Ulcerative colitis (UC) is an inflammatory bowel disease that causes gastrointestinal lesions, bleeding, diarrhoea and nutritional complications. Insufficient nutrient intake can additionally deteriorate nutritional status. The present cross-sectional study aimed to determine whether UC patients adhere to national dietary guidelines and to assess their dietary habits. An online questionnaire ( n 93) was used to assess health-related conditions, current nutritional knowledge, professional dietary guidance and food avoidance. A 24 h dietary recall ( n 81) was used to assess nutrient intakes, which were then compared with the national recommended intake values. The results showed that the nutritional knowledge of participants was limited with unofficial sources being used, including websites. Numerous food groups, predominantly fibre-rich foods and fruit and vegetables, were largely avoided by the participants. Almost half of the study population eliminated foods such as dairy products to alleviate symptoms, possibly unnecessarily. Energy intakes were significantly ( P < 0·05) lower than the national recommended intake values in women aged 18–65 years and men aged 18–60 years. Fat intake exceeded the national recommended intake values ( P < 0·0001), at the expense of carbohydrate and fibre intakes, which were significantly ( P < 0·005) lower than the national recommended intake values. Protein intake was significantly high in women aged 19–50 years ( P < 0·00) and men aged 19–50 years ( P < 0·005). Vitamin C, vitamin B 12 and Ca intake levels were overachieved by all participants ( P < 0·001), while women aged 19–50 years did not achieve their dietary Fe reference nutrient intake levels ( P < 0·001). Osteopaenia, osteoporosis and anaemia were reported by 12, 6 and 31 % of the participants, respectively. Findings indicate that food avoidance may contribute to nutrient deficiencies in UC patients. Low intakes of these food groups, especially during remission, are preventing patients from adhering to dietary guidelines.
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Iron is a functional component of oxygen transport and energy production in humans and therefore is a critically important micronutrient for sport and exercise performance. Athletes, particularly female athletes participating in endurance sport, are at increased risk of compromised iron status due to heightened iron losses through menstruation and exercise-induced mechanisms associated with endurance activity. Conventionally oral iron supplementation is used in prevention or/and treatment of iron deficiency. However, this approach has been criticised because of the side effects and increased risk of iron toxicity associated with the use of supplements. Thus, more recently there has been a growing interest in using dietary modification rather than the use of supplements to improve iron status of athletes. Dietary iron treatment methods include the prescription of an iron-rich diet, or/and haem iron-based diet, dietary advice counselling and inclusion of novel iron-rich products into the daily diet. Although studies using dietary modification are still scarce, current literature suggests that dietary iron interventions can assist in maintaining iron status in female athletes, especially during intensive training and competition. Future research should focus on the most efficient method(s) of dietary modification for improvement of iron status and whether these approaches can have a favourable impact on sports and exercise performance.
Public awareness of the health benefits associated with less-utilised yet nutritious grains has led to a growing demand for healthier cereal products. This has resulted in an interest in improving the nutritional properties of refined white wheat bread, which is one of the main staple foods for most Western nations. Teff is a small-grained cereal that is rich in nutrients and particularly abundant in iron. Therefore, Teff offers the potential to provide a healthier alternative bread product. Female athletes, especially runners are at risk of iron deficiency due to increased iron loss, inadequate dietary iron and limited iron bioavailability in the diet. Good nutrition has been suggested as the first line of action to prevent iron deficiency in this population. As cereals and cereal products are a main contributor to iron in the diet, the modification of dietary iron intakes through a staple food offers a good opportunity to improve the iron status of physically active females.
The aims of this research project were 1) to develop a novel, iron-rich bread product by incorporating Teff grain; 2) to explore dietary iron intervention by the means of a staple food product and to measure the effects of this intervention on iron status and exercise performance in female runners.
The results indicated that the addition up to 20% of Teff (flour weight) into the bread formulation significantly (P<0.05) increased dietary iron levels without detrimental effects on bread quality. By the use of enzyme combinations, this level was increased to 30%, giving a product that provides over 75% RNI for dietary iron if daily amount of 200g of bread is consumed. A cohort of 11 female runners reported inadequate daily dietary iron intake of 11 mg/day, which was associated with overall compromised iron status. A 6-week dietary intervention resulted in significantly (P<0.05) higher total iron intakes and improved iron tissue supply but not enlarged iron stores. In terms of exercise performance, there were significant (P<0.05) improvements in submaximal VO2 at anaerobic threshold and time-to-exhaustion but not maximal VO2max peak. Moreover, improvements in submaximal gas exchange parameters and endurance were significantly (P<0.05) correlated to improved iron status.
It was concluded that Teff bread is a promising iron-rich staple food alternative. It offers the opportunity to improve habitual dietary iron intakes. Favourable trends were observed between improved iron intakes, iron status and exercise performance in this study. Further research is advised to determine the bioavailability of iron from Teff bread and to confirm these findings using larger groups of participants.
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Adequate nutrient intake is critically important for achieving optimal sports performance. Like all athletes, female runners require a nutritionally balanced diet to maintain daily activities and a successful training regime. This study investigates the effects of cereal product based dietary iron intervention on iron status of recreational female runners (n = 11; 32 ± 7yr; 239 ± 153 minutes exercise/week, of which 161 ± 150 minutes running activity/week; VO2max 38 ± 4 ml/kg/min).
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