Consumption of fruit and vegetables by children in Australia and NSW: Results from National Surveys in 1995 and 2007. Monitoring Update.

Fruit and vegetables provide multiple health benefits in children and adults, including a likely role in the prevention of excess weight gain. As such, the promotion of fruit and vegetables is included as a core component of policies and programs to promote healthy eating and reduce obesity. In order to ascertain the effectiveness of promotional efforts, it is important to measure and report on levels of consumption of fruit and vegetables over time. This brief report provides detailed information on the levels of consumption of fruit and vegetables among children aged 2‐16 years, in Australia and in NSW. Data are derived from the two most recent national dietary surveys, the 1995 National Nutrition Survey (1995 NNS) and the 2007 Australian National Children Nutrition and Physical Activity Survey (2007 Survey). The national surveys use detailed 24‐hour recall methods, enabling amounts of fruit and vegetables consumed as well as numbers of serves consumed to be reported

Socio-demographic determinants of diet quality in Australian adults using the validated Healthy Eating Index for Australian adults (HEIFA-2013)

Diet quality indices have been shown to predict cardiovascular disease, cancer, Type 2 Diabetes, obesity and all-cause mortality. This study aimed to determine the socio-demographics of Australian adults with poor diet quality. Diet quality was assessed for participants of the 2011–2012 National Nutrition and Physical Activity Survey aged 18 years or above (n = 9435), with the validated 11-component Healthy Eating Index for Australians (HEIFA-2013), based on the 2013 Australian Dietary Guidelines. Differences in scores by demographics (ANOVA) and regression models for associations between the HEIFA-2013 score and demographic characteristics were conducted. The mean (SD) HEIFA-2013 score was 45.5 (14.7) out of 100 due to poor intakes of vegetables, fruit, grains, dairy and fat and high intakes of added sugar, sodium and discretionary foods. Lower mean HEIFA-2013 scores (SD) were found for males 43.3 (14.7), young-adults 41.6 (14.2) obese 44.1 (14.3), smokers 40.0 (14.2), low socio-economic status 43.7 (14.9) and Australian country-of-birth 44.2 (14.6) (p < 0.05). The overall diet quality of the Australian population is poor and targeted interventions for young-adults, males, obese and those with lower socio-economic status are recommended

Typical food portion sizes consumed by Australian adults: results from the 2011–12 Australian National Nutrition and Physical Activity Survey

Considerable evidence has associated increasing portion sizes with elevated obesity prevalence. This study examines typical portion sizes of commonly consumed core and discretionary foods in Australian adults, and compares these data with the Australian Dietary Guidelines standard serves. Typical portion sizes are defined as the median amount of foods consumed per eating occasion. Sex- and age-specific median portion sizes of adults aged 19 years and over (n = 9341) were analysed using one day 24 hour recall data from the 2011–12 National Nutrition and Physical Activity Survey. A total of 152 food categories were examined. There were significant sex and age differences in typical portion sizes among a large proportion of food categories studied. Typical portion sizes of breads and cereals, meat and chicken cuts, and starchy vegetables were 30–160% larger than the standard serves, whereas, the portion sizes of dairy products, some fruits, and non-starchy vegetables were 30–90% smaller. Typical portion sizes for discretionary foods such as cakes, ice-cream, sausages, hamburgers, pizza, and alcoholic drinks exceeded the standard serves by 40–400%. The findings of the present study are particularly relevant for establishing Australian-specific reference portions for dietary assessment tools, refinement of nutrition labelling and public health policies

Fasting-mimicking diet cycles reduce neuroinflammation to attenuate cognitive decline in Alzheimer's models

The effects of fasting-mimicking diet (FMD) cycles in reducing many aging and disease risk factors indicate it could affect Alzheimer's disease (AD). Here, we show that FMD cycles reduce cognitive decline and AD pathology in E4FAD and 3xTg AD mouse models, with effects superior to those caused by protein restriction cycles. In 3xTg mice, long-term FMD cycles reduce hippocampal Aβ load and hyperphosphorylated tau, enhance genesis of neural stem cells, decrease microglia number, and reduce expression of neuroinflammatory genes, including superoxide-generating NADPH oxidase (Nox2). 3xTg mice lacking Nox2 or mice treated with the NADPH oxidase inhibitor apocynin also display improved cognition and reduced microglia activation compared with controls. Clinical data indicate that FMD cycles are feasible and generally safe in a small group of AD patients. These results indicate that FMD cycles delay cognitive decline in AD models in part by reducing neuroinflammation and/or superoxide production in the brain

Vitamin D deficiency causes inward hypertrophic remodeling and alters vascular reactivity of rat cerebral arterioles

BACKGROUND AND PURPOSE: Vitamin D deficiency (VDD) is a global health problem, which can lead to several pathophysiological consequences including cardiovascular diseases. Its impact on the cerebrovascular system is not well understood. The goal of the present work was to examine the effects of VDD on the morphological, biomechanical and functional properties of cerebral arterioles. METHODS: Four-week-old male Wistar rats (n = 11 per group) were either fed with vitamin D deficient diet or received conventional rat chow with per os vitamin D supplementation. Cardiovascular parameters and hormone levels (testosterone, androstenedione, progesterone and 25-hydroxyvitamin D) were measured during the study. After 8 weeks of treatment anterior cerebral artery segments were prepared and their morphological, biomechanical and functional properties were examined using pressure microangiometry. Resorcin-fuchsin and smooth muscle actin staining were used to detect elastic fiber density and smooth muscle cell counts in the vessel wall, respectively. Sections were immunostained for eNOS and COX-2 as well. RESULTS: VDD markedly increased the wall thickness, the wall-to-lumen ratio and the wall cross-sectional area of arterioles as well as the number of smooth muscle cells in the tunica media. As a consequence, tangential wall stress was significantly lower in the VDD group. In addition, VDD increased the myogenic as well as the uridine 5'-triphosphate-induced tone and impaired bradykinin-induced relaxation. Decreased eNOS and increased COX-2 expression were also observed in the endothelium of VDD animals. CONCLUSIONS: VDD causes inward hypertrophic remodeling due to vascular smooth muscle cell proliferation and enhances the vessel tone probably because of increased vasoconstrictor prostanoid levels in young adult rats. In addition, the decreased eNOS expression results in endothelial dysfunction. These morphological and functional alterations can potentially compromise the cerebral circulation and lead to cerebrovascular disorders in VDD

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Recommendations for short questions to assess food consumption in children for the NSW Health Surveys

Monitoring key food habits of children is important for planning and improving health services in New South Wales. The NSW Health Department conducts the NSW Health survey program using Computer Assisted Telephone Interviews (CATI). This survey includes questions for monitoring food habits of children aged 0-16 years. In this report, we recommend survey questions to be used in the NSW Health survey for this purpose, which meet a range of criteria for good survey questions about nutrition and food habits

The effects of legume consumption on markers of glycaemic control in individuals with and without diabetes mellitus: A systematic literature review of randomised controlled trials

Legumes are a rich source of dietary fibre, plant protein, and low‐Glycaemic Index (GI) carbohydrate. Evidence suggests a positive effect on glycaemic control following a single meal; however, the effects of habitual consumption are less clear. This review aimed to investigate whether medium‐to‐long‐term legume consumption had an effect on markers of glycaemic control in individuals with diabetes mellitus, without diabetes mellitus, or with prediabetes. As per the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) protocol, the online databases MEDLINE, Embase, CENTRAL, and CINAHL were searched from inception through to 31 March 2020. Randomised controlled trials (RCTs) ≥6 weeks in duration, reporting ≥1 of the following: fasting blood glucose (FBG), fasting blood insulin (FBI), glycosylated haemoglobin (HbA1c), homeostatic model assessment‐insulin resistance (HOMA‐IR), or 2‐h postprandial glucose (2‐h PPG), were deemed eligible. The overall quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment. A total of 18 RCTs were included, of which, 5 focused on individuals with diabetes mellitus, 12 on individuals without diabetes mellitus, and one on individuals with prediabetes. Only studies of those with type 2 diabetes mellitus (n = 5) reported significant effects for legume interventions, three of which consistently reported reductions in FBG, two reported reductions in HbA1c, one reported a reduction in FBI, and another a reduction in 2‐h PPG (p \u3c 0.05); however, the overall quality of evidence was very low. The findings of this review support the dietary inclusion of legumes; however, the need for further high‐quality RCTs to be conducted is also highlighted, particularly among individuals with prediabetes, gestational diabetes mellitus and type 1 diabetes mellitus