Candidate approaches and challenges

Funding Information: The development of this paper, its open access, assembly, and meetings of the Calcium Task Force were supported by funding from the Children’s Investment Fund Foundation to the Nutrition Science Program of the New York Academy of Sciences. Publisher Copyright: © 2022 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of New York Academy of Sciences.Inadequate dietary calcium intake is a global public health problem that disproportionately affects low- and middle-income countries. However, the calcium status of a population is challenging to measure, and there are no standard methods to identify high-risk communities even in settings with an elevated prevalence of a disease caused or exacerbated by low calcium intake (e.g., rickets). The calcium status of a population depends on numerous factors, including intake of calcium-rich foods; the bioavailability of the types of calcium consumed in foods and supplements; and population characteristics, including age, sex, vitamin D status, and genetic attributes that influence calcium retention and absorption. The aim of this narrative review was to assess candidate indicators of population-level calcium status based on a range of biomarkers and measurement methods, including dietary assessment, calcium balance studies, hormonal factors related to calcium, and health outcomes associated with low calcium status. Several promising approaches were identified, but there was insufficient evidence of the suitability of any single indicator to assess population calcium status. Further research is required to develop and validate specific indicators of calcium status that could be derived from the analysis of data or samples that are feasibly collected in population-based surveys.publishersversionpublishe

prevalence of inadequate intakes and associated health outcomes

© 2022 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of New York Academy of Sciences.Dietary calcium deficiency is considered to be widespread globally, with published estimates suggesting that approximately half of the world's population has inadequate access to dietary calcium. Calcium is essential for bone health, but inadequate intakes have also been linked to other health outcomes, including pregnancy complications, cancers, and cardiovascular disease. Populations in low- and middle-income countries (LMICs) are at greatest risk of low calcium intakes, although many individuals in high-income countries (HICs) also do not meet recommendations. Paradoxically, many LMICs with lower calcium intakes show lower rates of osteoporotic fracture as compared with HICs, though data are sparse. Calcium intake recommendations vary across agencies and may need to be customized based on other dietary factors, health-related behaviors, or the risk of calcium-related health outcomes. The lack of standard methods to assess the calcium status of an individual or population has challenged efforts to estimate the prevalence of calcium deficiency and the global burden of related adverse health consequences. This paper aims to consolidate available evidence related to the global prevalence of inadequate calcium intakes and associated health outcomes, with the goal of providing a foundation for developing policies and population-level interventions to safely improve calcium intake and status where necessary.publishersversionepub_ahead_of_prin

Including calcium-fortified water or flour in modeled diets based on local foods could improve calcium intake for women, adolescent girls, and young children in Bangladesh, Uganda, and Guatemala

Adequate calcium intake is essential for health, especially for infants, children, adolescents, and women, yet is difficult to achieve with local foods in many low- and middle-income countries. Previous analysis found it was not always possible to identify food-based recommendations (FBRs) that reached the calcium population recommended intake (PRI) for these groups in Bangladesh, Guatemala, and Uganda. We have modeled the potential contribution of calcium-fortified drinking water or wheat flour to FBR sets, to fill the remaining intake gaps. Optimized diets containing fortified products, with calcium-rich local foods, achieved the calcium PRI for all target groups. Combining fortified water or flour with FBRs met dietary intake targets for adolescent girls in all geographies and allowed a reduction from 3-4 to the more feasible 1-2 FBRs. Water with a calcium concentration of 100 mg/L with FBRs was sufficient to meet calcium targets in Uganda, but higher concentrations (400-500 mg/L) were mostly required in Guatemala and Bangladesh. Combining calcium-fortified wheat flour at 400 mg/100 g of flour and the FBR for small fish resulted in diets meeting the calcium PRI in Bangladesh. Calcium-fortified water or flour could improve calcium intake for vulnerable populations, especially when combined with FBRs based on locally available foods

Could local foods achieve recommended calcium intakes for nutritionally vulnerable populations in Uganda, Guatemala, and Bangladesh?

Globally, dietary intake of calcium is often insufficient, and it is unclear if adequacy could be achieved by promoting calcium-rich local foods. This study used linear programming and household consumption data from Uganda, Bangladesh, and Guatemala to assess whether local foods could meet calcium population reference intakes (Ca PRIs). The most promising food-based approaches to promote dietary calcium adequacy were identified for 12- to 23-month-old breastfed children, 4- to 6-year-old children, 10- to 14-year-old girls, and nonpregnant and nonbreastfeeding (NPNB) women of reproductive age living in two regions of each country. Calcium-optimized diets achieved 75-253% of the Ca PRI, depending on the population, and were <100% for 4- to 6-year-olds in one region of each country and 10- to 14-year-old girls in Sylhet, Bangladesh. The best food sources of calcium were green leafy vegetables and milk, across geographic locations, and species of small fish, nixtamalized (lime-treated) maize products, sesame seeds, and bean varieties, where consumed. Food-based recommendations (FBRs) achieving the minimum calcium threshold were identified for 12- to 23-month-olds and NPNB women across geographic locations, and for 4- to 6-year-olds and 10-to 14-year-old girls in Uganda. However, for 4- to 6-year-olds and 10- to 14-year-old girls in Bangladesh and Guatemala, calcium-adequate FBRs could not be identified, indicating a need for alternative calcium sources or increased access to and consumption of local calcium-rich foods

Dietary Intake and Representativeness of a Diverse College-Attending Population Compared with an Age-Matched US Population

Young adults typically gain more dietary autonomy as they start college, though this can also present nutritional challenges; however, research on the generalizability of their dietary intake data is scarce. To address this representativeness concern, we compared food and nutrient intakes reported by college freshmen attending a large, diverse university to an age-matched sample from the National Health and Nutrition Examination Survey (NHANES). We studied 269 students 18–24 years old recruited through the Mason: Health Start Here (HSH) study, a population-based cohort study of college students. Diet was assessed using a diet history questionnaire (DHQ-III) and estimated with food source composition tables. The NHANES sample of 835 adults was the reference dataset. Reported dietary intakes were weighted and compared with national intakes via t-tests. We observed comparable energy, carbohydrate, fat, and protein intakes in both groups; however, the HSH cohort reported a higher density intake of most micronutrients than the NHANES sample. Differences between these samples in intake, mode of dietary assessment administration, and reactivity may help explain the differences detected. These results demonstrate that when appropriately contextualized in terms of methodology and potential sources of bias, single college studies can be useful for understanding nutrition in young adults more broadly

Overweight or Obesity Onset and Past Attempts to Lose/Manage Weight: A Qualitative Study

This study aims to investigate the prevalence of weight control attempts along with their strategies and motivations. This study used a retrospective observational qualitative method, and adults who had body mass index (BMI) of at least 25 kg/m2 were included. The qualitative data were analyzed using a descriptive phenomenological approach. The summaries and emergence of major concepts identified by the participants were analyzed in-depth using a systematized retrieval and review of the data. NVivo was used to establish interrater reliability and percent agreement and analyze and manage the data. 91.7% of participants had tried to lose weight, and 72% were successful at least in one of their attempts. Health, appearance, and sports training were salient motivating factors. Their attempts to lose weight ranged from 2 to 30 times (median 4 times). Different dietary strategies and physical exercises were often tried. Among the most notable strategies were diet methods, following weight management programs, and consulting with dietitians. A number of barriers were reported, including ineffective weight loss, non-sustainability, demotivation, and unaffordability. For advancing evidence-based long-term weight control, it is vital to evaluate the quality and nature of weight management strategies and services from the perspective of users

Comparison of Muscle and Subcutaneous Tissue Fatty Acid Composition of Bangladeshi Nondescript Deshi Bulls Finished on Pasture Diet

The objective of this study was to characterize and compare the tissue-associated differences in the fatty acid profiles of intramuscular and subcutaneous fat from pasture fed nondescript deshi breed bulls of Bangladesh. The average chemical composition of the longissimus muscle was as follows: moisture 74.65±0.48%, protein 21.55±0.83%, intramuscular fat 2.78±0.28%, and ash 1.02±0.03%. There was significant evidence that the lipids of longissimus muscle from the nondescript deshi bulls had a lower content of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and conjugated linoleic acid (CLA) and a higher content of polyunsaturated fatty acids (PUFA) compared to subcutaneous fat. Intramuscular fat also showed the highest PUFA/SFA and ∑n-6/∑n-3 fatty acids ratios and total n-3 and n-6 PUFAs compared to subcutaneous tissue depots. Overall findings suggest that the meat from pasture fed nondescript deshi breed can be considered as lean meat and healthy for human consumption

Comparison of the Proximate Composition, Total Carotenoids and Total Polyphenol Content of Nine Orange-Fleshed Sweet Potato Varieties Grown in Bangladesh

In an attempt to develop the food composition table for Bangladesh, the nutritional composition of nine varieties of orange-fleshed sweet potato was analyzed together with total carotenoids (TCC) and total polyphenol content (TPC). Each variety showed significant variation in different nutrient contents. The quantification of the TCC and TPC was done by spectrophotometric measurement, and the proximate composition was done by the AOAC method. The obtained results showed that total polyphenol content varied from 94.63 to 136.05 mg gallic acid equivalent (GAE)/100 g fresh weight. Among the selected sweet potatoes, Bangladesh Agricultural Research Institute (BARI) Sweet Potato 7 (SP7) contained the highest, whereas BARI SP6 contained the lowest amount of total polyphenol content. The obtained results also revealed that total carotenoids content ranged from 0.38 to 7.24 mg/100 g fresh weight. BARI SP8 showed the highest total carotenoids content, whereas BARI SP6 showed the lowest. Total carotenoids content was found to be higher in dark orange-colored flesh varieties than their light-colored counterparts. The results of the study indicated that selected sweet potato varieties are rich in protein and carbohydrate, low in fat, high in polyphenol and carotenoids and, thus, could be a good source of dietary antioxidants to prevent free radical damage, which leads to chronic diseases, and also to prevent vitamin A malnutrition

Autonomous ships for container shipping in the Arctic routes

This study investigates the competitiveness of various autonomous ship categories for container shipping in the Arctic route. We propose a multi-criteria decision-making (MCDM) framework using four ship categories as alternatives and eight criteria for competitiveness evaluation. We analyse collected data using the Best-Worst Method (BWM), one of the recently developed MCDM methods. The findings reveal that operating expenses, navigation aspects, and environmental protection are the three most important criteria for deploying autonomous ships in the Arctic route. Among the three investigated autonomous ships alternatives, the semi-autonomous ship operated from a shore control centre (SCC) is prioritized for Arctic shipping in the foreseeable future, when benchmarked against the conventional ship. The SCC-controlled semi-autonomous ship alternative is competitive in the majority of the considered criteria including operating expenses, capital expenses, navigation, ship-shore and ship-ship communication, search and rescue, and environmental protection