Academic literature on the topic 'Total Diet Study'

Sodium (Na) and potassium (K) are essential nutrients. We investigated Na and K content of foods collected from the 2007 Vancouver Total Diet Study (TDS). Our food nutrient content data showed that processed foods and soups had a high Na content while fluid milk, unprocessed meats and several fruits and vegetables had a high K content. The Na/K ratio indicated, with few exceptions, a segregation of the foods high in Na from ones high in K. Based on this data, new Na and K intakes were generated using Canadian Community Health Survey (CCHS2.2), cycle 2.2 Nutrition dietary recall. In general, the results showed a lower Na intake than indicated by CCHS2.2, but still higher than the Tolerable Upper Level of Intake (UL). K intakes were similar to CCHS2.2 data showing an intake lower than the AI.<br>Le sodium (Na) ainsi que le potassium (K) sont des nutriments essentiels. Nous avons examiné le contenu de Na et de K d'aliments collectés pour l'Étude Canadienne sur l'alimentation totale de Vancouver conduite en 2007. Notre base de données sur le contenu nutritionnel des aliments a démontré que les aliments traités et les soupes ont un haut niveau de Na alors que le lait, les viandes non-traitées ainsi que plusieurs fruits et légumes détiennent un niveau élevé de K. Basés sur ces données, de nouvelles prises ont été générées en utilisant l'Enquête sur la santé dans les collectivités canadiennes (ESCC 2.2), cycle 2.2, Nutrition. En général, les résultats ont démontré un niveau d'ingestion de Na moins que CCHS mais plus élevé que l'apport maximum tolérable (AMT). Les ingestions de K étaient similaires aux données contenues dans l'ESCC 2.2, démontrant une ingestion inférieure à l'apport suffisant (AS).

This thesis quantified risks of lead (Pb), cadmium (Cd), and mercury (Hg) in the diet of First Nations peoples residing on-reserve in the province of Ontario, Canada. Data was obtained from the 2011-2012 First Nations Food, Nutrition, and Environment Study (FNFNES) and Health Canada to construct total diet studies and probabilistic assessments. Results indicated that the majority of the population is at low risk of exceeding the reference values for these contaminants. Average exposures of Pb and Hg were higher than the general Canadian population (1.7 and 1.6 times greater, respectively), whereas Cd was 59% lower than the Canadian average. The upper percentiles of the population exposure distributions were characterized for contributing food items to assist risk management strategies. For cadmium exposures, smokers had elevated exposures compared to non-smokers. Women of childbearing age had lower dietary MeHg exposures than the total population and were largely below the reference value.

A segurança alimentar é uma necessidade fundamental e de grande preocupação pública em todo o mundo. A Organização Mundial de Saúde (WHO) recomenda o Estudo de Dieta Total (EDT) como sendo o método mais adequado de estimativa para as ingestões de contaminantes e nutrientes para um país ou grandes grupos populacionais. A implantação de um estudo relacionando a ingestão de alimentos em uma Região de Elevada Radioatividade Natural (HBRA) motivou o presente estudo, uma vez que no planalto de Poços de Caldas há ocorrência de anomalias radiativas com concentrações naturais significativas de urânio e tório. O presente estudo teve por objetivo avaliar e comparar as ingestões de elementos essenciais, tóxicos e radionuclídeos, a partir dos alimentos que compõem as dietas das populações urbana e rural, da cidade de Poços de Caldas. As determinações das concentrações dos elementos essenciais e tóxicos foram realizadas aplicando-se a técnica de análise por ativação neutrônica (As, Ca, Cl, Co, Cr, Fe, K, Mg, Mn, Na e Zn), espectrometria de absorção atômica com forno de grafite (Cd, Cu e Pb) e por geração de vapor frio (Hg). As determinações dos radionuclídeos foram realizadas aplicando-se as técnicas de análise por espectrometria gama (40K), separação radioquímica seguida de contagem alfa e beta total (210Pb, 226Ra e 228Ra) e espectrometria alfa (210Po, 228Th, 230Th, 232Th, 234U, 235U e 238U). Os grupos de alimentos foram estabelecidos de acordo com os dados de consumo da região sudeste do país, obtidos pela Pesquisa Orçamentária Familiar (POF) 2008-2009 do Instituto Brasileiro de Geografia e Estatística (IBGE). A lista final totalizou 82 alimentos distribuídos em 20 grupos, incluindo a água, e com massa total de 3,6180 Kg. Com o EDT aplicado para a região do Planalto de Poços de Caldas, foi possível observar que as ingestões diárias média para todos os elementos essenciais na dieta da população urbana apresentaram valores mais elevados quando comparados à dieta da população rural, porém não apresentaram diferenças estatisticamente significativas. As dietas estudadas foram deficientes nos elementos essenciais Ca, K, Mg e Se quando comparadas aos valores de ingestão diária recomendados. Os teores dos elementos tóxicos Cd e Pb no presente estudo estiveram dentro do intervalo relatado pela WHO a partir de EDT realizados em diversos países e/ou diferentes regiões no mundo. A ingestão total do elemento tóxico Hg foi encontrada muito abaixo do limite estabelecido pela WHO. Em relação aos radionuclídeos naturais, o cálculo de dose efetiva comprometida por ingestão da região rural (0,89 mSv/ano) apresentou-se 61% mais elevado quando comparado à região urbana (0,56 mSv/ano). Isto pode ser explicado pelo fato dos maiores pontos de anomalias radioativas estarem localizados na zona rural. Porém, a partir dos valores encontrados no presente estudo não apresentaram níveis que representassem ameaça à saúde da população deste planalto.<br>Food security is a fundamental need and a great public concern throughout the world. The World Health Organization (WHO) recommends the Total Diet Study (TDS) as the most appropriate method of estimating the intake of contaminants and nutrients for a country or large population groups. The implementation of a study relating food intake in a High Background Radiation Area (HBRA) motivated the present study, since in the Poços de Caldas plateau there are occurrences of radiative anomalies with significant natural concentrations of uranium and thorium. Therefore, the objective is to evaluate and to compare the intakes of essential, toxic elements, and radionuclides from the foods that composed the diets of the urban and rural populations of the city. The concentration determination of the essential and toxic elements was performed using the neutron activation analysis (As, Ca, Cl, Co, Cr, Fe, K, Mg, Mn, Na and Zn) and atomic absorption spectrometry with graphite furnace (Cd, Cu and Pb) and cold vapor atomic (Hg). The determination of radionuclides was performed by gamma spectrometry (40K), radiochemical separation followed by total alpha and beta counting (210Pb, 226Ra and 228Ra) and alpha spectrometry (210Po, 228Th, 230Th, 232Th, 234U, 235U and 238U). The food groups were established according to consumption data from the southeast region of the country obtained by the Household food budget survey POF 2008-2009 by the Brazilian Institute for Geography and Statistics (IBGE). The final list contained 82 foods distributed in 20 groups, including drinking water, and with a total mass of 3.6180 kg. The TDS applied to the region of the Poços de Caldas Plateau allowed to observe that the average daily intakes for all the essential elements in the urban population diet presented higher values compared to the diet of the rural population but did not present statistical differences. The essential elements Ca, K, Mg and Se were deficient in the diets studied compared to the recommended daily intake values. The toxic element level of Cd and Pb in the present study were within the range reported by the WHO from TDS conducted in several countries and/or different regions in the world. The total intake of the toxic element Hg was found well below the established limit by WHO. Intake effective dose compromised calculation of the rural region (0.89 mSv/year) was 61% higher compared to the urban region (0.56 mSv/year). This can be explained by the fact that the highest points of radioactive anomalies in the plateau are located in the rural zone, but the values found in the present study do not present levels that represent a threat to the health of the population in this plateau.

L’Etude de l’Alimentation Totale en Afrique Subsaharienne a couvert plus de 90% de l’alimentation moyenne de populations correspondant à 7291 ménages et 4020 échantillons d’aliments, représentatifs des habitudes alimentaires locales et préparés tels que consommés. Les polluants organiques persistants tels que les dioxines, les polychlorobiphényles, les retardateurs de flamme bromés ainsi que les composés perfluorés ont été quantifiés à des teneurs très faibles. Une sélection de 68 substances, dont l’exposition a été étudiée de façon semi-probabiliste a permis de mettre en évidence que 24 de celles-ci sont, de façon individuelle ou en groupe, susceptibles de représenter un fardeau de santé publique. L’Aflatoxine B1, compte tenu des prévalences du virus de l’hépatite B, est susceptible de générer chaque année des cas de cancer du foie, à raison de 0,2 (Douala) - 23,9 (Nord Cameroun) cas additionnels pour 100 000 habitants. La co-exposition à l’aflatoxine B1, à la sterigmatocystine et aux fumonisines est particulièrement préoccupante dans certains centres de l'étude. La co-exposition à des niveaux importants à l’ochratoxine A, à la citrinine et à de l’aluminium, qui sont toutes des substances néphrotoxiques, a été relevé au Bénin. Des teneurs fortes de chlopyrifos dans le poisson fumé consommé au Mali alertent les autorités sur le risque chronique et aigu. Les expositions aux treize hydrocarbures aromatiques polycycliques dans le poisson fumé et les huiles de cuisson ne permettent pas des marges d’exposition sécurisantes eu égard à leur caractère génotoxique et cancérogène. L’exposition au plomb, en particulier au Nigeria révèle un risque d’augmentation de la pression artérielle chez les adultes et des pertes de points de QI chez les enfants. Les données générées aider ont les gestionnaires de risques à mieux protéger le consommateur. Une étude visant spécifiquement l'exposition du nourrisson et du jeune enfant permettrait d'aller plus loin dans la connaissance du risque chimique en Afrique Subsaharienne<br>The Total Diet Study in Sub-Saharan Africa covered 90% of the average diet of 7291 households with 4020 samples of typical foods prepared as consumed. Persistent organic pollutants such as dioxins, polychlorinated biphenyls and brominated flame retardants, as well as perfluorinated compounds were quantified at very low concentrations. The exposure of a selection of 68 chemicals was assessed, individually or in group, following a semi-probabilistic approach. Among these, 24 substances were characterized as a potential public health concern. The co-exposure to aflatoxin B1 and hepatitis B is likely to induce a morbidity factor in additional cases of liver cancer/100 000 inhabitants/year ranging from 0.2 (Duala) to 23.9 (North Cameroon). The co-exposure to aflatoxin B1, sterigmatocystin and fumonisins is of concern in some of the studied areas. The co-exposure to ochratoxin A, citrinin and aluminium, each of which are nephrotoxic, represents a concern identified in Benin. High Chlorpyrifos concentrations in smoked fish from Mali represent chronic and acute risks for consumers. The 13 genotoxic polycyclic aromatic hydrocarbons in smoked fish and edible oils do not allow for safe margins of exposure. Lead exposure, particularly in Nigeria, might elevate blood pressure in adults and affect children neurodevelopment. The generated data will inform the risk managers and help them to better protect consumers. Additional studies, more specifically focusing on the infant and young child would be au beneficial perspective in terms of contribution to knowledge about food chemical risks in Sub-Saharan Africa

Foods, from the earliest times, are subjected to man-made modifications to ensure microbiological safety, enzymatic inactivation, destruction of toxic substances, and optimization of storage time. An undisputable role in making the food softer, tasty and preservable over time is exerted by heat treatment. It is during this phase that a series of chain reactions, known like Maillard's reaction, are triggered. During this reaction, products that affect the flavor, color and aroma of foods are formed. Among these, glyoxal, methylglyoxal and 3-deoxyglucosone are of particular importance. These compounds are present in food, have antimicrobial activity, are promoters of advanced glycation end products formationand also have toxic effects in in vitro and in vivo studies. Research activity carried out during Ph.D. study had a common thread: increasing knowledge on 1,2-dicarbonyl compounds. In this field, the overall aims of this thesis work were: assessment of the content of dicarbonyl compounds in Italian food; assessment of their dietary intake; study of formation/degradation of dicarbonyl compounds using food model systems; evaluation of antimicrobial activity of the main dicarbonyl compounds; study of the interaction between the dicarbonyl compounds and the nutrients present in the microbiological culture media, both in the presence and absence of the microorganism. The results obtained by the survey on Italian food show that the concentration is variable and the predominant 1,2-dicarbonyl compounds is 3-deoxyglucosone. The estimation on dietary intake with a Total Diet Study-like investigation, have brought new evidence to assert that the ingestion with foods is high especially for infants (0-2 years) and children (3-9 years). The results obtained with the model systems show that time, temperature and ingredients have a strong influence on the formation of the compounds and that it is possible to reduce the level of 1,2-dicarbonyl compounds. The results of antimicrobial assays lead us to conclude that dicarbonyl compounds, especially GO and MGO, could have a role in the microbial stability of foods, although food composition may strongly influence their availability to act as antimicrobials. The results obtained by the study of the interaction between the dicarbonyl compounds and the nutrients present in the culture media allow us to assert that the 1,2-dicarbonyl compounds are degraded very quickly when they come into contact with bacteria. The results obtained outline a framework of knowledge that is a prelude to subsequent important developments.

碩士<br>中國醫藥大學<br>營養學系碩士班<br>102<br>The objective of this study was to apply the food consumption data of National Nutrition Survey in Taiwan (NHSIT) to the Total Diet Study (TDS). It was to establish representative food categories, food lists, sampling model, and to analyze the distribution of preservatives and bleaching agents in food samples. The results can be used not only to provide food safety risk assessment, but also to monitor the changes and trend of eating habits, food consumption and food contaminants in Taiwan. By applying the food consumption data from National Nutrition Survey in Taiwan (2005-2008), this study established the national food classification system for TDS, which included 12 major categories and 47 minor categories. Using foods in higher consumption rate as the guide, we compiled a list of 128 representative food items. By focusing on how preservatives and bleaching agents were added to food items, we established a list of 97 preservatives and a list of 59 bleaching agents. By taking into account the seasonal and regional foods, we divided the seasons into spring-summer and fall-winter and regions into north, central, south and east regions in Taiwan. We randomly selected two counties from each region and purchased foods from the list of 225 food samples from hypermarkets, supermarkets, traditional markets, night markets and restaurants. The purchased food samples were prepared into ready-to-eat foods and were combined according to proper ratios into national composite food samples. They were sent to a certified laboratory for food testing and analysis for benzoic acid, sorbic acid, dehydroacetic acid, salicylic acid, p-hydroxybenzoate and sulfur dioxide in the food samples. The result showed that the 128 food items on the representative food list accounted for 82.34% of the total diets consumed in Taiwan. For two seasons (spring-summer and fall-winter) and in eight counties, total 3,025 food samples were purchased according to 225 food items. 312 composite samples were prepared for analysis of preservatives and 186 composite samples were prepared for analysis of bleaching agents. The result showed the following unacceptable rates in the food samples: benzoic acid (8%), sorbic acid (3.8%), dehydroacetic acid (3.2%), and sulfur dioxide (2%). Salicylic acid and p-hydroxybenzoate were not detected. Preservatives were most frequently added, against safety regulations, in products of rice, wheat, flour, meat, soy bean and preserved vegetables. The bleaching agent sulfur dioxide was often added to preserved vegetables in excessive amount. In summary, it is necessary to carry out TDS periodically for accurate assessment of food safety in Taiwan.

The diploma thesis deals with the issue of catering in the home for elderly people in Prague. The topic is reviewed from a socio-cultural point of view. The main objective is to penetrate the world of diet and catering of seniors living in a total institution, which is characterized by specific features affecting the rights and personal freedoms of its clients. The home for elderly people is committed to comply with the statutory regulations of the Social Services Act as well as its own internal guidelines, while the compliance with legislation and various aspects of catering, including dining, eating, the environment in which food is consumed, as well as those participating in preparation and serving of meals is negotiated at a committee. The relationship between the layers above is captured by an ethnographic study that gives an overall picture of the catering process with all its specifics. Research has revealed that the catering process is becoming an individualized activity at many levels, enabling clients to make autonomous decisions about the process. Nevertheless, staff and clients are aware of limits that prevent individualisation. Key words: diet - meal - catering - senior - total institution - ethnographic study - individualization

The formal study of diet, nutrition and cancer is still relatively young, with most epidemiological studies and randomized controlled trials (RCTs) having occurred in the last twenty to thirty years. Despite methodological challenges of studying diet and cancer in free-living populations, there is scientific consensus that overweight and obesity increase the risk of certain cancers and growing evidence that dietary patterns rich in vegetables, fruits, and whole grains and low in red and processed meat are associated with lower risk of colorectal cancer and total cancer mortality. Although it is more difficult to isolate the specific components of diet that affect risk, several key factors appear to play a role. Dietary composition appears to operate by both affecting energy intake and also independent of energy intake. Despite extensive research, evidence does not support an important impact of the macronutrient composition of diet on cancer risk.

The aim of the study was to determine the effect of feed additives (algae, soybean, and sunflower oil) used in the rabbit feed on: growth indices and slaughter traits, pH, colour, texture, chemical composition, fatty acid profile and oxidative stability (TBARS) of the meat as well as FTO and FABP4 genes expression in the meat’s intramuscular fat (m. longissimus lumborum), depending on the age and sex. The experimental material consisted of Termond White rabbits (n = 160, 80 females and 80 males). Animals were weaned on the 35th day of life, and housed in metal cages arranged in batteries (4 rabbits of the same sex in a cage). From weaning to 12 or 18 weeks of age, the rabbits were fed pellets ad libitum. Animals in the control group (C) received non-supplemented pellets throughout the experiment. In the other groups, the pellet contained 1% algae (A), 3% sunflower oil (OS), and 3% soybean oil(SO).The experimental diets were formulated to have similar protein and energy content. Diets were balanced by lowering the proportion of other feed components. The total share of all components remained at 100%. The results indicate that 3% vegetable oils (soybean or sunflower) supplementation of diets for growing rabbits leads to an increase of body weight and improvement of some of the slaughter traits, while 1% addition of algae to the feed causes deterioration of body weight and slaughter traits. The effect of oil additive depends on the animals’ age. Supplementation of the rabbits’ diet with algae (1%) or sunflower and soybean oils (3%) led to an increase in the dressing percentage of rabbits slaughtered at 18 weeks of age (approx. 3%), but had no effect on the dressing percentage of rabbits slaughtered at 12 weeks of age. Feeding pellets with either 3% vegetable oils or 1% algae additive to the rabbits did not significantly change the chemical composition of the meat. Protein content increased and intramuscular fat content decreased with age, while ash and water content were similar. The feed additives significantly differentiated meat acidity without deteriorating meat quality. Diet modification has not affected negatively meat colour. 24 h after the slaughter, the colour of rabbit meat was similar across the studied feeding groups. Correlation between diet and rabbits’ age was found. Meat texture (hardness, springiness and chewiness) of all rabbit groups slaughtered at 12 weeks of age was similar, and the shear for cewas greater in rabbits fed pellets with algae and soybean oil. At 18 weeks of age, rabbit meat from experimental groups had lower hardness and chewiness, compared to meat of the animals from the control group. Meat shear force was higher in the control group, and from algae-supplemented group. The correlation between diet and age was also found. The use of 3% vegetable oils or 1% algae as feed additives significantly reduced meat oxidative stability. Soybean or sunflower oil (3%) usedas feed additives favourably modified the fatty acid composition of intramuscular fat. Polyunsaturated fatty acids (PUFA) content was increased, including linoleic acid, and PUFA/MUFA ratio was improved. The content of these acids decreased with age. The use of algae (1%) as a feed additive resulted in positive effect on the increase of n-3 fatty acid content (EPA and DHA) in meat intramuscular fat. Algae supplementation improved pro-health properties of meat, with low n-6/n-3 acid ratio (2.5), indicating that diet modification may affect the fatty acid composition of rabbit meat. The influence of diet and age on FTO and FABP4 gene expression in meat intramuscular fat (m. longissimus lumborum) was found. FTO and FABP4 gene expression increased with age and was the highest in the group of rabbits with 1% algae supplementation in the diet. The effect of rabbits’ gender on growth, slaughter traits, meat quality and gene expression in rabbits was not observed. In conclusion, the use of natural feed additives, such as sunflower, soybean oil or algae, can improve the nutritional value of rabbit meat, without changing its chemical or physical properties, and therefore the meat can serve as functional food, with properties beneficial to human health. The results obtained in this study also indicate that the expression of FTO and FABP4 genes in rabbit muscles is regulated by dietary factors and age, which, in addition to cognitive significance, has practical implications for improving technological and dietary quality of rabbit meat.

No studies have explicitly addressed the attitudes and desires of terminally ill patients on euthanasia and physician-assisted suicide (PAS). In this prospective cohort study, 988 terminally ill patients and 893 caregivers were surveyed. A total of 60.2% patients supported euthanasia or PAS in a standard poll question, but only 10.6% seriously considered these interventions for themselves. Patients with depressive symptoms, moderate to severe pain, and significant care needs were more likely to consider euthanasia and PAS. Half of the patients who initially considered euthanasia or PAS changed their minds at the follow-up interview, and an almost equal number newly considered these interventions. Patients with depressive symptoms and dyspnea were more likely to change their minds over time. According to the caregivers of 256 deceased patients, 5.6% of patients discussed euthanasia or PAS in the last month of life, 2.5% hoarded drugs for suicide, and 0.4% died by PAS.

Bones are multifunctional passive organs of movement that supports soft tissue and directly attached muscles. They also protect internal organs and are a reserve of calcium, phosphorus and magnesium. Each bone is covered with periosteum, and the adjacent bone surfaces are covered by articular cartilage. Histologically, the bone is an organ composed of many different tissues. The main component is bone tissue (cortical and spongy) composed of a set of bone cells and intercellular substance (mineral and organic), it also contains fat, hematopoietic (bone marrow) and cartilaginous tissue. Bones are a tissue that even in adult life retains the ability to change shape and structure depending on changes in their mechanical and hormonal environment, as well as self-renewal and repair capabilities. This process is called bone turnover. The basic processes of bone turnover are: • bone modeling (incessantly changes in bone shape during individual growth) following resorption and tissue formation at various locations (e.g. bone marrow formation) to increase mass and skeletal morphology. This process occurs in the bones of growing individuals and stops after reaching puberty • bone remodeling (processes involve in maintaining bone tissue by resorbing and replacing old bone tissue with new tissue in the same place, e.g. repairing micro fractures). It is a process involving the removal and internal remodeling of existing bone and is responsible for maintaining tissue mass and architecture of mature bones. Bone turnover is regulated by two types of transformation: • osteoclastogenesis, i.e. formation of cells responsible for bone resorption • osteoblastogenesis, i.e. formation of cells responsible for bone formation (bone matrix synthesis and mineralization) Bone maturity can be defined as the completion of basic structural development and mineralization leading to maximum mass and optimal mechanical strength. The highest rate of increase in pig bone mass is observed in the first twelve weeks after birth. This period of growth is considered crucial for optimizing the growth of the skeleton of pigs, because the degree of bone mineralization in later life stages (adulthood) depends largely on the amount of bone minerals accumulated in the early stages of their growth. The development of the technique allows to determine the condition of the skeletal system (or individual bones) in living animals by methods used in human medicine, or after their slaughter. For in vivo determination of bone properties, Abstract 10 double energy X-ray absorptiometry or computed tomography scanning techniques are used. Both methods allow the quantification of mineral content and bone mineral density. The most important property from a practical point of view is the bone’s bending strength, which is directly determined by the maximum bending force. The most important factors affecting bone strength are: • age (growth period), • gender and the associated hormonal balance, • genotype and modification of genes responsible for bone growth • chemical composition of the body (protein and fat content, and the proportion between these components), • physical activity and related bone load, • nutritional factors: – protein intake influencing synthesis of organic matrix of bone, – content of minerals in the feed (CA, P, Zn, Ca/P, Mg, Mn, Na, Cl, K, Cu ratio) influencing synthesis of the inorganic matrix of bone, – mineral/protein ratio in the diet (Ca/protein, P/protein, Zn/protein) – feed energy concentration, – energy source (content of saturated fatty acids - SFA, content of polyun saturated fatty acids - PUFA, in particular ALA, EPA, DPA, DHA), – feed additives, in particular: enzymes (e.g. phytase releasing of minerals bounded in phytin complexes), probiotics and prebiotics (e.g. inulin improving the function of the digestive tract by increasing absorption of nutrients), – vitamin content that regulate metabolism and biochemical changes occurring in bone tissue (e.g. vitamin D3, B6, C and K). This study was based on the results of research experiments from available literature, and studies on growing pigs carried out at the Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences. The tests were performed in total on 300 pigs of Duroc, Pietrain, Puławska breeds, line 990 and hybrids (Great White × Duroc, Great White × Landrace), PIC pigs, slaughtered at different body weight during the growth period from 15 to 130 kg. Bones for biomechanical tests were collected after slaughter from each pig. Their length, mass and volume were determined. Based on these measurements, the specific weight (density, g/cm3) was calculated. Then each bone was cut in the middle of the shaft and the outer and inner diameters were measured both horizontally and vertically. Based on these measurements, the following indicators were calculated: • cortical thickness, • cortical surface, • cortical index. Abstract 11 Bone strength was tested by a three-point bending test. The obtained data enabled the determination of: • bending force (the magnitude of the maximum force at which disintegration and disruption of bone structure occurs), • strength (the amount of maximum force needed to break/crack of bone), • stiffness (quotient of the force acting on the bone and the amount of displacement occurring under the influence of this force). Investigation of changes in physical and biomechanical features of bones during growth was performed on pigs of the synthetic 990 line growing from 15 to 130 kg body weight. The animals were slaughtered successively at a body weight of 15, 30, 40, 50, 70, 90, 110 and 130 kg. After slaughter, the following bones were separated from the right half-carcass: humerus, 3rd and 4th metatarsal bone, femur, tibia and fibula as well as 3rd and 4th metatarsal bone. The features of bones were determined using methods described in the methodology. Describing bone growth with the Gompertz equation, it was found that the earliest slowdown of bone growth curve was observed for metacarpal and metatarsal bones. This means that these bones matured the most quickly. The established data also indicate that the rib is the slowest maturing bone. The femur, humerus, tibia and fibula were between the values of these features for the metatarsal, metacarpal and rib bones. The rate of increase in bone mass and length differed significantly between the examined bones, but in all cases it was lower (coefficient b &lt;1) than the growth rate of the whole body of the animal. The fastest growth rate was estimated for the rib mass (coefficient b = 0.93). Among the long bones, the humerus (coefficient b = 0.81) was characterized by the fastest rate of weight gain, however femur the smallest (coefficient b = 0.71). The lowest rate of bone mass increase was observed in the foot bones, with the metacarpal bones having a slightly higher value of coefficient b than the metatarsal bones (0.67 vs 0.62). The third bone had a lower growth rate than the fourth bone, regardless of whether they were metatarsal or metacarpal. The value of the bending force increased as the animals grew. Regardless of the growth point tested, the highest values were observed for the humerus, tibia and femur, smaller for the metatarsal and metacarpal bone, and the lowest for the fibula and rib. The rate of change in the value of this indicator increased at a similar rate as the body weight changes of the animals in the case of the fibula and the fourth metacarpal bone (b value = 0.98), and more slowly in the case of the metatarsal bone, the third metacarpal bone, and the tibia bone (values of the b ratio 0.81–0.85), and the slowest femur, humerus and rib (value of b = 0.60–0.66). Bone stiffness increased as animals grew. Regardless of the growth point tested, the highest values were observed for the humerus, tibia and femur, smaller for the metatarsal and metacarpal bone, and the lowest for the fibula and rib. Abstract 12 The rate of change in the value of this indicator changed at a faster rate than the increase in weight of pigs in the case of metacarpal and metatarsal bones (coefficient b = 1.01–1.22), slightly slower in the case of fibula (coefficient b = 0.92), definitely slower in the case of the tibia (b = 0.73), ribs (b = 0.66), femur (b = 0.59) and humerus (b = 0.50). Bone strength increased as animals grew. Regardless of the growth point tested, bone strength was as follows femur &gt; tibia &gt; humerus &gt; 4 metacarpal&gt; 3 metacarpal&gt; 3 metatarsal &gt; 4 metatarsal &gt; rib&gt; fibula. The rate of increase in strength of all examined bones was greater than the rate of weight gain of pigs (value of the coefficient b = 2.04–3.26). As the animals grew, the bone density increased. However, the growth rate of this indicator for the majority of bones was slower than the rate of weight gain (the value of the coefficient b ranged from 0.37 – humerus to 0.84 – fibula). The exception was the rib, whose density increased at a similar pace increasing the body weight of animals (value of the coefficient b = 0.97). The study on the influence of the breed and the feeding intensity on bone characteristics (physical and biomechanical) was performed on pigs of the breeds Duroc, Pietrain, and synthetic 990 during a growth period of 15 to 70 kg body weight. Animals were fed ad libitum or dosed system. After slaughter at a body weight of 70 kg, three bones were taken from the right half-carcass: femur, three metatarsal, and three metacarpal and subjected to the determinations described in the methodology. The weight of bones of animals fed aa libitum was significantly lower than in pigs fed restrictively All bones of Duroc breed were significantly heavier and longer than Pietrain and 990 pig bones. The average values of bending force for the examined bones took the following order: III metatarsal bone (63.5 kg) &lt;III metacarpal bone (77.9 kg) &lt;femur (271.5 kg). The feeding system and breed of pigs had no significant effect on the value of this indicator. The average values of the bones strength took the following order: III metatarsal bone (92.6 kg) &lt;III metacarpal (107.2 kg) &lt;femur (353.1 kg). Feeding intensity and breed of animals had no significant effect on the value of this feature of the bones tested. The average bone density took the following order: femur (1.23 g/cm3) &lt;III metatarsal bone (1.26 g/cm3) &lt;III metacarpal bone (1.34 g / cm3). The density of bones of animals fed aa libitum was higher (P&lt;0.01) than in animals fed with a dosing system. The density of examined bones within the breeds took the following order: Pietrain race&gt; line 990&gt; Duroc race. The differences between the “extreme” breeds were: 7.2% (III metatarsal bone), 8.3% (III metacarpal bone), 8.4% (femur). Abstract 13 The average bone stiffness took the following order: III metatarsal bone (35.1 kg/mm) &lt;III metacarpus (41.5 kg/mm) &lt;femur (60.5 kg/mm). This indicator did not differ between the groups of pigs fed at different intensity, except for the metacarpal bone, which was more stiffer in pigs fed aa libitum (P&lt;0.05). The femur of animals fed ad libitum showed a tendency (P&lt;0.09) to be more stiffer and a force of 4.5 kg required for its displacement by 1 mm. Breed differences in stiffness were found for the femur (P &lt;0.05) and III metacarpal bone (P &lt;0.05). For femur, the highest value of this indicator was found in Pietrain pigs (64.5 kg/mm), lower in pigs of 990 line (61.6 kg/mm) and the lowest in Duroc pigs (55.3 kg/mm). In turn, the 3rd metacarpal bone of Duroc and Pietrain pigs had similar stiffness (39.0 and 40.0 kg/mm respectively) and was smaller than that of line 990 pigs (45.4 kg/mm). The thickness of the cortical bone layer took the following order: III metatarsal bone (2.25 mm) &lt;III metacarpal bone (2.41 mm) &lt;femur (5.12 mm). The feeding system did not affect this indicator. Breed differences (P &lt;0.05) for this trait were found only for the femur bone: Duroc (5.42 mm)&gt; line 990 (5.13 mm)&gt; Pietrain (4.81 mm). The cross sectional area of the examined bones was arranged in the following order: III metatarsal bone (84 mm2) &lt;III metacarpal bone (90 mm2) &lt;femur (286 mm2). The feeding system had no effect on the value of this bone trait, with the exception of the femur, which in animals fed the dosing system was 4.7% higher (P&lt;0.05) than in pigs fed ad libitum. Breed differences (P&lt;0.01) in the coross sectional area were found only in femur and III metatarsal bone. The value of this indicator was the highest in Duroc pigs, lower in 990 animals and the lowest in Pietrain pigs. The cortical index of individual bones was in the following order: III metatarsal bone (31.86) &lt;III metacarpal bone (33.86) &lt;femur (44.75). However, its value did not significantly depend on the intensity of feeding or the breed of pigs.

Studies suggest that dogs preferentially choose fat as their major dietary energy source (59-63% of the total metabolisable energy (ME) content of the diet). However, high fat diets have been linked to the development of pancreatitis in dogs. This study investigated several biomarkers associated with pancreatitis in dogs fed either a high fat (HF; Protein: Fat: Carbohydrate content; 35%:63%:2% ME; n= 10 dogs) or high carbohydrate (HC; Protein: Fat: Carbohydrate content; 17%:32%:51% ME) diet.A high fat meal tolerance test (MTT) was undertaken on dogs (n=20) at baseline consuming a commercial dry food diet (Protein: Fat: Carbohydrate content; 23%:25%:52% on an ME basis) and then again after 8 weeks consuming either a HF (n=10) or HC (n=10) diet. Briefly, after an overnight fast, dogs were fed a single meal containing 100% of their daily requirements (P: F: C content; 35%:63%:2% ME). Each dog was then blood sampled 1, 2, 3, 4, 5, 6, 12, and 24 hours post-prandially. Samples were analysed for plasma triglycerides and markers of pancreatitis (i.e., pancreatic lipase, endotoxin, C-reactive protein, Interleukin 1-alpha, Interleukin 6 and Tumour necrosis factor-alpha). The postprandial peak plasma concentration of triglycerides (Cmax) were higher (p less than 0.001) at baseline, compared to after feeding of the either the HC or HF diets for 8 weeks. This suggests dietary components such as moisture level, specific ingredients, level of diet processing, and possibly apparent nutrient digestibility were potential factors driving this response. There was no effect of feeding either HF or HC diets on Cmax values (P &gt;0.05) during the final MTT. This study suggests that feeding a HF diet for 8 weeks does not elevate blood markers associated with pancreatitis, with the serum biochemistry and complete blood count indicating the dogs remained clinically healthy.

Feeding livestock a balanced diet with a differentiated crude protein (CP) content, depending on the lactation phase can reduce nitrogen emissions from livestock excrement and urine. A higher content of non-starch polysaccharides in livestock diets improves feed absorption in the livestock body and, consequently, nitrogen is emitted more from protein present in livestock manure than from urea acid present in livestock urine. The aim of the study is to calculate the ammonia emission reduction potential in Latvia by optimizing the feeding of dairy cows and ensuring life longevity, as well as provide justification for ammonia emission reduction in dairy farms. Calculations made by using the NorFor Model for optimization of dairy cow (Bos primigenius f. taurus) diets revealed that compared with lowyielding cows, a higher CP content diet fed to high-yielding cows at the beginning of lactation increased the amount of nitrogen (N) in their excrement and urine by 90–180 g d-1. Reducing the CP content in the cow diet by an average of 10 g kg-1 dry matter (DM) during mid-lactation resulted in the same trend. Reducing the CP content in the cow diet during late lactation and the dry period by another 20–30 g kg-1 of DM, N emissions from excrement and urine significantly decreased. Increasing the lifespan of dairy cows also means reducing ammonia emissions from the farm. By increasing the number of lactations per cow on dairy farm, it is possible to reduce the number of heifers per cow. The total reduction of ammonia emissions in Latvia was calculated based on a long-term projection of a decrease of 0.1 heifer per dairy cow. Ammonia emissions could be reduced by 0.051 kt by decreasing the number of heifers by 12.54 thou. at the planned increase in the lifespan of dairy cows by 2030.

ABSTRACT Following a balanced diet is essential, not only for maintaining a good body shape, but it is also crucial for our health. By controlling our nutrition, we can reduce the symptoms and also the progression of many diseases such as diabetes, anemia, cardiovascular disease, movement disorders, and more. Of particular importance is the right proportion of the main energy sources - carbohydrates, proteins, and fats, which aim to reduce excess body fat and increase muscle mass. In search of an answer to whether a balanced diet is enough, we studied 20 volunteers to build a harmonious body. The present study focuses on the diagnosis and control of the main physical indicators of managed 20 to 30 years and how they are affected by 50 days balanced diet combined with and without strength training, divided into two groups - basic and experimental. Anthropometric parameters were measured using a body composition analyzer from the Japanese company TANITA. Based on the indicators of daily caloric intake and kilograms of muscle mass, the required daily intake of proteins, carbohydrates, and fats is calculated. In the main group, after 50 days, a decrease in body weight was reported on average by 5.87% (6.07 kg). What is concerning is the fact that body fat was reduced by only 1.8%, while muscle loss was 4.83% (3.73 kg). In the experimental group, which was on the same diet, but included strength training, the muscle mass was increased by 4.14% (3 kg) and a decrease in total fat by 3.05%. No significant differences are observed in total body weight - 0.89% (0.68 kg), due to the increase in muscle mass. After the research, we concluded that following a diet is not enough to build a harmonious body. This should be used in combination with a training process aimed at increasing muscle mass and lower in total body fat.

ABSTRACT Background: Kebo rubber leaves (ficus elastica roxb) contain flavonoids, polyphenols, and tannins. Flavonoids in the leaves of ficus elastica roxb such as catechins, isoflavones are polyphenolic antioxidants from plant metabolites. The leaves of ficus elastica roxb are trusted and proven empirically in the community to reduce cholesterol levels in the blood. Mice choose animals because they are considered to have physiological similarities with humans. This study aimed to determine the effect of ethanol extract of ficus elastica roxb leaves on reducing total cholesterol level in male Swiss Webster mice. Subjects and Method: This was a quasi-experimental study conducted at Biology Laboratory of the Faculty of Agriculture, Fisheries and Biology, University of Bangka Belitung from April to June, 2017. A sample of 25 male Swiss Webster mice was selected at random and allocated into groups. The dependent variable was total cholesterol. The independent variable was the extract of ficus elastica rox. The data were tested by One-Way ANOVA. Result: There were statistically significant mean differences among the study groups (p= 0.002), indicating the effect of ethanol extract of Ficus Elastica Roxb leaves on reducing total cholesterol level in male Swiss Webster mice at various doses. Conclusion: There are statistically significant mean differences among the study groups, indicating the effect of ethanol extract of Ficus Elastica Roxb leaves on reducing total cholesterol level in male Swiss Webster mice at various doses. Keyword: Ethanol extract of Ficus Elastica Roxb leaves, total cholesterol, mice Correspondence: Muhamad Seto Sudirman. School of Health Polytechnic, Pangkalpinang. Email: MuhamadSeto@gmail.com DOI: https://doi.org/10.26911/the7thicph.05.10

Platelet derived growth factor(s) probably synthesized by the megakaryocyte are important in atherogenesis. In a pilot study destruction of the circulating platelets was induced by injection of goat serum containing a specific platelet antibody (APS) to rabbits fed a high cholesterol diet (2g per day) for 12 weeks. Seven days after APS the percentage of atheroma in the aorta measured by planimetry was increased in these animals compared to control animals on the same diet that had been injected with goat serum (GS) 7 days before. In a new study 15 pairs of male litter mate rabbits on high cholesterol diet were randomised in pairs to treatment with either APS or GS. Five pairs of animals were killed 18 hours after the injection, 5 pairs 4 days after and 5 pairs 7 days after the injection and the platelet count, mean platelet volume, megakaryocyte nuclear, cytoplasmic and total size, megakaryocyte DNA distribution and the percentage of atheroma in the aorta were measured. Comparison of these variables between the 2 groups revealed the following statistically significant findings (p&lt;0.05) : 18 hours after the injection the platelet count was decreased and the mean platelet volume increased in the APS group. At day 4 the platelet count, megakaryocyte nuclear, cytoplasmic and total size and the megakaryocyte DNA content were increased in the APS group. At day 7 the platelet count and the percentage of the atheroma were higher in the APS group. Since platelets produced by big megakaryocytes with high DNA content are more reactive than normal platelets, we suggest that the acceleration of atheroma formation demonstrated 7 days after APS is caused by the large number of platelets with possible high concentrations of growth factor(s) derived from the large megakaryocytes with increased DNA content.

Here, we present a specific atlas of mouse metabolome and lipidome (MetaboAtlas21) in the context of systemic energy balance (chow diet) and under chronic nutrient stress (high-fat diet). Male mice were fed a control (chow) diet for 2 months or a high-fat diet for 2 months and 10 months. Urine, plasma, feces, and 18 different tissues were collected from each animal for metabolomics and lipidomics analysis. These matrices cover digestive, excretory, respiratory, reproductive, endocrine, muscular, cardiovascular, and nervous systems. Also, chow and high-fat diet feeds were analyzed along with quality control human plasma/serum materials (NIST SRM 1950 plasma, Merck S1-100ML serum, Sigma–Aldrich S7023 serum). In total, 408 samples were included in this study. An “all-in-one” extraction protocol LIMeX using methyl tert-butyl ether, methanol, and water was used to isolate metabolite fractions and analyzed using a multiplatform LC-MS-based approach (7 platforms for non-fat tissues and biofluids; 8 platforms for adipose tissues). Raw data files were processed using MS-DIAL 4. Metabolites were annotated using in-house retention time–m/z library and using MS/MS libraries available from commercial and open sources (NIST20, MassBank, MoNA). Lipids were annotated using LipidBlast in MS-DIAL. Ultimately, we annotated over 3,000 unique polar metabolites and complex lipids. To better understand the structure of generated data, we provide a user-friendly data visualization tool (metaboatlas21.metabolomics.fgu.cas.cz) to easily access and analyze the different combinations of tissues and biofluids in response to the metabolic challenge (NIST20, MassBank, MoNA). Lipids were annotated using LipidBlast in MS-DIAL. Ultimately, we annotated over 3,000 unique polar metabolites and complex lipids. To better understand the structure of generated data, we provide a user-friendly data visualization tool (metaboatlas21.metabolomics.fgu.cas.cz) to easily access and analyze the different combinations of tissues and biofluids in response to the metabolic challenge.

Background: In the era of technology 4.0, the rapid and instantaneous development of information media affects people’s lifestyles and consumption patterns. This study aims to analyze the effect of online-based health education media on knowledge and attitudes about balanced diet in youth during the COVID-19 pandemic in Medan. Subjects and Method: This was a quasi-experiment study with pretest-posttest control group design. This study was located in MAN 1 Medan and MAN 2 Model Medan, from March to September 2020. A total sample of 40 students was selected by simple random sampling. Furthermore, the sample was given treatment, namely providing health education through Google Meet media to see differences in student knowledge and attitudes before and after being given health education. The data were analyzed by paired t-test. Result: Mean of the adolescent knowledge after given education of balanced diet through Google Meet (Mean= 42.05; SD= 2.43) was higher than before education (Mean= 38.90; SD = 3.024), it was statistically significant (p&lt; 0.05). Mean of the attitude of adolescents after given education of balanced diet through Google Meet (Mean= 49.60; SD= 3.32) was higher than before given education (Mean= 45.50; SD= 3.10), it was statistically significant (p&lt; 0.05). Conclusion: It is hoped that the Medan City Health Office can design a prevention strategy for the problems caused by not knowing and implementing balanced nutrition during the COVID-19 pandemic by increasing a healthy lifestyle by using Google Meet media, which is packaged attractively to the public, especially teenagers in Medan City. Keywords: health education media, google meet, balanced diet in youth, covid-19 Correspondence: Septo Tepriandy. Faculty of Public Health, University of North Sumatra. Jl. University No.32, Padang Bulan, Kec. Medan Baru, Medan City, North Sumatra. Email: stsimamora@gmail.com. Mobile: 085358863555 DOI: https://doi.org/10.26911/the7thicph.02.18

The association of factor VII coagulant activity (VIIC) with plasma lipid concentrations has been a consistent feature of a number of studies in man and points to plasma lipoproteins as determinants of VIIC.To modify plasma lipoprotein concentrations and to study the effect of this on VIIC, rabbits were fed a 1%- cholesterol-supplemented diet. Treatment resulted in a many-fold increase in plasma cholesterol concentration with the major fraction of excess cholesterol associated with the very low and intermediate density lipoprotein fractions. VIIC was considerably higher in rabbits fed 1%- cholesterol-supplemented than in rabbits fed the standard diet. In both groups of rabbits, the direction and extent of variation in VIIC coincided with variation in cholesterol concentration so that over time there were significant and positive correlations between VIIC and plasma cholesterol. A method that provides a measure of the total functionalfactor VII concentration (VII) was also used. This assay involves clotting the plasma in the presence of excess tissue factor and therefore the conversion of VII tothe more reactive two-chain form of theprotein (αVIIa) .The concentration of αVIIa present in the serum was measured from the rate of activation of excess of [sialyl-3H]-bovine factor X. By day 10 of treatment, and in all furthercomparisons VTIt was only slightly higher in the group of rabbits fed cholesterol-supplemented than in that fed the standard diet.This increase in VI11 istoo small to explain the considerable increasin VIIC in the hypercholesterolaemic rabbit. We conclude thattheincrease in VIIc was to ahigher proportion of αVIIa in theplasma of hyperchol⋆esterol-aemic rabbits rather thanto an increase in the concentration of the single-chain protein.

Overweight and obese children often suffer for many physiological and psychological is-sues. Resistance training allows them to excel over their peers due to strength ability which is related to their somatotype. The aim of this study was to examine the effect of an eight-week resistance training program on body composition in overweight and obese children. Study sample included 8 boys and 4 girls (age = 11.7 ± 1.54) who were involved in an eight-week strength specifically designed program consisted of two strength training unit per week. Resistance of exercise was set on 8‒10 RM. Body composition were measured by InBody 720 two times before and after the training intervention. The Wilcoxon matched pairs test was used. Results showed increase in total body weight (2.7%), lean body mass (2.5%) and fat mass (3.7%). This effect indicates that used resistance training program is suficient to lean body mass grow. Nevertheless, program proved to be inadequate to avoid an increase in fat mass. This could be caused by many factors which should be consider in further research (e.g. longer technique practice, diet, number of training units).

В исследовании участвовали 20 спортсменов-юниоров (мастера спорта и кандидаты в мастера спорта) в возрасте 17-18 лет и 10 добровольцев соответствующего возраста и интенсивности физической нагрузки. В результате исследований установлено, что суммарная калорийность потребленных за сутки продуктов в основном соответствовала энерготратам спортсменов обследованных групп. Соотношение белки/жиры/углеводы в суточном рационе спортсменов свидетельствует о недостаточной квоте углеводов в соответствии с формулой оптимального питания для юных спортсменов. При этом потребление добавленного сахара у спортсменов всех категорий превышало рекомендуемый уровень (10% от калорийности суточного рациона). The study involved 20 junior athletes (masters of sports and candidates for masters of sports) aged 17-18 and 10 volunteers of the corresponding age and intensity of physical activity. As a result of the research, it was found that the total calorie content of products consumed per day basically corresponded to the energy consumption of athletes in the surveyed groups. The ratio of protein / fat / carbohydrates in the daily diet of athletes indicates an insufficient carbohydrate quota in accordance with the optimal nutrition formula for young athletes. At the same time, the consumption of added sugar in athletes of all categories exceeded the recommended level (10% of the caloric content of the daily diet).

The effect of rumen available protein amino acids and carbohydrates on microbial protein synthesis, amino acid flow and performance of high yielding dairy cows was studied. A significant relationship between the effective degradabilities of OM in feedstuffs and the in vivo ruminal OM degradation of diets of dairy cows was found. The in situ method enabled the prediction of ruminal nutrients degradability response to processing of energy and nitragenous supplements. The AA profile of the rumen undegradable protein was modified by the processing method. In a continuous culture study total N and postruminal AA flows, and bacterial efficiency, is maximal at rumen degradable levels of 65% of the CP. Responses to rumen degradable non carbohydrate (NSC) were linear up to at least 27% of DM. Higher CP flow in the abomasum was found for cows fed high ruminally degradable OM and low ruminally degradable CP diet. It appeared that in dairy cows diets, the ratio of rumen degradable OM to rumenally degradable CP should be at least 5:1 in order to maximize postruminal CP flow. The efficiency of microbial CP synthesis was higher for diets supplemented with 33% of rumen undegradable protein, with greater amounts of bacterial AA reaching the abomasum. Increase in ruminal carbohydrate availability by using high moisture corn increased proportions of propionate, postruminal nutrients flow, postruminal starch digestibility, ruminal availability of NSC, uptake of energy substrates by the mammory gland. These modifications resulted with improvement in the utilization of nonessential AA for milk protein synthesis, in higher milk protein yield. Higher postruminal NSC digestibility and higher efficiency of milk protein production were recorded in cows fed extruded corn. Increasing feeding frequency increased flow of N from the rumen to the blood, reduced diurnal variation in ruminal and ammonia, and of plasma urea and improved postruminal NSC and CIP digestibility and total tract digestibilities. Milk and constituent yield increased with more frequent feeding. In a study performed in a commercial dairy herd, changes in energy and nitrogenous substrates level suggested that increasing feeding frequency may improve dietary nitrogen utilization and may shift metabolism toward more glucogenesis. It was concluded that efficiency of milk protein yield in high producing cows might be improved by an optimization of ruminal and post-ruminal supplies of energy and nitrogenous substrates. Such an optimization can be achieved by processing of energy and nitrogenous feedstuffs, and by increasing feeding frequency. In situ data may provide means for elucidation of the optimal processing conditions.

Review question / Objective: The purpose of this study is to summarize the characteristics of RCT in the treatment of obesity by acupuncture and other related intervention measures, so as to enhance evidence-based clinical practice about acupuncture for obesity. Condition being studied: Obesity is a chronic metabolic disease that is defined as a body's excessive accumulation or abnormal distribution of total or local fat content. Their complications such as Type II diabetes mellitus, hyperlipidemia, and cardiovascular diseases are strongly related to higher risks of mortality. In recent years, with the changes in diet structure and living habits, 1.9 billion adults were overweight and over 650 million were obese according to the report by the WHO in 2016. Acupuncture is a characteristic therapy of traditional Chinese medicine, which is effective and safe for the treatment of simple obesity. In recent years, many RCTs using acupuncture in simple obesity were carried out within and outside of China. But currently, acupuncture treatment has no uniform standard, and there are a number of problems with this current clinical application of modern Chinese Medicine. Unfortunately, there is an absence of high-quality data supporting their use. This scoping review aims to summarize the characteristics of RCT in the treatment of obesity by acupuncture and other related intervention measures, so as to enhance evidence-based clinical practice about acupuncture and moxibustion for obesity.

Objectives. This systematic review evaluates breast reconstruction options for women after mastectomy for breast cancer (or breast cancer prophylaxis). We addressed six Key Questions (KQs): (1) implant-based reconstruction (IBR) versus autologous reconstruction (AR), (2) timing of IBR and AR in relation to chemotherapy and radiation therapy, (3) comparisons of implant materials, (4) comparisons of anatomic planes for IBR, (5) use versus nonuse of human acellular dermal matrices (ADMs) during IBR, and (6) comparisons of AR flap types. Data sources and review methods. We searched Medline®, Embase®, Cochrane CENTRAL, CINAHL®, and ClinicalTrials.gov from inception to March 23, 2021, to identify comparative and single group studies. We extracted study data into the Systematic Review Data Repository Plus (SRDR+). We assessed the risk of bias and evaluated the strength of evidence (SoE) using standard methods. The protocol was registered in PROSPERO (registration number CRD42020193183). Results. We found 8 randomized controlled trials, 83 nonrandomized comparative studies, and 69 single group studies. Risk of bias was moderate to high for most studies. KQ1: Compared with IBR, AR is probably associated with clinically better patient satisfaction with breasts and sexual well-being but comparable general quality of life and psychosocial well-being (moderate SoE, all outcomes). AR probably poses a greater risk of deep vein thrombosis or pulmonary embolism (moderate SoE), but IBR probably poses a greater risk of reconstructive failure in the long term (1.5 to 4 years) (moderate SoE) and may pose a greater risk of breast seroma (low SoE). KQ 2: Conducting IBR either before or after radiation therapy may result in comparable physical well-being, psychosocial well-being, sexual well-being, and patient satisfaction with breasts (all low SoE), and probably results in comparable risks of implant failure/loss or need for explant surgery (moderate SoE). We found no evidence addressing timing of IBR or AR in relation to chemotherapy or timing of AR in relation to radiation therapy. KQ 3: Silicone and saline implants may result in clinically comparable patient satisfaction with breasts (low SoE). There is insufficient evidence regarding double lumen implants. KQ 4: Whether the implant is placed in the prepectoral or total submuscular plane may not be associated with risk of infections that are not explicitly implant related (low SoE). There is insufficient evidence addressing the comparisons between prepectoral and partial submuscular and between partial and total submuscular planes. KQ 5: The evidence is inconsistent regarding whether human ADM use during IBR impacts physical well-being, psychosocial well-being, or satisfaction with breasts. However, ADM use probably increases the risk of implant failure/loss or need for explant surgery (moderate SoE) and may increase the risk of infections not explicitly implant related (low SoE). Whether or not ADM is used probably is associated with comparable risks of seroma and unplanned repeat surgeries for revision (moderate SoE for both), and possibly necrosis (low SoE). KQ 6: AR with either transverse rectus abdominis (TRAM) or deep inferior epigastric perforator (DIEP) flaps may result in comparable patient satisfaction with breasts (low SoE), but TRAM flaps probably increase the risk of harms to the area of flap harvest (moderate SoE). AR with either DIEP or latissimus dorsi flaps may result in comparable patient satisfaction with breasts (low SoE), but there is insufficient evidence regarding thromboembolic events and no evidence regarding other surgical complications. Conclusion. Evidence regarding surgical breast reconstruction options is largely insufficient or of only low or moderate SoE. New high-quality research is needed, especially for timing of IBR and AR in relation to chemotherapy and radiation therapy, for comparisons of implant materials, and for comparisons of anatomic planes of implant placement.