BACKGROUND: Due to cognitive impairments, people with dementia (PWD) often have difficulties in eating and drinking. This study aimed to assess the nutritional status, dietary quality and eating disturbance issues among PWD in Vietnam.
METHODS: We conducted a cross-sectional study at the Vietnamese National Geriatric Hospital from April to December 2022. We used Mini-Mental State Exam (MMSE) to classify the severity levels of dementia. Mini Nutritional Assessment (MNA), 24-hour recall, eating disturbance questionnaires, and anthropometric indicators were used to evaluate the nutritional status, dietary quality, and eating disorders of study subjects.
RESULTS: Overall, among 63 study participants, 74.6 per cent of PWD were at risk of or having malnutrition. By dementia classification according to MMSE scale, people with moderate and severe dementia accounted for 53.3 per cent of those who met the recommended energy levels, compared to 42.4 per cent of people with mild dementia and normal people. In the above two groups, around three per cent of participants reached the recommended amount of fibre. Calcium (50-70%), vitamin A (80-90%), and D (90%) were found to be the most severe deficiency forms of minerals and vitamins in both male and female participants. The majority of participants (90.5%) had at least one form of eating disorders with the most frequent issue being appetite changes (76.2%) and swallowing issues (50.8%).
CONCLUSIONS: PWD in our sample frequently experienced malnutrition, a lack of essential nutrients, difficulties swallowing, changes in eating habits and appetite. It is neccesary to early screen and assess nutritional status and swallowing disturbance in PWD, and instruct their caregivers to prepare nutritious meals for them.

BACKGROUND: Poor dietary quality is a risk factor for diet-related chronic disease and suboptimal nutritional patterns often begin early in the life course. While the dietary intakes of young children, adolescents, and middle-aged and older adults are well established, much less is known about emerging adults, who represent a unique timepoint in life, as they are undergoing significant changes in food environments, autonomy, finances, and caregiver and parental involvement.
OBJECTIVE: To examine dietary quality, as assessed via the Healthy Eating Index (HEI), by demographic, socioeconomic, and health-related characteristics among U.S. emerging adults (18-23y) who participated in the 2015-2018 National Health and Nutrition Examination Survey (NHANES).
METHODS: NHANES data were collected via a household interview and 2 24-hour dietary recalls (24HR). Usual dietary intakes from the 24HRs were approximated using the multivariate National Cancer Institute Method to compute mean HEI-2015 overall and component scores (range 0-100, higher scores indicating higher dietary quality).
RESULTS: Overall dietary quality among U.S. emerging adults [HEI-2015: 50.3±1.3] was significantly lower than other U.S. adults (≥24y) [HEI-2015: 56.3±0.5; p<0.0001], with differences primarily driven by lower intakes of whole fruit, vegetables, and whole grains, and higher intakes of sodium, refined grains, and saturated fat. Few differences in HEI-2015 scores were noted across population subgroups by sex, food security, family income, and food assistance program participation, except for added sugar; intakes of added sugar were significantly higher among women, food insecure, and food assistance program participants as compared to their counterparts, respectively.
CONCLUSIONS: Dietary quality is poor among U.S. emerging adults and persists across all population subgroups, suggesting a significant need for tailored public health interventions to improve dietary quality among this population. Future research investigating to what extent emerging adults prioritize healthful behaviors and exploring other indicators for identifying nutritionally vulnerable subgroups may be impactful for identifying disparities among this life stage.

The association between dietary quality and type 2 diabetes mellitus (T2DM) based on the Chinese Dietary Balance Index (DBI-16) is seldom reported. We hypothesized that poor dietary quality might increase the risk of T2DM in the middle-aged and older populations. A total of 1816 individuals (≥50 years) were included in the study. Demographic characteristics and dietary intake data were collected. Logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DBI-16 indexes and the risk of T2DM. The insufficient intake of vegetables and dairy might decrease the risk of T2DM (ORVegetable = 0.77, 95% CI = 0.60-0.97; ORDairy = 0.58, 95% CI = 0.35-0.96), but the individuals with insufficient intake of fruit were more likely to have a higher risk of T2DM (ORfruit = 2.26, 95% CI = 1.69-3.06). Compared with the subjects with the lowest quartile of Low Bound Score (LBS) or Diet Quality Distance (DQD), the individuals with Q2 and Q3 level of LBS (ORQ2 = 1.40, 95% CI = 1.03-1.90, P = .033; ORQ3 = 1.52, 95% CI = 1.11-2.08, P < .01) or DQD (ORQ2 = 1.45, 95% CI = 1.06-1.99, P = .021; ORQ3 = 1.64, 95% CI = 1.20-2.24, P < .01) showed increased risk of T2DM with a nonlinear association observed by RCS analysis. We concluded that imbalanced dietary intake, especially insufficient daily fruit intake, might predict an increased risk of T2DM in the middle-aged and elderly Chinese.

The success of conservation programs for the taruka (Hippocamelus antisensis d\'Orbigny), an endemic and endangered deer, depends on many factors, highlighting anthropogenic and ecological effects. Among the latter, how this herbivore interacts with forage resources is important. The objective of the study was to describe the main attributes of the diet of this deer in rangelands adjacent to agricultural areas of the foothills of the Tarapacá Region, Chile. The botanical composition of the diet (BCD) was determined by microhistology of feces and fecal nitrogen (NF, %) was measured in two contrasting seasons (rainy summer and dry winter). From the BCD and FN, their relative diversity (J) and crude protein percentage were estimated. In the BCD, Medicago sativa dominated (27.6 ± 8.2% vs. 53.9 ± 9.2%, in rainy summer and dry end winter, respectively), followed by herbaceous dicots (46.2 ± 9.4% vs. 19.4 ± 8.7%) and shrubby species (21.5 ± 7.8% vs. 23.4 ± 7.0%), from rangelands. The contribution of grasses and graminoid species was low, not exceeding 3% and 0.4% of the diet, respectively, with no differences between seasons of the year. Intake of horticultural crop species was marginal (1.3 ± 1.3%), being detected only in the wet season. Diet relative diversity was higher during the wet period (0.75 ± 0.07) compared to the dry period (0.58 ± 0.06), since in the first period it was possible to find a greater number of palatable species. There were no significant differences in the FN attributed to the time of the year (average of 1.8 ± 0.19%), which indicates that the diet of this deer would be stable in terms of its protein quality. These FN levels estimate sufficient dietary protein content to satisfy maintenance and early pregnancy, but these could be limiting during late gestation and lactation.

OBJECTIVE: To investigate the situation of women's dietary quality during pregnancy and explore the correlations between maternal dietary index and fetal immune function.
METHODS: From September 2010 to February 2011, pregnant women who had routine physical examination in Yuexiu District and Baiyun District Maternal and Child Health Hospital of Guangzhou were recruited as study objects to use 3-day 24-hour dietary review to investigate diet during pregnancy, and general demographic information of pregnant women was collected through questionnaire, and the neonatal umbilical cord blood was collected during delivery. Laboratory detection of immunological indicators included IgG, IgA, IgM, IFN-γ and IL-6. The quality of diet during pregnancy was evaluated by diet quality index for pregnancy(DQI-P), dietary balance index for pregnancy(DBI-P) and alternate Medierranean diet score(aMED). Spearman correlation analysis and multiple linear regression analysis were used to explore the correlations between dietary quality during pregnancy and fetal immune function.
RESULTS: The mean score of total DQI-P score of the study subjects was 55.8±10.0, and the mean score of overall food diversity and protein food source diversity was as high as 12.0±2.4 and 4.8±0.7. The mean score of nutrient energy ratio and fatty acid energy ratio was only 0.3±1.0 and 0.4±1.0, indicating that the population had good dietary diversity during pregnancy, but the dietary adequacy, suitability and balance were poor. The total score of DBI-P score was-19.2±9.4. The positive end score was 4.6±2.9, only 7.2% of the subjects had a high degree of dietary intake during pregnancy. The negative end score was 23.9±7.9, indicating the status of moderate dietary intake. Dietary quality was 28.5±7.1. Only 0.6% of the study population had a balanced dietary situation, and more than 67.9% of pregnant women had high intake imbalance. The mean total score of aMED score was 4.9±1.3, and the proportion of the food intake of beans and nuts was less than the median population was 62.5% and 79.1%, respectively, indicating that the food intake of beans and nuts was insufficient in this population. After adjusting for confounding factors such as maternal age, parity, parity, prepregnancy BMI, weight gain during pregnancy, and mode of delivery, multiple linear regression analysis showed DQI-P during pregnancy and negatively with IL-6(β=0.143, β=-0.155, P<0.05). DBI-P was negatively associated with IL-6(β=-0.177, P<0.01) and aMED and IFN-γ(β=-0.161, P<0.01).
CONCLUSIONS: The dietary quality of women in late pregnancy in Guangzhou is low, the dietary structure is unbalanced. Higher dietary quality during pregnancy can promote the development of fetal immune system and improve fetal immune function.

UNASSIGNED: Adolescent nutrition has faced a policy neglect, partly owing to the gaps in dietary intake data for this age group. The Food Recognition Assistance and Nudging Insights (FRANI) is a smartphone application validated for dietary assessment and to influence users toward healthy food choices.
UNASSIGNED: This study aimed to assess the feasibility (adherence, acceptability, and usability) of FRANI and its effects on food choices and diet quality in female adolescents in Vietnam.
UNASSIGNED: Adolescents (N = 36) were randomly selected from a public school and allocated into 2 groups. The control group received smartphones with a version of FRANI limited to dietary assessment, whereas the intervention received smartphones with gamified FRANI. After the first 4 wk, both groups used gamified FRANI for further 2 wk. The primary outcome was the feasibility of using FRANI as measured by adherence (the proportion of completed food records), acceptability and usability (the proportion of participants who considered FRANI acceptable and usable according to answers of a Likert questionnaire). Secondary outcomes included the percentage of meals recorded, the Minimum Dietary Diversity for Women (MDDW) and the Eat-Lancet Diet Score (ELDS). Dietary diversity is important for dietary quality, and sustainable healthy diets are important to reduce carbon emissions. Poisson regression models were used to estimate the effect of gamified FRANI on the MDDW and ELDS.
UNASSIGNED: Adherence to the application was 82% and the percentage of meals recorded was 97%. Acceptability and usability were 97%. MDDW in the intervention group was 1.07 points (95% CI: 0.98, 1.18; P = 0.13) greater than that in the control (constant = 4.68); however, the difference was not statistically significant. Moreover, ELDS in the intervention was 1.09 (95% CI: 1.01, 1.18; P = 0.03) points greater than in the control (constant = 3.67).
UNASSIGNED: FRANI was feasible and may be effective to influence users toward healthy food choices. Research is needed for FRANI in different contexts and at scale.The trial was registered at the International Standard Randomized Controlled Trial Number as ISRCTN 10681553.

UNASSIGNED: Internet use is changing nutritional intake and health outcomes, but the results are mixed, and less attention is given to the rural developing regions. Based on the China Health and Nutrition Survey (CHNS) data from 2004 to 2015, this study seeks to better understand the effect of Internet use on nutritional intake and health outcomes.
UNASSIGNED: An instrumental variable estimation is used to address endogeneity problem.
UNASSIGNED: The results show that Internet use improves the dietary knowledge of rural residents, and thus has a positive impact on dietary quality, such as healthy eating index (HEI) and dietary diversity score (DDS). The higher the dietary quality, the better the nutritional health status. However, results also show that Internet use increases the risk of overweight, and obesity among rural Chinese residents. Because Internet use has significantly reduced the physical activity of rural residents in China. Interestingly, we also find that the Internet increases the risk of chronic diseases such as diabetes and high blood pressure, but there is a positive causal relationship between Internet use and the self-assessment score of health.
UNASSIGNED: Our findings suggest that there may be a serious lack of awareness of the health risks of chronic diseases among Chinese rural residents. Therefore, policymakers are suggested to consider the possible negative effects when promoting digital development.

OBJECTIVE: To evaluate the dietary quality of the rural elderly aged 65 years and above.
METHODS: In February-March 2023, a convenience sampling method was adopted to select 454 rural elderly aged 65 years and above in a township of Luzhou City. The dietary survey was conducted using a semi-quantitative food frequency questionnaire(FFQ-25), and the questionnaire information was collected by face-to-face interviews. Dietary quality was evaluated using the Dietary Balance Index-16(DBI-16) score.
RESULTS: The proportion of older people in the region with moderate and high dietary imbalances was 79.7%. Inadequate and excessive dietary intake coexisted. The average daily intake of cereals and potatoes and livestock and meat foods were 356.7 g and 76.2 g, exceeding the recommended intake. The average daily intake of fruit, milk and fish and shrimp intake was 22.8 g, 36 g and 3.7 g, respectively, which was only 10% of the recommended amount, and the intake was seriously insufficient. In addition, the degree of food diversity is relatively low, with most of the average daily intake of food types ranging from five to eight, and only 4.6% of the elderly having more than eight. A total of seven dietary patterns were found among the rural elderly in the region, including a certain degree of under-consumption pattern, a severe under-consumption pattern, a certain degree of over-consumption pattern, and a pattern of both under-consumption and over-consumption. That was dominated by the pattern of severe underconsumption and the pattern of some degree of underconsumption and higher degree of overconsumption, which accounted for 72.3% of the total.
CONCLUSIONS: The rural elderly aged 65 years and above in Luzhou City have a serious dietary imbalance, with a high proportion of insufficient intake of vegetables, fruits and milk, as well as aquatic products and eggs; and excessive intake of livestock, poultry, meat and cereals and potatoes.

UNASSIGNED: Metabolic dysfunction-associated fatty liver disease (MAFLD) is presently the most prevalent chronic liver disorder globally that is closely linked to obesity, dyslipidemia metabolic syndrome, and type 2 diabetes mellitus (T2DM). Its pathogenesis is strongly associated with inflammation, and diet is a major factor in reducing inflammation. However, current research has focused primarily on exploring the relationship between diet and NAFLD, with less research on its link to MAFLD.
UNASSIGNED: In this research, using dietary inflammatory index (DII) as a measure to assess dietary quality, we analyzed the relationship between diet and MAFLD. Data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, including 3,633 adults with complete DII and MAFLD, were used to develop cross-sectional analyses. Logistic regression analysis was adapted for investigating the relationship between DII and MAFLD development. Additionally, subgroup analysis and threshold effect analysis were carried out.
UNASSIGNED: A positive link between DII and MAFLD was found in the fully adjusted model (OR = 1.05; 95%CI, 1.00-1.11, p < 0.05). Subgroup analysis indicated that there was no significant dependence for the connection between DII and MAFLD except for the subgroup stratified by age. Compared with other age groups, people with MAFLD had 20% higher DII scores than non-MAFLD participants in those aged 20-41 years old (OR = 1.20; 95%CI, 1.08-1.33, p < 0.001). Furthermore, we found a U-shaped curve with an inflection point of 3.06 illustrating the non-linear connection between DII and MAFLD.
UNASSIGNED: As a result, our research indicates that pro-inflammatory diet may increase the chance of MAFLD development, thus improved dietary patterns as a lifestyle intervention is an important strategy to decrease the incidence of MAFLD.

Food security (FS) is a powerful social determinant of health (SDOH) and is crucial for human and planetary health. The objectives of this article are to (i) provide clarity on the definitions of FS and nutrition security; (ii) provide a framework that clearly explains the links between the two constructs; (iii) summarize measurement approaches, and (iv) illustrate applications to monitoring and surveillance, policy and program design and evaluation, and research, mainly based on the ongoing rich experience with food insecurity (FI) scales. A clear and concise definition of FI and corresponding frameworks are available. There are different methods for directly or indirectly assessing FI. The best method(s) of choice need to be selected based on the questions asked, resources, and time frames available. Experience-based FI measures disseminated from the United States to the rest of the world in the early 2000s became a game changer for advancing FI research, policy, program evaluation, and governance. The success with experience FI scales is informing the dissemination, adaptation, and validation of water insecurity scales globally. The many lessons learned across countries on how to advance policy and program design and evaluation through improved FS conceptualization and measurement should be systematically shared through networks of researchers and practitioners.