Pulse crops are important sources of nutrients in low income countries (LIC). Not only do they pr... more Pulse crops are important sources of nutrients in low income countries (LIC). Not only do they provide good sources of proteins when mixed with cereals, but they also contain good to very good sources of key minerals such as iron, zinc and calcium. These minerals are important for growth and development of children as well as women’s health. Pulses, however, contain phytate and polyphenols, and these can bind to divalent minerals and prevent absorption, thus limiting bioavailability. Home processing methods of soaking, germination and fermentation can reduce the effects of phytate and polyphenols.
The consumption of fruits and vegetables (F&V) has many health benefits, yet the majority of the ... more The consumption of fruits and vegetables (F&V) has many health benefits, yet the majority of the world’s population, including young children, consume less than recommended. This article provides caregivers’ perspectives on cultural determinants of F&V consumption in children in Fiji. A qualitative study design using focus group discussions with caregivers of children aged 6 months to 5 years old in Suva was used. Thematic content analysis was undertaken to identify common issues using four main themes. Subthemes were further analyzed from the broad themes to understand caregiver’s perceptions. Caregivers perceived that meal components lacked F&V and food preparation and cooking methods of F&V did not stimulate children’s appetite. Non-vegetable products such as meat and fish were perceived as more valued and privileged for those consuming them. Understanding cultural determinants as perceived by caregivers is important to inform strategies to increase F&V consumption in children.
Animal source foods such as eggs are often lacking in complementary foods in Ethiopia, a country ... more Animal source foods such as eggs are often lacking in complementary foods in Ethiopia, a country with a high rate of malnutrition in under 5-year-old children. It is recommended that young children receive an egg a day, but rural households often cannot afford them or do not have experience raising chickens. The aim of this study was to conduct a poultry intervention, providing two chickens to households with a young child, stipulating that the child was the owner, and required an egg a day. This randomized, controlled, community trial was conducted in southern Ethiopia with children 6-12 mo living in selected kebeles. Chickens were gifted to families who guaranteed that eggs would be fed to the child in the Intervention, along with education on poultry production and promotion of eggs for children. Eggshell powder (ESP) was encouraged for use as a calcium supplement by children ≥ 1 y. Control kebeles continued with existing nutrition education for the 6-month trial. Baseline and en...
American Journal of Physiology-Renal Physiology, 1985
The proximal tubule cell adjusts its phosphate absorption appropriately to meet the needs of the ... more The proximal tubule cell adjusts its phosphate absorption appropriately to meet the needs of the organism. Studies were performed to characterize some of the cellular changes involved with dietary phosphate adaptation. First, early proximal convoluted tubules were perfused with equilibrium Ringer solutions buffered to pH 7.65 or 6.5. Saturation kinetics for phosphate transport were determined at each pH value. Rats maintained on a diet of normal phosphate composition demonstrated the apparent Jmax and Km parameters about twofold greater with intraluminal pH 7.65 vs. pH 6.5. The Jmax values increased to 53.47 +/- 3.71 and 42.73 +/- 5.48 pmol X min-1 X mm-1, respectively, when the rats were placed on a phosphate-restricted diet for 5 days. By contrast, adaptation to a high dietary phosphate content resulted in diminished phosphate absorption, 8.53 +/- 1.80 and 12.87 +/- 1.61 pmol X min-1 X mm-1, for the respective pH 7.65 and 6.5 values. Second, the effect of peritubule phosphate conc...
SummaryWe investigated the impact of food group intake during adolescence on bone structure and s... more SummaryWe investigated the impact of food group intake during adolescence on bone structure and strength during adulthood. In females, we found a beneficial effect of adolescent milk and alternatives and fruit and vegetable intake on adult radius shaft and distal tibia bone structure, respectively. No association was observed in males.IntroductionThe purpose of this study was to investigate whether adolescents with high intake of milk and alternatives (M&A) or fruit and vegetables (F&V) had better adult bone structure and strength compared to those with low intake levels.MethodsWe analyzed data from 47 males and 69 females enrolled in the Pediatric Bone Mineral Accrual Study (PBMAS 1991–2011), who had one peripheral quantitative computed tomography scan at age 29 ± 2 years. We measured radius and tibia shaft total area (ToA), cortical area (CoA), cortical content (CoC), cortical density, bone strength (SSIp), and muscle area, as well as distal radius and tibia ToA, total density, trabecular area, trabecular content, trabecular density, and bone strength (BSIc). Sequential 24-h recalls were used to assess M&A and F&V intake; participants were grouped for their mean intake during adolescence (low = bottom quartile, moderate = middle quartiles, high = top quartile) and were compared using multivariate analysis of covariance while adjusting for adult height, muscle area, physical activity, energy and calcium intake and adolescent energy intake, and physical activity.ResultsFemales with high M&A intake compared to low M&A intake group (mean 3.8 vs. 1.3 servings/day, respectively) had greater adult ToA (14 %, p < 0.05), CoA (15 %, p < 0.01), and CoC (16 %, p < 0.01) at radius shaft. Females with moderate F&V intake compared to low F&V intake group (mean 3.7 vs. 2.1 servings/day, respectively) had greater adult ToA (8.5 %, p < 0.05) at distal tibia.ConclusionHigher intake of M&A or F&V during adolescence had a long-term beneficial effect on bone structure in females, an association not observed in males.
Dietary moderation plays an important role in reducing the risk of recurrent calcium oxalate ston... more Dietary moderation plays an important role in reducing the risk of recurrent calcium oxalate stone disease. Most emphasis has been placed on managing hypercalciuria by limiting dietary calcium, sodium and protein but xanthine derivatives, such as caffeine and theophylline may play a significant role in some patients.
Abstract: There are many nutrients required for optimal bone health throughout the lifecycle. Bon... more Abstract: There are many nutrients required for optimal bone health throughout the lifecycle. Bone is a living tissue and needs all the nutrients that other tissues require. In addition, bone has extraordinary requirements for calcium, phosphorus and protein, as these make up its major structural components. Other nutrients such as vitamin D, vitamin K, and dietary factors such as soy isoflavones and milk basic protein (MBP) have been shown to promote optimal bone health. In several case studies of functional foods provided in Canada that are intended to promote bone health, we show that there can be a combination of bone-enhancing factors in ‘familiar’ foods that will appeal to different target populations.
Journal of the American College of Nutrition, 1998
Studies using adult human subjects indicate that dietary protein and sodium chloride have negativ... more Studies using adult human subjects indicate that dietary protein and sodium chloride have negative effects on the retention of calcium by increasing urinary calcium excretion, while alkaline potassium improves calcium retention along with decreasing urinary calcium losses. This study investigated the effect of these dietary factors on acute urinary calcium excretion in 14 prepubescent girls age 6.7 to 10.0 years. Subjects provided a fasting urine sample then consumed a meal containing one of five treatments: moderate protein (MP) providing 11.8 g protein, moderate protein plus 26 mmol sodium chloride (MP+Na), high protein (HP) providing 28.8 g protein, high protein plus 26 mmol sodium chloride (HP+Na), or high protein plus 32 mmol potassium as tripotassium citrate (HP+K). Urine was collected at 1.5 and 3.0 hours after the meal. Supplemental protein was given as 80:20 casein:lactalbumin. Test meals were isocaloric, and unless intentionally altered, components of interest except phosphate were equal between treatments. Each subject completed all five treatments. Urinary calcium excretion rose after the meal, peaking at 1.5 hours. There were no significant differences in calcium excretion between treatments at any time point. The high protein treatments did not result in a significant increase in either net acid or sulfate excretion at 1.5 hours compared to moderate protein. Dietary sodium chloride had no effect on urinary sodium or calcium excretion over the 3 hours. After the potassium treatment, sodium excretion increased (p&lt; or =0.002) and net acid excretion decreased (p&lt;0.001) compared to other treatments at 1.5 hours. In children, a simultaneous increase in protein and phosphorus due to increased milk protein intake did not increase acute urinary calcium excretion. An effect of dietary sodium chloride on acute urinary calcium excretion was not observed. Both these findings were similar to those of adult studies previously conducted in the same laboratory using similar format and treatments. Potassium citrate was not hypocalciuric in children, a response differing from that for adults, who have shown a decrease in acute urinary calcium excretion in response to alkaline potassium treatment. Further characterization of calciuric responses to dietary factors is required for children, who may differ from adults in many respects.
BackgroundIn the Ethiopian Rift Valley, ways to reduce the fluoride (F) burden from drinking wate... more BackgroundIn the Ethiopian Rift Valley, ways to reduce the fluoride (F) burden from drinking water have been unsuccessful. Calcium (Ca) intake may mitigate fluorosis by binding with F ions and preventing absorption. The purpose of this study was to examine the association between Ca intake and proportion of fluorosis symptoms in school-age children in an area where F levels are known to be higher than WHO limit of 1.5 mg F/L water.MethodsA cross-sectional survey in the Halaba zone involved 135 eligible children aged 6–13 year who were recruited to have dental fluorosis assessed by a dentist and skeletal fluorosis assessed by a physiotherapist. Dietary Ca intake was determined by 24-h recall. Food items and samples from ground wells, taps and spring water were collected for F concentration. Associations were measured using bivariate logistic regression, adjusted for known confounders.ResultsWater F averaged 5.09 mg/L. Total F intake was high, 10.57 mg/day, and Ca intake was low, 520 ...
Vitamin D status was assessed in 19–79 year old whites (8351 participants of European ancestry) a... more Vitamin D status was assessed in 19–79 year old whites (8351 participants of European ancestry) and non-whites (1840 participants encompassing allother ancestries) from cycles 1 to 3 (years 2007–2013) of the Canadian Health Measures Survey. Status was assessed using the U.S. Institute of Medicine (IOM) 25-hydroxyvitamin D [25(OH)D] cut point values of 30 and 40 nmol/L. Overall, median 25(OH)D concentrations were significantly higher in whites [58.9 (28.6, 100.1) nmol/L; 5th and 95th percentile] compared with non-whites [43.5 (19.0, 83.2); P < 0.001]. Values were higher in females [58.5 (27.5, 101.3) nmol/L] when compared with males[53.5 (24.2, 92.7) nmol/L] and increased with age. Non-whites were more likely to have 25(OH)D values below IOM established cut points for optimum bone health with 20.1 (16.0, 24.2) and 42.2% (36.8, 47.7) of non-whites having serum 25(OH)D concentrations <30 and <40 nmol/L, respectively. The correspondingvalues for whites were 5.9 (4.6, 7.2) and 1...
Poor complementary feeding practices contribute to infants and young children (IYC) malnutrition,... more Poor complementary feeding practices contribute to infants and young children (IYC) malnutrition, with lack of protein-containing food and micronutrients as major concerns. A cross-sectional survey was conducted to assess the dietary diversity, nutrient contents and use of pulse crops in complementary feeding at Taba kebele, Southern Ethiopia. A questionnaire was used to collect socio-demographic and dietary diversity data from a random sample of 128 mother-child pairs. A one day weighed food record assessed IYC median nutrient intake. Focus group discussion explored mothers’ perceptions and use of pulse crops in complementary food preparation. Dietary diversity assessment found that 43.7% consumed pulses, and only 18.7% consumed meat and 26.6% eggs. Focus group discussion showed that mothers had little interest in incorporating pulses into complementary foods. Raising awareness of mothers/caregivers on food diversification and promoting the inclusion of pulses in food preparation f...
Pulse crops are important sources of nutrients in low income countries (LIC). Not only do they pr... more Pulse crops are important sources of nutrients in low income countries (LIC). Not only do they provide good sources of proteins when mixed with cereals, but they also contain good to very good sources of key minerals such as iron, zinc and calcium. These minerals are important for growth and development of children as well as women’s health. Pulses, however, contain phytate and polyphenols, and these can bind to divalent minerals and prevent absorption, thus limiting bioavailability. Home processing methods of soaking, germination and fermentation can reduce the effects of phytate and polyphenols.
The consumption of fruits and vegetables (F&V) has many health benefits, yet the majority of the ... more The consumption of fruits and vegetables (F&V) has many health benefits, yet the majority of the world’s population, including young children, consume less than recommended. This article provides caregivers’ perspectives on cultural determinants of F&V consumption in children in Fiji. A qualitative study design using focus group discussions with caregivers of children aged 6 months to 5 years old in Suva was used. Thematic content analysis was undertaken to identify common issues using four main themes. Subthemes were further analyzed from the broad themes to understand caregiver’s perceptions. Caregivers perceived that meal components lacked F&V and food preparation and cooking methods of F&V did not stimulate children’s appetite. Non-vegetable products such as meat and fish were perceived as more valued and privileged for those consuming them. Understanding cultural determinants as perceived by caregivers is important to inform strategies to increase F&V consumption in children.
Animal source foods such as eggs are often lacking in complementary foods in Ethiopia, a country ... more Animal source foods such as eggs are often lacking in complementary foods in Ethiopia, a country with a high rate of malnutrition in under 5-year-old children. It is recommended that young children receive an egg a day, but rural households often cannot afford them or do not have experience raising chickens. The aim of this study was to conduct a poultry intervention, providing two chickens to households with a young child, stipulating that the child was the owner, and required an egg a day. This randomized, controlled, community trial was conducted in southern Ethiopia with children 6-12 mo living in selected kebeles. Chickens were gifted to families who guaranteed that eggs would be fed to the child in the Intervention, along with education on poultry production and promotion of eggs for children. Eggshell powder (ESP) was encouraged for use as a calcium supplement by children ≥ 1 y. Control kebeles continued with existing nutrition education for the 6-month trial. Baseline and en...
American Journal of Physiology-Renal Physiology, 1985
The proximal tubule cell adjusts its phosphate absorption appropriately to meet the needs of the ... more The proximal tubule cell adjusts its phosphate absorption appropriately to meet the needs of the organism. Studies were performed to characterize some of the cellular changes involved with dietary phosphate adaptation. First, early proximal convoluted tubules were perfused with equilibrium Ringer solutions buffered to pH 7.65 or 6.5. Saturation kinetics for phosphate transport were determined at each pH value. Rats maintained on a diet of normal phosphate composition demonstrated the apparent Jmax and Km parameters about twofold greater with intraluminal pH 7.65 vs. pH 6.5. The Jmax values increased to 53.47 +/- 3.71 and 42.73 +/- 5.48 pmol X min-1 X mm-1, respectively, when the rats were placed on a phosphate-restricted diet for 5 days. By contrast, adaptation to a high dietary phosphate content resulted in diminished phosphate absorption, 8.53 +/- 1.80 and 12.87 +/- 1.61 pmol X min-1 X mm-1, for the respective pH 7.65 and 6.5 values. Second, the effect of peritubule phosphate conc...
SummaryWe investigated the impact of food group intake during adolescence on bone structure and s... more SummaryWe investigated the impact of food group intake during adolescence on bone structure and strength during adulthood. In females, we found a beneficial effect of adolescent milk and alternatives and fruit and vegetable intake on adult radius shaft and distal tibia bone structure, respectively. No association was observed in males.IntroductionThe purpose of this study was to investigate whether adolescents with high intake of milk and alternatives (M&A) or fruit and vegetables (F&V) had better adult bone structure and strength compared to those with low intake levels.MethodsWe analyzed data from 47 males and 69 females enrolled in the Pediatric Bone Mineral Accrual Study (PBMAS 1991–2011), who had one peripheral quantitative computed tomography scan at age 29 ± 2 years. We measured radius and tibia shaft total area (ToA), cortical area (CoA), cortical content (CoC), cortical density, bone strength (SSIp), and muscle area, as well as distal radius and tibia ToA, total density, trabecular area, trabecular content, trabecular density, and bone strength (BSIc). Sequential 24-h recalls were used to assess M&A and F&V intake; participants were grouped for their mean intake during adolescence (low = bottom quartile, moderate = middle quartiles, high = top quartile) and were compared using multivariate analysis of covariance while adjusting for adult height, muscle area, physical activity, energy and calcium intake and adolescent energy intake, and physical activity.ResultsFemales with high M&A intake compared to low M&A intake group (mean 3.8 vs. 1.3 servings/day, respectively) had greater adult ToA (14 %, p < 0.05), CoA (15 %, p < 0.01), and CoC (16 %, p < 0.01) at radius shaft. Females with moderate F&V intake compared to low F&V intake group (mean 3.7 vs. 2.1 servings/day, respectively) had greater adult ToA (8.5 %, p < 0.05) at distal tibia.ConclusionHigher intake of M&A or F&V during adolescence had a long-term beneficial effect on bone structure in females, an association not observed in males.
Dietary moderation plays an important role in reducing the risk of recurrent calcium oxalate ston... more Dietary moderation plays an important role in reducing the risk of recurrent calcium oxalate stone disease. Most emphasis has been placed on managing hypercalciuria by limiting dietary calcium, sodium and protein but xanthine derivatives, such as caffeine and theophylline may play a significant role in some patients.
Abstract: There are many nutrients required for optimal bone health throughout the lifecycle. Bon... more Abstract: There are many nutrients required for optimal bone health throughout the lifecycle. Bone is a living tissue and needs all the nutrients that other tissues require. In addition, bone has extraordinary requirements for calcium, phosphorus and protein, as these make up its major structural components. Other nutrients such as vitamin D, vitamin K, and dietary factors such as soy isoflavones and milk basic protein (MBP) have been shown to promote optimal bone health. In several case studies of functional foods provided in Canada that are intended to promote bone health, we show that there can be a combination of bone-enhancing factors in ‘familiar’ foods that will appeal to different target populations.
Journal of the American College of Nutrition, 1998
Studies using adult human subjects indicate that dietary protein and sodium chloride have negativ... more Studies using adult human subjects indicate that dietary protein and sodium chloride have negative effects on the retention of calcium by increasing urinary calcium excretion, while alkaline potassium improves calcium retention along with decreasing urinary calcium losses. This study investigated the effect of these dietary factors on acute urinary calcium excretion in 14 prepubescent girls age 6.7 to 10.0 years. Subjects provided a fasting urine sample then consumed a meal containing one of five treatments: moderate protein (MP) providing 11.8 g protein, moderate protein plus 26 mmol sodium chloride (MP+Na), high protein (HP) providing 28.8 g protein, high protein plus 26 mmol sodium chloride (HP+Na), or high protein plus 32 mmol potassium as tripotassium citrate (HP+K). Urine was collected at 1.5 and 3.0 hours after the meal. Supplemental protein was given as 80:20 casein:lactalbumin. Test meals were isocaloric, and unless intentionally altered, components of interest except phosphate were equal between treatments. Each subject completed all five treatments. Urinary calcium excretion rose after the meal, peaking at 1.5 hours. There were no significant differences in calcium excretion between treatments at any time point. The high protein treatments did not result in a significant increase in either net acid or sulfate excretion at 1.5 hours compared to moderate protein. Dietary sodium chloride had no effect on urinary sodium or calcium excretion over the 3 hours. After the potassium treatment, sodium excretion increased (p&lt; or =0.002) and net acid excretion decreased (p&lt;0.001) compared to other treatments at 1.5 hours. In children, a simultaneous increase in protein and phosphorus due to increased milk protein intake did not increase acute urinary calcium excretion. An effect of dietary sodium chloride on acute urinary calcium excretion was not observed. Both these findings were similar to those of adult studies previously conducted in the same laboratory using similar format and treatments. Potassium citrate was not hypocalciuric in children, a response differing from that for adults, who have shown a decrease in acute urinary calcium excretion in response to alkaline potassium treatment. Further characterization of calciuric responses to dietary factors is required for children, who may differ from adults in many respects.
BackgroundIn the Ethiopian Rift Valley, ways to reduce the fluoride (F) burden from drinking wate... more BackgroundIn the Ethiopian Rift Valley, ways to reduce the fluoride (F) burden from drinking water have been unsuccessful. Calcium (Ca) intake may mitigate fluorosis by binding with F ions and preventing absorption. The purpose of this study was to examine the association between Ca intake and proportion of fluorosis symptoms in school-age children in an area where F levels are known to be higher than WHO limit of 1.5 mg F/L water.MethodsA cross-sectional survey in the Halaba zone involved 135 eligible children aged 6–13 year who were recruited to have dental fluorosis assessed by a dentist and skeletal fluorosis assessed by a physiotherapist. Dietary Ca intake was determined by 24-h recall. Food items and samples from ground wells, taps and spring water were collected for F concentration. Associations were measured using bivariate logistic regression, adjusted for known confounders.ResultsWater F averaged 5.09 mg/L. Total F intake was high, 10.57 mg/day, and Ca intake was low, 520 ...
Vitamin D status was assessed in 19–79 year old whites (8351 participants of European ancestry) a... more Vitamin D status was assessed in 19–79 year old whites (8351 participants of European ancestry) and non-whites (1840 participants encompassing allother ancestries) from cycles 1 to 3 (years 2007–2013) of the Canadian Health Measures Survey. Status was assessed using the U.S. Institute of Medicine (IOM) 25-hydroxyvitamin D [25(OH)D] cut point values of 30 and 40 nmol/L. Overall, median 25(OH)D concentrations were significantly higher in whites [58.9 (28.6, 100.1) nmol/L; 5th and 95th percentile] compared with non-whites [43.5 (19.0, 83.2); P < 0.001]. Values were higher in females [58.5 (27.5, 101.3) nmol/L] when compared with males[53.5 (24.2, 92.7) nmol/L] and increased with age. Non-whites were more likely to have 25(OH)D values below IOM established cut points for optimum bone health with 20.1 (16.0, 24.2) and 42.2% (36.8, 47.7) of non-whites having serum 25(OH)D concentrations <30 and <40 nmol/L, respectively. The correspondingvalues for whites were 5.9 (4.6, 7.2) and 1...
Poor complementary feeding practices contribute to infants and young children (IYC) malnutrition,... more Poor complementary feeding practices contribute to infants and young children (IYC) malnutrition, with lack of protein-containing food and micronutrients as major concerns. A cross-sectional survey was conducted to assess the dietary diversity, nutrient contents and use of pulse crops in complementary feeding at Taba kebele, Southern Ethiopia. A questionnaire was used to collect socio-demographic and dietary diversity data from a random sample of 128 mother-child pairs. A one day weighed food record assessed IYC median nutrient intake. Focus group discussion explored mothers’ perceptions and use of pulse crops in complementary food preparation. Dietary diversity assessment found that 43.7% consumed pulses, and only 18.7% consumed meat and 26.6% eggs. Focus group discussion showed that mothers had little interest in incorporating pulses into complementary foods. Raising awareness of mothers/caregivers on food diversification and promoting the inclusion of pulses in food preparation f...
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Papers by Susan Whiting