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Ayer — Octubre 2nd 2025Tus fuentes RSS

Knowledge, attitude and practice of artificial intelligence among dietitians in Saudi Arabia: a cross-sectional study

Por: Alhazmi · A. · Ibrahem · M. · Dawria · A.
Objectives

This study assesses the knowledge, attitudes and practices (KAP) of licensed dietitians in Saudi Arabia regarding artificial intelligence (AI) in dietetics and identifies sociodemographic factors associated with higher AI knowledge and use, along with perceived benefits and concerns.

Design

Descriptive, cross-sectional study with an analytical component.

Setting

Conducted online across Saudi Arabia, targeting licensed dietitians in public and private healthcare sectors.

Participants

161 licensed dietitians completed the study. Inclusion criteria consisted of current registration and active practice in either clinical or community settings.

Primary and secondary outcome measures

The primary outcomes were levels of AI-related KAPs assessed via a structured questionnaire. The secondary outcomes examined associations between KAP and demographic factors.

Results

Among participants, 62.7% reported using AI in practice; 72.3% found it easy to use and 63.4% believed it improved their work. Higher knowledge was significantly linked to being aged 24–40, female, married, Saudi, a university graduate and employed (p

Conclusions

Dietitians in Saudi Arabia generally recognise AI’s value in dietetic practice, particularly in programme development and personalisation. However, concerns about diminished human interaction remain. Structured training and further longitudinal research are recommended to support balanced AI integration.

Nutritional status and its influencing factors among elderly patients with malignant tumours: a retrospective study from a tertiary hospital in Chengdu, China

Por: Duan · R. · Wang · F. · Zhang · T. · Feng · T. · Ren · T.
Objective

To investigate the nutritional status and its influencing factors in elderly patients aged 60 years and above with malignant tumours.

Design

A retrospective observational study.

Setting

The First Affiliated Hospital of Chengdu Medical College, a tertiary care hospital in Chengdu, China.

Participants

A total of 450 elderly patients with cancer (aged ≥60 years) admitted between January 1, 2022, and January 1, 2023. Patients were selected based on their clinical records, excluding those with communication disorders, mental illness or incomplete data.

Primary outcome measures

Nutritional status was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA). Participants were categorised based on the presence or absence of malnutrition. Multivariate logistic regression was used to identify independent risk factors for malnutrition.

Results

Of the 450 patients included, 63.7% were male and 36.3% female, with a median age of 69 years. The prevalence of severe malnutrition was 46.4%. Univariate analysis showed significant associations between malnutrition and factors such as older age (p

Conclusions

Malnutrition is highly prevalent in elderly patients with cancer and is significantly associated with age, BMI, albumin levels and self-care ability. Early identification and targeted nutritional interventions may improve outcomes and quality of life in this population.

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Effect of plant-based foods and (poly)phenol supplementation on gut-microbiota metabolism in participants with overweight or obesity and cardiometabolic risk: a study protocol for a single-blind, parallel and randomised controlled trial

Por: Lanuza · F. · Romero-Lopez · C. · Nova-Luna · R. · Cuyul-Vasquez · I. · Saez-Venegas · M. · Guzman · N. · Diaz-Velis · L. · Zamora-Ros · R. · Martinez-Huelamo · M. · Andres-Lacueva · C.
Introduction

Dietary (poly)phenols have beneficial properties that may play a relevant role in the management of overweight/obesity and cardiometabolic risk factors, modulating physiological and molecular pathways involved in energy metabolism, adiposity and gut microbiota-derived metabolites.

Methods and analysis

The Prevention/Precision Diet in Araucanía (PREDIET-ARAC) trial is a randomised, single-blind, parallel arm, placebo-controlled, clinical trial designed to assess the potential health benefits of (poly)phenol intake through either diet or supplementation. The study will evaluate the effectiveness of a healthy plant-based diet (PBD) rich in (poly)phenols compared with (poly)phenol supplementation during a caloric restriction intervention.

A total of 99 adults (aged 25–45 years) with overweight or obesity (body mass index: 25–35 kg/m²) and cardiovascular risk factors will be recruited from primary health centres in Temuco, Araucanía Region, Chile. Participants will be randomised (stratified by age:

Dietary data will be collected using dedicated software through three 24-hour dietary recalls at baseline and post-intervention. (Poly)phenol intake will be estimated using the Phenol-Explorer database. The main data collection will include general and lifestyle questionnaires, anthropometric and bioimpedance measurements, blood pressure assessments using sphygmomanometers, physical activity monitoring through accelerometers and strength evaluations via dynamometry. Blood samples will be collected at both baseline and after 12 weeks. For the analysis of plasma metabolites, a large-scale targeted metabolomics approach will be employed, specifically utilising ultra-high performance liquid chromatography coupled to tandem mass spectrometry. The healthy PBD will be primarily supplied by the food industry, encompassing a selection of regional and Latin American foods: blueberries, apple, nuts, olive oil and coffee. A descriptive and inferential statistical plan will be conducted, based on comparison tests, regression models and machine-learning algorithms.

Ethics and dissemination

This trial adheres to the Declaration of Helsinki and the CONSORT statement. Signed informed consent will be obtained from all participants. Ethical approval has been granted by the Ethical-Scientific Committee of the Health Service of Araucanía Sur, Chile (Approval No 11250095–58) and the Biosafety Committee of the Catholic University of Temuco. Findings will be disseminated through peer-reviewed publications, conference presentations and engagement with healthcare professionals and policymakers.

Trial registration number

NCT06911346.

Food system determinants of seasonal malnutrition in children under 5 years in sub-Saharan Africa: a scoping review protocol

Por: Nasagre · E. · Dugle · G. · Bawontuo · V.
Introduction

Child malnutrition remains a pressing public health challenge in sub-Saharan Africa (SSA), where approximately 148 million children are stunted and 45 million are wasted. Although often conceptualised as a persistent condition, evidence indicates that malnutrition among children under 5 years frequently follows seasonal patterns shaped by agricultural cycles, climatic variability and socioeconomic conditions. Current interventions have paid limited attention to the food system dynamics that underpin these fluctuations. Adopting a system perspective, this scoping review will synthesise existing evidence on the food system determinants of seasonal malnutrition in children under 5 years in SSA.

Methods and analysis

The review will be conducted in accordance with the Joanna Briggs Institute methodological framework for scoping reviews and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search will be undertaken across electronic databases (Google Scholar, ProQuest Central, PubMed, Scopus and African Index Medicus) for literature published from 2015 onwards. Grey literature will also be sought from institutional repositories of the WHO, United Nations Children’s Fund, Food and Agriculture Organization and World Food Programme. Screening of titles, abstracts and full texts will be performed independently by two reviewers using predefined eligibility criteria. Data extraction will capture study characteristics and food system determinants of seasonal malnutrition at micro, meso and macro levels. The Food Insecurity and Vulnerability Information and Mapping Systems framework will guide the analysis and synthesis.

Ethics and dissemination

As this review involves analysis of previously published data, ethical approval is not required. Findings will be disseminated through a peer-reviewed publication and social media engagements. Results will inform the development of integrated system-based approaches to address seasonal malnutrition in children under five in SSA. The full study protocol, datasets and supplementary forms will be published in an open-access repository in compliance with the Findability, Accessibility, Interoperability and Reuse principles.

Registration

This scoping review protocol is registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/RU4ZX).

Feasibility of an online nutrition intervention to improve adherence to healthy and sustainable diets in young Australian adults: protocol for a pilot pre-post intervention study

Por: Lam · B. T. · Szymlek-Gay · E. A. · Larsson · C. · Margerison · C.
Introduction

Current diets which are commonly high in meat and ultra-processed foods are unhealthy and unsustainable and contribute significantly to climate change, environmental degradation and poor health outcomes. Transitioning to healthy and sustainable diets that are rich in plant-based foods and low in animal products could reduce environmental impacts and improve population health. Young Australian adults are a critical target group for dietary intervention as they are motivated towards climate action and have the lowest diet quality out of all adult age groups. As such, this study proposes a digital nutrition intervention to promote healthy and sustainable diets in this population group.

Methods and analysis

A 4-week pilot pre-post intervention will be conducted on the Deakin Wellbeing mobile application between July and August 2025. 32 young adults (18–25 years old; current student and/or staff at Deakin University; consume less than 260 g/week of legumes or 175 g/week nuts, living in Australia) will receive 4 weeks of the intervention to improve their adherence to a healthy and sustainable diet. Primary outcomes include feasibility (retention rate) and acceptability (engagement and user experience). Secondary outcomes include sustainable food literacy, legume and nut intakes, and adherence to a healthy and sustainable diet. Primary outcomes will be reported with descriptive statistics, while changes in secondary outcomes at each study time point will be measured using repeated measures Analysis of Variance, Friedman tests and McNemar’s tests.

Ethics and dissemination

Ethics approval to conduct the study was granted by the Deakin University Human Research Ethics Committee (2024/HE000163). A summary of findings will be disseminated to key stakeholders, for example, Deakin University Student Engagement groups, and will also be presented to the wider research community at conferences and via peer-reviewed publications. A summary of the results will be sent to all participants via email.

Trial registration number

Australian New Zealand Clinical Trials Registry Registration ID: ACTRN12625000335493p, prospectively registered on 22 April 2025. Universal Trial Number: U1111-1319-0745.

Exploring exhaled breath biomarkers for lactose intolerance diagnosis: the Lactobreath pilot study protocol

Por: Giannoukos · S. · Burton-Pimentel · K. J. · Guillod · R. · Vergeres · G. · Pohl · D.
Introduction

Food intolerances are prevalent in Europe and can cause considerable physical discomfort, dietary restrictions and psychosocial challenges. Among the prominent causes of food intolerance are defects in the digestion and/or transport of short-chain fermentable carbohydrates, fermentable oligo-, di-, monosaccharides and polyols (FODMAPs). A common diagnostic tool for food intolerance is the hydrogen breath test, which monitors the production of H2 gas from the fermentation of ingested FODMAPs by colonic microbiota. However, this method is limited due to its relatively poor correlation with gastrointestinal (GI) symptoms experienced by patients. Diagnosis is complicated as food intolerance is often associated with functional GI disorders, while FODMAPs may exert their effects individually or in combination. Further research on the pathophysiology and the impact of intervention strategies for these conditions is required to improve the diagnosis of food intolerance.

Methods and analyses

The Lactobreath pilot study is a randomised, two-arm, double-blinded controlled study. 120 healthy, free-living adults will undergo 6-hour postprandial tests with lactose or glucose (control) to investigate the molecular composition of human exhaled breath (exhalome) as a potential source of biomarkers associated with clinical and metabolic traits of lactose malabsorption (Lactobreath profiles). This serves as a proof-of-concept for the future application of this technology in diagnosing food intolerance. We will use a sensitive, non-invasive, real-time measurement technique based on secondary electrospray ionisation coupled with high-resolution mass spectrometry to analyse the chemical profile of the postprandial exhalome after lactose ingestion. Symptoms of lactose intolerance will be assessed using a standardised questionnaire and mechanistically linked to specific key metabolites of the discriminating breath profile. In parallel, a solid-state sensor will measure postprandial hydrogen gas in breath samples, while GI gases (CH4, H2, O2) and intestinal transit time will be monitored using a novel ingestible gas sensor (Atmo Gas capsule). Metabolites in urine, including lactose-derived metabolites, will be investigated using gas chromatography coupled with mass spectrometry. Postprandial bowel sounds will be recorded by wearable sensors (DigeHealth AG). Baseline assessments will be completed before the dietary challenge to capture usual dietary intake (repeated 24-hour recall), faecal microbiota (shallow shotgun sequencing) and to evaluate genetic polymorphisms using saliva samples (PCR analysis of selected penetrant single-nucleotide polymorphisms).

Ethics and dissemination

The Lactobreath study has been approved by the Ethics Committee of the Canton of Zurich, Switzerland (#2023-01639). The project results will be published in open-access journals, presented at national and international conferences and communicated to the public and other relevant stakeholders via the communication channels of all investigators and partners. All results derived from the study will be accessible, in line with the Swiss National Science Foundation open access policy.

Trial registration number

NCT06177938.

NutriNet-Brasil, a web-based prospective study on dietary patterns and risk of chronic diseases: cohort profile

Por: Costa · C. d. S. · Gabe · K. T. · dos Santos · F. S. · Leite · M. A. · Quinta · F. P. · Torquato · B. M. d. A. · Martinez Steele · E. · Rauber · F. · Rezende · L. F. M. · da Costa Louzada · M. L. · Levy · R. B. · Monteiro · C. A.
Purpose

Non-communicable diseases (NCDs), such as diabetes, cardiovascular diseases and cancer, are major global public health concerns. Diet quality—particularly the consumption of ultra-processed foods—has been associated with increased risk of NCDs. Traditional cohort studies are often expensive and logistically complex. The NutriNet-Brasil cohort leverages a web-based approach, offering a cost-effective and practical solution for comprehensive data collection and long-term follow-up.

Participants

Recruitments began in January 2020 through mass media, social media campaigns and collaborations with health organisations. Eligible participants are adults (aged ≥18 years) living in Brazil with internet access. Participants complete self-administered online questionnaires covering dietary intake, health status and other health determinants. Dietary assessment is based on the Nova classification system, which categorises foods by their level of processing.

Findings to date

Over 88 000 participants have completed the initial questionnaire. The cohort is predominantly women (79.9%) and highly educated (67.9% had completed higher education). The web-based design enabled the development and application of innovative dietary assessment tools, including the Nova24h and the Nova24hScreener, specifically designed to evaluate food processing levels. These tools have shown good performance in capturing dietary patterns and are central to the cohort’s aim. The online platform facilitates efficient recruitment, data collection and participant retention.

Future plans

NutriNet-Brasil is pioneering the development of web-based cohort methodologies and instruments tailored to food processing research. Future work includes leveraging collaborations with national and international research centres to conduct multidisciplinary analyses and inform public health policies.

Time to full recovery and its predictors among children with complicated severe acute malnutrition admitted to inpatient and subsequently to outpatient therapeutic care, Sanaa city, Yemen, a prospective follow-up study

Por: Al Amad · M. A. · Rajaa · Y. A. · Algendari · K.
Objective

To determine the time to full recovery and its predictors among children with severe acute malnutrition (SAM) admitted to therapeutic feeding centres (TFCs) in Sana’a, Yemen.

Design

A prospective cohort study conducted from August 2023 to November 2024.

Setting

Two public hospitals in Sana’a City (Al-Sabeen and Al-Zubairi hospital) that provide therapeutic feeding services for children with SAM.

Participants

Children aged 6–59 months who were admitted to TFCs based on WHO SAM criteria and successfully transferred to outpatient therapeutic programmes (OTPs).

Outcome measures

The primary outcome was time to full recovery from SAM, defined as the normalisation of both weight-for-height z-score (WHZ) and mid-upper arm circumference (MUAC). Secondary outcomes included identification of predictors associated with recovery time.

Results

Among 267 children, 51% were aged 6 to

Conclusion

Three months and a half were the median time to full recovery from complicated SAM. Concurrent WHZ and MUAC deficits, antibiotic use and the absence of diarrhoea were the significant predictors. Standardising the use of combined WHZ and MUAC recovery is recommended to improve comparability across programmes and better reflect nutritional outcomes.

Has the prevalence of malnutrition and obesity in children from North Korean refugee families improved after resettlement in South Korea? A longitudinal cohort study

Por: Choi · S.-W. · Kim · S.-Y.
Objectives

This study assessed changes in the prevalence of malnutrition and obesity in children from North Korean (NK) refugee families resettling in South Korea (SK).

Design

A longitudinal cohort study.

Setting

This study, conducted between 2017 and 2023, recruited participants through snowball sampling using local Hana Centres, alternative schools, religious organisations, civic groups, and other community-based networks.

Participants

Of the 441 children initially recruited, 406 participated in the baseline survey after excluding 35 with missing height or weight data. Among them, 187 (46.1%) completed a follow-up survey conducted at least 1 year later.

Primary outcome measures

The prevalences of stunting, underweight, wasting and obesity were defined according to the 2017 Korean National Growth Chart: stunting as height-for-age below the third percentile, underweight as weight-for-age below the fifth percentile, wasting as weight-for-height below the fifth percentile for ages 0–23 months or body mass index (BMI)-for-age below the fifth percentile for ages 2–18 years and obesity as BMI-for-age at or above the 95th percentile for ages 2–18 years.

Results

The prevalence of stunting was 7.5% at baseline and 5.4% at follow-up, while those of underweight and wasting were 6.4% vs 5.4% and 11.2% vs 5.9%, respectively; however, none of these changes were statistically significant. In contrast, the prevalence of obesity increased significantly from 11.1% at baseline to 18.8% at follow-up (p=0.045).

Conclusion

Despite residing in SK for an extended period, children from NK refugee families continue to experience malnutrition, while the prevalence of obesity is rising significantly.

Wearable sensing in eating episode monitoring: an updated systematic review protocol

Por: Zhou · J. · Cai · M. · Shi · M.
Introduction

Objective and accurate dietary monitoring is critical for comprehensive dietary assessment and improving nutritional health outcomes. The rapid advancement of wearable sensing technology presents a promising solution for effective dietary monitoring by reducing recall bias and enhancing user convenience, with potential benefits for both clinical chronic disease management and nutritional research. This systematic review aims to evaluate the effectiveness and feasibility of wearable sensors in monitoring dietary behaviours, while also examining the latest advancements in the field since 2020.

Methods and analysis

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines for systematic review reporting. We will conduct a comprehensive search across MEDLINE, EMBASE, PubMed, IEEE Xplore and Web of Science to identify studies published between January 2020 and March 2025 involving human participants using wearable sensors for dietary intake monitoring. Studies that focus solely on the development of algorithms or applications for these sensors will be excluded. The outcomes of this review will include evaluations of sensor design, performance metrics and user experience.

Ethics and dissemination

Findings of this systematic review will be disseminated through peer-reviewed journals, conferences and seminar presentations. The data used do not include individual patient data, so no ethical approval is required.

Randomised waitlist-controlled trial of a 10-week community programme using a plant-based diet in a predominantly Maori population in Tairawhiti (Gisborne)

Por: Smith · M. · Wright · N. · McHugh · P. · Duncan · B. · Chwyl · C.
Objectives

Investigate the impact of a 10-week whole-food plant-based (WFPB) community programme on weight and type 2 diabetes up to 36 months postintervention.

Design

Randomised waitlist-controlled trial.

Setting

Community-based General Practice clinic classified as ‘Very Low-Cost Access’ in Gisborne, the main city of the Tairāwhiti region of New Zealand.

Participants

Adults (n=56) aged 30–72 years, with obesity (Body Mass Index (BMI) ≥30) and glycated haemoglobin (HbA1c≥40 mmol/mol) in the last 6 months. Of the participants, 59% identified as Māori and 5% as Pasifika.

Intervention

A 10-week programme consisting of 2 hours, two times per week sessions (40 hours total), involving skills-based learning and health education.

Primary and secondary outcome measures

Primary measures were changes in weight, BMI and HbA1c. Secondary measures included changes in cholesterol, waist circumference, exercise levels, plant-based and non-plant-based dietary scores and association with Big Five Inventory personality traits. The primary endpoint was assessed at post-treatment (10 weeks), with follow-up at 6 and 36 months postintervention.

Results

Differences between the intervention and waitlist control groups at 10 weeks were compared with independent samples t-tests. In intention-to-treat analyses, the intervention group demonstrated significantly greater weight loss of 3.3 kg (95% CI (0.8 to 5.7), pp values

Conclusions

This 10-week WFPB diet community intervention decreased weight, BMI, HbA1c and cholesterol. The intervention produced a weight loss of 5 kg post-treatment, with 3 kg weight loss sustained at 36 months.

Trial registration number

This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (https://anzctr.org.au); ACTRN12617000541303, date of registration 07/04/2017.

Effects of potassium-enriched salt substitutes on blood pressure in Iranian hypertensive patients: the protocol for a randomised, double-blind controlled trial

Por: Daneshzad · E. · Hatami · S. E. · Sobhani · S. · Ghoreshi · B. · Khonsari · N.-M. · Shahrestanaki · E. · Pezeshki · M. · Kiaee · Z. F. · Assar · O. · Qorbani · M.
Introduction

Potassium-enriched salt substitutes have favourable effects on blood pressure, but it has not been tested in Iran. The present protocol is a double-blinded, randomised-controlled trial designed to investigate the effects of potassium-enriched salt substitutes on blood pressure in Iranian hypertensive patients.

Methods and analysis

The primary objectives are to determine the effects on systolic and diastolic blood pressure at 3 months and 6 months. The secondary objectives are to assess the effects on serum levels of potassium, sodium, urea and creatinine; the urinary ratio of sodium to potassium; participants’ attitudes toward the use of salt or salt substitutes; the recurrence of hypertensive crisis; and the occurrence and/or reoccurrence of strokes, transient ischaemic attack and cardiovascular accidents. Eligible individuals will receive the usual salt (100% sodium chloride) in the control group or salt substitute (70% sodium chloride and 30% potassium chloride) in the intervention group. A total of 500 hypertensive participants aged 40–65 years will be recruited and randomised to intervention or control groups. Potassium-enriched salt substitution in Iran will be considered to improve CVD complications and prevent deaths. Continuous and categorical baseline characteristics will be tested using the independent t-test and 2 test. The effect of the intervention on primary and secondary outcomes will be assessed using the intention-to-treat method and two-way mixed ANOVA models.

Ethics and dissemination

This study has been approved by Alborz University of Medical Sciences (0-0-103-6369) and has received ethics approval (IR.ABZUMS.REC.1402.293). We will publish our study findings for peer-reviewed publications, conference presentations and digital stories.

Trial registration number

IRCT20240121060757N1.

Efficacy of oral nutrition supplementation enriched with hydroxymethylbutyrate (HMB) and undenatured type-II collagen (UC-II) combined with exercise training on osteoarthritis-related outcomes among adults with knee osteoarthritis in Klang Valley of Malay

Por: Yap · A. X. W. · You · Y. X. · Ajit Singh · D. K. · Mat · S. · Chong · C. P. · Mohamad Yahaya · N. H. · Maktar · J. F. · Abdul Rani · R. · Ooi · T. C. · Ismail · M. · Shahar · S. · Han · W. C. · Kwan · L. K. · Centhyea · C.
Introduction

Knee osteoarthritis (OA) is a serious public health problem since it is linked to loss of muscular function and independence, especially in older adults. In this study, the researchers have proposed a randomised controlled trial with a three-arm study strategy to explore the effectiveness of an oral nutritional supplementation containing hydroxymethylbutyrate and undenatured type-II collagen combined with exercise training (ET) on the OA-related symptoms and biomarkers among adults with knee OA.

Methods and analysis

Adults with knee OA aged between 50 years and 75 years will be invited to participate in the study and thereafter will be randomly assigned to either one of three groups: oral nutrition supplementation+ET, ET or usual care. The primary outcomes include changes in OA-related symptoms and biomarkers. The secondary outcomes include changes in body composition, blood profiles, physical fitness, quality of life, dietary intake, disability, psychology status and morphological changes of the knee.

Ethics and dissemination

Ethics approval was granted by the Medical Research Ethics Committee of the National University of Malaysia (reference number JEP-2024–264). Findings of this study will be disseminated via peer-reviewed presentations at scientific conferences as well as open access publications.

Trial registration number

ISRCTN14284561.

Incidence and predictors of mortality among children with severe acute malnutrition admitted to therapeutic feeding units in Ethiopia: a systematic review and meta-analysis

Por: Adugna · A. · Abebe · G. F. · Alie · M. S. · Girma · D.
Objective

To estimate the mortality rate and identify predictors of mortality among under-five children with severe acute malnutrition (SAM) admitted to therapeutic feeding units (TFUs) in Ethiopia.

Methods

We searched PubMed, HINARI, Science Direct, Google Scholar and African Journals Online from 1 March to 30 May 2024. The Joanna Briggs Institute checklist was used to appraise the included studies. Heterogeneity was identified using I2 statistics. Funnel plots and Egger’s tests were used to determine publication bias.

Results

Out of 1085 studies, 15 were included in this analysis. The pooled mortality rate among under-five children with SAM admitted to TFUs in Ethiopia was 8.32 per 1000 person-days of observation (95% CI: 6.25 to 11.06). The mortality rate has not changed over time. HIV infection (HR: 2.84; 95% CI: 1.25 to 6.42), tuberculosis (HR: 1.86; 95% CI: 1.35 to 2.56), intravenous fluid use (HR: 3.37; 95% CI: 2.39 to 4.75), altered body temperature (HR: 4.47; 95% CI: 1.90 to 10.51), impaired consciousness (HR: 2.91; 95% CI: 1.94 to 4.37), not receiving F-100 supplementation (HR: 4.51; 95% CI: 3.25 to 6.26), shock (HR: 4.20; 95% CI: 2.92 to 6.04), and nasogastric tube feeding (HR: 2.02; 95% CI: 1.67 to 2.44) were predictors of mortality.

Conclusion

The pooled mortality rate in Ethiopia was 8.32 per 1000 person-days, and it has not decreased over time. Most of the identified factors are related to comorbidities and complications of SAM, as well as nutritional therapy. Thus, it is essential to strengthen nutrition policies, programme implementation and healthcare services, which focus on the timely management of SAM complications, integrated care for comorbidities and improved F-100 supplementation.

PROSPERO registration number

CRD42024555014.

Causal analysis of undernutrition among adolescents in the context of the agrarian community of North-West Ethiopia: a general structural equation modelling approach

Por: Agedew · E. · Abebe · Z. · Ayelign · A.
Objective

This study was conducted to evaluate the causal analysis of undernutrition among adolescents in the context of the agrarian community of North-West Ethiopia.

Design

A community-based case-control study was conducted among 149 cases and 297 control adolescents.

Setting

Agrarian communities of North-West Ethiopia.

Participants

Adolescents aged 10–19 years, who reside in a randomly selected study setting.

Outcome measures

The stunting and thinness nutritional status of adolescents was determined using the WHO AnthroPlus 2010 software. A general structural equation modelling approach was used to determine a multicausal analysis of undernutrition. The Food Frequency Questionnaire was tested for internal reliability among 30 adolescents. The reliability test for the actual dietary tool was done using Cronbach’s alpha coefficient (α), which was 0.79. The model adequacy was tested using the Akaike information criterion and Bayesian information criterion. The significant direct and indirect determinants were identified with a value of p

Result

Adolescents with lower traditional and mixed dietary pattern consumption habits were determinant factors for stunting with adjusted β=0.65, 95% CL (0.143 to 1.159) with a value of p=0.012, adjusted β=2.697, 95% CL (0.563 to 4.831) with a value of p=0.013, respectively. Breakfast eating frequency had a negative indirect determinant factor on the reduction of stunting via lower traditional habits, with adjusted β=–0.207 (–0.299 to–0.116) with a value of p=0.001, and higher consumption habits of animal sources with traditional alcoholic drinking habits with adjusted β=–0.163, 95% CL (–0.260 to –0.065) with a value of p=0.001. Whereas breakfast eating frequency had a direct influence on thinness with adjusted β=–0.332, 95% CL (–0.588 to –0.076) with a value of p=0.011, and an indirect influence via dietary patterns for both stunting and thinness (p

Conclusion

Dietary patterns and breakfast-eating frequency were direct and indirect determinant factors for adolescents’ stunting and thinness. Public health interventions should be implemented to reduce stunting and thinness by improving the dietary feeding and breakfast consumption habits of adolescents and strengthening the national deworming programmes in study areas and similar settings.

Autonomy at the table: the role of food parenting practices in childrens fruit and vegetable consumption - a systematic review and meta-analysis protocol

Por: Lopes · E. C. · Vilella · P. R. · Moreira · P. R. · Noll · M. · de Almeida · G. M. · Martins · K. A.
Introduction

Despite parents’ efforts, many children have nutrient-poor diets with insufficient fruit and vegetable consumption. Parents significantly influence children’s eating habits at home through their food parenting practices. Although previous systematic reviews have explored food parenting practices, they were conducted some time ago. Therefore, it is timely to investigate the relationship between autonomy-supportive practices and fruit/vegetable consumption in children aged 2 to 12.

Methods and analysis

The systematic review and meta-analysis protocol will be conducted by Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The databases PubMed, Scopus, Web of Science, PsycINFO, EMBASE, LILACS and Google Scholar will be searched with no restrictions on publication year, country or language. In addition to the databases, the search will be supplemented by manual searches of reference lists from the included articles. Studies that assess at least one parental autonomy-supportive food practice and its relationship with fruit and vegetable consumption in healthy children aged 2 to 12 years will be included. Results will be organised in tables and figures. A meta-analysis will be conducted if data availability permits. Risk of bias will be assessed using Joanna Briggs Institute tools. All steps will be conducted independently by two reviewers.

Ethics and dissemination

Findings from this review will be important for understanding the influence of parental autonomy-supportive food practices on children’s fruit and vegetable consumption, potentially informing health practices that promote healthy eating habits from childhood. No ethical approval is required for this review, and we plan to publish the findings in a peer-reviewed journal.

PROSPERO registration number

CRD42023442680.

Exploring methods for assessing stakeholder perspectives in Scaling-Up Nutrition (SUN) countries: a scoping review

Por: Putri · O. Q. · Akinreni · T. · Kurniawan · A. L.
Objectives

The scaling-up nutrition (SUN) initiative, which was launched in 2010 to eradicate malnutrition in all its forms by 2030, collaborates with a diverse range of stakeholders, such as governments, non-governmental organisations (NGOs), donors, businesses and academia. Given the widespread adoption of this multisectoral approach, it is crucial to explore methods for evaluating the perspectives of multiple stakeholders in child undernutrition topics.

Design

This scoping review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.

Data sources

Six peer-reviewed databases, including PubMed, Web of Science, Cochrane, Embase, CINAHL and PROQUEST ASSIA, were systematically searched.

Eligibility criteria

Original English studies published between 1 January 2010 and 1 June 2023, focusing on undernutrition in SUN countries.

Data extraction and synthesis

Two reviewers independently screened titles, abstracts and full texts for inclusion and extracted data using Rayyan.

Results

Out of the 4533 articles, 19 met the inclusion criteria for the review, and 5 more were added through manual searches. These studies were conducted in 14 SUN countries, with 62% using mixed methods and the remaining using qualitative methods. Six methods were used to gather stakeholder perspectives, including in-depth interviews, focus group discussions, Net-Map, organisational network analysis and Q methodology. Most studies focused on government, development partners and NGOs, while only two studies involved the business network.

Conclusions

Our study indicates that study on stakeholder perspectives in SUN countries focuses mainly on those showing progress in malnutrition/undernutrition reduction. Future research should explore countries with less progress to improve partnership frameworks. The SUN movement should establish a standard method for evaluating stakeholder perspectives, considering both outcomes and processes.

Trial registration number

The final protocol was registered prospectively with the Open Science Framework in July 2023 (https://osf.io/te7cb).

Qualitative exploration of the experiences and perceptions of diet in psoriasis management among UK adults

Por: Hawkins · P. · Mason · S. · Earl · K. · Tektonidis · T. G. · Fallaize · R.
Objective

This study aimed to explore the use, experiences and perceptions of diet in psoriasis management among adults with lived experience in the UK.

Design

Qualitative. Data were analysed thematically using a reflexive thematic approach.

Setting

Online discussions with adults living with psoriasis in the UK.

Participants

Nine adults (two men, seven women) ≥18 years of age, living in the UK, English speaking, with a diagnosis of psoriasis of any severity.

Results

Four key themes were generated: (1) impact of diet, (2) dietary modification, (3) dietary information and (4) dietary support. Overall, the majority (n=8) perceived that diet had an impact on their psoriasis. Most participants (n=7) reported trying restrictive diets including dairy free, gluten free and ‘cleanses’ to help manage their psoriasis with limited success. A perceived lack of dietary support resulted in participants relying on social media and online forums for dietary information. Participants reported a high cognitive burden due to the lack of reliable nutrition guidance and insufficient dietary support from healthcare professionals (HCPs).

Conclusions

Participants rely on social media and online forums for dietary information, which suggest unsubstantiated restrictive diets that could negatively impact health. Participants felt overwhelmed by dietary recommendations and wanted more relevant dietary support. In the absence of evidence-based dietary information for psoriasis, HCPs need to be able to provide basic dietary support and combat misinformation. Larger studies aimed at understanding how best to support people with psoriasis are needed.

Serum folate and dietary folate intake in beta thalassaemia trait: a case-control study from Sri Lanka

Por: Thilakarathne · S. · Jayaweera · U. P. · Herath · T. U. · Silva · R. · Premawardhena · A.
Objectives

Ineffective erythropoiesis, although at a mild degree, could make individuals with beta thalassaemia trait (BTT) vulnerable to folate deficiency. This could be more pronounced in communities where dietary intake of folate is substantially lower. We aimed to assess serum folate levels and dietary folate consumption in individuals with BTT and compare them with healthy matched controls.

Design

A case–control study.

Setting

This study was conducted between June 2021 and June 2022 at a regional thalassaemia centre in Sri Lanka.

Participants

The study includes 100 sets of samples, including a BTT and an age-matched, sex-matched and body mass index-matched healthy individual from the same household in each set, aged between 6 and 25 years.

Primary and secondary outcome measures

The primary outcomes were serum folate levels and the daily dietary intake of folate in BTTs and controls. Serum folate levels were determined using a fully automated Cobas immunoassay analyser. The dietary folate intake was determined by recording 24-hour dietary recall recorded over 3 consecutive days, with the average intake calculated.

Results

The results suggested that 34% of cases and 24% of controls had serum folate deficiency (

Conclusions

There were high levels of folate deficiency in both controls and those with BTT, while those with BTT were no more likely to be folate deficient than the controls. Based on our findings, a policy of indiscriminate folic acid supplementation for all with BTT does not seem rational.

Study protocol for a randomised controlled trial evaluating the efficacy of dietary modulation of probiotics on nutritional status and antibody response to SARS-CoV-2 in Indonesian adolescents: gut-lung axis (DIVINE)

Por: Agustina · R. · Ekawidyani · K. R. · Mutiyani · M. · Prafiantini · E. · Nindya · T. S. · Damayanti · W. · Rejeki · P. S. · Djuari · L. · Huriyati · E. · Bines · J. E. · Juffrie · M.
Introduction

During the pandemic, overweight and obese adolescents were at a higher risk of COVID-19 infection. Indonesia’s government has implemented prevention programmes and immunisation; however, the rise in SARS-CoV-2 infections among adolescents is exacerbated by low-quality diet and lifestyle habits. Also, the vaccine programme is not prioritised in this population. To address this, a solution involves providing probiotics and counselling on healthy lifestyle habits to improve diet and immunity. Therefore, we designed a protocol for a randomised controlled trial with a 20-week intervention to investigate the effect of probiotics supplementation and counselling on healthy lifestyle habits, including healthy eating and physical activity, and psychosocial stimulation, on nutritional status and antibody response against SARS-CoV-2 in this group.

Methods and analysis

This clinical trial aims to investigate the effects of probiotic supplementation on healthy overweight and obese adolescents. The study will involve 440 adolescents aged 12–17 living in Jakarta, Surabaya or Yogyakarta for at least 6 months and have completed at least two doses of the COVID-19 vaccine. The intervention group will receive daily probiotic supplementation of three strains, including Bifidobacterium animalis subsp. Lactis (BB-12), Lactobacillus acidophilus (LA-5) and Lactobacillus rhamnosus (LGG), at the level of 109–1010 colony-forming units for 20 weeks, while the control group will receive a placebo. Both groups will receive weekly counselling on healthy eating habits, physical activity and psychosocial stimulation. The primary outcomes will be changes in the body mass index for age z-score and IgG specific to SARS-CoV-2 titre concentrations between groups. The secondary outcomes will include changes in secretory IgA specific to SARS-CoV-2 titre concentrations, monoclonal antibodies against SARS-CoV-2 spike protein, gut microbiota diversity and the score of Healthy Eating Index 2015.

Ethics and dissemination

The study protocol was approved by the Ethics Committee of the Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital (KET 763/UN2.F1/ETIK/PPM.00.02/2022: 1 August 2022). The study results will be disseminated in open-access international journals, scientific meetings and conferences with stakeholders.

Trial registration number

The study has been registered at https://clinicaltrials.gov with identifier number NCT05623007.

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