Search results for: dietary supplementation

Authors: Hae Dun Kim, Joo Hyun Jang, Geu Rim Seo, Kyung Soo Ra, Hyung Joo Suh

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Lactuca sativa (lettuce) has been known for its medical property to relieve anxiety and nervous. This study was implemented to investigate sleep-promoting effects of the lettuce alcohol extract (LAE). Caffeine is widely used psychoactive substance known to induced wakefulness and insomnia to its consumers. In the present study, the sedative-hypnotic activity of the LAE was studied using the method of pentobarbital-induced sleep in the mouse model. The LAE was administrated to mice 30 min before the pentobarbital injection. The LAE prolonged the pentobarbital-induced sleep duration and decreased sleep latency. The effects of LAE were comparable to those of induced by diazepam. Another study was performed to examine whether LAE ameliorates caffeine-induced sleep disturbance in mice. Additionally, caffeine (10 mg/kg, p.o) delayed sleep onset and reduced sleep duration of mice. Conversely, LAE treatment (80 or 160 mg/kg, p.o), especially at 160 mg/kg, normalized the sleep disturbance induced by caffeine. LAE supplementation can counter the sleep disturbance induced by caffeine. These results suggest that LAE possess significant sedative-hypnotic activity, which supports the popular use of lettuce for treatment of insomnia and provide the basis for new drug discovery. Furthermore, these results demonstrate that the lettuce extract may be preferable for the treatment of insomnia.

Keywords: caffeine, Lactuca sativa, sleep duration, sleep latency

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Authors: Novia Dwi Prabandari, Diah Ayu Asmarani

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Soluble fiber can accelerate the metabolism of cholesterol. Pectin and gum has been used in the form of substance additive for material stabilizer and emulsifier. Pectin supplementation in laying hens can decimate the cholesterol content in egg yolk and muscle. Therefore, this laying hens’ feed is regular feed chickens enriched with soluble fiber (Pectin, Xanthan gum, and Guar gum) to produce eggs and muscle with lower cholesterol than usual.The ingredients are mixed in the ratio of concentrate 45%, corn flour 25%, soybean meal 20%, and extract of soluble fiber 10%. Once all the ingredients are mixed and then evaporated with temperature < 80 °C. Then put in the grinding machine resulting in a circular shape with holes 2-3 mm in diameter, after it dried up the water content in the feed is less than 14%. Eggs from laying hen with soluble fiber fortification feed intake will have lower cholesterol levels in eggs than regular feed. So even with the cholesterol content in the muscle, it is because chicken feed fortified with soluble fiber will accelerate the metabolism of cholesterol and cause cholesterol deposits in the chicken less. The use of this kind of laying hens feed is produce eggs with high protein content can be consumed more for people who have hypercholesterolemia.

Keywords: pectin, xanthan gum, guar gum, laying hen, cholesterol

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Authors: Zahra Ranjbar

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Interpretive structural modeling (ISM) is a well-established methodology for identifying relationships among specific variables, which define a problem or an issue. In this study most important variables that have critical role in children obesity problem were introduce by ISM questionnaire technique and their relationships were determine. Our findings suggested that sedentary activities are top level variables and school teachers and administrators, public education and scientific collaborations are bottom level variables in children obesity problem. Control of dietary, Physical education program, parents, government and motivation strategies variables are depend to other variables. They are very sensitive to external variables. Also, physical education program, parents, government, motivation, school teachers and administrators, public education and collaboration variables have strong driving power. They are linkage factors; it means that they can be effective on children obesity problem directly.

Keywords: ISM, variable, obesity, physical education, children

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Authors: Fatema Ali Lanewala, Akhtar Jamal Khan

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The ocular complications in renal transplant recipients at the biggest transplant center in Pakistan were seen to be diverse, multiple, and sight-threatening. These complications could mainly be due to the primary disease causing renal failure, the process of transplantation, and/or the medications used pre and post-transplantation. A retrospective case series recently published in the Journal of Pakistan Medical Association highlights the common ocular pathologies encountered in renal transplant population. Majority of the patients suffered from cataract, which is a known side-effect of long-term steroids routinely used for graft survival. There was a unique finding in Pakistani population, never reported before from any other transplant centre world over; a large number of recipients was reported to be suffering from night blindness, which significantly improved on vitamin A supplementation. There were a variety of other ocular complications seen which emphasizes the necessity of ocular care and routine examination of transplant recipient’s eyes by an ophthalmologist in order to avoid visual compromise and improve the quality of life of the transplant recipient.

Keywords: cataract, night blindness, ocular complications, renal transplantation

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Authors: Hafiz Khuram Wasim Aslam, Muhammad Saeed, Azam Shakeel, Muhammad Inam Ur Raheem, Moazzam Rafiq Khan, Muhammad Atif Randhawa

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Inulin is significant ingredient used in food industry that functions technologically as a fat replacer often without compromising taste and texture. In this study inulin was extracted from the chicory roots and the effect of inulin addition as a fat replacer on the physiochemical, microbiological and sensory properties of non-fat yogurt was investigated. The supplementation of chicory inulin reduced the magnitude of firmness in comparison with non-inulin ¬supplemented non-fat yoghurt. Higher values of acidity were observed due to the more microbial fermentation in the inulin containing yogurt as compared to non-inulin yogurt and were in the range of 0.56 to 0.75 during storage days. Syneresis in control sample increased from 43.9% to 47.9% during the storage study. However inulin addition at different treatment enhanced syneresis from 44.5% to 47.6%. Inulin addition at various concentrations caused an increase in the TPC due to its probiotic effect. No effects of inuline addition on fat and protein contents were observed. Non-fat yoghurt supplemented with inulin demonstrated sensory behavior better than that of the control yoghurt. The most important effect of the addition of inulin to non-fat yoghurt is an increase in the sensory attributes appearance, body and texture, taste and mouth feel, overall acceptability. On an average, yoghurt supplemented with 1 to 2% inulin was better in overall acceptance as compared to control yoghurt.

Keywords: inulin, fat replacer, yoghurt, sensory evaluation, low fat

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Authors: Ihtasham Hamza

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In the contemporary world, where the West is afflicted by the diseases of excess nutrition, much of the rest globe suffers at the hands of hunger. A troubling constituent of hunger is micronutrient deficiency, also called hidden hunger. Major dependence on calorie-rich diets and low diet diversification are responsible for high malnutrition rates, especially in African and Asian countries. But the dilemma isn’t immune to solutions. Highlighting the substantial cause to be sole dependence on staples for food, biofortification has emerged as a novel tool to confront the widely distributed jeopardize of hidden hunger. Biofortification potentials the better nutritional approachability to commonalities overcoming various difficulties and reaching the doorstep. The crops associated with biofortification offer a rural-based involvement that, proposal, primarily reaches these more remote populations, which comprise a majority of the malnourished in many countries, and then penetrates to urban populations as assembly overages are marketed. Initial investments in agricultural research at a central location can generate high recurrent benefits at low cost as adapted biofortified cultivars become widely available in countries across time at low recurrent costs as opposed to supplementation which is comparatively expensive and requires continued financing over time, which may be imperilled by fluctuating political curiosity.

Keywords: biofortified crops, hunger, malnutrition, agricultural practices

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Authors: Mai Ashraf Talaat

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Background: Vitamin C (ascorbic acid) is an essential nutrient for the development and repair of all body tissues. It can be obtained from a healthy diet or through supplementation. Due to its importance, vitamin C has become a mainstay in the treatment and prevention of many diseases and in maintaining immune, skin, bone and overall health. This review article aims to discuss the studies and case reports conducted to evaluate the effect of Vitamin C on oral health and the recent advances in oral medicine that involve the use of vitamin C. Data/Sources: The review was conducted for clinical studies, case reports and published literature in the English language that addresses this topic. An extensive search in the electronic databases of PubMed, PubMed Central, Web of Science, National Library of Medicine and ResearchGate was performed. Conclusion: Vitamin C is thought to treat periodontal diseases and gingival enlargement. It also affects biofilm formation and therefore, it helps in reducing caries incidence. Recently, vitamin C mesotherapy has been used to treat inflamed gingiva, bleeding gums and gingival hyperpigmentation. More research and randomized controlled trials are needed on this specific topic for more accurate judgment. Clinical significance: A minimally invasive approach - the usage of vitamin C in dental care could drastically reduce the need for surgical intervention.

Keywords: oral health, periodontology, vitamin C, Gingivitis

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Authors: Christos E. Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Tamta Sirbilatze, Ifigenia Apostolou, Christina Kordali, Konstantina Panouria, Kostas Argyros, Georgios Mavras

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Malnutrition in hospitalized patients is related to increased morbidity and mortality. Purpose of our study was to assess nutritional status of hospitalized, elderly patients with various nutritional scores and to detect unfavorable prognostic factors, related to increased mortality and extended duration of admission. Methods: 150 patients (78 men, 72 women, mean age 80±8.2) were included in this cross-sectional study. Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). The following data were incorporated in analysis: Anthropometric and laboratory data, physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, dietary habits and mediterranean diet (assessed by MedDiet score), cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were the mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Mann-Whitney two-sample statistics or t-test was used for group comparisons and Spearman or Pearson coefficients for testing correlation between variables. Results: Normal nutrition was assessed in 54/150 (36%), 92/150 (61.3%) and in 106/150 (70.7%) of patients, according to full MNA, MUST and sNAQ questionnaires respectively. Mortality rate was 20.7% (31/150 patients). The patients who died until 6 months after admission had lower BMI (24±4.4 vs 26±4.8, p=0.04) and albumin levels (2.9±0.7 vs 3.4±0.7, p=0.002), significantly lower full MNA (14.5±7.3 vs 20.7±6, p<0.0001) and short-form MNA scores (7.3±4.2 vs 10.5±3.4, p=0.0002) compared to non-dead one. In contrast, the aforementioned patients had higher MUST (2.5±1.8 vs 0.5±1.02, p=<0.0001) and sNAQ scores (2.9±2.4 vs 1.1±1.3, p<0.0001). Additionally, they showed significantly lower MedDiet (23.5±4.3 vs 31.1±5.6, p<0.0001) and IPAQ scores (37.2±156.2 vs 516.5±1241.7, p<0.0001) compared to remaining one. These patients had extended hospitalization [5 (0-13) days vs 0 (-1-3) days, p=0.001]. Patients who admitted due to cancer depicted higher mortality rate (10/13, 77%), compared to those who admitted due to infections (12/73, 18%), stroke (4/15, 27%) or other causes (4/49, 8%) (p<0.0001). Extension of hospitalization was negatively correlated to both full (Spearman r=-0.35, p<0.0001) and short-form MNA (Spearman r=-0.33, p<0.0001) and positively correlated to MUST (Spearman r=0.34, p<0.0001) and sNAQ (Spearman r=0.3, p=0.0002). Additionally, the extension was inversely related to MedDiet score (Spearman r=-0.35, p<0.0001), IPAQ score (Spearman r=-0.34, p<0.0001), albumin levels (Pearson r=-0.36, p<0.0001), Ht (Pearson r=-0.2, p=0.02) and Hb (Pearson r=-0.18, p=0.02). Conclusion: A great proportion of elderly, hospitalized patients are malnourished or at risk of malnutrition. All nutritional scores, physical activity and albumin are significantly related to mortality and increased hospitalization.

Keywords: dietary habits, duration of admission, malnutrition, prognostic factors for mortality

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Authors: Eszter Repasi, Akos Koller

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Our genetic information determines our look, physiology, sports performance and all our features. Maximizing the performances of athletes have adopted a science-based approach to the nutritional support. Nowadays genetics studies have blended with nutritional sciences, and a dynamically evolving, new research field have appeared. Nutritional genomics is needed to be used by nutritional experts. This is a recent field of nutritional science, which can provide a solution to reach the best sport performance using correlations between the athlete’s genome, nutritions, molecules, included human microbiome (links between food, microbiome and epigenetics), nutrigenomics and nutrigenetics. Nutritional genomics has a tremendous potential to change the future of dietary guidelines and personal recommendations. Experts need to use new technology to get information about the athletes, like nutritional genomics profile (included the determination of the oral and gut microbiome and DNA coded reaction for food components), which can modify the preparation term and sports performance. The influence of nutrients on the genes expression is called Nutrigenomics. The heterogeneous response of gene variants to nutrients, dietary components is called Nutrigenetics. The human microbiome plays a critical role in the state of health and well-being, and there are more links between food or nutrition and the human microbiome composition, which can develop diseases and epigenetic changes as well. A nutritional genomics-based profile of athletes can be the best technic for a dietitian to make a unique sports nutrition diet plan. Using functional food and the right food components can be effected on health state, thus sports performance. Scientists need to determine the best response, due to the effect of nutrients on health, through altering genome promote metabolites and result changes in physiology. Nutritional biochemistry explains why polymorphisms in genes for the absorption, circulation, or metabolism of essential nutrients (such as n-3 polyunsaturated fatty acids or epigallocatechin-3-gallate), would affect the efficacy of that nutrient. Controlled nutritional deficiencies and failures, prevented the change of health state or a newly discovered food intolerance are observed by a proper medical team, can support better sports performance. It is important that the dietetics profession informed on gene-diet interactions, that may be leading to optimal health, reduced risk of injury or disease. A special medical application for documentation and monitoring of data of health state and risk factors can uphold and warn the medical team for an early action and help to be able to do a proper health service in time. This model can set up a personalized nutrition advice from the status control, through the recovery, to the monitoring. But more studies are needed to understand the mechanisms and to be able to change the composition of the microbiome, environmental and genetic risk factors in cases of athletes.

Keywords: gene-diet interaction, multidisciplinary team, microbiome, diet plan

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Authors: Samara R. Dania, Maulana S. Aji, Dewi Lestari

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Diabetes is a common disease in Indonesia. One of the risk factors of diabetes is an unhealthy diet which is consuming food that contains too much glucose, one of glucose sources presents in food containing carbohydrate. The purpose of this study is to identify the amount of glucose level in the consumed food. The authors use literature studies for this research method. For the results of this study, the authors expect diabetics to be more aware of diabetes by applying daily dietary regulation through D-Care. D-Care is an application that can enhance people awareness to diabetes in Indonesia. D-Care provides two menus; there are nutrition calculation and healthy food. Nutrition calculation menu is used for knowing estimated glucose intake level by calculating food that consumed each day. Whereas healthy food menu, it provides a combination of healthy food menu for diabetic. The conclusion is D-Care is useful to be used for reducing diabetes prevalence in Indonesia.

Keywords: D-Care, diabetes, awareness, healthy food

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Authors: Sasan Khademnematolahi, Kevine Kamga Silihe, Katarína Pružinská, Martina Chrastina, Elisabeth Louise Ndjengue Mindang, František Dráfi, Katarína Bauerová

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Background: In ethnomedicine, plant parts and compounds are traditionally utilized to treat many disorders. Azadirachta indica, known as Neem, has been traditionally used in medicinal practices. Neem has various pharmaceutical activities, such as antioxidant and anti-inflammatory, due to the content of bioactive compounds like nimbolide, azadirachtin, and gedunin.Through its effect on pathological inflammatory processes, supplementation with it could alleviate the symptoms of rheumatoid arthritis (RA). Methods: This research aimed to assess Neem seed oil's impact on rats with adjuvant arthritis. Three doses in monotherapy and two in combination with methotrexate (MTX) have been studied and their effect was compared. Neem p.o. doses of 100, 200, and 300 mg/kg and MTX p.o. doses of 0.3 mg/kg were examined. After clinical parameters assessment, biochemical analysis was performed in plasma. Results: During the acute phase of the experimental arthritis (Day21), levels of MMP-9, MCP-1 and cytokines IL-1beta and IL-17A were measured. The positive results of inflammatory mediators evaluation in plasma encourage additional analysis also in related tissues to prove if Neem seed oil can be used as an adjuvant therapy for RA. Conclusion: In this study, the combination therapy of Neem with MTX was most effective from all therapies investigated.

Keywords: adjuvant, neem, methotrexate, arthritis

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Authors: O. G. Onuoha, O. G. Akagu

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The potentials of acha (Digitaria exiles), aya (Cyperus esculentus) and defatted water melon seed (Citrullis lanatus) as a weaning formula was investigated using the following blends for acha, aya and defatted water melon seed respectively in percentage proportion to obtain the weaning formulae; WS1(20:50:30); WS2(30:40:30); WS3(40:30:30); WS4(50:20:30). The result of the chemical analysis showed that; the sample WS1 had the highest value (15.6%) for protein while sample WS4 had the least value (14.1%). The fat content sample WS4 having the highest value (30.8%) while sample WS1 had the least value (27.3%). The ash content sample WS4 had the highest value (3.22%) while sample WS1 had the least value (2.63%). The carbohydrate content showed that sample WS1 having the highest value (50.5%) while sample WS4 had the least value (46.58%). While sample WS4 had the highest energy value (528.32 Kcal) and sample WS2 had the least value (515.06 Kcal). However, all the sample results fell within the dietary daily reference intake for infants between 0-3 years and required only local technology in its production.

Keywords: weaning formula, acha, aya, deffted water melon seed

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Authors: Abebe Yimer, Sirawdink Fikereyesus Forsido, Getachew Addis, Abebe Ayelign

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Background: Oxidative stress has been an important health problem as itinduceschronic diseases such as cancer, cardiovascular, diabetics, and neurodegenerative disease. Plant source natural antioxidant has gained attention as synthetic antioxidant negatively impact human health. Wild edible plants arecheap source of dietary-medicine in mainly rural communityin south-west Ethiopia and elsewhere the country. Thus, the study aimed to determine total pheneol,flavoinoids, antioxidant, vitamin C, and beta-carotene content from wild edible plants Solanum nigrum L., Vigna membranacea A. Rich, Dioscorea praehensilis Benth., Trilepisium madagascariense D.C.andCleome gynandra L. Methods: Methanol was used to extract samples of oven-dried edible plants. Total phenolic compound (TPC) was determined using a Folin Ciocalteu method, whereas total flavonoid content (TFC) was determined using the Aluminium chloride colorimetric method. By using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) tests, antioxidant activities were evaluated in vitro. Additionally, beta-carotene was assessed using a spectrophotometric technique, whilst vitamin C was determined using a titration approach. Results: Total flavonoid contentranged from 0.85±0.03 to 11.25±0.01 mg CE/g in D. praehensilis Benth. tuber and C. gynandra L, respectively. Total phenolic compounds varied from 0.25±0.06 GAE/g in D. praehensilis Benth tuber to 35.73±2.52 GAE/g in S.nigrum L. leaves. In the DPPH test, the highest antioxidant value (87.65%) was obtained in the S.nigrum L. leaves, whereas the smallest amount of antioxidant (50.12%)was contained in D. praehensilis Benth tuber. Similarly in FRAP assay,D. praehensilis Benth tuber showed the least reducing potential(49.16± 2.13mM Fe2+/100 g)whilst the highest reducing potential was presented in the S.nigrum L. leaves(188.12±1.13 mM Fe2+/100 g). The beta-carotene content was found between 11.81±0.00 mg/100g in D. praehensilis Benth tubers to 34.49±0.95 mg/100g in V. membranacea A. Rich leaves. The concentration of vitamin C ranged from 10.00±0.61 in D. praehensilis Benth tubers to 45±1.80 mg/100g in V. membranacea A. Rich leaves. The results showed that high positive linear correlations between TPC and TFC of WEPs (r=0.828), as well as between FRAP and total phenolic contents (r = 0.943) and FRAP and vitamin C (r= 0.928). Conclusion: These findings showed the total phenolic and flavonoid contents of Solanum nigrum L. and Cleome gynandra L, respectively, are abundant. The outcome may be used as a natural supply of dietary antioxidants, which may be useful in preventing oxidative stress. The study's findings also showed that Vigna membranacea A. Rich leaves were cheap source of vitamin C and beta-carotene for people who consumed these wild green. Additional research on the in vivo antioxidant activity, toxicological analysis, and promotion of these wild food plants for agricultural production should be taken into consideration.

Keywords: antioxidant activity, beta-carotene, flavonoids, phenolic content, and vitamin c

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Authors: Bakytzhan Bimbetov, Abay Zhangabilov, Saule Aitbaeva, Galymzhan Meirambekov

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Mare’s milk (saumal) contains in total about 40 biological components necessary for the human body. The most significant among them are amino acids, fats, carbohydrates, enzymes (lysozyme, amylase), more minerals and vitamins which are well balanced with each other. In Kazakhstan, Company "Eurasia Invest Ltd.” produces a freeze-dried saumal in form of powder by the use of modern German innovative technology by means of evaporating at low temperature (-35°C) with an appropriate pasteurization. Research of freeze-dried biomilk for the qualitative content showed that main ingredients of freshly drown milk are being preserved. We are currently studying medical and dietary properties of freeze-dried mare's milk for diseases of the digestive system, including for nonalcoholic steatohepatitis (NASH) and liver cirrhosis (LC) viral etiology. The studied group consisted of 14 patients with NASH, and 7 patients with LC viral etiology of Class A severity degree as per Child-Pugh. Patients took freeze-dried saumal, preliminary dissolved in boiled warm water (24 g. powder per 200 ml water) 3-4 times a day for a month in conjunction with basic therapy. The results were compared to a control group (11 patients with NASH and LC) who received only basic therapy without mare’s milk. Results of preliminary research showed an improvement of subjective and objective conditions of all patients, but more significant improvement of clinical symptoms and syndromes were observed in the treatment group compared to the control one. Patients with NASH significantly over time compared to the beginning of therapy decreased asthenic and dyspeptic syndromes (p<0,01). Hepatomegaly, identified on the basis of ultrasound prior to treatment was observed in 92,8±2,4% of patients, and after combination therapy hepatomegaly the rate decreased by 14,3%, amounting to 78,5±2,8%. Patients with LC also noted the improvement of asthenic (p<0,01) and dyspeptic (p<0,05) syndromes and hemorrhagic syndrome (nosebleeds and bleeding gums when brushing your teeth, p<0,05), and jaundice. Laboratory study also showed improvement in the research group, but more significant changes were observed in the experimental group. Group of patients with NASH showed a significant improvement of index in cytolysis in conjunction with a combination therapy (p<0,05). In the control group, these indicators were also improved, but they were not statistically reliable (p>0,05). Markers of liver failure were additionally studied during the study of laboratory parameters in patients with liver cirrhosis, in particular, bilirubin, albumin and prothrombin index (PTI). Combined therapy with the use of basic treatment and mare's milk showed a significant improvement in cytolysis and bilirubin (p<0,05). In our opinion, a very important and interesting fact is that, in conjunction with basic therapy, the use of mare's milk revealed an improvement of liver function in the form of normalized PTI and albumin in patients with liver cirrhosis viral etiology. Results of this work have shown therapeutic efficiency of the use of mare's milk in complex treatment of patients with liver disease and require further in-depth study.

Keywords: liver cirrhosis, non-alcohol steatohepatitis, saumal, mare’s milk

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Authors: Maryam Nazari

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COVID-19 is a respiratory disease triggered by the novel coronavirus, SARS-CoV-2, that has reached pandemic status today. Acute inflammation and immune cells infiltration into lung injuries result in multi-organ failure. The presence of other non-communicable diseases (NCDs) with systemic inflammation derived from COVID-19 may exacerbate the patient's situation and increase the risk for adverse effects and mortality. This pandemic is a novel situation and the scientific community at this time is looking for vaccines or drugs to treat the pathology. One of the biggest challenges is focused on reducing inflammation without compromising the correct immune response of the patient. In this regard, addressing the nutritional factors should not be overlooked not only as a matter of avoiding the presence of NCDs with severe infections but also as an adjunctive way to modulate the inflammatory status of the patients. Despite the pivotal role of nutrition in modifying immune response, due to the novelty of the COVID-19 disease, information about the effects of specific dietary agents is limited in this area. From the macronutrients point of view, protein deficiency (quantity or quality) has negative effects on the number of functional immunoglobulins and gut-associated lymphoid tissue (GALT). High biological value proteins or some amino acids like arginine and glutamine are well known for their ability to augment the immune system. Among lipids, fish oil has the ability to inactivate enveloped viruses, suppress pro-inflammatory prostaglandin production and block platelet-activating factors and their receptors. In addition, protectin D1, which is an Omega-3 PUFAs derivation, is a novel antiviral drug. So it seems that these fatty acids can reduce the severity and/or improve recovery of patients with COVID-19. Carbohydrates with lower glycemic index and fibers are associated with lower levels of inflammatory cytokines (CRP, TNF-α, and IL-6). Short-Chain Fatty acids not only exert a direct anti-inflammatory effect but also provide appropriate gut microbial, which is important in gastrointestinal issues related to COVID-19. From the micronutrients point of view, Vitamins A, C, D, E, iron, magnesium, zinc, selenium and copper play a vital role in the maintenance of immune function. Inadequate status in these nutrients may result in decreased resistance against COVID-19 infection. There are specific bioactive compounds in the diet that interact with the ACE2 receptor, which is the gateway for SARS and SARS-CoV-2, and thus controls the viral infection. Regarding this, the potential benefits of probiotics, resveratrol (a polyphenol found in grape), oleoylethanolamide (derived from oleic acid), and natural peroxisome proliferator-activated receptor γ agonists in foodstuffs (like curcumin, pomegranate, hot pepper) are suggested. Yet, it should be pointed out that most of these results have been reported in animal models and further human studies are needed to be verified.

Keywords: Covid-19, inflammation, nutrition, dietary agents

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Authors: N. Uchegbu Nneka

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This study was conducted to investigate the effect of the antioxidant activity of germinated African Yam Bean (AYB) on oxidative stress markers in alloxan-induced diabetic rat. Rats were randomized into three groups; control, diabetic and germinated AYB–treated diabetic rats. The Total phenol and flavonoid content and DPPH radical scavenging activity before and after germination were investigated. The glucose level, lipid peroxidation and reduced glutathione of the animals were also determined using the standard technique for four weeks. Germination increased the total phenol, flavonoid and antioxidant activity of AYB extract by 19.14%, 32.28%, and 57.25% respectively. The diabetic rats placed on germinated AYB diet had a significant decrease in the blood glucose and lipid peroxidation with a corresponding increase in glutathione (p<0.05). These results demonstrate that consumption of germinated AYB can be a good dietary supplement in inhibiting hyperglycemia/hyperlipidemia and the prevention of diabetic complication associated with oxidative stress.

Keywords: African yam bean, antioxidant, diabetes, total phenol

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Authors: Makda Aamir, Sood Aayushi, Syed Omar, Nihan Khuld, Iskander Peter, Ijaz Naeem, Sharma Nishant

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Introduction:Glycogen Storage Disease Type-1 (GSD-1) is a rare phenomenon primarily affecting the liver and kidney. Excessive accumulation of glycogen and fat in liver, kidney, and intestinal mucosa is noted in patients with deficiency of Glucose-6-phosphatase deficiency. Patients with GSD-1 have a wide spectrum of symptoms, including hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, and growth retardation. Age of onset, rate of disease progression and its severity is variable in this disease.Case:An 18-year-old male with GSD-1a, Von Gierke’s disease, hyperuricemia, and hypertension presented to the hospital with nausea and vomiting. The patient followed an hourly cornstarch regimen during the day and overnight through infusion via a PEG tube. The complaints started at work, where he was unable to tolerate oral cornstarch. He washemodynamically stable on arrival. ABG showed pH 7.372, PaCO2 30.3, and PaO2 92.2. WBC 16.80, K+ 5.8, HCO3 13, BUN 28, Cr 2.2, Glucose 60, AST 115, ALT 128, Cholesterol 352, Triglycerides >1000, Uric Acid 10.6, Lactic Acid 11.8 which trended down to 8.0. CT abdomen showed hepatomegaly and fatty infiltration with the PEG tube in place.He was admitted to the ICU and started on D5NS for hypoglycemia and lactic acidosis. Per request by the patient’s pediatrician, he was transitioned to IV D10/0.45NS at 110mL/Hr to maintain blood glucose above 75 mg/L. Frequent accuchecks were done till he could tolerate his dietary regimen with cornstarch. Lactic acid downtrend to 2.9, and accuchecks ranged between 100-110. Cr improved to 1.3, and his home medications (Allopurinol and Lisinopril) were resumed. He was discharged in stable condition with plans for further genetic therapy work up.Discussion:Mainstay therapy for Von Gierke’s Disease is the prevention of metabolic derangements for which dietary and lifestyle changes are recommended. A low fructose and sucrose diet is recommended by limiting the intake of galactose and lactose to one serving per day. Hypoglycemia treatment in such patients is two-fold, utilizing both quick and stable release sources. Cornstarch has been one such therapy since the 1980s; its slow digestion provides a steady release of glucose over a longer period of time as compared with other sources of carbohydrates. Dosing guidelines vary from age to age and person to person, but it is highly recommended to check BG levels frequently to maintain a BG > 70 mg/dL. Associated high levels of triglycerides and cholesterol can be treated with statins, fibrates, etc. Conclusion:The management of hypoglycemia in GSD 1 disease presents various obstacles which could prove to be fatal. Due to the deficiency of G6P, treatment with a specialized hypoglycemic regimen is warranted. A D10 ½ NS infusion can be used to maintain blood sugar levels as well as correct metabolic or lactate imbalances. Infusion should be gradually weaned off after the patient can tolerate oral feeds as this can help prevent the risk of hypoglycemia and other derangements. Further research is needed in regards to these patients for more sustainable regimens.

Keywords: von gierke, glycogen storage disease, hypoglycemia, genetic disease

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Authors: Raymond D. Uzoh, Philip K. Shallsuku, Christopher S. Vaachia

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Selected edible leafy vegetables from North-eastern Nigeria were analysed for their sodium and potassium content in mg/100 g and the ratio Na+/K+ worked out. From experimental results, Venonia amydalina (bitter leaf) contained 150 mg (0.15 g) of sodium and 20500 mg (20.5 g) potassium with a ratio of 0.007, Brassica oleracea var capitata (cabbage) contained 300 mg (0.3 g) of sodium and 19000 mg (19 g) of potassium with a ration of 0.012. Others are Telfairia occidentalis (fluted pumpkin) with 400 mg (0.45 g) of sodium and 19500 mg (19.5 g) of potassium with a ratio of 0.020; Hibiscus sabdriffa (sorrel) has 200 mg (0.2 g) of sodium and 600 mg (0.6 g) of potassium with a ratio of 0.300; and Amarantus caudatus (spinach) contained 450 mg (0.45 g) of sodium and 23000 mg (23 g) of potassium with a ratio of 0.020. The presence of sodium and potassium in foods has become increasingly important as recent studies and dietary information gathered in this research has shown that sodium intake is not the sole consideration in elevated blood pressure but its considered as a ratio Na+/K+ fixed at 0.6. This ratio has been found to be a more important factor, suggesting that our diet should contain 67 % more potassium than sodium.

Keywords: vegetables, sodium, potassium, blood pressure, diet, foods

Procedia PDF Downloads 479

Authors: So Hyun Ahn, Geu Rim Seo, Byungsoo Shin, Kwang-Won Yu, Hyung Joo Suh, Sung Hee Han

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We investigated the effects of GOS, lactulose and DuOligo in loperamide-induced constipation rat model. Dual-Oligo saccharide (DuOligo) was composed with galacto-oligosaccharide (GOS) and lactulose. GOS is an important dietary prebiotics that affects intestinal microbiota and barrier functions to have beneficial effect and lactulose is used as a laxative to treat constipation. To study the DuOligo, after adaptation period of four weeks of Spraque-Dawley rats, loperamide (5 mg/kg, twice per day) was injected to induce constipation for 1 week. DuOligo increased the fecal pellet amount, fecal weight, and water content of feces in rats with loperamide-induced constipation. DuOligo groups tended to produce more total fatty acid than that of observed for the control group. Gastrointestinal transit ratio and length and area of intestinal mucosa increased after treatment with DuOligo in loperamide-induced rats. These results showed that oral administration of DuOligo significantly modulated intestinal peristalsis.

Keywords: constipation, DuOligo, GOS, lactulose

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Authors: M. A. Siti Faridah, K. Muhammad, H. M. Ghazali, Y. A. Yusof

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This study was conducted to investigate the effects of three variables namely types of cell wall degrading enzymes (Viscozyme L, Pectinex Ultra SP-L, Rapidase PAC, Rohament CL and Rohapect PTE) at varying concentrations (0.25-3% v/w) and times (30 min-24 h) on the zinc (Zn-) amaranth purees. Liquefaction treatment of the Zn-amaranth purees with Viscozyme (1% v/w at pH 5 and 45ºC for 3 h) was found to be the best procedure, which produced Zn-amaranth puree with low viscosity (8.60 mPas). Zn-amaranth purees were also found to have the highest metallo-chlorophyll derivative contents (0.16 mg/g), free radical 2, 2-diphenyl-1-picrylhydrazyl (DPPH) values (12.49 mM (TE)/g fresh weight) and ferric reducing antioxidant power (FRAP) values (4.57 mM (TE)/g fresh weight) within 3 h of liquefaction. Other physicochemical properties of the enzyme-liquefied Zn-amaranth purees indicated that lightness (L*) (12.54), greenness a*/b* (-0.30), reducing sugar (103.88 mg/mL) and soluble dietary fibre (5.94%) of the purees were higher compared to that of nonenzyme-liquefied amaranth purees.

Keywords: amaranth, antioxidant, chlorophyll derivative, enzymatic liquefaction

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Authors: Ali Asghar Saki, Sayed Ali Hosseini Siyar, Abbass Ashoori

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This study was conducted to evaluate the effect of Echinacea purpurea on the expression of cyclooxygenase-2 (COX-2), interleukin-17F (IL-17F) in seven-day-old broiler chickens. Four groups were fed with concentration of 0 g/kg, 5 g/kg, 10 g/kg and 20 g/kg from the root of E. purpurea in the basal diet and two other groups were only fed with the basal diet for 21 days. At the 28^th day, lipopolysaccharide (LPS, 2 mg/kg diet) was injected in four groups and the basal diet group was injected by saline as control. The chickens’ spleen RNA expression was measured for the COX-2 and IL-17F genes by Real-Time PCR. The results have shown that chickens which were fed E. purpurea had a lower COX-2 and IL-17F mRNA expression. The chickens who have received LPS only, lymphocyte was lower than other treatments. Vital organ weights were not significantly different, but body weight loss was recovered by dietary herbs inclusion. The results of this study have shown the positive effect of an anti-inflammatory herb to prevent the undesirable effect of inflammation.

Keywords: broiler chickens, Echinacea purporea, gene expression, lipopolysaccharide

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Authors: Rahim Ada, Mustafa Harmankaya, Sadiye Ayse Celik

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The safflower seed contains about 25-40% solvent extract and 20-33% fiber. It is well known that dietary phospholipids lower serum cholesterol levels effectively. The nutrient composition of safflower seed changes depending on region, soil and genotypes. This research was made by using of six natural selected (A22, A29, A30, C12, E1, F4, G8, G12, J27) and three commercial (Remzibey, Dincer, Black Sun1) varieties of safflower genotypes. The research was conducted on field conditions for two years (2009 and 2010) in randomized complete block design with three replications in Konya-Turkey ecological conditions. Oil contents, mineral contents and their correlations were determined in the research. According to the results, oil content was ranged from 22.38% to 34.26%, while the minerals were in between the following values: 1469, 04-2068.07 mg kg^-1 for Ca, 7.24-11.71 mg kg^-1 for B, 13.29-17.41 mg kg^-1 for Cu, 51.00-79.35 mg kg^-1 for Fe, 3988-6638.34 mg kg^-1 for K, 1418.61-2306.06 mg kg^-1 for Mg, 11.37-17.76 mg kg^-1 for Mn, 4172.33-7059.58 mg kg^-1 for P and 32.60-59.00 mg kg^-1 for Zn. Correlation analysis that was made separately for the commercial varieties and wild lines showed that high level of oil content was negatively affected by all the investigated minerals except for K and Zn in the commercial varieties.

Keywords: safflower, oil, quality, mineral content

Procedia PDF Downloads 267

Authors: Dinh-Ha Tran, Chung-Ruey Yen, Yu-Kuang H. Chen

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A collection of thirty cultivars/clones of red pitaya was used to investigate flowering response to lighting supplementation in the winter season of 2013-2014 in southern Taiwan. The night-breaking treatment was conducted during the period of 10 Oct. 2013 to 5 Mar. 2014 with 4-continuous hours (22.00–02.00 hrs) of additional lighting daily using incandescent bulbs (100W). Among cultivars and clones tested, twenty-three genotypes, most belonging to the red-magenta flesh type, were found to have positive flowering response to the lighting treatment. The duration of night-breaking treatment for successful flowering initiation varied from 33 - 48 days. The lighting-sensitive genotypes bore 1-2 flowering flushes. Floral and fruiting stages took 21-26 and 46-59 days, respectively. Among sixteen fruiting genotypes, the highest fruit set rates were found in Damao 9, D4, D13, Chaozou large, Chaozhou 5, Small Nick and F22. Five cultivars and clones (Orejona, D4, Chaozhou large, Chaozhou 5, and Small Nick) produced fruits with an average weight of more than 300 g per fruit which was higher than those of the fruits formed in the summer of 2013. Fruits produced during off-season contain total soluble solids (TSS) from 17.5 to 20.7 oBrix, which was higher than those produced in-season.

Keywords: flowering response, long-day plant, night-breaking treatment, off-season production, pitaya

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Authors: Aikaterini-Melpomeni Papadopoulou, Kyriaki Apergi, Margarita-Vasiliki Panagopoulou, Olga Malisova

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Introduction: Adequate hydration is a vital factor that enhances concentration, memory, and decision-making abilities throughout the workday. Various factors may affect hydration status in workplace settings, and many variables, such as age, gender and activity level affect hydration needs. Employees frequently overlook their hydration needs amid busy schedules and demanding tasks, leading to dehydration that can negatively affect cognitive function, productivity, and overall well-being In addition, dietary habits, including fluid intake and food choices, can either support or hinder optimal hydration. However, factors that affect hydration balance among workers in Greece have not been adequately studied. Objective: This study aims to evaluate the hydration status of the working population in Greece and investigate the various factors that impact hydration status in workplace settings, considering demographic, dietary, and occupational influences in a Greek sample of employees from diverse working environments Materials & Methods: The study included 212 participants (46.2% women) from the working population in Greece. Water intake from both solid and liquid foods was recorded using a semi-quantified drinking frequency questionnaire the validated Water Balance Questionnaire was used to evaluate hydration status. The calculation of water from solid and liquid foods was based on data from the USDA National Nutrient Database. Water balance was calculated subtracting the total fluid loss from the total fluid intake in the body. Furthermore, the questionnaire including additional questions on drinking habits and work-related factors.volunteers answered questions of different categories such as a) demographic socio-economic b) work style characteristics c) health, d) physical activity, e) food and fluid intake, f) fluid excretion and g) trends on fluid and water intake. Individual and multivariate regression analyses were performed to assess the relationships between demographic, work-related factors, and hydration balance. Results: Analysis showed that demographic factors like gender, age, and BMI, as well as certain work-related factors, had a weak and statistically non-significant effect on hydration balance. However, the use of a bottle or water container during work hours (b = 944.93, p < 0.001) and engaging in intense physical activity outside of work (b = -226.28, p < 0.001) were found to have a significant impact. Additionally, the consumption of beverages other than water (b = -416.14, p = 0.059) could negatively impact hydration balance. On average, the total consumption of the sample is 3410 ml of water daily, with men consuming approximately 440 ml / day more water (3470 ml / day) compared to women (3030 ml / day) with this difference also being statistically significant. Finally, the water balance, defined as the difference between water intake and water excretion, was found to be negative on average for the entire sample. Conclusions: This study is among the first to explore hydration status within the Greek working population. Findings indicate that awareness of adequate hydration and individual actions, such as using a water bottle during work, may influence hydration balance.

Keywords: hydration, working population, water balance, workplace behavior

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Authors: E. Grochowska-Niedworok, K. Brukalo, B. Całyniuk, J. Piekorz, M. Kardas

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The aim of the study was to assess diets of residents of nursing homes. Provided by social welfare home, 10 day menus were introduced into the computer program Diet 5 and analyzed in respect of protein, fats, carbohydrates, energy, vitamin D and calcium. The resulting mean values of 10-day menus were compared with the existing Nutrition Standards for Polish population. The analysis menus showed that the average amount of energy supplied from food is not sufficient. Carbohydrates in food supply are too high and represent 257% of normal. The average value of fats and proteins supplied with food is adequate 85.2 g/day and 75.2 g/day. The calcium content of the diet is 513.9 mg/day. The amount of vitamin D supplied in the age group 51-65 years is 2.3 µg/day. Dietary errors that have been shown are due to the lack of detailed nutritional guidelines for nursing homes, as well as state-owned care facilities in general.

Keywords: assessment of diet, essential nutrients, social welfare home, nutrition

Procedia PDF Downloads 152

Authors: Beihai Xiong, Dengke Hua, Wouter Hendriks, Wilbert Pellikaan

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To improve the energy status of dairy cows in the early lactation, lots of jobs have been done on adjusting the starch to fiber ratio in the diet. As a complex ecosystem, the rumen contains a large population of microorganisms which plays a crucial role in feed degradation. Further study on the microbiota alterations and metabolic changes under different dietary energy sources is essential and valuable to better understand the function of the ruminal microorganisms and thereby to optimize the rumen function and enlarge feed efficiency. The present study will focus on the effects of two glucogenic diets (G: ground corn and corn silage; S: steam-flaked corn and corn silage) and a lipogenic diet (L: sugar beet pulp and alfalfa silage) on rumen fermentation, gas production, the ruminal microbiota and metabolome, and also their correlations in vitro. The gas production was recorded consistently, and the gas volume and producing rate at times 6, 12, 24, 48 h were calculated separately. The fermentation end-products were measured after fermenting for 48 h. The ruminal bacteria and archaea communities were determined by 16S RNA sequencing technique, the metabolome profile was tested through LC-MS methods. Compared to the diet G and S, the L diet had a lower dry matter digestibility, propionate production, and ammonia-nitrogen concentration. The two glucogenic diets performed worse in controlling methane and lactic acid production compared to the L diet. The S diet produced the greatest cumulative gas volume at any time points during incubation compared to the G and L diet. The metabolic analysis revealed that the lipid digestion was up-regulated by the diet L than other diets. On the subclass level, most metabolites belonging to the fatty acids and conjugates were higher, but most metabolites belonging to the amino acid, peptides, and analogs were lower in diet L than others. Differences in rumen fermentation characteristics were associated with (or resulting from) changes in the relative abundance of bacterial and archaeal genera. Most highly abundant bacteria were stable or slightly influenced by diets, while several amylolytic and cellulolytic bacteria were sensitive to the dietary changes. The L diet had a significantly higher number of cellulolytic bacteria, including the genera of Ruminococcus, Butyrivibrio, Eubacterium, Lachnospira, unclassified Lachnospiraceae, and unclassified Ruminococcaceae. The relative abundances of amylolytic bacteria genera including Selenomonas_1, Ruminobacter, and Succinivibrionaceae_UCG-002 were higher in diet G and S. These affected bacteria was also proved to have high associations with certain metabolites. The Selenomonas_1 and Succinivibrionaceae_UCG-002 may contribute to the higher propionate production in the diet G and S through enhancing the succinate pathway. The results indicated that the two glucogenic diets had a greater extent of gas production, a higher dry matter digestibility, and produced more propionate than diet L. The steam-flaked corn did not show a better performance on fermentation end-products than ground corn. This study has offered a deeper understanding of ruminal microbial functions which could assistant the improvement in rumen functions and thereby in the ruminant production.

Keywords: gas production, metabolome, microbiota, rumen fermentation

Procedia PDF Downloads 153

Authors: Muhammad Imran Hussain, Ramisha Ibtisam, Tayyaba Fatima, Huba Khalid, Ayesha Aziz, Khansa, Adan Sitara, Anam Shahzad, Aymen Jabeen

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Vitamin D supports the immune system fight TB by inhibiting Interferon-gamma (IFN-γ) and lowering host inflammation. The purpose of the research was to see if giving the vitamin D supplements to TB patients affected their prognosis. A randomized placebo control study of 200 TB patients was performed among which 106 received 400,000 IU of injectable vitamin D3 and 94 received placebo for 2 doses. Assessment was carried out at the end of every month for 3 months. IFN-γ responses to whole blood stimulation generated by the Mycobacterium tuberculosis sonicate (MTBs) antigen and early secreted and T cell activated 6 kDa (ESAT6) were assessed at 0 and 12 weeks. The statistical analysis used descriptive statistics (mean and standard deviation), Friedman's test and Fisher's test. The vitamin D group gained significantly more weight (+3.90 pounds) and had less persistent lung disease on imaging (1.33 zones vs. 1.84 zones). They also had a 50% decrease in cavity size. Additionally, patients with low baseline serum concentrations of 25-(OH)D had a significant increase in MTB-induced IFN-γ production after taking vitamin D supplements. Vitamin D administration in large amounts can hasten the recovery of TB patients. The findings point is a therapeutically useful activity of Vitamin D's in the management for tuberculosis.

Keywords: tuberculosis, vitamin D, interferon gamma, protein, infection

Procedia PDF Downloads 52

Authors: V. Krishna, Shashikumar

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Edible Bananas (Musa spp.) are the major staple food for rural and urban consumers in India and an important source of rural income. The cultivar Musa paradisiaca cv. Karibale Monthan is an endemic cultivar of Malnad region of Karnataka and used as a glomolueroprotective neutraceutical to solve kidney problems. The protocol for mass multiplication of plantlets for this indigenous banana cultivar Karibale Monthan has not yet been standardized so far. In the present study, an attempt has been made to develop high frequency in vitro regeneration protocol and evaluation of morphoagronomic characteristics in the farmyard. The high frequency shoot initiation (93.33 %) was recorded at the synergetic effect of BAP (2 to 8mg/L), TDZ (0.1 to 1.2mg/L) and coconut water (0.1 to 1.2ml/L). It was optimized at the concentration 5 mg/l BAP, 0.5 mg/l TDZ and 0.5 ml/l coconut water with 15.90 ± 1.66 frequency of shoots per propagule. Supplementation of 1.0 mg/l IBA induces 5.33 ± 1.21 numbers of roots with a mean root length of 7.50 ± 1.87 roots. 99% of plantlets with distinct roots and shoots were successfully acclimatized in the green house and transferred to the field to evaluate the agro-morphological variations. The micropropagated plants showed significantly higher morphometric values for height of the plant (16.80±2.17), number of leaves (12.40±1.14), length of the bunch (56.20±2.17), weight of the bunch (13.60±1.14), number of hands in a bunch (11.40±1.14) and girth of the pseudostem (49.80±1.48) when compared with in vivo plants.

Keywords: banana cv. Karibale Monthan, neutraceutical, high-frequency regeneration, morphometric evaluation

Procedia PDF Downloads 287

Authors: Michael Graz, Andrew Shearer, Gareth Evans

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Manipulation of rumen bacteria is receiving increasing attention as a way of controlling greenhouse gas (GHG) emissions that are generated by the agricultural sector. Feed supplementation in particular is one of the ways in which this drive is being addressed, in particular with reference to livestock-generated GHG emissions. A blend of naturally occurring chemical extracts obtained from garlic and bitter orange extracts has been identified as a natural, sustainable and non-antibiotic based way of reducing methane production by ruminant livestock. In the current study, the acceptability and impact of this blend of natural extracts on feed rations of beef cattle was trialed in vivo on a commercial farm in Europe. Initial findings have demonstrated acceptable palatability, with all animals accepting the feed supplement into their ration both when it was mixed into the total daily ration and when used as a part of their high energy rations. Measurement of the impact of this feed supplement on productivity weight gain and milk quality is ongoing. In conclusion, this field study confirmed the palatability of the combination of garlic and citrus extracts and hence pointed to possibility of the extract blend to improve digestion, enhance body energy retention and limit CH4 formation in relation to feed intake.

Keywords: citrus, garlic, methane reduction, palatability, ruminants

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Authors: Tuleshova Gulnara, Abduldayeva Aigul

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The goal is based on the studying the prevalence of micronutrient deficiencies among children and women of reproductive age to develop evidence-based recommendations aimed at improving the effectiveness of programs to prevent micronutrient deficiency. Subject: In our study we used a representative, random sample, carried out with the cluster method in the precinct of the principle areas of medical care for children 5 years of old. If the site has at least 60 children under 5 years of old, each second child was sampled, and if more than 60 children - each third child (first child selected by random sampling). The total number of investigated persons was within 80-86 women of reproductive age and children - within 80-92 people. Results: The studies found that the average prevalence of anemia among children aged 6-59 months was 35.2%, with the most susceptible to iron deficiency anemia in infants aged 6-23 months (53.3%). The prevalence of anemia among non-pregnant women was 39.0% among pregnant women - 43.8%. In children, the prevalence of folate deficiency was the highest (27.6%). Among non-pregnant women, frequent prevalence of folic acid deficiency was 37.0%. The prevalence of vitamin A deficiency was higher among children living in Astana (37.4%) compared with the medium-republican level (23.2%).

Keywords: nutrition, pregnant women, micronutrients, macronutrients

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