Validation of a Nutritional Screening Tool for Ambulatory Use in Pediatrics
. Journal of Pediatric Gastroenterology and Nutrition 2016
. Publisher's VersionAbstract
Objectives:To evaluate the use of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) in a primary health care clinic in the community and to assess the impact of its use on medical staff's awareness of nutritional status.
STAMP scoring system was tested as is and with modifications in the ambulatory setting. Nutritional risk according to STAMP was compared with a detailed nutritional assessment performed by a registered dietitian. Recording of nutrition-related data and anthropometric measurements in medical files were compared prior and post implementation.
Sixty children were included (31 girls, 52%), ages between 1 and 6 years, mean age 2.8 ± 1.5 (mean ± SD). STAMP scores yielded a fair agreement between STAMP and the dietitian's nutritional assessment: κ = 0.47 (95% confidence interval [CI] 0.24–0.7), sensitivity of 47.62% (95% CI 28.34–67.63). Modified STAMP yielded more substantial agreement: κ = 0.57 (95% CI 0.35–0.79), sensitivity of 76.19% (95% CI 54.91–89.37), specificity of 82.05% (95% CI 67.33–91.02). The use of STAMP resulted in an increase in recording of appetite, dietary intake, and anthropometric measurements.
Modification of the STAMP improved nutritional risk evaluation in community setting. The use of STAMP in a primary health care clinic raised clinician's awareness to nutritional status. Further work will identify whether this could be translated into lower malnutrition rates and better child care.
Challenges and opportunities in food engineering: Modeling, virtualization, open innovation and social responsibility
. Journal of Food Engineering 2016
, 2-8. Publisher's VersionAbstract
Food engineering should shed its historical mindset, embrace new challenges and opportunities that the 21st century holds. Unabated scientific progress and breakthroughs highlight mounting challenges with some vital paradigm shifts. Four main challenges have been identified: modeling, virtualization, open innovation (OI) and social responsibility (SR). The shift from empirical to physics-based food modeling is paramount to benefit from new sensor technology, proliferation of the 'Internet of Things', and big-data information. An overriding part of modeling continues to be food uniqueness and complexity, consumer needs and expectations, health and wellness, sustainability and SR. Virtualization is to significantly benefit from expanding computational power, dedicated software, cloud computing, big data, and other breakthroughs. Collaboration and partnerships with all innovation ecosystem stakeholders are paramount. Academia's role as a 'startup university' requires revising its intellectual property models, curricula rejuvenating, OI, creativity, employability and SR. Food engineers are at a verge of a very prosperous future. © 2015 Elsevier Ltd.
Food engineering: Attitudes and future outlook
. Journal of Food Engineering 2016
, 71-80. Publisher's VersionAbstract
A global web survey was conducted collecting academia and industry perceived attitudes, identifying curriculum gaps, challenges and opportunities of food engineering (FE). Participation criterion was: "A person who has one or more formal degrees in FE, and/or an equivalent degree in another field and whose job description includes/included FE activities". Respondents with formal FE education was lower than 25%. More than two-thirds of the respondents holding a formal BSc or MSc in FE selected other domains for their higher degrees, and 56.7% indicated that FE should become a part of another study program. Traditional FE topics were preferred over health, nutrition and wellbeing, innovation related to firm's activities, marketing molecular biology. FE profession should undergo a self-examination required to ensure its future growth and impact in addressing forthcoming challenges in the food sector, and concurrently make paradigm shifts in its vision in the pursuit of excellence and innovation. © 2016 Elsevier Ltd. All rights reserved.
Open Innovation Opportunities Focusing on Food SMEs
; Innovation Strategies in the Food Industry: Tools for Implementation; 2016; pp. 41-59. Publisher's VersionAbstract
The food industry, especially small and medium enterprises (SMEs), is facing increasingly complex challenges, more regulation, as well as fierce local and global competition. Open innovation (OI) can enhance innovation options by accessing external assets and collaborations with unique opportunities, facilitating partnerships, and alleviating hurdles such as limited resources, R&D expertise, skills, etc. Highlighted topics include: adapting OI for the food industry's special needs, with a focus on SMEs' unique challenges, and the roles of academia and intellectual property. Examples provided depict SMEs with typical OI utilization and the steps required to initiate and develop new concepts. Specific recommendations include: collaboration, creation of a four-helix innovation ecosystem (industry, academia, government, and private sector), metrics to quantify academia's social responsibility, and revised curricula promoting OI to encourage SMEs involvement. OI presents a unique opportunity for all stakeholders, especially for SMEs, to proactively engage in meeting future challenges and opportunities. © 2016 Elsevier Inc. All rights reserved.
Moderate ‘multivitamin’ supplementation improved folate and vitamin B12 status in the elderly
. Experimental Gerontology 2016
, 101-106. Publisher's VersionAbstract
The dependent elderly are widely considered to be at higher risk of nutritional problems. Suboptimal micronutrient intake might put the elderly, especially those living in nursing homes, at high risk of morbidity. So far, no public authority, except for the Israel Ministry of Health, has issued particular recommendations for micronutrient supplementation for the elderly. We hypothesized that moderate ‘multivitamin’ supplementation could improve the vitamin status of the dependent elderly. The study took place in two nursing homes and included 144 dependent elderly (males/females, 35/109). Demographic and clinical data as well as routine blood tests were retrieved from the patient electronic medical records. After a two-year daily ‘multivitamin’ supplementation, containing 120 μg of folic acid, there was a small and non-significant increase of 12% in serum folate; the same ‘multivitamin’ preparatory, containing 2.4 μg of vitamin B12, significantly increased serum vitamin B12 by 8%. Three models of evaluation clearly showed the effect of a two- year vitamin supplementation: 1. The number of subjects with the lowest baseline concentration range, decreased, with moderate concentration, increased, with no difference at the higher concentrations; 2. Above each vitamin concentration, the number of subjects was higher than at baseline; 3. The two vitamins at the two lower concentration tertiles increased, and at the highest tertile, folate was not affected, whereas vitamin B12 decreased. Therefore, very moderate ‘multivitamin’ supplementation, as practiced in our study, has a high probability of improving vulnerable old population health status without causing any adverse effects to others. © 2016 Elsevier Inc.
Can desalinated seawater contribute to iodine-deficiency disorders? An observation and hypothesis
. Public Health Nutrition 2016
, 2808-2817. Publisher's VersionAbstract
Objective Over 300 million people rely on desalinated seawater and the numbers are growing. Desalination removes iodine from water and could increase the risk of iodine-deficiency disorders (IDD). The present study assessed the relationship between iodine intake and thyroid function in an area reliant on desalination. Design A case–control study was performed between March 2012 and March 2014. Thyroid function was rigorously assessed by clinical examination, ultrasound and blood tests, including serum thyroglobulin (Tg) and autoimmune antibodies. Iodine intake and the contribution made by unfiltered tap water were estimated by FFQ. The contribution of drinking-water to iodine intake was modelled using three iodine concentrations: likely, worst-case and best-case scenario. Setting The setting for the study was a hospital located on the southern Israeli Mediterranean coast. Subjects Adult volunteers (n 102), 21–80 years old, prospectively recruited. Results After screening, seventy-four participants met the inclusion criteria. Thirty-seven were euthyroid controls. Among those with thyroid dysfunction, twenty-nine were classified with non-autoimmune thyroid disease (NATD) after excluding eight cases with autoimmunity. Seventy per cent of all participants had iodine intake below the Estimated Average Requirement (EAR) of 95 µg/d. Participants with NATD were significantly more likely to have probable IDD with intake below the EAR (OR=5·2; 95 % CI 1·8, 15·2) and abnormal serum Tg>40 ng/ml (OR=5·8; 95 % CI 1·6, 20·8). Conclusions Evidence of prevalent probable IDD in a population reliant on desalinated seawater supports the urgent need to probe the impact of desalinated water on thyroid health in Israel and elsewhere.
Low protein and high-energy diet: a possible natural cause of fatty liver hemorrhagic syndrome in caged White Leghorn laying hens
. Poultry Scienceps 2016
, 612 - 621. Publisher's VersionAbstract
Fatty liver hemorrhagic syndrome (FLHS) is a metabolic condition of chicken and other birds caused by diverse nutritional, hormonal, environmental, and metabolic factors. Here we studied the effect of different diet composition on the induction of FLHS in single comb White Leghorn (WL) Hy-line laying hens. Seventy six (76) young WL (26 wks old) laying hens and 69 old hens (84 wks old) of the same breed were each divided into 4 treatment groups and provided 4 different diet treatments. The diet treatments included: control (C), 17.5% CP, 3.5% fat (F); normal protein, high fat (HF), 17.5% CP, 7% F; low protein, normal fat (LP), 13% CP, 3.5% F; and low protein, high fat (LPHF), 13% CP, 6.5% F. The diets containing high fat also had a higher ME of 3,000 kcal/kg of feed while the other 2 diets with normal fat had a regular lower amount of ME (2750 kcal/kg). Hen-day egg production (HDEP), ADFI, BW, egg weight, plasma enzymes indicating liver damage (alkaline phosphatase [ALP], aspartate aminotransferase [AST], gamma-glutamyl transferase [GGT]), liver and abdominal fat weight, liver color score (LCS), liver hemorrhagic score (LHS), liver fat content (LFC), liver histological examination, lipid peroxidation product in the liver, and genes indicating liver inflammation were evaluated. HDEP, ADFI, BW, and egg weight were significantly decreased in the LPHF diet group, while egg weight was also decreased in the LP diet group. In the young hens (LPHF group), ALP was found significantly higher at 30 d of diet treatment and was numerically higher throughout the experiment, while AST was significantly higher at 105 d of treatment. LCS, LHS, and LFC were significantly higher in young hens on the LPHF diet treatment. A liver histological examination shows more lipid vacuolization in the LPHF treatment diet. HF or LP alone had no significant effect on LFC, LHS, or LCS. We suggest that LP in the diet with higher ME from fat can be a possible natural cause for predisposing laying hens to FLHS.
Prolonged feeding with green tea polyphenols exacerbates cholesterol-induced fatty liver disease in mice
. Molecular Nutrition & Food ResearchMolecular Nutrition & Food ResearchMol. Nutr. Food Res. 2016
, 2542 - 2553. Publisher's VersionAbstract
Scope This study investigated the potential deleterious impact of dietary supplementation with green tea extract (GTE) on the progression of fatty liver disease, in a mouse model of cholesterol-induced steatohepatitis that represents chronic liver injury. Methods and results Male C57BL mice (n = 32, 8-wk-old) were fed for 6 wk with one of the following diets: normal control diet (ND, Con), Con + 1% w/w polyphenols from GTE (Con + GTE); high cholesterol diet, Con + 1% cholesterol + 0.5% cholate w/w (HCD); HCD + 1% green tea polyphenols w/w (HCD + GTE). Hepatic steatosis, oxidative, and inflammatory markers and bile acid synthesis pathways were measured. HCD supplementation resulted in hepatic steatosis and liver damage. In animals supplemented with the HCD + GTE an exacerbated hepatic steatosis, oxidative stress, and inflammatory response were observed compared to HCD supplemented animals. HCD + GTE supplementation elevated blood levels of liver enzymes and serum bile acids compared HCD-treated animals. HCD + GTE supplementation altered bile acid synthesis in the cholesterol clearance pathway, inducing a shift from the classically regulated CYP7A1 pathway to the alternative acidic pathway. Conclusion Prolonged GTE supplementation dramatically increased hepatic oxidative stress, inflammation and liver injury, and altered the bile acid synthesis pathway in mice fed a HCD.
Documentation of the dietetic care process: developing a sectoral, tailored system
, 753 - 755. Publisher's VersionAbstract
Use of electronic health records necessitates a systematic approach for documentation of the Dietetic Care Process (DCP). However, no standardized system exists in Israel. The authors propose a novel documentation system developed by an expert advisory committee and tailored to a specific patient population. In this pilot study, 12 experienced Israeli Registered Dietitians (RDs) (median years of practice=23.0; s.d.=8.8; practice in geriatric populations median=13.0; s.d.=8.5) were recruited to evaluate the new tool for DCP documentation. Participants completed an explanatory short course online and evaluated the utility of the tool. There was full agreement that the proposed tool is necessary and an effective method for documenting the DCP within geriatric populations in clinical practice. In conclusion, a novel, tailored and sectoral tool designed for standardized documentation of dietetic care was recommended for implementation by an experienced group of RDs with substantive clinical experience in geriatric populations.
Past and Present Insights on Alpha-linolenic Acid and the Omega-3 Fatty Acid Family
. Critical Reviews in Food Science and NutritionCritical Reviews in Food Science and Nutrition 2016
, 2261 - 2267. Publisher's Version
Fatty acids composition of human milk fed to small for gestational age infants
. The Journal of Maternal-Fetal & Neonatal MedicineThe Journal of Maternal-Fetal & Neonatal Medicine 2016
, 3041 - 3044. Publisher's Version
Chapter 18 - Comparing Class A GPCRs to bitter taste receptors: Structural motifs, ligand interactions and agonist-to-antagonist ratios
. In Methods in Cell BiologyG Protein-Coupled Receptors
; Methods in Cell BiologyG Protein-Coupled Receptors; Academic Press, 2016; Vol. 132, pp. 401 - 427. Publisher's VersionAbstract
G protein-coupled receptors (GPCRs) are seven transmembrane (TM) proteins that play a key role in human physiology. The GPCR superfamily comprises about 800 members, classified into several classes, with rhodopsin-like Class A being the largest and most studied thus far. A huge component of the human repertoire consists of the chemosensory GPCRs, including ∼400 odorant receptors, 25 bitter taste receptors (TAS2Rs), which are thought to guard the organism from consuming poisons, and sweet and umami TAS1R heteromers, which indicate the nutritive value of food. The location of the binding site of TAS2Rs is similar to that of Class A GPCRs. However, most of the known bitter ligands are agonists, with only a few antagonists documented thus far. The agonist-to-antagonist ratios of Class A GPCRs vary, but in general are much lower than for TAS2Rs. For a set of well-studied GPCRs, a gradual change in agonists-to-antagonists ratios is observed when comparing low (10μM)- and high (10nM)-affinity ligand sets from ChEMBL and the DrugBank set of drugs. This shift reflects pharmaceutical bias toward the therapeutically desirable pharmacology for each of these GPCRs, while the 10μM sets possibly represent the native tendency of the receptors toward either agonists or antagonists. Analyzing ligand–GPCR interactions in 56 X-ray structures representative of currently available structural data, we find that the N-terminus, TM1 and TM2 are more involved in binding of antagonists than of agonists. On the other hand, ECL2 tends to be more involved in binding of agonists. This is of interest, since TAS2Rs harbor variations on the typical Class A sequence motifs, including the absence of the ECL2-TM3 disulfide bridge. This suggests an alternative mode of regulation of conformational states for TAS2Rs, with potentially less stabilized inactive state. The comparison of TAS2Rs and Class A GPCRs structural features and the pharmacology of the their ligands highlights the intricacies of GPCR architecture and provides a framework for rational design of new ligands.
Probing the Binding Pocket of the Broadly Tuned Human Bitter Taste Receptor TAS2R14 by Chemical Modification of Cognate Agonists
. Chemical Biology & Drug DesignChemical Biology & Drug DesignChem Biol Drug Des 2016
, 66 - 75. Publisher's VersionAbstract
Sensing potentially harmful bitter substances in the oral cavity is achieved by a group of ?25 receptors, named TAS2Rs, which are expressed in specialized sensory cells and recognize individual but overlapping sets of bitter compounds. The receptors differ in their tuning breadths ranging from narrowly to broadly tuned receptors. One of the most broadly tuned human bitter taste receptors is the TAS2R14 recognizing an enormous variety of chemically diverse synthetic and natural bitter compounds, including numerous medicinal drugs. This suggests that this receptor possesses a large readily accessible ligand binding pocket. To allow probing the accessibility and size of the ligand binding pocket, we chemically modified cognate agonists and tested receptor responses in functional assays. The addition of large functional groups to agonists was usually possible without abolishing agonistic activity. The newly synthesized agonist derivatives were modeled in the binding site of the receptor, providing comparison to the mother substances and rationalization of the in vitro activities of this series of compounds.
In vitro effects of anthocyanidins on sinonasal epithelial nitric oxide production and bacterial physiology
, 261-268. Publisher's VersionAbstract
Background: T2R bitter taste receptors play a crucial role in sinonasal innate immunity by upregulating mucociliary clearance and nitric oxide (NO) production in response to bitter gram-negative quorum-sensing molecules in the airway surface liquid. Previous studies showed that phytochemical flavonoid metabolites, known as anthocyanidins, taste bitter and have antibacterial effects. Our objectives were to examine the effects of anthocyanidins on NO production by human sinonasal epithelial cells and ciliary beat frequency, and their impact on common sinonasal pathogens Pseudomonas aeruginosa and Staphylococcus aureus. Methods: Ciliary beat frequency and NO production were measured by using digital imaging of differentiated air-liquid interface cultures prepared from primary human cells isolated from residual surgical material. Plate-based assays were used to determine the effects of anthocyanidins on bacterial swimming and swarming motility. Biofilm formation and planktonic growth were also assessed. Results: Anthocyanidin compounds triggered epithelial cells to produce NO but not through T2R receptors. However, anthocyanidins did not impact ciliary beat frequency. Furthermore, they did not reduce biofilm formation or planktonic growth of P. aeruginosa. In S. aureus, they did not reduce planktonic growth, and only one compound had minimal antibiofilm effects. The anthocyanidin delphinidin and anthocyanin keracyanin were found to promote bacterial swimming, whereas anthocyanidin cyanidin and flavonoid myricetin did not. No compounds that were tested inhibited bacterial swarming. Conclusion: Results of this study indicated that, although anthocyanidins may elicited an innate immune NO response from human cells, they do not cause an increase in ciliary beating and they may also cause a pathogenicity-enhancing effect in P. aeruginosa. Additional studies are necessary to understand how this would affect the use of anthocyanidins as therapeutics. This study emphasized the usefulness of in vitro screening of candidate compounds against multiple parameters of both epithelial and bacterial physiologies to prioritize candidates for in vivo therapeutic testing.
Design and synthesis of novel protein kinase R (PKR) inhibitors
, 805 - 819. Publisher's VersionAbstract
Protein kinase RNA-activated (PKR) plays an important role in a broad range of intracellular regulatory mechanisms and in the pathophysiology of many human diseases, including microbial and viral infections, cancer, diabetes and neurodegenerative disorders. Recently, several potent PKR inhibitors have been synthesized. However, the enzyme’s multifunctional character and a multitude of PKR downstream targets have prevented the successful transformation of such inhibitors into effective drugs. Thus, the need for additional PKR inhibitors remains. With the help of computer-aided drug-discovery tools, we designed and synthesized potential PKR inhibitors. Indeed, two compounds were found to inhibit recombinant PKR in pharmacologically relevant concentrations. One compound, 6-amino-3-methyl-2-oxo-N-phenyl-2,3-dihydro-1H-benzo[d]imidazole-1-carboxamide, also showed anti-apoptotic properties. The novel molecules diversify the existing pool of PKR inhibitors and provide a basis for the future development of compounds based on PKR signal transduction mechanism.
Physiological Responses to Abiotic Stresses
. In The Olive Tree Genome
; The Olive Tree Genome; Springer International Publishing: Cham, 2016; pp. 99 - 122. Publisher's VersionAbstract
Olive (Olea europaea L.) trees are widespread in Mediterranean agroecosystems and are now extensively cultivated in different warm-temperate regions of the world such as North and South America, Australia, New Zealand, and South Africa, and even in the monsoon systems of China and India. In the Mediterranean area, the biological and agronomical success of this species is due to its adaptability to the Mediterranean climatic conditions: mild, wet winters with temperatures that drop below 10 °C but rarely below 0 °C and warm, dry summers. When weather conditions become more extreme (drought, high, or low temperatures) or soil conditions are not optimal for olive growth (salinity, low oxygen, nutrient deficiencies), the plant can be subjected to abiotic stresses, which may have negative effects on its physiology. The damages derived from stresses caused by environmental constrains are often not immediately recognized in olive orchards, since plants are largely grown in non-specialized planting systems that are managed with limited cultural practices. However, due to the renewed interest in extra-virgin olive oil for its beneficial health effects, olive cultivation has now been modified from traditional low-density and low-input to high-density and high-input growing systems. Information on the effect of abiotic stresses on trees under the new cultivation systems is scarce due to the wide differences in management practices, environmental conditions and the increase in the use of selected varieties. Under these new conditions, the abiotic factors and their related stresses might have a strong impact on both yield and quality. In this chapter, we focus on physiological responses of olive trees to drought, salinity, and temperature stress. The reader can refer to the existing literature for other abiotic stresses.