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The amount of nutrients required by an individual is determined by a number of physiological processes, including absorption, metabolism, stability, and bio-activation. These processes determine nutrient needs and provide variations in requirements in the population. All have modifiers and sensitizers, such as sex, genetics, pregnancy, age, pharmaceuticals, toxins, food matrix, and epigenetics. Disease can also be a major modifier of these processes. In April 2018, the National Academies of Science, Engineering and Medicine convened a workshop in order to explore the evidence for special nutritional requirements in disease states and the medical conditions that cannot be met with a normal diet. Participants explored the impact a disease state can have on nutrient metabolism and nutritional status, and attempted to close informational gaps. This publication summarizes the presentations and discussions from the workshop.

Background The aims of this study were to 1) assess dietary intake of male collegiate rugby sevens players relative to sport dietary guidelines, 2) quantify match demands across a competitive season using GPS-derived workload metrics, and 3) explore changes in match workloads throughout tournament play.Methods Division 1-AA male collegiate rugby sevens players (n = 13, age 20 ± 1 yrs; height 2 ± 0 m; weight 87 ± 14 kg; body fat 20 ± 4 %; FFM 71 ± 12 kg) participated. Dietary intake was assessed at the start of the season using a 4-day food log (MyNetDiary, Marlton, NJ, USA). Players were equipped with a 10-Hz GPS/GNSS device (Vector Core; Catapult Sports, Melbourne, Australia) to wear in all matches (n = 17) across four tournaments. GPS-derived workload metrics included: Total distance (m), sprint distance (> 20.1 km/hr), high-intensity distance (> 18.1–20.0 km/hr), meters per minute (m/min), acceleration efforts (#), deceleration efforts (#), sprint efforts (#), high speed efforts (#), player load (AU), player load per minute (AU/min), and estimated energy expenditure (kcal). A one-samples t-test was used to assess dietary intake for energy, carbohydrates, proteins, and fats relative to established recommended guidelines (40 kcal/kg bw, 5 g/kg bw, 1.6 g/kg bw, and 1 g/kg bw, respectively). A repeated measures analysis of variance examined changes in workload parameters across tournament matches (p < 0.05).Results Players underconsumed calories (31.8 ± 10.6 kcal/kg, p = 0.028) and carbohydrates (2.8 ± 1.3 g/kg, p < 0.01) relative to recommended intakes. In contrast, protein intake was higher than guidelines (2.1 ± 0.7, p = 0.038), while fat intake did not differ (1.2 ± 0.4, p = 0.141). A descriptive summary of workload parameters and changes across matches is presented in Table 1.Table 1. Summary of external workloads across tournament matches.[Table: see text]Values are presented as mean ± SD; TD = total distance; SD = sprint distance; HI distance = high intensity distance; meters/min = meterage per minute; accel = accelerations; decel = decelerations; PL = player load; PL/min = player load per minute; SE = sprint efforts; HSE = high speed efforts; EE = energy expenditure; AU = arbitrary units.Conclusion Although players experienced high match workloads during tournaments, their energy and carbohydrate intakes were insufficient. This imbalance may compromise recovery and performance, underscoring the need for tailored nutritional strategies to meet the demands of competition.

This book explores the reasons for abnormal post-natal growth in preterm infants. It examines the long-term effects on developmental outcome as well as metabolic risks such as insulin resistance, type 2 diabetes, and hypertension. The contributors explore the risks and benefits of faster post-natal growth and catch-up growth in preterm infants. They describe tools for assessment of growth and early identification of faltering growth. They also explain methods for reducing growth faltering and for optimizing catch-up growth, including the new possibilities offered by customized fortification of human breast milk.

Poor quality dietary habits are one of the most pressing public health concerns of our time. As a society, we are faced with the paradox of malnutrition and overconsumption existing side-by-side. Many people in our communities deal with the stark reality of food insecurity coupled with a reliance on inexpensive, nutrient-poor calories that contribute to the nationwide prevalence of obesity, type 2 diabetes, heart disease, and other chronic conditions. As a resource for both students and practitioners, Public Health and Community Nutrition provides an overview of how social determinants of health?socioeconomic factors that influence a population's or an individual's well-being?contribute to the existence of health disparities in the United States. Now more than ever, diet and health experts are needed to address these 21st-century public health challenges that require specific professional competencies related to nutritional assessment, knowledge of food assistance and support options, and nutrition education skills that are appropriate for targeted audiences.

Recently, food recommender systems have received increasing attention due to their relevance for healthy living. Most existing studies on the food domain focus on recommendations that suggest proper food items for individual users on the basis of considering their preferences or health problems. These systems also provide functionalities to keep track of nutritional consumption as well as to persuade users to change their eating behavior in positive ways. Also, group recommendation functionalities are very useful in the food domain, especially when a group of users wants to have a dinner together at home or have a birthday party in a restaurant. Such scenarios create many challenges for food recommender systems since the preferences of all group members have to be taken into account in an adequate fashion. In this paper, we present an overview of recommendation techniques for individuals and groups in the healthy food domain. In addition, we analyze the existing state-of-the-art in food recommender systems and discuss research challenges related to the development of future food recommendation technologies.

To analyze the eating habits of the transgender population throughout the transition process, evaluate the nutritional requirements associated with gender transition, and reflect on the possible dietary challenges facing the transgender population. A cross-sectional observational study was carried out with 146 individuals (58.90% transgender women [n = 86] and 41.09% transgender men [n = 60]) aged between 18 and 60 y old. Eating habits and nutritional intake were evaluated through a food consumption frequency questionnaire, 24-h dietary recall, and subsequent data entry using DIAL software. The anthropometric parameters weight and height were determined following the protocol proposed by the International Society for the Advancement of Kinathropometry and waist circumference was determined following the protocol of the World Health Organization. The study found that the diets of the studied population were unhealthy, with low fruit consumption (6.4 ± 4.39 rations in transgender men versus 11.5 ± 2.59 rations in transgender women, P = 0.758898323). Diets were high in lipids (43.62 and 44.24 in transgender women and transgender men, respectively) and protein (16.63 and 15.65 in transgender women and transgender men, respectively). Deficiencies in carbohydrates, folate, vitamin D, and minerals such as calcium, iodine, and zinc were detected along with an excess of selenium and especially phosphorus, which could affect hormone levels. Changes were detected as a result of their desire to look similar physically to the desired sex, they followed rules, ways of acting, and habits of primary socialization (learned in the family during their life). The analysis of the changes observed in our study revealed that during the transition process, eating habits changed based on information, often incorrect, obtained from the internet. Therefore, it is advisable to recommend implementing strategies that increase the consumption of fruits, vegetables and whole grains. In this study, we detected some nutritional deficiencies depending on the type of hormone treatment, so nutritional care must be individualized. Therefore, individualized nutritional interventions focused on increasing the consumption of fruits, vegetables, and whole grains should be carried out. It would be advisable to develop guidelines for nutritional advice, diagnosis, and intervention for transgender people based on scientific evidence as well as provide nutritional advice to the clinicians responsible for their follow-up. •Dietary patterns and hormonal and social factors remain unclear in transgender people undergoing gender-affirming hormone therapy.•Transgender individuals tend to adapt their dietary patterns to look similar physically to the desired sex.•Changes in dietary patterns can have adverse physiological consequences and cause late-onset chronic diseases.•Nutrition, exercise, and diseases related to changes in body composition and strength should be monitored in transgender women.

Individuals with autism spectrum disorders (ASD) are often characterized by food-selectivity, food-neophobia and a marked preference for mild flavor, semi-liquid foods with pale colors. Therefore, they adopt a monotonous dietary pattern, and they prefer ultra-processed food, leading to a high risk of developing malnutrition. In Italy, where 75,072 individuals are diagnosed with ASD, center-based services play a crucial role in their daily management. Despite the centrality of nutrition in maintaining a good state of health, even more for vulnerable subjects, no validated protocol at collective catering level has been developed yet. The manuscript presents customized dietary recommendations aimed at managing the meals for individuals with ASD at collective catering service, derived from a non-systematic literature review exploring food behaviors and nutritional needs in individuals with ASD. Simple practical tips for mealtimes, such as eating together, proper seating, lighting, smell control, presenting food in a simple manner and using the same type of tableware at each meal, to meet the needs of individuals with ASD, were described. The proposal could represent a starting point in developing official guidelines aimed at ASD individuals, in collective catering service. Level of Evidence: Level V.

Despite recent advances, the causes of and effective therapies for pediatric chronic cholestatic diseases remain elusive, and many patients progress to liver failure and need liver transplantation. Malnutrition is a common complication in these patients and is a well-recognized, tremendous challenge for the clinician. We undertook a narrative review of both recent and relevant older literature, published during the last 20 years, for studies linking nutrition to pediatric chronic cholestasis. The collected data confirm that malnutrition and failure to thrive are associated with increased risks of morbidity and mortality, and they also affect the outcomes of liver transplantation, including long-term survival. Malnutrition in children with chronic liver disease is multifactorial and with multiple potential nutritional deficiencies. To improve life expectancy and the quality of life, patients require careful assessments and appropriate management of their nutritional statuses by multidisciplinary teams, which can identify and/or prevent specific deficiencies and initiate appropriate interventions. Solutions available for the clinical management of these children in general, as well as those directed to specific etiologies, are summarized. We particularly focus on fat-soluble vitamin deficiency and malnutrition due to fat malabsorption. Supplemental feeding, including medium-chain triglycerides, essential fatty acids, branched-chain amino acids, and the extra calories needed to overcome the consequences of anorexia and high energy requirements, is reviewed. Future studies should address the need for further improving commercially available and nutritionally complete infant milk formulae for the dietary management of this fragile category of patients. The aid of a specialist dietitian, educational training regarding nutritional guidelines for stakeholders, and improving family nutritional health literacy appear essential.

This study aimed to investigate Romanian physicians’ awareness, recommendation practices, and opinions regarding the use of Foods for Special Medical Purposes (FSMPs) products. A total of ten physicians were interviewed using a structured questionnaire, and their responses were analysed using thematic content analysis. The study found that physicians were aware of FSMPs and recommended them to their patients based on nutritional deficits, weight loss, or deglutition impairments. In addition, disease stage, treatment scheme, taste, affordability, and availability were identified as factors influencing the recommendation and use of FSMPs. While physicians generally did not consult clinical trials, clinical experience was deemed essential for recommending FSMPs to patients. Patients’ feedback regarding the usage and sourcing of FSMPs was generally positive, with some expressing concerns about the availability of different flavours and the costs of purchasing the products. This study concluded that physicians play a vital role in recommending FSMPs to patients and ensuring they have the necessary nutritional support during treatment. However, it may be imperative to consider the provision of additional patient education materials and fostering collaborative efforts with nutritionists in order to optimise the prospects of positive outcomes in oncology treatment, while simultaneously alleviating the financial burdens faced by patients.

Suboptimal nutrient quality/quantity during complementary feeding (CF) can impact negatively on infants’ healthy growth, even with adequate energy intake. CF must supplement at best human milk (HM) or formulas, which show nutritional differences. Considering this, a differentiated CF is probably advisable to correctly satisfy the different nutritional needs. To assess whether current needs at 6–24 months of age can still be met by one single CF scheme or different schemes are needed for breastfed vs. formula/cow’s milk (CM) fed infants, protein, iron and calcium intakes were assessed from daily menus using the same type and amount of solid food, leaving same amounts of HM and follow-up formula at 9 and again 18 months of age, when unmodified CM was added. Depending on the child’s age, calcium- and iron-fortified cereals or common retail foods were used. The single feeding scheme keeps protein intake low but higher than recommended, in HM-fed children while in formula/CM-fed ones, it achieves much higher protein intakes. Iron Population Recommended Intake (PRI) and calcium Adequate Intakes (AI) are met at the two ages only when a formula is used; otherwise, calcium-fortified cereals are needed. ESPGHAN statements on the futility of proposing different CF schemes according to the milk type fed do not allow to fully meet the nutritional recommendations issued by major Agencies/Organizations/Societies for all children of these age groups.