Variables were described as medians (P25 and P75 ). Wilcoxon signed-rank and Mann-Whitney tests were used for statistical comparisons. A p-value of <0.05 was considered statistically significant. Participants consumed 38.0 (P25 = 35.0; P75 = 40.0) meals, resulting in an intake of 84.5 g (P25 = 74.9; P75 = 98.4) of cooked legumes per meal, meaning 11 subjects (57.9%) met the Portuguese guidelines for legume consumption (≥80 g/day of legumes). The current dietary intervention did not seem to aggravate the prevalence of nutritional inadequacies for the macro- and micronutrients tested, except for the case of vitamin B12 (52.6% [95% CI: 28.9-75.6] vs. 78.9% [95% CI: 54.4-94.0]). This could be linked to the reduction of dietary sources of this vitamin which is an expected consequence of vegetarian meals. Dietary changes towards grain legume-based diets are desirable yet need to be carefully implemented to prevent exacerbating potential nutrient inadequacies, especially of vitamin B12 .

Asunto(s)

RESUMEN

In the context of the global childhood obesity, it is essential to monitor the nutrition value of commercial foods. A cross-sectional study (November 2018 to April 2019) aimed to evaluate the nutritional adequacy of processed/ultra-processed food products targeted at 0-36-month-old children in Portugal and in Brazil. The nutrient profiling model developed by the Pan American Health Organization was used. A total of food 171 products were assessed (123 in Portugal and forty eight in Brazil). From the fifteen available meat- or fish-based meals in Brazil, 60 % exceeded the amount of Na and 100 % exceeded the target for total fat. Given the lack of specification of sugars within carbohydrates in the label of the foods in Brazil, it was not possible to calculate free sugars. In Portugal, from the seventeen fruit and vegetable purees and the six juice/smoothie/tea/drinks available, 82 % and 67 %, respectively, surpassed the level of free sugar, while total and saturated fat was excessive in all yogurt and yogurt-related products (n 21), 40 % of biscuit/wafer/crisps (two out of five) and 13 % meat- or fish-based meals (two out of sixteen). These findings demonstrate the relevance of improving the nutritional profile of some food products targeted to young children.

Asunto(s)

RESUMEN

Background: Mushrooms are rich in fiber and vitamins B and vitamin D when exposed to UV light and are sometimes used as a meat substitute. A modeling study showed that adding a mushroom portion (84 g/d) to the diet of an American population caused a significant improvement in the intake of several nutrients. Objective: To study the association between habitual intake of mushrooms and nutrient intake and to assess the change in micronutrient intake with the modeled addition of 60 or 84 grams of UV-exposed mushrooms to the diet of the Dutch population, with a subanalysis on subjects with a low animal: plant protein ratio. Methods: A modeling study was conducted in 3121 Dutch persons aged 9-80 y, using cross-sectional data from the Dutch National Food Consumption Survey 2012-2016. Linear regression was used to explore the association between habitual intake of mushrooms and nutrients. Habitual intake and nutritional adequacy were calculated before and after the modeled addition of mushrooms. Results: A small association was observed between the habitual intake of mushrooms and the intake of copper, niacin, and vitamin B2 (beta ranging from 0.002 to 0.039). The modeled addition of UV-exposed mushrooms increased the intakes of plant protein (by 5-7%), fiber (4-6%), niacin (10-20%), vitamin D (176-388%), folate (11-17%), potassium (6-10%), and copper (29-48%). Nutritional adequacy also improved significantly. For subjects with a low animal:plant protein ratio, the added mushrooms increased the intakes of niacin (11-22%), potassium (6-11%), and vitamin D (190-445%). Conclusions: Consumption of mushrooms contributes to higher intakes of copper, niacin, and vitamin B2. Addition of UV-exposed mushrooms to the diet of the Dutch further improves nutrient intakes and, most notably, vitamin D, especially for people with low animal food consumption.

RESUMEN

Background: Micronutrient malnutrition is a serious public health problem in most developing countries, including Morocco, due to poor and therefore lower quality diets that lack dietary diversity. Objective: The present study aimed to assess dietary diversity and variety and their relationship with micronutrient adequacy in children and adolescents with type 1 diabetes (T1D). Materials and methods: A cross-sectional study was carried among 240 children and adolescents with T1D. Weight and height were measured and BMI was calculated. Dietary intake data were obtained from two 24-h recalls. A Dietary diversity (DDS) and dietary variety scores (DVS) and mean adequacy ratio (MAR) and nutritional adequacy ratios (NARs) were calculated and compared according to sociodemographic/anthropometric categories. Results: 52.1% of the patients were female. The mean age of the patients was 8.49 ± 4.1 years. The mean BMI was 19.44 ± 5.24 kg/m2; the mean DDS was 4.62±1.20 and the mean MAR was 0.66 ± 0.11. Older children living in rural areas have a low DDS/DVS. Parental education and income level are associated with DDS/DVS. General and central obesity were significantly elevated in children with high DDS. In addition, a high intake of vegetables, eggs, fiber and micronutrients (Magnesium, Calcium, Potassium, Zinc, Phosphorus and Vit B1) is associated with a high DDS; however, high DVS is associated with high consumption of dairy products, carbohydrates and low intake of protein and fat. There are also positive correlations between DDS/DVS and NARs for various nutrients. Conclusion: The quality of the respondents' diets are moderately diversified. DDS or DVS can be used as indicators of micronutrient adequacy in Moroccan T1D children. Nutritional education needs to be strengthened to improve dietary diversity in children, especially in rural areas.

Asunto(s)

RESUMEN

Dietary diversity might be essential to meet nutritional demands during adolescence. Diet diversity among 818 urban and rural Costa Rican adolescents aged 13−18 years was studied using the Minimum Dietary Diversity Score for Women. The Nutrient Adequacy Ratio (NAR) was calculated for 11 nutrients to estimate the nutrient adequacy of the diet. A NAR < 0.7 was considered inadequate for micronutrient intake. The optimal Diet Diversity Score (DDS) cut-off point for this study was 4, established using receiver-operating characteristic curves. The mean DDS for the overall sample was 4.17 ± 1.43, although DDS was significantly higher in adolescents from rural vs. urban areas (4.33 ± 1.43 vs. 4.00 ± 1.42, p-value = 0.001). The odds of having a diverse diet were 62% higher in rural vs. urban adolescents. Overall, 80−95% of adolescents reached a NAR ≥ 0.70 for 8 nutrients except for calcium, zinc, and vitamin A. The residence area plays a key role in adolescent dietary diversity. Although overall DDS was low, foods that make up the rural adolescent diet were nutritionally dense enough to satisfy the EAR for most micronutrients. A high DDS is not necessarily required for the diet to meet most micronutrient demands in adolescence. Improved dietary adequacy of vitamin A, zinc, and calcium is required due to the importance of these micronutrients in maintaining optimal health.

Asunto(s)