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Diet, lifestyle, and livelihoods during coronavirus disease 2019 (COVID-19)–related lockdowns and the value of web-based nutrition studies
Anika Knuppel
doi : 10.1093/ajcn/nqaa408
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 763–764
In October 2020, the WHO warned of the impact of coronavirus disease 2019 (COVID-19) on nutritional status and quality through changes in socioeconomic conditions (1). Although these predictions were mainly speculative at the time, 2 articles in this issue of the Journal now add prospective evidence on changes in diet quality and lifestyle during the April 2020 COVID-19 lockdowns in relation to sociodemographic circumstances. Both studies used data from ongoing web-based cohort studies, NutriNet-Santé from France and NutriQuébec...
To assist the large number of countries facing the double burden of malnutrition we must understand its causes and recognize the need for policies that do no harm
Barry M Popkin
doi : 10.1093/ajcn/nqaa419
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 765–766
Globally, from Latin America to sub-Saharan Africa to Asia, we find a surprisingly high and rapidly increasing prevalence of overweight, even though stunting remains high also (1). Stunting, linked to poor nutrition and poor environmental conditions in the first 1000 d from conception through infancy, has declined slowly in most countries across the globe, whereas overweight and obesity have risen rapidly (2, 3). Today no country can claim that <20% of its adult women have BMIs > 25 kg/m2. Stunting has always been associated with poverty, and increasingly we find overweight and obesity are also shifting to the...
Growth in the first 1000 days lays the foundation for human capital formation
Maureen M Black, Angela C B Trude, Alysse J Kowalski
doi : 10.1093/ajcn/nqaa426
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 767–768
Two articles in this issue of the American Journal of Clinical Nutrition demonstrate that performance on standardized intelligence quotient (IQ) tests at ages 5 and 18 y can be predicted by birth weight, length, and early growth (1, 2). The studies, set in Brazil and Denmark, highlight the long-term relationship of nutritional adequacy in the first 1000 d (from conception to the second birthday) with intelligence, a key component of human capital. These insights can inform population-level strategies to foster intelligence and evoke research questions on mechanisms linking early nutrition with human capital.
When should universal distribution of periodic high-dose vitamin A to children cease?
Wafaie W Fawzi, Dongqing Wang
doi : 10.1093/ajcn/nqaa428
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 769–771
Vitamin A deficiency (VAD) results in night blindness; continued and severe deficiency leads to more serious forms of xerophthalmia, including corneal ulceration and permanent blindness. VAD also increases the risk of morbidity and mortality from infections, including measles, diarrhea, and respiratory tract infection. Based on the latest Cochrane systematic review, periodic vitamin A supplementation (VAS) among older infants and young children aged 6–59 mo reduced all-cause mortality by 12% (1). The WHO currently recommends periodic VAS among children aged 6–59 mo in settings with a high prevalence of night blindness or VAD. The recommended regimen is 30,000 ?g of retinol activity...
Milky ways: effects of maternal obesity on human milk composition and childhood obesity risk
Elvira Isganaitis
doi : 10.1093/ajcn/nqab009
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 772–774
Breastfeeding is promoted by the American Academy of Pediatrics, Institute of Medicine, WHO, and other leading medical organizations as a way to curb childhood obesity (1–3). Although breastfeeding has numerous benefits for maternal and infant health, the evidence on obesity prevention is contradictory at best. Several large studies have documented protective effects (4), but meta-analyses have found evidence of publication bias (5, 6) and mixed effects on obesity (7). Potential benefits of breastfeeding on offspring BMI may be blunted in women with obesity or gestational diabetes mellitus (8). When confounders such as maternal BMI,...
?-3 fatty acids and their interactions
A David Smith, Fredrik Jernerén, Helga Refsum
doi : 10.1093/ajcn/nqab013
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 775–778
Nutritional scientists are familiar with the fact that a biological effect might not always be explained by the actions of a single nutrient in food. But often the public seeks a simple explanation for findings in nutritional research, for example, that “nutrient A will prevent heart disease.” Randomized clinical trials in nutrition are usually based on such reductionist principles. However, even when a nutrient has a certain effect, the overall results may be due to interactions with other nutrients, with physiologic factors or with genetic polymorphisms that influence the outcomes. The n–3 (?-3) long-chain PUFAs provide several examples of interactions that may determine the functional...
Assessing the Omega-3 Index in a population: Canada did it right
Kristina H Jackson, William S Harris
doi : 10.1093/ajcn/nqab021
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 779–780
Obtaining a representative sample of the population for nutritional status assessment is one of the most difficult and important tasks in nutritional research. Although national surveys of nutritional intake have long been conducted, going back to 1960 in the US NHANES program, measuring nutritional biomarkers is a more recent advancement, including the assessment of circulating fatty acids, in particular the long-chain marine omega (?)-3 fatty acids EPA (20:5n–3) and DHA (22:6n–3) (1) which have been associated with reduced risk of cardiovascular disease (2).
Vitamin B-6 intake is related to physical performance in European older adults: results of the New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE) study
Pol Grootswagers, Marco Mensink, Agnes A M Berendsen, Carolien P J Deen, Ido P Kema ...
doi : 10.1093/ajcn/nqaa368
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 781–789
Maintenance of high physical performance during aging might be supported by an adequate dietary intake of niacin, vitamins B-6 and B-12, and folate because these B vitamins are involved in multiple processes related to muscle functioning. However, not much is known about the association between dietary intake of these B vitamins and physical performance.
The effect of daily protein supplementation, with or without resistance training for 1 year, on muscle size, strength, and function in healthy older adults: A randomized controlled trial
Kenneth H Mertz, S?ren Reitelseder, Rasmus Bechshoeft, Jacob Bulow, Grith H?jfeldt ...
doi : 10.1093/ajcn/nqaa372
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 790–800
Protein supplementation alone or combined with resistance training has been proposed to be effective in counteracting age-related losses of muscle mass and strength.
Positive effects of folic acid supplementation on cognitive aging are dependent on ?-3 fatty acid status: a post hoc analysis of the FACIT trial
Annick P M van Soest, Ondine van de Rest, Renger F Witkamp, Lisette C P G M de Groot
doi : 10.1093/ajcn/nqaa373
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 801–809
Although epidemiological studies suggest a protective role of B vitamins and omega-3 (?-3) fatty acids in cognitive decline, findings from intervention studies are conflicting. Mechanistic studies suggest that the ?-3 (n–3) fatty acid status can modulate the effects of B vitamins on cognitive decline.
Healthy lifestyles, genetic modifiers, and colorectal cancer risk: a prospective cohort study in the UK Biobank
Jungyoon Choi, Guochong Jia, Wanqing Wen, Xiao-Ou Shu, Wei Zheng
doi : 10.1093/ajcn/nqaa404
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 810–820
Both genetic and lifestyle factors play an etiologic role in colorectal cancer (CRC).
Soy protein supplementation in men following radical prostatectomy: a 2-year randomized, placebo-controlled clinical trial
Maarten C Bosland, Erika Enk, Joanne Schmoll, Michael J Schlicht, Carla Randolph ...
doi : 10.1093/ajcn/nqaa390
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 821–831
Many studies have addressed effects of dietary supplementation with soy protein, but most have been inconsistent and few have been long-term studies in men.
Food-related quality of life is impaired in inflammatory bowel disease and associated with reduced intake of key nutrients
Kevin Whelan, Trevor Murrells, Myfanwy Morgan, Fraser Cummings, Catherine Stansfield ...
doi : 10.1093/ajcn/nqaa395
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 832–844
Inflammatory bowel disease (IBD) may impact the extent to which food, eating, and drinking bring satisfaction and enjoyment to peoples’ lives, and this may impact dietary intake. The prevalence of an impaired food-related quality of life (FR-QoL), its associated factors, and its impact on diet have not been explored.
Goat milk protein digestibility in relation to intestinal function
Sindhu Kashyap, Nirupama Shivakumar, Veerasamy Sejian, Nicolaas E P Deutz, Thomas Preston ...
doi : 10.1093/ajcn/nqaa400
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 845–853
Milk is an important high-quality animal protein source in low- and middle-income countries (LMICs). Although the true ileal digestibility and absorption of milk has been shown to be high in French adults, this may be lower in individuals from LMICs who are at risk of environmental enteropathy.
Vitamin A deficiency has declined in Malawi, but with evidence of elevated vitamin A in children
Anne M Williams, Sherry A Tanumihardjo, Elizabeth C Rhodes, Carine Mapango, Benson Kazembe ...
doi : 10.1093/ajcn/nqab004
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 854–864
Reduction of vitamin A deficiency (VAD) in Malawi coincided with introduction of vitamin A-fortified staple foods, alongside continued biannual high-dose vitamin A supplementation (VAS).
The double burden of malnutrition in Peru: An update with a focus on social inequities
Maria P Santos, Beja Turner, M Pia Chaparro
doi : 10.1093/ajcn/nqaa387
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 865–873
The decrease in stunting in Peru is seen as a “success story” in the fight against malnutrition; however, the parallel increase in obesity has often been ignored.
Aflatoxin exposure and child nutrition: measuring anthropometric and long-bone growth over time in Nepal
Johanna Y Andrews-Trevino, Patrick Webb, Gerald Shively, Ahmed Kablan, Kedar Baral ...
doi : 10.1093/ajcn/nqaa397
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 874–883
Naturally occurring aflatoxins may contribute to poor growth and nutritional statuses in children.
Impact of nutritional interventions among lactating mothers on the growth of their infants in the first 6 months of life: a randomized controlled trial in Delhi, India
Sunita Taneja, Ravi Prakash Upadhyay, Ranadip Chowdhury, Anura V Kurpad, Himani Bhardwaj ...
doi : 10.1093/ajcn/nqaa383
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 884–894
In lower-middle-income settings, growth faltering in the first 6 mo of life occurs despite exclusive breastfeeding.
Maternal diet in pregnancy is associated with differences in child body mass index trajectories from birth to adolescence
Carmen Monthé-Drèze, Sheryl L Rifas-Shiman, Izzuddin M Aris, Nitin Shivappa, James R Hebert ...
doi : 10.1093/ajcn/nqaa398
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 895–904
Nutrition in pregnancy and accelerated childhood growth are important predictors of obesity risk. Yet, it is unknown which dietary patterns in pregnancy are associated with accelerated growth and whether there are specific periods from birth to adolescence that are most sensitive to these associations.
Probiotic stool secretory immunoglobulin A modulation in children with gastroenteritis: a randomized clinical trial
Stephen B Freedman, Rachael Horne, Kathene Johnson-Henry, Jianling Xie, Sarah Williamson-Urquhart ...
doi : 10.1093/ajcn/nqaa369
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 905–914
We previously conducted the Probiotic Regimen for Outpatient Gastroenteritis Utility of Treatment (PROGUT) study, which identified no improvements in children with acute gastroenteritis (AGE) administered a probiotic. However, the aforementioned study did not evaluate immunomodulatory benefits.
Correcting iron deficiency anemia with iron dextran alters the serum metabolomic profile of the infant Rhesus Monkey
Brian J Sandri, Gabriele R Lubach, Eric F Lock, Pamela J Kling, Michael K Georgieff ...
doi : 10.1093/ajcn/nqaa393
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 915–923
The effects of infantile iron deficiency anemia (IDA) extend beyond hematological indices and include short- and long-term adverse effects on multiple cells and tissues. IDA is associated with an abnormal serum metabolomic profile, characterized by altered hepatic metabolism, lowered NAD flux, increased nucleoside levels, and a reduction in circulating dopamine levels.
Diet and physical activity during the coronavirus disease 2019 (COVID-19) lockdown (March–May 2020): results from the French NutriNet-Santé cohort study
Mélanie Deschasaux-Tanguy, Nathalie Druesne-Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, Benjamin Allès ...
doi : 10.1093/ajcn/nqaa336
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 924–938
Since December 2019, coronavirus disease 2019 (COVID-19) has been spreading steadily, resulting in overwhelmed health-care systems and numerous deaths worldwide. To counter these outcomes, many countries, including France, put in place strict lockdown measures, requiring the temporary closure of all but essential places and causing an unprecedented disruption of daily life.
Vitamin A deficiency among children younger than 5 y in India: an analysis of national data sets to reflect on the need for vitamin A supplementation
G Bhanuprakash Reddy, Raghu Pullakhandam, Santu Ghosh, Naveen K Boiroju, Shalini Tattari ...
doi : 10.1093/ajcn/nqaa314
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 939–947
Biochemical vitamin A deficiency (VAD) is believed to be a serious public health problem (low serum retinol prevalence >20%) in Indian children, justifying universal high-dose vitamin A supplementation (VAS).
Dietary cholesterol and egg intake in relation to incident cardiovascular disease and all-cause and cause-specific mortality in postmenopausal women
Guo-Chong Chen, Li-Hua Chen, Yasmin Mossavar-Rahmani, Victor Kamensky, Aladdin H Shadyab ...
doi : 10.1093/ajcn/nqaa353
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 948–959
The potential cardiovascular impact of dietary cholesterol intake has been actively debated for decades.
Nut consumption and type 2 diabetes risk: a systematic review and meta-analysis of observational studies
Nerea Becerra-Tom?s, Indira Paz-Graniel, Pablo Hern?ndez-Alonso, David J A Jenkins, Cyril W C Kendall ...
doi : 10.1093/ajcn/nqaa358
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 960–971
Previous meta-analyses, with some methodological controversies, have assessed the relation between nut consumption and type 2 diabetes (T2D) risk and pointed to contradictory results, making desirable the performance of an updated meta-analysis.
Prospective associations of protein intake parameters with muscle strength and physical performance in community-dwelling older men and women from the Quebec NuAge cohort
Linda M Hengeveld, Stéphanie Chevalier, Marjolein Visser, Pierrette Gaudreau, Nancy Presse
doi : 10.1093/ajcn/nqaa360
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 972–983
Dietary protein has been related to muscle function in aging. Beyond total intake, parameters such as protein distribution across meals might also be important.
Changes in diet quality and food security among adults during the COVID-19–related early lockdown: results from NutriQuébec
Benoît Lamarche, Didier Brassard, Annie Lapointe, Catherine Laramée, Michèle Kearney ...
doi : 10.1093/ajcn/nqaa363
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 984–992
The impact that the coronavirus disease 2019 (COVID-19)–related early lockdown has had on dietary habits of the population and on food insecurity is unknown.
Proportions of long-chain ?-3 fatty acids in erythrocyte membranes of Canadian adults: Results from the Canadian Health Measures Survey 2012–2015
Isabelle Demonty, Kellie Langlois, Linda S Greene-Finestone, Rana Zoka, Loan Nguyen
doi : 10.1093/ajcn/nqaa401
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 993–1008
The Omega-3 Index (OI) is a proposed marker of coronary artery disease (CAD) risk. Another index, the EPA/arachidonic acid (AA) ratio has also been proposed as a possible risk marker for CAD.
Maternal BMI is positively associated with human milk fat: a systematic review and meta-regression analysis
Allison I Daniel, Sara Shama, Samantha Ismail, Celine Bourdon, Alex Kiss ...
doi : 10.1093/ajcn/nqaa410
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1009–1022
Lack of robust estimates of human-milk nutrient composition and influential maternal factors, such as body composition, are barriers to informing nutrition policies and programs.
Causal effects of relative fat, protein, and carbohydrate intake on chronic kidney disease: a Mendelian randomization study
Sehoon Park, Soojin Lee, Yaerim Kim, Yeonhee Lee, Min Woo Kang ...
doi : 10.1093/ajcn/nqaa379
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1023–1031
The effects of specific macronutrients on kidney function independent of total calorie intake have rarely been studied, although the composition of macronutrient intake has been reported to affect health outcomes.
Behavioral consequences at 5 y of neonatal iron deficiency in a low-risk maternal–infant cohort
Elaine K McCarthy, Deirdre M Murray, Jonathan O?B Hourihane, Louise C Kenny, Alan D Irvine ...
doi : 10.1093/ajcn/nqaa367
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1032–1041
Iron is critical to the developing brain, but fetal iron accretion is compromised by several maternal and pregnancy-related factors. Little consideration has been given to the long-term neurologic consequences of neonatal iron deficiency, especially in generally healthy, low-risk populations.
Total estimated usual nutrient intake and nutrient status biomarkers in women of childbearing age and women of menopausal age
Prasad P Devarshi, LeeCole L Legette, Ryan W Grant, Susan Hazels Mitmesser
doi : 10.1093/ajcn/nqaa392
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1042–1052
Women of childbearing age (WCBA) and women of menopausal age (WMENO) have distinct nutritional needs. Understanding nutrient intake and status in these life stages is critical for tailoring dietary recommendations.
Immunonutrition in head and neck cancer patients undergoing chemoradiotherapy: an alternative approach for overcoming potential bias
Riccardo Caccialanza, Emanuele Cereda, Ester Orlandi, Andrea Riccardo Filippi, Patrizia Comoli ...
doi : 10.1093/ajcn/nqaa421
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1053–1054
We read with interest the article by Boisselier et al. (1), in which the authors presented the results of their phase III trial on immunonutrition in head and neck cancer (HNSCC) patients undergoing adjuvant chemoradiotherapy (CRT). The intervention with the immunomodulating formula failed to reduce severe mucositis during CRT, but improvements in overall survival (OS) and progression-free survival (PFS) were observed in patients who were compliant to the immunomodulating supplement.
Reply to Caccialanza et al.
Pierre Boisselier, Simon Thézénas, Nicolas Flori, Marie Vinches, Jean Bourhis ...
doi : 10.1093/ajcn/nqaa425
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1054–1055
We appreciate the opportunity to respond to the letter of Caccialanza et al. concerning our randomized multicenter study (NCT01149642) to evaluate the specific effect of oral immunomodulating regimens on severe (grade >3) acute mucosal toxicity. The major criticism was the absence in our study of first-line nutritional counseling designed to increase protein intake, which would explain the lack of effectiveness of the immunomodulating supplement on the primary outcome—mucositis.
Reply to DJ Millward
Sylwia Szwiega, Paul B Pencharz, Glenda Courtney-Martin
doi : 10.1093/ajcn/nqab032
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1055–1056
We appreciate the opportunity to respond to the issues raised by Dr Millward and to clarify aspects of our methodology in relation to these concerns.
Leucine requirements for the elderly
D Joe Millward
doi : 10.1093/ajcn/nqab030
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1056–1057
Recently Szwiega et al. (1) reported work involving the indicator amino acid oxidation method (IAAO) suggesting that the dietary leucine requirement of older men and women is more than double the amount in current recommendations. As a result, they argue that current leucine recommendations for older adults should be revised.
Low vitamin B-12–high folate status in adolescents and pregnant women may have deleterious effects on health of the offspring
Rishikesh V Behere, Chittaranjan S Yajnik
doi : 10.1093/ajcn/nqab007
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Pages 1057–1059
We read with interest the paper by Bailey et al. (1) and the associated editorial by Molloy (2). They report a significant interaction between low vitamin B-12 and high folate status in relation to lower cognitive functioning in elderly participants of the NHANES cohort. There is a suggestion that unmetabolized folic acid might be related to such outcomes, raising a concern about dose of folic acid in fortified foods and supplements.
Corrigendum to: Formal maternal employment is associated with lower odds of exclusive breastfeeding by 14-weeks postpartum: a cross-sectional survey in Naivasha, Kenya. Am J Clin Nutr 2021;113(3):562–73
S B Ickes
doi : 10.1093/ajcn/nqab055
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Page 1060
Corrigendum to: Formal maternal employment is associated with lower odds of exclusive breastfeeding by 14-weeks postpartum: a cross-sectional survey in Naivasha, Kenya. Am J Clin Nutr 2021;113(3):562–73.
Calendar of Events
doi : 10.1093/ajcn/nqab118
The American Journal of Clinical Nutrition, Volume 113, Issue 4, April 2021, Page 1061
Due to the ongoing COVID-19 pandemic, events around the world are being postponed or moved online. For the most current information on events listed below, please visit the meeting's website.
