Deporte sano: control del dopaje en el caballo de deporte

Treball presentat a l'assignatura de Deontologia i Veterinària Legal (21223

Biofortified yellow cassava and vitamin A status of Kenyan children: a randomized controlled trial.

BACKGROUND: Whereas conventional white cassava roots are devoid of provitamin A, biofortified yellow varieties are naturally rich in β-carotene, the primary provitamin A carotenoid. OBJECTIVE: We assessed the effect of consuming yellow cassava on serum retinol concentration in Kenyan schoolchildren with marginal vitamin A status. DESIGN: We randomly allocated 342 children aged 5-13 y to receive daily, 6 d/wk, for 18.5 wk 1) white cassava and placebo supplement (control group), 2) provitamin A-rich cassava (mean content: 1460 μg β-carotene/d) and placebo supplement (yellow cassava group), and 3) white cassava and β-carotene supplement (1053 μg/d; β-carotene supplement group). The primary outcome was serum retinol concentration; prespecified secondary outcomes were hemoglobin concentration and serum concentrations of β-carotene, retinol-binding protein, and prealbumin. Groups were compared by using ANCOVA, adjusting for inflammation, baseline serum concentrations of retinol and β-carotene, and stratified design. RESULTS: The baseline prevalence of serum retinol concentration <0.7 μmol/L and inflammation was 27% and 24%, respectively. For children in the control, yellow cassava, and β-carotene supplement groups, the mean daily intake of cassava was 378, 371, and 378 g, respectively, and the total daily supply of provitamin A and vitamin A from diet and supplements was equivalent to 22, 220, and 175 μg retinol, respectively. Both yellow cassava and β-carotene supplementation increased serum retinol concentration by 0.04 μmol/L (95% CI: 0.00, 0.07 μmol/L); correspondingly, serum β-carotene concentration increased by 524% (448%, 608%) and 166% (134%, 202%). We found no effect on hemoglobin concentration or serum concentrations of retinol-binding protein and prealbumin. CONCLUSIONS: In our study population, consumption of yellow cassava led to modest gains in serum retinol concentration and a large increase in β-carotene concentration. It can be an efficacious, new approach to improve vitamin A status. This study was registered with clinicaltrials.gov as NCT01614483

Idiopathic toe-walking in children, adolescents and young adults: a matter of local or generalised stiffness?

<p>Abstract</p> <p>Background</p> <p>Idiopathic Toe Walking (ITW) is present in children older than 3 years of age still walking on their toes without signs of neurological, orthopaedic or psychiatric diseases. ITW has been estimated to occur in 7% to 24% of the childhood population. To study associations between Idiopathic Toe Walking (ITW) and decrease in range of joint motion of the ankle joint. To study associations between ITW (with stiff ankles) and stiffness in other joints, muscle strength and bone density.</p> <p>Methods</p> <p>In a cross-sectional study, 362 healthy children, adolescents and young adults (mean age (sd): 14.2 (3.9) years) participated. Range of joint motion (ROM), muscle strength, anthropometrics sport activities and bone density were measured.</p> <p>Results</p> <p>A prevalence of 12% of ITW was found. Nine percent had ITW and severely restricted ROM of the ankle joint. Children with ITW had three times higher chance of severe ROM restriction of the ankle joint. Participants with ITW and stiff ankle joints had a decreased ROM in other joints, whereas bone density and muscle strength were comparable.</p> <p>Conclusion</p> <p>ITW and a decrease in ankle joint ROM might be due to local stiffness. Differential etiological diagnosis should be considered.</p

Proxy markers of serum retinol concentration, used alone and in combination, to assess population vitamin A status in Kenyan children: a cross-sectional study

Background Serum retinol concentration determined by high-performance liquid chromatography (HPLC) is recommended by the World Health Organization to assess population vitamin A status. This assay is expensive, technically demanding and rarely available in developing countries. Our objective was a) to assess the diagnostic performance of proxy markers in detecting vitamin A deficiency and b) to derive decision rules based on these markers to estimate vitamin A deficiency prevalence. Methods A survey was conducted in 15 rural primary schools in Eastern Province, Kenya, with 375 children aged 6 to 12 years (25 randomly selected per school). Serum retinol concentration ¿0.496} yielded prevalence estimates of vitamin A deficiency that is unbiased by diagnostic error. Conclusions The combination of transthyretin, RBP and C-reactive protein concentrations could eventually replace retinol concentration by HPLC in resource-poor settings as the preferred method to assess the population burden of vitamin A deficiency

Diet quality indices for research in low- and middle-income countries: A systematic review

Context: Dietary intake research has increasingly focused on improving diet quality in low- and middle-income countries (LMICs). Accompanying this is the need for sound metrics to assess diet quality. Objective: This systematic literature review aims to describe existing diet quality indices for general populations and highlights recommendations for developing such indices for food system research in LMICs. Data sources: Three electronic databases were searched for papers published between January 2008 and December 2017. Data extraction: Articles published in English and describing the development of an index to measure overall diet quality, irrespective of whether they were for high-income countries or LMICs, were included. Data analysis: Eighty-one indices were identified, over two thirds were based on national dietary guidelines from high-income countries. Of the 3 key diet quality dimensions, "diversity" was included in all 18 indices developed for LMICs, "moderation" was captured by most, and "nutrient adequacy" was included 4 times. Conclusions: Indices need to be developed that include all dimensions, include foods and/or food groups rather than nutrients, use an optimal range for individual components in the score, and express the intake of healthy and unhealthy components separately. Importantly, validation of the index should be part of its development. 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the International Life Sciences Institute.</p

Diet quality indices for research in low- and middle-income countries: A systematic review

Context: Dietary intake research has increasingly focused on improving diet quality in low- and middle-income countries (LMICs). Accompanying this is the need for sound metrics to assess diet quality. Objective: This systematic literature review aims to describe existing diet quality indices for general populations and highlights recommendations for developing such indices for food system research in LMICs. Data sources: Three electronic databases were searched for papers published between January 2008 and December 2017. Data extraction: Articles published in English and describing the development of an index to measure overall diet quality, irrespective of whether they were for high-income countries or LMICs, were included. Data analysis: Eighty-one indices were identified, over two thirds were based on national dietary guidelines from high-income countries. Of the 3 key diet quality dimensions, "diversity" was included in all 18 indices developed for LMICs, "moderation" was captured by most, and "nutrient adequacy" was included 4 times. Conclusions: Indices need to be developed that include all dimensions, include foods and/or food groups rather than nutrients, use an optimal range for individual components in the score, and express the intake of healthy and unhealthy components separately. Importantly, validation of the index should be part of its development. 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the International Life Sciences Institute.</p

Method for the development of wish, a globally applicable index for healthy diets from sustainable food systems

Promoting both a healthy diet and at the same time considering the environmental sustain-ability aspects of production and consumption of the diet are urgent global issues. We developed the WISH (World Index for Sustainability and Health) to evaluate diets for healthiness and sustainability. The WISH seeks to measure two complex multidimensional concepts, diet quality and environmental sustainability, in one scoring system. The WISH is based on the EAT-Lancet recommendations for a healthy and sustainable diet in the general population with global applicability across multiple settings. Thirteen food groups are scored between 0 and 10, based on their association with disease and impact on environmental indicators. The scoring system was applied using a dataset of duplicate 24 h dietary recalls from 396 urban Vietnamese men and women. Out of a maximum score of 130, the mean total WISH score was 46 (SD 11), and scores for the healthy and high-environmental impact sub-scores were mean 25 (11) (out of 100) and mean 26 (8) (out of 70) respectively. A higher score was observed for the less-healthy (mean 20 (2) out of 30) sub-score. Our initial analysis shows that the WISH is able to differentiate between the healthiness and the environmental sustainability of a Vietnamese diet.</p

When food systems meet sustainability – Current narratives and implications for actions

The concept of food system has gained prominence in recent years amongst both scholars and policy-makers. Experts from diverse disciplines and backgrounds have in particular discussed the nature and origin of the “unsustainability” of our modern food systems. These efforts tend, however, to be framed within distinctive disciplinary narratives. In this paper we propose to explore these narratives and to shed light on the explicit -or implicit- epistemological assumptions, mental models, and disciplinary paradigms that underpin those. The analysis indicates that different views and interpretations prevail amongst experts about the nature of the “crisis”, and consequently about the research and priorities needed to “fix” the problem. We then explore how sustainability is included in these different narratives and the link to the question of healthy diets. The analysis reveals that the concept of sustainability, although widely used by all the different communities of practice, remains poorly defined, and applied in different ways and usually based on a relatively narrow interpretation. In so doing we argue that current attempts to equate or subsume healthy diets within sustainability in the context of food system may be misleading and need to be challenged. We stress that trade-offs between different dimensions of food system sustainability are unavoidable and need to be navigated in an explicit manner when developing or implementing sustainable food system initiatives. Building on this overall analysis, a framework structured around several entry points including outcomes, core activities, trade-offs and feedbacks is then proposed, which allows to identify key elements necessary to support the transition toward sustainable food system

Biofortified cassava with pro-vitamin A is sensory and culturally acceptable for consumption by primary school children in Kenya.

BACKGROUND: Biofortification of cassava with pro-vitamin A can potentially reduce vitamin A deficiency in low-income countries. However, little is known about consumer acceptance of this deep yellow variety of cassava compared to the commonly available white varieties. We aimed to determine the sensory and cultural acceptability of the consumption of pro-vitamin A rich cassava in order to identify key factors predicting the intention to consume pro-vitamin A rich cassava by families with school-aged children in Eastern Kenya. METHODS: Sensory acceptability was measured by replicated discrimination tests and paired preference tests among 30 children (7-12 yr) and 30 caretakers (18-45 yr) in three primary schools. Cultural acceptability was assessed with a questionnaire based on the combined model of The Theory of Planned Behavior and The Health Belief Model in one primary school among 140 caretakers of children aged 6 to 12 years. Correlations and multivariate analyses were used to determine associations between summed scores for model constructs. RESULTS: Caretakers and children perceived a significant difference in taste between white and pro-vitamin A rich cassava. Both preferred pro-vitamin A rich cassava over white cassava because of its soft texture, sweet taste and attractive color. Knowledge about pro-vitamin A rich cassava and it's relation to health ('Knowledge' ((β = 0.29, P = <.01)) was a strong predictor of 'Health behavior identity'. Worries related to bitter taste and color ('Perceived barriers 1' (β = -0.21, P = .02)), the belief of the caretaker about having control to prepare cassava ('Control beliefs' (β = 0.18, P = .02)) and activities like information sessions about pro-vitamin A rich cassava and recommendations from health workers ('Cues to action'(β = 0.51, P = <.01)) were the best predictors of intention to consume pro-vitamin A rich cassava. CONCLUSIONS: Pro-vitamin A rich cassava is well accepted by school children in our study population