The Development and Validation of Food Atlas for Portion Size Estimation in the Balkan Region

Assessment of portion sizes is an important factor for the accuracy of food consumption surveys. The objective of this study was to develop and validate a food atlas of commonly consumed foods in the Balkan region in order to improve the accuracy of portion size estimation for food consumption surveys. A list of 135 foods and their portion sizes was based on previously conducted food consumption surveys in this region. Food was cooked, measured and served in three or four portion sizes right before being photographed. A validation study was conducted through the visual perception method. Without receiving training on usage of the food picture book, participants were asked to evaluate two portion sizes of 20 selected foods by comparison with a photo series of each food. Portion sizes were evaluated by 18 nutrition professionals and 17 lay individuals who had no nutritional education. Mean differences and the standard deviations of the mean differences (SD) between the portions estimated by each participant and the served portion were calculated. The percentages of participants who selected the correct, adjacent or distant portion size also were calculated. The number of food items that were quantified within the predefined acceptable range (i.e., mean difference lt vertical bar 0.7 vertical bar and SD lt 1) was 16 (80%) among lay individuals and 17 (85%) among nutritional professionals. Among 16 photo series that were assessed as "acceptable," the percentage of all participants, who selected the correct picture, was between 44.3 and 82.9%, with an average of 60.2%. Only three foods were assessed correctly by lt 50% participants. The percentage of participants who selected the correct or adjacent serving size was above 98% for both lay and professional evaluators. This is the first food atlas containing representative foods and recipes commonly consumed in the Balkan region. However, further adjustments of the methodology should include larger number of food items to be tested, involvement of more participants and provision of training for the users of the food atlas. This food atlas could be used in food consumption surveys in the Balkan region after further testing and validation

Vitamin D status in mothers with pre-eclampsia and their infants: a case-control study from Serbia, a country without a vitamin D fortification policy

Objective: The objective of the present study was to determine if vitamin D intake and status are associated with pre-eclampsia in a country without a vitamin D fortification policy. Design: A case-control study of pregnancies with (case) and without (control) pre-eclampsia was conducted from January to April when UVB is minimal. Maternal and cord blood obtained at delivery were measured for plasma 25-hydroxycholecalciferol (25-OH-D-3), 3-epimer of 25-OH-D-3 (3-epi-25-OH-D-3) and 24,25-dihydroxycholecalciferol (24,25-(OH)(2)D-3) by LC-MS/MS and maternal 1,25-dihydroxyvitamin D (1,25-(OH) 2D). Differences between groups were tested with ANOVA and Bonferroni post hoc tests (P lt 0.05). Setting: Clinical Center of Serbia. Subjects: Pregnant women with and without pre-eclampsia (n 60) and their infants. Results: Exogenous vitamin D intake (0.95-16.25 mu g/d (38-650 IU/d)) was not significantly different between groups. Women with pre-eclampsia delivered infants at an earlier gestational age and had significantly lower mean total plasma 25-hydroxyvitamin D (25-OH-D; case: 11.2 (SD 5.1); control: 16.1 (SD 5.7) ng/ml; P=0.0006), 25-OH-D-3 (case: 10.0 (SD 4.9); control: 14.2 (SD 5.8) ng/ml; P=0.002), 3-epi-25-OH-D-3 (case: 0.5 (SD 0.2); control: 0.7 (SD 0.2) ng/ml; P=0.0007) and 1,25-(OH)(2)D (case: 56.5 (SD 26.6); control: 81.0 (SD 25.7) pg/ml; P=0.018), while 24,25-(OH)(2)D-3 was not different between groups. Infants did not differ in total plasma 25-OH-D, 25-OH-D-3, 3-epi-25-OH-D-3 and 24,25-(OH)(2)D-3, but the mean proportion of 3-epi-25-OH-D-3 was higher in the infant case group (case: 7.9 (SD 1.1); control: 7.0 (SD 1.4) % of total 25-OH-D-3; P=0.005). Conclusions: A high prevalence of vitamin D deficiency, as defined by plasma 25-OH-D lt 12 ng/ml, was observed in 47 % of all mothers and 77 % of all infants. These data underscore the need for prenatal vitamin D supplementation and a food fortification policy in Serbia

Validity of the Food Frequency Questionnaire Assessing the Folate Intake in Women of Reproductive Age Living in a Country without Food Fortification: Application of the Method of Triads

The study aimed to examine the external validity of the Folate Food Frequency Questionnaire (F-FFQ) designed for assessing the folate intake in Serbian women of reproductive age. The F-FFQ was tested against repeated 24 h dietary recalls and correspondent nutritional biomarkers (red blood cells (RBC) and serum folate concentrations) using the method of triads. In a cross sectional study, 503 women aged 18-49 years completed dietary questionnaires and representative validation subsample (n = 50) provided fasting blood samples for biomarker analyses. Correlation coefficients were calculated between each of the dietary methods and three pair-wise correlations were applied for the calculation of validity coefficients. Correlation coefficients observed between F-FFQ and three 24 h recalls were r = 0.56 (p lt 0.001) and r = 0.57 ( p lt 0.001) for total sample and validation group, respectively. Bland-Altman plot and cross-classification analyses indicated good agreement between methods. High validity coefficients were determined between the true intake (I) and dietary assessment methods, F-FFQ (Q) and 24 h dietary recalls (R) (rho QI(rbc) = 0.871 and rho QI(ser) = 0.814; rho RIrbc = 0.652 and rho RIser = 0.698), and moderate ones for biomarkers (B) (rho BIrbc = 0.428 and rho BIser = 0.421). The F-FFQ is valid instrument for the assessment of dietary folate intake in women living in Serbia, a country without mandatory folic acid food fortification

Validity of an FFQ assessing the vitamin D intake of young Serbian women living in a region without food fortification: the method of triads model

Objective: The objective of the present study was to examine the external validity of an FFQ designed to estimate dietary vitamin D intake compared with a plasma biomarker and three repeated 24 h dietary recalls in women of reproductive age in Serbia, where there is no exposure to food fortified with vitamin D. The method of triads was applied. Design: In a cross-sectional study, 422 women completed the Women and Reproductive Health FFQ (WRH-FFQ) during the winter months. From a representative subgroup (n 44), three 24 h dietary recalls and anthropometric parameters were collected as well as a fasting blood sample for vitamin D biomarker analyses. Correlation coefficients were calculated between each of the dietary methods. Validity coefficients, as a correlation between the measured and estimated 'true' exposure, were calculated using the method of triads. Bland-Altman plots were also constructed. Setting: Three major universities in Serbia. Subjects: Healthy young women (n 422) aged 18-35 years. Results: The WRH-FFQ estimate of vitamin D intake for all participants was 4.0 (SD 3.3) mu g/d and 3.1 (SD 2.3) mu g/d for the subgroup. Bland-Altman plots for these intakes showed high agreement. Validity coefficients for the FFQ, 24 h recall and biomarker were. rho(QI) = 0.847 (95 % CI 0.564, 0.928), rho(RI) = 0.810 (95 % CI 0.537, 0.997) and rho(BI) = 0.499 (95 % CI 0.190, 0.840), while the correlation coefficients were 0.686, 0.422 and 0.404. Conclusions: The FFQ applied in the present study is a valid tool for assessing dietary vitamin D intake in women living in Serbia, a region without mandatory vitamin D food fortification

Assessment of vitamin D intake among Libyan women - adaptation and validation of specific food frequency questionnaire

Vitamin D deficiency (VDD) has pandemic proportions worldwide. Numerous studies report on high prevalence of VDD in sunny regions like Near East and North Africa (NENA). Previous studies indicated that Libyan population was at risk of VDD. To contribute to the body of evidence, measurement of vitamin D status on children, adults, in Misurata region was conducted, and confirmed with validated dietary intake study. Serum 25(OH)D was analysed using electrochemiluminescence protein binding assay. Existing Food Frequency Questionnaires (FFQ) were adapted to Libyan Women Food Frequency Questionnaire (LW-FFQ). Repeated 24h dietary recalls and LW-FFQ were employed in vitamin D intake evaluation. LW-FFQ was validated using 24h dietary recall and vitamin D status as referent methods. The questionnaires included anthropometry and lifestyle information. Vitamin D status assessment revealed inadequate levels (25(OH)D lt 50nmol/l) in almost 80% of participants. Women (25-64y) were identified as the most vulnerable group with vitamin D inadequacy present in 82% (61.6% had 25(OH)D lt 25nmol/l, and 20.2% had 25-50nmol/l 25(OH)D). Average Vitamin D intake within the study sample (n=316) was 3.9 +/- 7.9 mu g/d, with 92% participants below both Institute of Medicine (IOM) (10 mu g/d) and European Food Safety Authority (15 mu g/d) recommendations. Measured vitamin D status, in 13% of this group, correlated significantly (p=0.015) with intake estimates. Based on self-report, consumption of vitamin D supplements does not exist among study participants. Additional lifestyle factors influencing vitamin D status were analysed. Only 2% of study participants spend approximately 11 min on the sun daily, 60.4% were obese, 23.1% were overweight and 71.2% reported low physical activity. These findings confirm previous reports on high prevalence of VDD in women across NENA, and in Libya. The situation calls for multi-sectoral actions and public health initiatives to address dietary and lifestyle habits

Uticaj tehnologije gajenja i tipa supstrata na kvalitet rasada Origanum vrsta

Aimed at intensifying the production of medicinal, aromatic and seasoning herbs seedlings, researches were conducted in the glass house of the Faculty of Agriculture of Belgrade. The researches included classical production of seedlings in cases according to bare root system and containter production of seedlings according to protected root system of Origanum species marjoram (Origanum majorana Moench) and oregano (Origanum heracleoticum L). Marjoram and oregano were grown on five different substrates: garden soil (control), Substrate 1, Steckemedium, Seedling and Tray substrate. Seedling production lasted 60 days. The following parameters of seedling quality were analyzed: seedlings height, number of branches and, seedlings plant mass. The best quality of marjoram and oregano seedlings were obtained with containter production and on the Substrate 1.Са циљем интензивирања производње расада лековитог, ароматичног и зачинског биља, спроведена су истраживања у стакленику Пољопривредног факултета у Београду. Истраживања су обухватала класичну производњу расада у сандучићима по систему тзв. голих жила и контејнерску производњу расада по систему тзв. заштићеног кореновог система Origanum врста: мајорана (Origanum majorana L.) и оригана (Origanum heracleoticum L). Мајоран и оригано су гајени на пет различитих супстрата: баштенска земља (контрола), Substrat 1, Steckemedium, Seedling и Tray супстрат. Производња расада расада је трајала 60 дана. Анализирани су следећи параметри квалитета расада: висина расада, број изданака и маса расада. Најбољи квалитет расада мајорана и оригана добијен је производњом у контејнерима на Substratu 1

Effect of school-based nutrition interventions among primary school children in sub-Saharan Africa: a systematic review protocol

Introduction Preadolescents are passing through an intensive growth and development period that will benefit from healthy eating practices. For those attending school, school environments offer several potential benefits and have been demonstrated to influence the quality of dietary intakes and consequentially, nutritional status of school-aged children (SAC). Considering the amount of time children spend in school and the enormous potential of evidence-based interventions, the purpose of this review is to critically appraise peer-reviewed literature addressing the impact of school-based interventions on the nutritional status of SAC aged 6–12 years in sub-Saharan Africa.Methods and analysis A systematic search will be conducted in the following databases and online search records: Medline, CINAHL, Web of Science, Embase, Global health, Global Index Medicus, Cochrane library, Hinari and Google Scholar using search terms and keywords codeveloped with two librarians. An additional search will also be conducted from the reference list of identified literature. Search results of titles and abstracts will be initially screened for eligibility criteria by two independent reviewers and where there is disagreement, a third reviewer will be consulted. Articles meeting these criteria will then undergo a full-text review for the eligibility and exclusion criteria. The Joanna Briggs Institute critical appraisal tool will be used to assess the risk of bias. Data from articles meeting all study criteria will be extracted, analysed and synthesised. A meta-analysis will also be conducted if sufficient data are available.Ethics and dissemination This systematic review is limited to publicly accessible data bases not requiring prior ethical approval to access. The results of the systematic review will be disseminated through publications in peer-reviewed journals as well as conference and stakeholder presentations.PROSPERO registration number CRD42022334829