Baobab fruit contains high levels of phenolic compounds and vitamin C. Previous work has associated these phenolic compounds and vitamin C with a range of health benefits including improvements in cerebral blood flow and cognition. In vivo, it has been demonstrated that consumption of baobab fruit can reduce the glycaemic response, which may provide a mechanism for cognitive benefits as other research has shown that variations in blood glucose levels can modulate cognitive performance. Preliminary work found that consumption of 15 g baobab fruit extract significantly improved reaction time but increased number of errors on an executive function task. Taken together it would suggest baobab fruit has the potential to improve cognitive performance that could be attributed to changes in cerebral blood flow and blood glucose levels.

The current study aimed to determine the effect of baobab fruit on cognitive performance, cerebral blood flow and blood glucose levels in a healthy young sample.

This randomised, placebo-controlled, double-blind, counterbalanced-crossover study assessed the effect of 10 g baobab fruit powder or sugar matched control in 24 healthy participants (17 female, 7 male, mean age = 22.91 SD = 3.37). All participants completed the cognitive assessments, a subset of 14 completed the cerebral blood flow and blood glucose assessments (mean age = 23.21, SD = 2.46). Participants completed baseline tasks before consuming a drink containing either 10 g baobab fruit powder or placebo, there was then a 45-minute absorption period before participants completed cognitive tasks again. Seven days after participants returned and completed the same procedure but consumed the opposite drink. In the 14 participant subset, cerebral blood flow was measured throughout using Near Infrared Spectroscopy (NIRS) and blood glucose was measured before testing, after absorption period and upon completion of post dose

Using the MIXED procedure in SPSS, results showed that after consumption of baobab there was improved accuracy on a sustained attention task and fewer errors on the last repetition of a serial subtraction task. Baobab consumption led to increased blood glucose levels but there was no significant effect on cerebral blood flow.

Results show that, in this sample, 10 g baobab fruit can improve certain aspects of cognitive performance and increase circulating blood glucose levels, which may explain these improvements. However, there was no significant effect on any cerebral blood flow measures. Future work may wish to explore further glucoregulation activity (in particular insulin response) after baobab consumption as a potential underlying mechanism.

Iron deficiency remains the most prevalent nutritional deficiency worldwide and is considered the most significant contributor to anaemia onset in children and women of reproductive age in both developing and developed countries. Iron plays a role in neurodevelopment and early deficits in iron have been found to impact hippocampal function affecting cognition and subjective mood. However, it is now recognised that neural structures can adapt throughout the lifespan and it is possible that changes in iron levels beyond infancy could stimulate neural changes and subsequent cognitive deficits at any time of life. Evidence for a causal link through the conduct of intervention studies is still sparse and varied in regards to the impact of iron deficiency in women of reproductive age. Our aim was to systematically review current evidence from intervention studies to determine the impact of iron supplementation upon cognition, subjective mood, well-being and fatigue in women of reproductive age. Searches included PubMed, Web of Science, Cochrane and bibliographies. Study selection and risk of bias assessment were duplicated and all intervention studies assessing cognition, subjective fatigue, mood and/or well-being that met the inclusion criteria were included in the review. Fifteen RCTs of women aged 12–49 were included. Nine studies investigated cognitive function following iron supplementation; eight found significant beneficial effects. All studies suggested that a reduced iron status at baseline was detrimental to one or more cognitive parameters, including attention and memory domains. Seven studies investigated subjective fatigue following iron supplementation; five found significant beneficial effects from baseline. Nine studies investigated mood and well-being; seven found significant effects, however they were somewhat conflicting. There is evidence to suggest that iron supplementation can improve attention, memory, subjective fatigue, mood and well-being, but additional studies using consistent measures, intervention methods and definitions of iron deficiency are warranted. Further studies should consider controlling for extraneous variables of diet, lifestyle choices and menstrual cycle to ensure an accurate measure of iron status.

In the rural region of northern Croatian county Koprivnica Krizevci, new school meals program “Smart meals for smart kids” was implemented since the beginning of 2019. Analysis of nutritional quality of standard school meals served in 18 primary schools indicated high consumption of cereal products, meat, particularly meat products, pastry and sweets, and lacking of fruits, vegetables, fish and legumes. New menu was designed with the aim of improving nutritional quality of schools’ meals through a new recipes based on gastronomy heritage, dietary habits and National guidelines, but also education and testing of children's acceptance. Initial step of the project was to test new menu through Pilot program in six schools during two weeks. Process was accompanied by educational activities through originally designed leaflet about healthy diet, new meals and nutritional benefits, and was distributed among all students. Children's acceptance of Pilot menu of 10 meals was analyzed on a 9-point pictured hedonic scale and qualitative discussion through focus groups. In every school questionnaire was distributed in 4th (age 9 to 10) and 7th grade (age 12 to 13). In total, 237 children filled out the questionnaire, 104 from 4th grade and 133 from 7th grade. In focus groups, 26 participated 14 students and 12 teachers. Results show that best accepted meals were Spaghetti Bolognese, Breaded fish with cabbage savoy and potatoes, and Chicken risotto. High acceptance of this meals can be explained by familiarity to the children, often being served at school, relatively simple dishes with lesser amount of known ingredients and adequate taste profile. Least preferred meals were Chickpea with barley and corn, and Gnocchi with turnip, these meals were in most schools served for the first time, ingredients were unfamiliar, and combination of tastes was not according to the children's preferences. Qualitative discussion revealed that children noticed the difference from standard meals, particularly increase in serving of fruits and different and new varieties of vegetables, and believe that new meals are healthier. They also liked the educational leaflet and think it is a good way of communicating about healthy diet. Teachers welcome the new menus, differences were noticeable in intensity of spiciness, new varieties of vegetables and legumes, and more served fruits. For a successful and sustainable Program follow-up, school meals should be adapted to children's dietary habits gradually with careful introduction of the new food and tastes, followed by continuous nutritional education.

Malnutrition, arising from a deficiency of energy and protein intake, occurs commonly among community-dwelling individuals. Oral nutritional supplements (ONS) are an effective method of managing malnutrition if prescribed for patients who are malnourished or at risk of malnutrition. However, previous research indicates that inappropriate prescribing of ONS occurs frequently in the community setting (30–70% prevalence). Moreover, it has been previously shown that the management of patients ‘at risk’ of malnutrition in the primary care/community setting in Ireland is sub-optimal, with low awareness of the condition and its management among non-dietetic health care professionals (HCPs). In Ireland, general practitioners (GPs) are the main prescribers of ONS in primary care. They are also on many occasions the first point of contact for individuals in the community who are malnourished or at risk of malnutrition. Therefore, exploring their experiences and perceptions can provide insight into the complexities of managing malnutrition and ONS prescribing in the community. The aim of this qualitative study was to explore GPs’ experiences and opinions on the management of malnutrition and the prescription of ONS in the primary care/community setting in Ireland. Semi-structured interviews were conducted with nine GPs. The interview explored among others the following domains; Barriers and facilitators in the management of malnutrition, ONS prescribing in the primary care/community setting, and future directions in the management of malnutrition and ONS prescribing. Recorded interviews were transcribed and analysed using inductive thematic analysis. Three main themes were identified; i) Malnutrition a secondary concern, encapsulating the idea that malnutrition is not something that GPs screen for in isolation ii) Resources and support for managing malnutrition are needed in the community iii) Reluctance to prescribe ONS. GPs reported not screening for malnutrition, but viewed it as a consequence of other conditions and social factors. According to the GPs, they should not have sole responsibility for malnutrition management and more dietitians and trained community nurses would be desirable to support them to deal with malnutrition in the community. A preference to avoid supplementation and implement dietary changes first was expressed by GPs. As main prescribers, GPs thought that they should receive further independent trainingon the different ONS available in the market as currently they did not feel confident prescribing a range of them. Awareness of ONS cost and its misuse by certain patients were reported as reasons that made GPs reluctant to prescribe them, potentially leading to under prescribing.

Despite the growing evidence supporting legume consumption as part of healthy and sustainable diet, little information is known on legume intake in the Swedish population. The aim of the present study was to describe legume consumers in Sweden, their nutrient intake and study the association with biomarkers of nutritional status using food consumption and biomonitoring data from Swedish adults in the 2010–11 National Riksmaten survey. Total legume intake - including pulses, fresh legumes, soy products, peanuts, sprouts and mixed meals with legumes - was estimated using a web-based 4-d food records in adults 18–80 years (n = 1772). A range of biomarkers including non-fasted plasma ferritin and folate, as well as erythrocyte folate, were measured for a subsample of the population (n = 282). Legumes were consumed by 44% of the population, median intake was 36 g/d (Q1 = 16; Q3 = 71; n = 777). Legumes provided on average 3.3% of individual's total energy intake (%E) with no significant difference between sexes. Pulses were consumed by 33% of consumers contributing to 3.2 ± 2.8 %E intake whereas soy products were consumed by 8.6% of legume consumers but contributing to 6 ± 7.5 %E. Legume intake among self-reported vegetarians (n = 55) was significantly higher (p < 0.000) than for non-vegetarians, with mean daily intakes of 92 ± 99 g/d and 21 ± 42 g/d, respectively. Age (p 0.0066) was significantly higher in Q4 of legume intake and alcohol consumption was significantly lower (p 0.0008); BMI, gender, smoking habits, education and total energy intake did not differ. 23% of legume consumers have a fiber intake of 25–35 g/d whereas only 11% of non-consumers reach recommended intake (p 0.0001). Iron, folate and dietary fiber intakes were significantly higher (p < 0.000) in Q4 of legume intake. 32% of legume consumers meet recommended intakes of folate (RI 300 μg/d) versus 18% for non-consumers (p 0.000). Notably, 5.76% of women of reproductive age (18–44 y.o.) eating legumes reach 400 μg/d versus 0.79% for non-consumers (p 0.002). Plasma ferritin and erythrocyte folate levels did not differ between legume consumers and non-consumers. However, for women in reproductive age (n = 31), plasma folate levels were significantly higher in consumers than non-consumers (p 0.0102). Legume consumers have higher fiber intake and more frequently meet recommended folate intakes while maintaining adequate iron intake. In conclusion, legume consumers in Sweden are characterized by a defined diet pattern that generally is associated with better health.

Organic food consumption has risen in many countries during the past decades, but individual behaviors leading to these choices remain unclear.. The aim of this study was to evaluate the associations between cognitive restraint, weight loss diet history and organic food intake, in French adults. This cross-sectional analysis included 21,516 participants from the NutriNet-Santé cohort (26.4% male, mean age 55.3 years; SD = 13.8). Cognitive restraint was evaluated by the Three-Factor Eating Questionnaire and practice of weight-loss diet in the past years was assessed by an ad hoc questionnaire. Organic food intake of 17 food groups was assessed by the Organic-Food Frequency Questionnaire. Adjusted means of proportions of organic food intakes out of total food intakes were compared across quartiles of the cognitive restraint score and weight loss diet history. Analyses were adjusted for sociodemographic and lifestyle factors. Women with higher levels of cognitive restraint had in average a lower contribution of organic foods in their diet (26.5% in Q4 vs. 30.9% in Q1; p < 0.0001). In addition, women with a history of weight loss diet had in average a lower contribution of organic foods in their diet (27.1% in current/past vs. 28.5% in never dieters; p = 0.0012). Associations were observed in men for specific food groups. Overall, individuals, and in particular women, with higher cognitive restraint scores or with a history of weight loss diet consumed less organic food. Results suggest that it can be too complex to follow both weight control and organic food choice strategies at the same time.

The results obtained by the national monitoring of dietary intake and nutritional status of Bulgarian infants, conducted during the last ten years, show some negative characteristics and trends associated with risk of chronic non-communicable diseases and micronutrient deficiencies later in life. The data on nutrition in infants were collected through active interviews with the mothers and information from the medical documentation of their GPs during the surveys in 2007 and 2014. Wrong practices of infant feeding and serious problems in their nutritional status, such as short duration of breastfeeding, low prevalence of exclusive breastfeeding, early and inadequate complementary feeding, high prevalence of stunting, underweight and anaemia among infants, especially in minorities, were identified. Results obtained during the survey in 2007 were: the rate of children breast-fed in the first days after their births were 90.7%. Only 1.8% was breast-fed during their first hour according to WHO and UNICEF recommendations; 12.5% of the infants were at exclusive breast-feeding. Data were compared with the results obtained for children at the same age from national surveys conducted in 2014, as the rate of infants who were breast-fed in the first days after their births was 86.3%; 9.9% were breast-fed during their first hour and 21.7% of the infants were at exclusive breast-feeding. The total duration of breast-feeding was short according to both surveys. The rate of breast-fed infants in the first days after birth is high in many European countries, however, the breast-feeding practices in Bulgaria do not comply with the international recommendations. The exclusive breast-feeding has a low prevalence rate. The breast-feeding period is very short. It is necessary to develop the national recommendations for healthy nutrition of infants that will concern all these problems and will aim to improve knowledge of the mothers regarding the best practices of healthy nutrition of their infants.

There is sufficient evidence that the periconceptional period is a key window during which poor maternal nutrition can adversely influence long-term health and disease risk into adulthood. The higher rate of obesity in women of childbearing age and bad quality of mother's diet may result in higher incidence of hyperglycemia or hyperlipidemia, associated with an impaired metabolism in the offspring.

This cross-sectional study analysed dietary habits and physical activity of 190 pregnant women aged 31 ± 6 years in the second and third trimester of their pregnancy in Austria. Dietary intake data were collected by two non-consecutive 24-h-recalls using GloboDiet software, physical activity was examined with the Pregnancy Physical Activity Questionnaire. 31.6 % of investigated women were overweight or obese; a moderate higher prevalence compared to non-pregnant women (21.9–27.8 %). Mean gestational weight gain (GWG) was 3.9 (± 4.8) kg in the second and 9.6 (± 5.1) kg in the third trimester. More than half of the pregnant women exceed the GWG recommendations of the Institute of Medicine (2009). In contrary, average energy consumption was 1765 kcal/d, which is below the DACH (German, Austrian and Swiss Society for Nutrition) reference value assuming a Physical Activity Level of 1,4. However, one quarter of participants exceeded reference value of energy intake. Ratio of energy supply by macronutrient intake was 36.2 E% fat: 48.5 E% carbohydrates: 15.3 E% protein. Mean intakes of linoleic acid and alpha-linoleic acid were within the DACH reference values, but DHA intake (125 mg/d) did not reach the recommendation of 200 mg/d. In addition, average intake of dietary fibre (19.8 g/d) was too low. Intakes of vitamins A, E, B1, B6, and folate as well as potassium, calcium, magnesium, iron, zinc, and iodine were unsatisfying. These results are in accordance with an inadequate supply with fruits, vegetables, cereals, and milk products, at the same time exceeding intake of meat(products) and sweets. Only half of the examined pregnant women have reached the recommendation of 120 minutes of physical activity of moderate to vigorous intensity per week.

This study demonstrates that dietary behaviour and physical activity during pregnancy need to be improved. Adequate energy and nutrient intake is essential before conception, as well as throughout pregnancy to support maternal needs, and to fill up stores required for foetal development. Health strategies supporting women in childbearing age in adopting a healthy lifestyle are important for the health of the next generation.

Women with obesity breastfeed for shorter durations than women of normal-weight body mass index (BMI). There is also evidence to suggest that women with obesity are less likely to initiate breastfeeding. This is important because breastfeeding is associated with a small, but significant, reduced risk of obesity among offspring; which may be particularly important for the offspring of mothers with obesity as these infants are at an increased risk of obesity. Using data prospectively collected during 2015 by medical staff in a large maternity hospital, we aimed to explore the association between maternal obesity status and early breastfeeding outcomes: breastfeeding initiation and exclusive breastfeeding at hospital discharge (approx. day 2 of life). Data were obtained from electronic records for all births in The National Maternity Hospital, Dublin in 2015. We included data from mothers who delivered a healthy, full-term, singleton infant (n = 7449). At the booking visit (approx. 12 weeks’ gestation), maternal height and weight were objectively measured by nursing staff and subsequently used to calculate BMI; other demographic data were recorded at this time. At delivery, epidural use, mode of delivery, and infant sex and weight were recorded. At discharge, mode of feeding was recorded. In SPSS, we explored unadjusted and adjusted associations between obesity status (BMI < 30kg/m2 [n = 964] vs. BMI ≥ 30kg/m2 [n = 6485]) and breastfeeding outcomes (dichotomous: yes/no) using Chi-squared analysis and multivariate logistic regression, respectively. In unadjusted analyses, there was a significant association between obesity status and breastfeeding initiation; 76% of women without obesity initiated breastfeeding compared with 59% of women with obesity (P < 0.001). There was also a significant association between obesity status and exclusive breastfeeding; 69% of women without obesity were exclusively breastfeeding at discharge compared with 37% of women with obesity (P < 0.001). In logistic regression analyses adjusted for maternal age, ethnicity, marital status, smoking status, parity, epidural use and delivery mode, the odds of women with obesity initiating breastfeeding were 51% lower than women without obesity (odds ratio [OR] 0.49, 95% confidence interval [CI] 0.42–0.57; P < 0.001). Similarly, in adjusted analyses, the odds of women with obesity exclusively breastfeeding at hospital discharge were 54% lower than women without obesity (OR 0.44, 95% CI 0.38–0.51; P < 0.001). Research is needed to understand whether the negative association between obesity and breastfeeding is biological or cultural in origin, or both. Interventions to promote and support breastfeeding among women with obesity may improve breastfeeding outcomes.

Recent evidence suggests that menaquinones (Vitamin K2) may be important for both bone health and cardiovascular health. With the exception of menaquinone-4 which is formed from the tissue specific conversion of phylloquinone or menadione, menaquinones are synthesized by bacteria. They are typically found in foods of animal origin such as meat, dairy and fermented foods and may account for up to 25% of total vitamin K intake. There are few data available on menaquinone intakes in population groups due to lack of available composition data. The Irish food composition database however has recently been updated to include data on menaquinones. Therefore, the aim of this study was to use these data to estimate the intakes and key dietary sources of menaquinones (menaquinone-4 & menaquinone-5–10) in the Irish population.

Analyses included data from four nationally representative surveys of the Irish population; The National Pre-School Nutrition Survey (1–4y; 2010–2011), the National Children's Food Survey (5–12y; 2003–2004), the National Teens’ Food Survey (13–17y; 2005–2006) and the National Adult Nutrition Survey (18–90y; 2008–2010) (www.iuna.net). For all of the surveys, food and beverage intake data (including supplements) were collected using food records and quantified using food scales, photographic atlases, household measures and standard portion sizes. Mean daily intakes of menaquinone-4 and menaquinone-5–10 were estimated using UK food composition tables and analytical values from published papers. The percent contribution of food groups to menaquinone intake was calculated by the mean proportion method (which provides information about the sources that are contributing to the nutrient intake ‘per person’). Statistical analyses were carried out using SPSS© V22.

Mean intakes of menaquinone-4 ranged from 8–12μg/d and 10–14μg/d in children aged 1–17 years and adults aged 18–90 years, respectively. Mean combined intakes of menaquinone-5–10 ranged from 32–43μg/d and 32–50μg/d in children aged 1–17 years and adults aged 18–90 years, respectively. ‘Meat & meat products’ were the top contributor of menaquinone-4 (50–66%) intakes across all population groups followed by ‘milks’ (9–25%). ‘Meat & meat products’ (44–61%) and ‘cheeses’ (21–37%) were important contributors to menaquinone-5–10 intakes across all population groups examined.

This study is the first of its kind to report the intakes and sources of menaquinones in the Irish population. ‘Meat & meat products’, ‘cheeses’ and ‘milks’ are important contributors to intakes of menaquinones in the Irish diet. Further research is required to fully understand the role of the menaquinones in human health.