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At least 19 recordsLinked to original sources

Impacts of climate-driven yield changes on the affordability of healthy diets: a modelling study.

BACKGROUND: Food security is central to global nutrition improvement and public health goals, and healthy diets represent a higher-level aspiration beyond merely avoiding hunger. Climate change poses an increasing threat to food systems by affecting crop yields and food prices. Although climate change-driven risks to hunger have been widely studied, the extent to which climate change undermines the affordability of healthy diets while accounting for socioeconomic responses and regional inequalities remains insufficiently understood. This study aimed to quantify the effects of climate change on the future affordability of healthy diets under alternative socioeconomic and climate scenarios. METHODS: We developed an integrated modelling framework that explicitly couples multimodel crop-yield projections with an integrated assessment model (Global Change Analysis Model [GCAM]). Yield responses from six global gridded crop models driven by four climate models were integrated into GCAM, allowing endogenous socioeconomic adjustments such as land-use shifts, production reallocation, and price responses to emerge under shared socioeconomic pathways (SSPs). Diet affordability was then assessed using the Food and Agriculture Organization of the UN's Cost and Affordability of a Healthy Diet framework across three socioeconomic-climate scenarios (SSP1-2.6, SSP2-4.5, and SSP3-6.0). FINDINGS: Under a high-emissions pathway (ie, SSP3-6.0), climate change was projected to render healthy diets unaffordable for a model-mean of 119 million people globally by 2100, even when CO2 fertilisation effects are included, with the upper end of the model ensemble reaching about 1·6 billion people. In contrast, climate-induced affordability losses were found to be negligible under both a low-emissions pathway (ie, SSP1-2.6; -0·3 million) and a medium-emission pathway (SSP2-4.5; +0·2 million). Under a high-emission pathway, model-mean projections indicated that diet costs could increase by up to 12% in the most affected regions by the end of the century. Under medium emissions, cost increases were projected to remain below 4%, whereas under low emissions, affordability changes were projected to be minimum across regions (within approximately 0·5%). Substantial regional disparities emerged, with the largest and most consistent affordability losses concentrated in low-income regions that contributed least to historical greenhouse gas emissions. Under SSP3-6.0, these disparities persisted particularly in regions of Africa and Asia despite projected three-to-five-fold increases in income over the century, with climate-induced disruptions to food systems increasing the number of people unable to afford a healthy diet through mid-century. INTERPRETATION: Climate change is likely to exacerbate global nutritional inequalities by disproportionately increasing the affordability risks of healthy diets in regions that have contributed least to historical greenhouse gas emissions. Under high-warming scenarios, socioeconomic development alone is insufficient to fully offset these risks, highlighting the structural vulnerability of low-income food systems to climate-driven price shocks. These findings suggest that in the absence of targeted interventions, climate change could continue to undermine progress towards equitable and health-oriented nutrition outcomes. FUNDING: Ministry of Science and Technology of the People's Republic of China; National Natural Science Foundation of China; National Aeronautics and Space Administration Goddard Institute for Space Studies Climate Impacts Group; Future of Life Institute; and Global Alliance for Improved Nutrition.

Journal Article

Low-burden metrics for monitoring healthy diets among nonpregnant females aged 15 to 49 years: a multicountry validation analysis using quantitative 24-hour dietary intake data.

BACKGROUND: Limited nationally representative quantitative dietary intake data and a lack of consensus on lower-burden tools and metrics hinder high-frequency monitoring of healthy diets globally. OBJECTIVES: This study aimed to evaluate the comparative construct validity and potential complementarity of low-burden metrics of a healthy diet among nonpregnant females aged 15 to 49 y. METHODS: Quantitative 24-h dietary intake data collected from 77,118 adolescent and adult females across 27 countries were used to construct low-burden metrics and reference metrics of dietary intake. Associations between mean-standardized low-burden measures or indicators and reference metrics were assessed using linear and logistic mixed-effect models, with Spearman's &#x3c1; used for survey-level rank correlations. Test characteristics identified low-burden indicators best differentiated adherence to reference indicators. RESULTS: An indicator reflecting nonconsumption of sweet foods and/or sweet beverages was most robustly associated with greater adherence to <10% energy from free sugars in upper-middle-income countries {odds ratio [OR] [95% confidence interval (CI)]: 5.35 [5.05, 5.66]}. Food group diversity score (FGDS) was most strongly associated with and differentiated higher mean adequacy ratio of micronutrients [&#x3b2; of 1-standard deviation (SD) change: &#x223c;11 percentage points (9, 12); &#x3c1;: 0.79], whereas noncommunicable disease-Protect score best reflected consumption of &#x2265;400 g/d of fruits and vegetables [range OR of 1-SD changes (95% CI): 2.56-3.01 (2.40, 3.13) in lower-middle and high-income countries, respectively; &#x3c1;: 0.56]. FGDS and Global Diet Quality Score Positive were most consistently associated with achieving &#x2265;25 g/d of fiber and &#x2265;3510 mg/d of potassium across contexts. CONCLUSIONS: Low-burden data collection tools yield valid metrics, enabling high-frequency monitoring of healthy diets across contexts. Specifically, avoiding sweet foods and/or sweet beverages is an indicator for adherence to WHO free sugar guidelines among nonpregnant females in upper-middle-income countries, whereas metrics reflecting nutritious food group diversity strongly reflect better micronutrient adequacy and adherence to WHO guidelines for fruits and vegetables, fiber, and potassium intakes within and across contexts.

Humans

Sustainable dietary recommendations for the Spanish population.

BACKGROUND/OBJECTIVES: The 2030 Agenda for Sustainable Development highlights the urgent need for a profound transformation in food production and consumption to enhance both sustainability and human health. The aim of this study is to provide both the general population and food system stakeholders with the most comprehensive and current information available on healthy and sustainable dietary patterns, in the form of culturally adapted food-based guidelines. METHODS: We performed a systematic review of the scientific evidence published since 2019 on the association between main food groups consumption and the risk of developing chronic diseases and premature mortality to update the information provided by the Dietary Guidelines for Americans 2020-2025, which summarized previous evidence. With this information, we updated the servings recommended in the former dietary guidelines for Spain. Then, we considered the recommendations of the EAT-Lancet Commission for healthy diets within planetary boundaries, specific dietary habits and food production in Spain, and adjusted the servings per each group to consider these characteristics. RESULTS: A minimum intake of 5 servings of vegetables and fruits per day is recommended, which may be distributed in at least 3 servings of vegetables per day, and 2-3 servings of fruits per day. Cereal consumption is set at 3-6 servings per day, adjusted to individual energy needs and prioritizing whole grains, no more than 4 servings per day are advised in cases of caloric restriction. Plant-based foods are recommended as the primary protein source, with legumes incorporated into at least one main daily meal and consumed at a frequency of at least 4 servings per week, ideally up to daily. Nut consumption should reach at least 3 servings per week, up to one serving per day, choosing those without added salt, fats or sugar. The remaining protein portions may include fish (&#x2265;3 servings/week, prioritizing oily fish and low-impact species), eggs (up to 4/week), dairy (up to 3/day, with low-sugar and low-salt options), and meat (up to 3/week, emphasizing poultry and rabbit, and minimizing processed meats). Daily consumption of olive oil at main meals is recommended. CONCLUSIONS: The proposed Sustainable Dietary Recommendations can help improve the health and well-being of the Spanish population, while reducing the environmental impact.

Humans

Hypocholesterolemic effect of substituting soybean protein for animal protein in the diet of healthy young women.

The effect of dietary protein on the level of plasma cholesterol in young, healthy, normolipidemic women was investigated in two separate studies by feeding either a conventional diet containing mixed protein, or a plant protein diet in which the animal protein of the first diet was replaced by soy protein meat analogues and soy milk. The diets were similar with respect to carbohydrate, fat and sterol composition. The first study, lasting 73 days and involving six subjects, gave an indication that plasma cholesterol levels were lower on the plant protein diet. The second study, which incorporated a number of improvements based on experience, lasted 78 days and used a cross-over design involving two groups of five subjects each. In this study, the mean plasma cholesterol level was found to be significantly lower on the plant protein diet.

Adult

Role of bioprocessing in modifying cardiometabolic outcomes of an oat-based dairy alternative in a randomised controlled clinical intervention.

BACKGROUND & AIMS: A healthy diet rich in fibre-containing foods such as oats supports cardiometabolic health. Bioprocessing methods, including fermentation and enzymatic treatment, may further enhance the health benefits of oat-based foods by altering their physicochemical properties. The aims of this study were to investigate the effects of consuming fermented and non-fermented oat-based products enriched with fibre and protein on cardiometabolic outcomes gastrointestinal symptoms, and to consider how assessed physicochemical and nutritional differences between the products might relate to any observed effects. METHODS: In a 12-week randomised crossover trial, 56 adults with mild metabolic deterioration consumed fermented (gurt) and non-fermented (porridge) oat-based products enriched with fibre and protein as part of their habitual diet for three weeks each. The study products were specifically developed and prepared for this study using identical ingredients. Primary cardiometabolic factors and gastrointestinal symptoms (GSRS) were measured at four time points, while secondary outcomes were assessed at baseline and after both product periods. Physicochemical and nutritional characterization of the study products included cereal &#x3b2;-glucan (BG) and protein molecular weight distribution, starch and sugar analysis, microscopy, acidity, and viscosity. RESULTS: During the gurt consumption, non-high-density lipoprotein (non-HDL) and low-density lipoprotein (LDL) cholesterol concentrations decreased (-0.15 &#xb1; 0.51 mmol/L, p = 0.028; and -0.12 &#xb1; 0.46 mmol/L, p = 0.047, respectively), with a minimal impact on blood pressure and GSRS scores. Additionally, ferritin was lower after the gurt compared with baseline (-4.00 [-16.50, 6.25] &#x3bc;g/L, p = 0.015). Similarly, ferritin levels were lower after the porridge period (-7.50 [-20.50, 4.25] &#x3bc;g/L), accompanied with a modest decrease in blood pressure and HbA1c. These effects, however, did not substantially differ between the product periods. Insulin showed a significant sequence effect (psequence&#x2217;time <0.05) and was analysed in sequence groups. Insulin levels significantly decreased during the gurt consumption in the group that started with the porridge (-2.22 &#xb1; 6.16 mU/L, p = 0.015). Fermentation and enzymatic treatment induced significant changes in BG MW, starch, and composition in the gurt, which may alongside with increased fibre intake during the intervention explain the observed results. CONCLUSION: Consuming a fermented, oat-based gurt as part of habitual diet may improve cholesterol metabolism, likely due to increased oat fibre intake rather than fermentation as such. Moreover, greater intake of oat-based products, regardless of processing, can reduce ferritin concentrations and marginally improve other cardiometabolic factors. The study was registered in ClinicalTrials.gov as NCT06393114.

Humans

Diet modulates cardiac metabolic stress during anthracycline treatment.

Diet is a modifiable determinant of cardiovascular risk and may influence tolerance to cancer therapies. The mechanisms by which specific dietary components affect cardiac metabolism during anthracycline treatment remain poorly defined, limiting the incorporation of dietary recommendations into treatment guidelines. Here, we integrated heart proteomics data from patients treated with or without anthracyclines with a genome-scale reconstruction of human cardiac metabolism (CardioNet). Using constraint-based flux analysis, we conducted >30,000 in silico simulations of diet scenarios generated from chemical profiles of &#x223c;500 foods curated in the Periodic Table of Food Initiative. These simulations revealed that diets enriched in rapidly absorbable sugars and depleted of essential fatty acids impair cardiac metabolic efficiency, increasing reactive oxygen species production and the demand for purine salvage fluxes. These predicted metabolic patterns were consistent with plasma metabolomics from patients treated with anthracyclines, validating our findings. Computational modeling of 39 recipes across six cuisines revealed cardiometabolic effects of omnivorous versus vegan diets in patients. Modeling of a healthy vegan diet increased cardiometabolic efficiency compared with a healthy omnivorous diet in patients treated with anthracyclines, independent of the culinary background. Our approach demonstrates that integrating the molecular composition of food with genome-scale metabolic models enables systematic analysis of diet patterns for translational testing. Ultimately, these in silico studies provide a framework for trials and may inform dietary recommendations for improving cardiometabolic health.NEW & NOTEWORTHY We developed a systems biology framework to predict how diet influences cardiac metabolism during cancer therapy. Across >30,000 in silico diet simulations, we identified nutrient patterns that either exacerbate or mitigate anthracycline-induced metabolic stress. These findings demonstrate how computational modeling can uncover diet-metabolism interactions driving cardiotoxicity and guide dietary interventions.

Humans

[Possibilities of calculating the fat-free body mass and its reaction to a carbohydrate-poor, fat-rich diet].

9 healthy medical students got an isocaloric fat-rich carbohydrate-reduced diet during 14 days. Body-weight and lean body mass were registrated. We calculated lean body mass from measurement of skinfold thickness, total body potassium and total body water. Body-weight was reduced highly significantly by 3.4 kg on an average. Body potassium and body water remained unchanged. It can be concluded from these results that weight loss was caused by an exclusive reduction of the fat mass.

Adult

The development of essential fatty acid deficiency in healthy men fed fat-free diets intravenously and orally.

The hypothesis that clinical and biochemical essential fatty acid deficiency (EFA) might occur from the feeding of eucaloric, fat-free diets was tested in two experiments in healthy men. In Study I, eight men were given fat-free, eucaloric diets containing 80% of calories as glucose and 20% as amino acid hydrolysates by a constant drip over a 24-h period. The diets were fed in succession for periods of 2 wk each, either through a superior vena cava catheter or via a nasogastric tube. EFA deficiency was detected by decreases in linoleic acid and by the appearance of 5, 8, 11-eicosatrienoic acid in lipid fractions of plasma. Linoleic acid decreased significantly during 2 wk of the fat-free diet given intravenously from 48.8 to 9.8% (percent of total fatty acids) in cholesterol esters, from 21.2 to 3.2% in phospholipids, from 9.6 to 2.0% in free fatty acids, and from 14.1 to 2.6% in triglycerides. Eicosatrienoic acid, normally undetectable, appeared 0.6% in cholesterol esters, 2.5% in phospholipids, 0.2% in free fatty acids, and 2.3% in triglycerides. EFA deficiency occurred similarly during the nasogastric feeding. In Study II a subject received the same diet continuously by the nasogastric route for 10 days followed by a 24-h fast. He was then given the fat-free diet intermittently in three meals per day for 3 days. Finally, he was repleted with a diet containing 2.6% linoleic acid. By the 3rd day of the continuous nasogastric feeding, linoleic acid had fallen significantly and eicosatrienoic acid had appeared in plasma lipid fractions as in Study I. These findings were accentuated by day 10. Adipose tissue fatty acid composition did not change. Free fatty acid outflow from adipose tissue was presumably suppressed during the 10 days of continuous feeding. With increased free fatty acid outflow during fasting and intermittent feeding, linoleic acid rose and eicosatrienoic acid decreased. After 13 days of repletion with dietary linoleic acid, the EFA deficiency readily develops when fat-free diets containing glucose are given intravenously or orally as constant 24-h infusions. These diets are similar to the hyperalimentation formulas now being used clinically.

Adipose Tissue

Development, feasibility, acceptability, and preliminary impact of NutriSOS&#xae;: A behavioral mobile app to promote sustainable diets.

The primary objective of this study was to describe the development of the NutriSOS&#xae; app and to evaluate its feasibility and acceptability for its use in the NutriSOS&#xae; Randomized Controlled Trial (RCT) to promote sustainable diets. A secondary objective was to explore preliminary changes in dietary and physical activity behaviors and environmental impact following app use. The NutriSOS&#xae; app integrates personalized dietary advice, educational content, self-monitoring, and social interaction features. A single-arm, pre-post pilot study was conducted in 37 young Mexican adults over four weeks. Feasibility, acceptability, quality, and usability were assessed using online surveys, alongside exploratory changes in dietary and physical activity behaviors, environmental indicators, and their association with perceived behavioral determinants. Feasibility and acceptability were high overall, with favorable responses reaching up to 100% in key components such as the nutritional guide and learning modules, and above 90% for messaging, registration, and design. Greater variability was observed in some sections, particularly the 24-h recall (41-86%). Reductions in red and processed meat and ultra-processed food consumption were observed (from 3 to 1 times/week, p&#xa0;<&#xa0;0.01), with &#x223c;60% decreases in their related environmental footprints (p&#xa0;<&#xa0;0.01) and favorable self-reported behavioral determinants (p&#xa0;<&#xa0;0.0001). Physical activity type and intensity changed (p&#xa0;<&#xa0;0.05). These findings support NutriSOS&#xae; as a feasible and acceptable tool, while highlighting areas for refinement, particularly those related to the time and effort required for data entry, prior to its implementation in the NutriSOS&#xae; RCT, in which its effectiveness will be formally evaluated.

Humans

The effect of a fish diet on serum lipids in healthy human subjects.

A cross-over study was done with 19 male and 23 female volunteers living in a monastery and a convent, respectively. The effect of a fat gish (mackerel) diet on the blood serum lipid composition was studied. As the normal diet of these volunteers was of the lacto-ovo-vegetarian type, a control diet in which the fish was replaced by full-fat cheese was used. Subjects consuming the fish diet had a daily uptake of polyunsaturated acids of the omega3 family of about 8 g; comparable amounts of linoleic acid were ingested with both diets. Both diets were consumed for a period of 3 weeks. Serum cholesterol was slightly but significantly (7.5%) lower and serum triglycerides considerably lower (35%) on the fish diet, whereas high density lipoprotein cholesterol increased slightly. Lipoprotein analysis showed a strong very low density lipoprotein decrease by the fish diet while, in the men, both low and high density lipoproteins increased. The fatty acid composition of serum lipids showed considerable differences; C20:5omega3 increased in all fractions and C22:6omega3 was found in the triglycerides and the phospholipids, but not in the sterol esters. These increases occurred chiefly at the expense of C18:1omega9 and, in particular, C18:2omega6, which indicates a replacement of omega6 by omega3 acids. Long-chain monoenoic acids which are abundant in the mackerel were not detected in any serum lipid fraction.

Adult

Serum lipid response to a high-caloric, high-fat diet in agricultural workers during 12 months.

The effect of a gluttony diet in healthy subjects was studied over an observation period of 12 months. Twenty-six agricultural workers, all of them Yemenite Jews, received a high-caloric, high-fat diet, and the changes in serum cholesterol (CH), high-density-lipoprotein-cholesterol, triglycerides, and body weight were assessed. Yemenite Jews as a group are characterized by low serum CH levels and by a low incidence of coronary artery disease. For a period of 7 months the subjects received a diet of 4553 cal/day, more than double their original "Yemenite diet". After this time they resumed their customary low-caloric diet for 3 months, and thereafter for another 2 months they continued with the high-caloric food regimen. The high-caloric, high-fat diet resulted in the expected increase of serum CH. A similar increase of high-density lipoprotein-CH was found. Serum triglyceride levels changed inversely to those of CH. It is suggested that the altered relation of calories derived from carbohydrates to those derived from fats brought about the decrease of triglycerides, and this irrespective of the increased intake of carbohydrates and fats. The rather small gain of body weight over the trial period--despite the doubled caloric intake--is similar to other studies that showed that the ability of normal individuals to gain weight through overeating varies considerably.

Adolescent

EWAS in a polyphenol dense, DNA methylation-targeted, controlled diet and lifestyle study.

BACKGROUND: Dietary and lifestyle factors can influence DNA methylation patterns. We previously reported epigenetic age attenuation following a controlled study using an 8-week polyphenol-dense, DNA methylation-targeted diet and lifestyle intervention in healthy males (Methylation Diet and Lifestyle Study), with phytonutrient/polyphenol-rich foods (green tea, oolong tea, curcumin, garlic, and berries) being most predictive of this effect. METHODS: Here we conducted an epigenome-wide association study (EWAS) in 38 participants from the Methylation Diet and Lifestyle Study. The intervention included a dietary pattern intentionally rich in substrate and cofactor nutrients for methylation pathways, and components known to alter DNA-methyltransferase (DNMT) enzyme activity. In line with prior EWAS studies with small sample sizes where FDR-significant findings are unlikely, we used pre-specified nominal P-value thresholds (0.001, 0.0001) for the exploratory analyses. RESULTS: At P < 0.001 (unadjusted), 676 differentially methylated loci (DML) were identified in the intervention group versus 286 in controls. At P < 0.0001 (unadjusted), 50 DML were identified in the intervention group compared to 13 in controls. Fifteen DML were in transcription start site-proximal regions of genes including those involved in zinc homeostasis and nutrient sensing, development and pluripotency, proteostasis and genome stability, tumor suppression, and synaptic function. A group-by-time interaction analysis identified 70 intervention-specific DML at P < 0.0001, with nominal enrichment including autophagy, mTOR signaling, and chromatin remodeling pathways. A regional DMR analysis identified 128 within-group and 129 interaction-specific DMRs. DMR functional enrichment analyses revealed convergent nominal associations with lipid metabolism (alpha-linolenic acid, lipoic acid, biosynthesis of unsaturated fatty acids, PPAR signaling, cholesterol homeostasis), central energy metabolism (TCA cycle, glycolysis/gluconeogenesis, pentose phosphate, pyruvate), and nutrient sensing (PI3K-Akt, mTOR, AMPK, autophagy as well as other pathways). As expected for the limited cohort size and short intervention duration, none of the single CpG findings or enrichment analyses survived multiple test correction and are therefore considered exploratory and hypothesis-generating only. CONCLUSION: This EWAS identified a larger number of nominally changing CpGs in the intervention group compared to controls as well as biologically coherent methylation changes. These findings provide mechanistic hypotheses for previously observed epigenetic age attenuation. Replication in larger cohorts, longer intervention durations, and functional validation remain essential.

DNA methylation

Acute and chronic effects of mixed nuts on energy metabolism in women at cardiometabolic risk: a randomized clinical trial.

BACKGROUND AND AIMS: The effect of consuming a mix of Brazilian nuts on energy metabolism has not been explored. Thus, the present study aimed to evaluate the effects of acute and chronic consumption of mixed nuts on markers of energy metabolism in women with overweight/obesity. METHODS AND RESULTS: This is a randomized, controlled, and parallel clinical trial with adult women. In an acute study, participants received a beverage containing mixed nuts (30&#xa0;g of cashew nuts&#xa0;+&#xa0;15&#xa0;g of Brazil nuts) or a control beverage, and energy metabolism markers were assessed for up to 3&#xa0;h postprandially. For the chronic study, participants received 45&#xa0;g of a mix of nuts/day and a -500kcal energy-restricted diet (MNG) or only a -500kcal energy-restricted diet free of nuts (CTG) for 8 weeks, and energy metabolism was assessed before and after the intervention period. In the postprandial period, fat oxidation was higher in the MNG than in the CTG (piAUC: 47.53&#xa0;&#xb1;&#xa0;5.78&#xa0;mg/min vs. 27.93&#xa0;&#xb1;&#xa0;6.98&#xa0;mg/min; p&#xa0;=&#xa0;0.048). After 8 weeks of the intervention, fasting fat oxidation increased in the MNG (+16.0&#xa0;&#xb1;&#xa0;7.0&#xa0;mg/min) and decreased in the CTG (-5.0&#xa0;&#xb1;&#xa0;6.0&#xa0;mg/min), with no significant difference between groups. Other acute and chronic markers also showed no significant changes between groups. CONCLUSION: The acute consumption of mixed nuts increased postprandial fat oxidation, whereas chronic intake within an energy-restricted diet did not affect energy metabolism markers in women at cardiometabolic risk. REGISTRATION NUMBER FOR BRAZILIAN REGISTRY OF CLINICAL TRIALS: RBR-3ntxrm.

Humans

The effect of dietetic counseling combined with digital tools intervention on hemodynamic markers in Greek adults: The GATEKEEPER Study.

BACKGROUND AND AIM: Hypertension is a leading cardiovascular risk factor with substantial global impact on morbidity, mortality, and healthcare costs. While lifestyle interventions remain central to management, mHealth technologies offer promising adjunctive support, though their clinical effectiveness remains uncertain. This study evaluated whether combining dietetic counseling with digital tools improves hemodynamic markers in adults aged &#x2265;55 years with increased cardiometabolic risk. METHODS AND RESULTS: This 3-month RCT (NCT05031299) included 954 adults with at least one metabolic syndrome risk factor, allocated 1:1:1 to Standard Care (dietetic counseling), Platform (counseling plus web-based platform), or Platform&#xa0;+&#xa0;Devices (counseling plus platform plus wearables). Outcomes included anthropometrics, lifestyle characteristics, blood pressure, pulse pressure, and estimated pulse wave velocity, analyzed using linear mixed-effects models adjusted for age and sex. All groups improved over 3 months. Waist circumference decreased by -6.29, -4.92, and -4.69&#xa0;cm across Standard Care, Platform, and Platform&#xa0;+&#xa0;Devices groups respectively, and systolic blood pressure declined by -4.84 to -7.15&#xa0;mmHg across groups. The Platform&#xa0;+&#xa0;Devices group showed greater increases in physical activity (94.62 MET-min/week; 95% CI 66.49 to 122.76) and greater reductions in pulse pressure (-3.90&#xa0;mmHg; -6.58 to -1.22) versus Standard Care. Weight loss was associated with lower odds of hypertension (OR 0.4; 95% CI 0.2-0.7), greater likelihood of hypertension reversal (OR 3.6; 1.2-10.3), and higher probability of achieving normal pulse pressure (OR 1.8; 1.1-3.1). CONCLUSIONS: Dietary lifestyle intervention improved cardiometabolic outcomes, with limited added benefit from digital tools. Weight loss was the primary driver of hemodynamic improvement.

Aged

Effects of high- and low-fiber diets on human feces.

Increased- and low-fiber diets composed of common hospital foods were tested for their ability to alter stool weight, frequency of defecation, transit time, and absorption efficiency. The diets were calculated to be isocaloric and similar in protein, fat, and carbohydrate. They were dissimilar in ash and fiber. No stimulants, secretagogues, food concentrates, or extracts were used on either diet. Six normal, healthy, male subjects consumed each constant diet for five to eight days. Diets and stool composites were analyzed for protein, fat, fiber, moisture, and ash. Carbohydrate and calories were calculated. Stool weight during ingestion of the low-fiber diet averaged 51 gm. per day; subjects had an average of one bowel movement every 33 hr.; and the mean transit rate was 48 hr. When subjects consumed the increased-fiber diet, values were 157 gm., 19h., and 12 hr., respectively. Measurements of fecal protein, fat, carbohydrate, and calories from the low-fiber diet were less than half those observed when the increased-fiber diet was consumed. By altering specific components of a normal diet, e.g., fiber, significant differences can be made in bowel habit and absorption efficiency.

Adult

Dietary iron absorption in pregnancy - a longitudinal study with repeated measurements of non-haeme iron absorption from whole diet.

In 22 healthy women the non-haeme iron absorption (bone-marrow smears and haematological parameters) was studied at the 12th, the 24th and the 36th week of gestation and two months after delivery. In eight non-pregnant women and in seven pregnant women (at the 36th week of gestation) the absorption of food iron was measured from different types of meals. The iron absorption was measured from radioiron-labelled test meals using a whole-body counter with a very high sensitivity. During pregnancy the non-haeme iron absorption increased continuously from less than 1 % in early pregnancy to almost 15 % in late pregnancy. Calculations indicated that the amount of iron absorbed from the diet covered only about half of the demands. The increasing absorption of food iron during pregnancy seems to be related to the still more increasing demands. However, the very low absorption values in early pregnancy was quite unexpected. The amount of iron absorbed was actually below the basal demands, which means that even in early pregnancy, for reasons unknown, there is a negative iron balance. Further studies are necessary to elucidate the significance of this finding. Two months after delivery the absorption of iron from the diet was increased compared to in non-pregnant women and exceeded the demands at that phase thus indicating that a positive iron balance was achieved.

Adult