Francene M. Steinberg

Outcomes from the COSMOS trial have reinforced the notion of flavanols as important plant-derived bioactives contributing to cardiovascular health. As discussions continue on whether specific dietary reference values for flavanols are warranted, it is possible that existing dietary guidelines emphasizing fruits and vegetables already yield sufficient flavanol intake levels. If this were the case, developing flavanol specific dietary reference values might be unnecessary. This study therefore aimed at assessing whether adherence to dietary recommendations for fruit and vegetable intake and overall diet quality achieves flavanol intake levels of 500 mg day⁻¹, the amount proven to mediate cardiovascular benefits in the COSMOS trial. Flavanol intake was objectively evaluated using two validated and complementary biomarkers, 5-(3′,4′-dihydroxyphenyl)-γ-valerolactone metabolites (gVLM_B) and structurally related (−)-epicatechin metabolites (SREM_B), in two geographically distinct studies: COSMOS (US; n = 6509) and EPIC-Norfolk (UK; n = 24 154). The results showed that higher fruit and vegetable intakes and diet quality (assessed via the alternative healthy eating index-aHEI) were associated with increased flavanol intake in COSMOS. Nevertheless, fewer than 25% of participants meeting dietary guidelines achieved an estimated flavanol intake of ≥500 mg day⁻¹. Similar findings were observed in EPIC-Norfolk as well as through flavanol intake simulations considering fruits and vegetables commonly consumed in the US diet. In conclusion, adherence to existing dietary guidelines does not yield flavanol intake levels comparable to those shown to provide cardiovascular benefits in COSMOS. Thus, specific dietary reference values for flavanols may still be necessary if aiming to increase the intake of these dietary compounds.

Outcomes from the COSMOS trial have reinforced the notion of flavanols as important plant-derived bioactives contributing to cardiovascular health. As discussions continue on whether specific dietary reference values for flavanols are warranted, it is possible that existing dietary guidelines emphasizing fruits and vegetables already yield sufficient flavanol intake levels. If this were the case, developing flavanol specific dietary reference values might be unnecessary. This study therefore aimed at assessing whether adherence to dietary recommendations for fruit and vegetable intake and overall diet quality achieves flavanol intake levels of 500 mg/day, the amount proven to mediate cardiovascular benefits in the COSMOS trial. Flavanol intake was objectively evaluated using two validated and complementary biomarkers, 5-(3□,4□-dihydroxyphenyl)-γ-valerolactone metabolites (gVLM _B ) and structurally related (–)-epicatechin metabolites (SREM _B ), in two geographically distinct studies: COSMOS (US; n=6,509) and EPIC-Norfolk (UK; n=24,154). The results showed that higher fruit and vegetable intakes and diet quality (assessed via the alternative healthy eating index–aHEI) were associated with increased flavanol intake in COSMOS. Nevertheless, fewer than 25% of participants meeting dietary guidelines achieved an estimated flavanol intake of ≥500 mg/day. Similar findings were observed in EPIC-Norfolk as well as through flavanol intake simulations considering fruits and vegetables commonly consumed in the US diet. In conclusion, adherence to existing dietary guidelines does not yield flavanol intake levels comparable to those shown to provide cardiovascular benefits in COSMOS. Thus, specific dietary reference values for flavanols may still be necessary if aiming to increase the intake of these dietary compounds. Graphical

In obesity research, the importance of core body temperature ( CBT ) regulation is often neglected. CBT thermogenic regulation, however, plays a crucial role in heat management through convection, radiation, and conduction processes to remove heat from the body, as well as metabolic processes that sequester heat through lipogenesis. This review emphasizes that even small changes in CBT can significantly impact metabolic events ranging from ATP production to fat deposition. Accordingly, a case is made that physical events, such as external heat exposure, also impact body compositional changes, as do work and metabolic processes. Examples are provided that suggest that independent diet and exercise, where one lives, can have an impact on body composition and obesity. For example, below 35 degrees of the earth's latitude, obesity rates are often 40 percent or greater among adults. However, in regions between 45 and 50 degrees latitude, such as the US ‐Canadian border, obesity rates are 25%–30%.

Objectives: Food insecurity among college students, combined with limited nutrition knowledge and barriers to healthy eating, significantly impacts diet quality and fruit and vegetable intake. Efforts to address these issues are further complicated by the challenges of accurately and efficiently collecting dietary data in research settings. This study aimed to explore the relationship between nutrition knowledge and fruit/vegetable intake using skin, plasma, and dietary carotenoid levels as biomarkers. Methods: Undergraduate and graduate students aged 18 years and older (n = 166) from a California public university were recruited. The sample was predominately female (n = 133, 80%), with 30 males (18%) and three individuals (2%) identifying as non-binary. Food security was assessed using the USDA’s 10-item Adult Food Security Survey Module and nutrition knowledge through a validated questionnaire. Biological data included blood samples and skin carotenoid measurements (Veggie Meter^®). Dietary quality (HEI-2015) and carotenoid intake were assessed through Diet ID™, a photo-based assessment tool. Results: The mean nutrition knowledge scores were 36.55 ± 8.83 out of 58 points, and the mean skin carotenoid score was 307.07 ± 110.22. Higher knowledge scores were associated with increased plasma carotenoids, HEI-score, and Diet ID™ total carotenoids. Food security classification did not significantly impact nutrition knowledge but did influence HEI scores and skin carotenoid levels, with very low food security linked to poorer diet quality and lower carotenoid levels. Conclusions: Nutrition knowledge may serve as a significant predictor of fruit and vegetable intake in university students. Despite this correlation, the impact of overall diet quality is potentially hindered by an individual’s food security status. Therefore, while knowledge is critical, addressing food insecurity is essential for enhancing diet quality among college students.

Background and Aim: Collecting accurate dietary information in the research setting is challenging due to the inherent biases, duration, and resource-intensive nature of traditional data collection methods. Diet ID™ is a novel, rapid assessment method that uses an image-based algorithm to identify dietary patterns and estimate nutrient intake. The purpose of this analysis was to explore the criterion validity between Diet ID™ and additional measures of dietary intake. Methods: This prospective cohort study (n = 42) collected dietary information using Diet ID™, the Nutrition Data System for Research (NDSR), plasma carotenoid concentrations, and the Veggie Meter^® to estimate carotenoid levels in the skin. Results: There were significant correlations between Diet ID™ and NDSR for diet quality, calories, carbohydrates, protein, fiber, and cholesterol. Vitamin A and carotenoid intake were significantly correlated, with the exception of α-carotene and lycopene. Significant correlations were observed for calcium, folate, iron, sodium, potassium, Vitamins B₂, B₃, B₆, C, and E. Skin carotenoid scores and plasma carotenoids were correlated with carotenoid intake from Diet ID™. Conclusions: Diet ID™ may be a useful tool in nutrition research as a less time-intensive and minimally burdensome dietary data collection method for both participants and researchers.