Potential Use of Edible Insects in Complementary Foods for Children::A Literature Review

Background: Childhood malnutrition is an important public health problem. Animal protein provides essential amino acids in a more adequate pattern than plant-based protein. However, the production of sufficient animal-sourced protein to feed the growing world population is a serious challenge. This review aims to explore the evidence on the use of edible insects as an alternative source of protein and micronutrients in complementary foods for children and their potential to address childhood malnutrition. Methods: Searches were conducted in two electronic databases PubMed and Cochrane. The reference lists of included studies were also searched. Results: Twelve studies were included in this review. All insect-enriched formulations (e.g., biscuits, cereals, porridge, paste, etc.) exceeded the daily recommended amount of protein and fat for children’s complementary foods and showed good acceptability. Only two studies assessed the efficacy of insect-enriched foods on nutritional indicators and found no effect on the reduction of stunting and wasting. However, one study found improvements in the haemoglobin levels and fewer cases of anaemia in the intervention group. Conclusions: Insect-enriched complementary foods for children are safe, acceptable and have the potential to tackle micronutrient deficiencies. More studies are needed to examine their effect on nutritional status in children

COVID-19: A Syndemic Requiring an Integrated Approach for Marginalized Populations

The novel coronavirus, SARS-CoV-2, responsible for the COVID-19 pandemic, has challenged healthcare systems globally. The health inequities experienced by immigrants, refugees, and racial/ethnic minorities have been aggravated during the COVID-19 pandemic. The socioeconomic, political, and demographic profile of these vulnerable populations places them at increased risk of contracting COVID-19 and experiencing significant morbidity and mortality. Thus, the burden of the COVID-19 pandemic is disproportionally higher among these at-risk groups. The purpose of this perspective is to: (1) highlight the interactions among the social determinants of health (SDoH) and their bi-directional relationship with the COVID-19 pandemic which results in the current syndemic and; (2) offer recommendations that consider an integrated approach to mitigate COVID-19 risk for marginalized populations in general. For these at-risk populations, we discuss how individual, structural, sociocultural, and socioeconomic factors interact with each other to result in a disparate risk to contracting and transmitting COVID-19. Marginalized populations are the world\u27s collective responsibility. We recommend implementing the Essential Public Health Services (EPHS) framework to promote those systems and policies that enable optimal health for all while removing systemic and structural barriers that have created health inequities. The pledge of “Health for All” is often well-accepted in theory, but the intricacy of its practical execution is not sufficiently recognized during this COVID-19 syndemic and beyond. “Where there is life, there is hope.” -R.I. Kelly, Irish Immigrant

Nutrition in Chronic Conditions

The effects of nutrition on chronic conditions, such as diabetes, cardiovascular disease, dementia and stroke, continue to generate interest among researchers. This is based on the fact that diet is a modifiable risk factor for these diseases, which manifest either as single entities or in co-morbid states in individuals and populations around the world. In particular, the prevalence of diabetes and cardiovascular disease is on the increase, especially in developed countries, but also in developing economies, partly due to lifestyle changes, including diet. For example, ischaemic heart disease is the leading cause of death globally. When combined with stroke, they accounted for 15 million deaths in 2015 and are the world’s greatest killers (WHO, 2017). Furthermore, WHO (2016) reported that there were an estimated 422 million adults living with diabetes in 2014. This is significantly higher than the 108 million in 1980, representing a rise in worldwide diabetes prevalence from 4.7% in 1980 to 8.5% in 2014 among the adult population. These chronic conditions and their associated complications have significant implications for morbidity and mortality, not to mention huge costs to the health services around the world. The composition of the diet, the proportion and types of macronutrients and micronutrients present in the diet are major contributors to these diseases. In addition, the beneficial effects of nutritional interventions have been well documented although differences remain among researchers with respect to their overall impact. The evaluation of the role of nutrition in chronic conditions draws on its effect on body weight and body composition, glycaemic and insulin excursions and vascular remodelling. The effect of the diet in modulating gut microbiota dysbiosis is also an evolving area of research. Therefore, this Special Issue Book on “Nutrition and Chronic Conditions” is aimed at examining the effect of nutrition in the development, care and management of chronic conditions

Nurses’ perceptions, attitudes, and perspectives in relation to climate change and sustainable healthcare practices:A systematic review

AbstractBackgroundClimate change threatens human existence and is caused by increasing carbon emissions. Healthcare systems generate about 5% of global net CO2 emissions, further contributing to the crisis. Green healthcare practices could be implemented and nurses, as the largest workforce group, could potentially drive these practices. This review explored nurses’ awareness, perceptions, attitudes and perspectives towards sustainable nursing and healthcare practices concerning climate change.MethodsThe Joanna Briggs Institute [JBI] methodology for conducting mixed methods systematic reviews was applied and results were reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines. CINAHL, PsycINFO, SCOPUS, and PUBMED databases were searched. JBI and Mixed Method Appraisal Tool [MMAT] critical appraisal tools were used for the data appraisal. Data synthesis and integration followed the JBI convergent integrated approach and thematic analysis was performed. https://doi.org/10.17605/OSF.IO/8H3TC.FindingsEighteen papers were included that represented nine different countries across five continents. One study was found in Africa, no studies in South America, and three in Asia. Five key themes were identified: i) knowledge and awareness of climate change, ii) link between nursing and climate change, iii) environmental sustainability, iv) barriers to environmentally responsible healthcare, and v) routes to environmentally sustainable nursing practices.InterpretationThe review indicates the need to raise awareness regarding climate change and sustainable practices among nurses. It is vital policy makers, and healthcare leaders ensure criteria relating to environmental sustainability and carbon reduction are included in decisions about procurement and service delivery. Nurses’ engagement could drive forward a net-zero agenda

The effect of self-reported lactose intolerance and dairy consumption on bone mineral density among American hip arthroplasty patients: A cross-sectional study

The relationship between osteoporosis and lactose intolerance is unclear. This study aims to evaluate the association between self-reported lactose intolerance and symptom severity caused by lactose malabsorption and bone mineral density (BMD). A total of 496 American hip arthroplasty patients took part in this study. Information on BMD and socio-demographic factors were retrospectively extracted from medical records. BMD of the lumbar spine (LS), femoral neck of the operative hip (FNOH), and femoral neck of the non-operative hip (FNH) were measured via dual-energy x-ray absorptiometry scans (DXA). Patients also completed a survey regarding dietary and lifestyle habits from the time of surgery. We found that 9.3% of participants reported lactose intolerance and 33.3%% suffered from either osteopenia or osteoporosis in at least one (location. The population that did not self-identify as lactose intolerant consumed significantly more dairy (p < 0.0001) and animal protein (p = 0.004) than those with intolerance. There was no significant difference in BMD between self-identified lactose intolerant individuals and non-lactose intolerant individuals. In a stepwise multiple regression analysis, body mass index (BMI) and age were the only common predictors of BMD for all locations (p < 0.05). However, yogurt intake was a significant predictor of BMD of FNOH in the multivariate analysis. This study suggests that lactose intolerance is not associated with bone mineral density. We also found that being vegan or vegetarian may increase the risk of low BMD

An Evaluation of the Nutritional Value and Physical Properties of Blenderised Enteral Nutrition Formula: A Systematic Review and Meta-Analysis

Background: Although there are merits in using commercial “enteral nutrition formula” (ENF) compared with blended ENF, there is a growing preference for the use of blended ENF in many countries globally. However, the nutritional value and physical properties of blended ENF compared with commercial ENF may be limiting its use. We have not found any evidence of a meta-analysis on the nutritional value of blended diets in the adult population. Aim: The aim of this review was to compare the nutritional value, physical properties, and clinical outcomes of blended ENF with commercial ENF. Methods: The preferred reporting items for systematic reviews and meta-analyses were used for this review. The search strategy was based on a Population, Intervention, Comparator, Outcome framework. The following databases; Pubmed, EMBASE, PSYCInfo, and Google scholar were searched for articles of interest using keywords, Medical Subject Heading (MeSH) and Boolean operators (AND/OR) from the inception of each database until 23 February 2020. The articles were evaluated for quality. Results: Based on the systematic review and meta-analysis, four distinct themes were identified; Nutritional value, Physical properties, Clinical outcomes; and Adverse events. The findings of this review showed inconsistencies in the macronutrient and micronutrient values of the blenderised ENF compared with the commercial ENF. The results of the meta-analysis demonstrated that there were no significant differences (p > 0.05) between the blenderised ENF and the commercial ENF in relation to the fat and protein contents of the diets. However, the blenderised ENF was significantly lower (p 0.05) than the commercial ENF regarding the energy content of the diets, with an overall mean difference of −29.17 Kcal/100 mL (95% CI, −51.12, −7.22) and carbohydrate content with an overall mean difference of -5.32 g/100 mL (95% CI, −7.64, −3.00). In terms of sodium, potassium, and vitamin A, there were no significant differences (p > 0.05) between the blenderised and commercial ENF, although significant differences (p 0.05) were observed between the two diets with respect to calcium, phosphorus, magnesium, zinc, iron, and vitamin C contents. Furthermore, the blenderised ENF showed significantly higher levels (p 0.05) of viscosity and osmolality than the commercial ENF. The significantly lower levels of some of the macro-nutrients and micro-nutrients in the blenderised ENF compared with the commercial ENF and the difference in the expected nutritional values may be due to the fact blenderised ENF is produced from common foods. Thus, the type of foodstuffs, cooking, and processing methods may lead to loss of nutrients and energy density. The deficits in the energy content and some of the macro- and micro-nutrients in the blenderised ENF compared with commercial ENF may have implications for patients’ health and clinical outcomes. The clinical implications of the underdelivering of nutrients may include increased risk of undernutrition, including energy malnutrition, which could have a negative effect on body composition and anthropometric parameters, morbidity, mortality, length of hospital stay, and costs. For outpatient care, this could increase the risk of hospital re-admission and homecare costs. Additionally, the higher viscosity and osmolality of the blenderised ENF compared with the commercial ENF can increase the risk of complications, including tube blockage, and impaired delivery of feed, water, and medications, with significant implications for patients’ nutritional status and health outcomes. Conclusion: The results of this systematic review and meta-analysis identified significant variability in the nutritional value of blenderised ENF compared with commercial ENF. Furthermore, the nutritional values of the blenderised ENF do not meet the expected recommended levels compared with commercial ENF and these may have implications for patients’ nutritional status and health outcomes, including the effect on body composition, morbidity, mortality, hospital re-admission, and costs. Further studies are needed to elucidate the nutritional value of blenderised ENF on patients’ clinical outcomes