American Society for Nutrition

Micronutrient inadequacies are estimated to affect billions of people worldwide, yet these estimates exclude fortification. There are no global estimates of the impact of current fortification programmes on micronutrient inadequacies. We aimed to estimate how improving existing programmes or establishing new ones affects the prevalence of micronutrient inadequacies and to estimate their global costs. In this modelling study, we estimated the prevalence of inadequate intakes of 13 micronutrients across 185 countries by integrating global modelled dietary intake data from the Global Dietary Database, with fortification programme parameters from the Global Fortification Data Exchange. We modelled six scenarios: no fortification, current fortification, improved compliance, aligned standards, aligned standards with improved compliance, and aligned standards with improved compliance and expanded coverage. Implementation costs were calculated as the sum of premix, industry-related, and government costs across five fortified foods: wheat flour, maize flour, oil, rice, and salt. Compared with no fortification, current fortification programmes prevent 7·0 billion inadequate person-nutrient intakes annually at a global cost of $1·06 billion (mean of $0·18 [SD 0·28] per person, 2021 US$, across the five fortified foods), with iodine fortification alone preventing 3·3 billion inadequacies. Despite current fortification, 38·6 billion inadequate intakes persist. Improving compliance would prevent 13·1 billion inadequacies at a global cost of $3·48 billion annually (mean $0·23 [SD 0·33] per person). Aligning standards and improving compliance would prevent 17·2 billion inadequacies at $6·56 billion annually (mean $0·63 [SD 0·53] per person). Aligning standards, improving compliance, and expanding coverage would prevent 24·7 billion inadequacies at $9·19 billion annually (mean $1·15 [SD 0·58] per person), although 20·9 billion inadequacies would remain. Fortification is a cost-effective intervention that greatly reduces micronutrient inadequacies, particularly for iodine and iron. Improving compliance offers immediate gains. Aligning with international guidelines and expanding programmes could triple their effects but cannot eliminate all inadequacies, underscoring the importance of complementary approaches to improve diet quality. Swiss Agency for Development and Cooperation and the Gates Foundation.

Background/Objectives: Avocados are nutrient-dense fruits rich in monounsaturated fats, fiber, and key micronutrients. Although avocado purchases increased in recent years, comprehensive national data on consumption patterns remains limited. Thus, this study aimed to characterize the prevalence, quantity, and context of avocado intake among the US population and to evaluate its contribution to daily nutrient intake. Methods: Day 1 24-h dietary recall data were analyzed from 19,086 participants aged ≥1 year in NHANES 2017–March 2020 and August 2021–August 2023. Avocado intake was identified using consumption data coded as avocado, avocado for use on a sandwich, guacamole, and guacamole with tomatoes. Weighted estimates described consumption prevalence, amount, form, self-selected eating occasion, location, and source. Nutrient contributions from avocado were calculated overall and by sex, age, and race/ethnicity. Results: 5.8% of participants consumed avocado. Prevalence was highest among women (6.9%), adults aged 19–50 years (7.4%), and Hispanic individuals (9.1%). Among consumers, the mean intake was 67.0 g/day. Plain avocado was the most common form (54.8%), and most intake occurred at dinner (43.4%) and at home (67.7%). Avocado was an important contributor to the mean daily intake among consumers for beta-cryptoxanthin (33.4%), alpha-carotene (27.0%), dietary fiber (19.9%), monounsaturated fatty acids (19.7%), and other nutrients. Conclusions: Although avocado consumption remains relatively modest, it contributes meaningfully to nutrient intake among avocado consumers. These findings provide descriptive insight into avocado consumption patterns and nutrient contributions in the U.S. population.

Traditional food markets in lower-income countries are constructed through the interactions of their participants: those who sell food and those who buy it. Their joint actions and motivations interact to determine what is sold, to whom, and at which price; these actions are shaped by interpersonal relationships and cultural norms. Understanding these dynamics is useful for crafting equitable and impactful policies and program interventions that leverage, rather than oppose, market actors’ initial motivations. This paper examines this process of “making a market” through a case study of vendors and consumers in Birnin Kebbi, Nigeria. It answers four interrelated research questions through a series of in-depth interviews with consumers (n = 47) and vendors (n = 37) using methods drawn from focused ethnography. The results demonstrate that market transactions are influenced by a complex interaction of vendors’ norms on competition and collaboration, consumers’ needs for credit amid unpredictable prices and restrictive gender norms, and a “moral economy” that appears to guide market actors’ behavior. Based on this, it is suggested that the conceptualization of which characteristics shape consumer choices within food environments should be broadened to include factors such as credit access and bargaining ability, and the trusted interpersonal relationships that enable them.

Here we report on a case series of six women who completed a methylation-supportive diet and lifestyle program designed to impact DNA methylation and measures of biological aging. This is a follow-up report to a paper that was published in Aging in April 2021 entitled: Potential reversal of epigenetic age using a diet and lifestyle intervention: A pilot randomized clinical trial (linked here: https://www.aging-us.com/article/202913/text), using an intervention that was largely the same as the aforementioned pilot trial but in a different study population. The intervention consisted of an 8-week program that included diet, sleep, exercise and relaxation guidance, supplemental probiotics and phytonutrients and nutritional coaching. DNA methylation and biological age analysis (Horvath DNAmAge clock (2013), normalized using the SeSAMe pipeline [a]) was conducted on blood samples at baseline and at the end of the 8-week period. Five of the six participants exhibited a biological age reduction of between 1.22 and 11.01 years from their baseline biological age. There was a statistically significant (p=.039) difference in the participants’ mean biological age before (55.83 years) and after (51.23 years) the 8-week diet and lifestyle intervention, with an average decrease of 4.60 years. The average chronological age at the start of the program was 57.9 years and all but one participant had a biological age younger than their chronological age at the start of the program, suggesting that biological age changes were unrelated to disease improvement and instead might be attributed to underlying aging mechanisms.

Metabolic disease risk in youth is influenced by sedentary behaviors. Acute in-lab studies show that, during a single day, interrupting a sedentary period with short bouts of physical activity improves glucometabolic outcomes. To determine if acutely improved glucose metabolism persists after multi-day interruptions of sitting with walking brief bouts. We hypothesized that children who underwent interrupting sitting on multiple days would demonstrate lower insulin area under the curve during an oral glucose tolerance test compared to uninterrupted sitting. Healthy, normoglycemic children (N=109) ages 7-11 years were randomized to one of two conditions: Control (3 h of daily Uninterrupted Sitting) or Interrupted Sitting (3-min of moderate-intensity walking every 30 min for 3 h daily); with dietary intake controlled through provision of foodstuffs for the entire experiment. Participants attended six consecutive daily visits at a research ambulatory unit. The primary outcome was insulin area under the curve during the oral glucose tolerance test on day 6 during interrupted or uninterrupted sitting; secondary outcomes included glucose and c-peptide area under the curve, energy intake at a buffet meal on day 6, and free-living activity. Among 93 children (42 uninterrupted sitting, 51 interrupted sitting), daily interrupted sitting resulted in 21% lower insulin (β=0.102 CI:0.032-0.172, p=0.005) and a 10% lower C-peptide (β=0.043, CI:0.001-0.084, p=0.045) area under the curve. Matsuda and Glucose Effectiveness Indices were also improved (p's < 0.05). There were no group differences in energy intake or expenditure. Sustained behavioral change by interrupting sedentary behaviors is a promising intervention strategy for improving metabolic risk in children.