Postnatal depression was the only type of depression known to the world two decades back and those women suffering from antenatal depression were simply told that it’s just their hormone calling for attention. It’s been observed that 1 in every 10 women will be depressed at any point of time during pregnancy while 1 of every 30 women will be depressed during pregnancy and after delivery. Pregnancy, as we all know, is the most joyous period in a woman’s life as the pregnant woman experiences the peak of womanhood looking forward to the birth of her loving child. But according to some pregnant women who experience prenatal depression, the same pregnancy term instead of being filled with happiness and excitement turns out into a period of despair and gloom. There are various causes including physical, emotional and hormonal effects that can raises the risk of prenatal depression but this has dangerous consequences on the newborn, child and adult health outcomes putting the individual at a higher risk of common disorders.
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Disasters of Depression in Pregnant Women
Depression as such is one of the highly common mental disorders that’s 50% more common in women than men. Almost 10-15% of women in developed countries and 20-40% of women in developing countries experience depression during pregnancy or after childbirth. Such depressions in pregnant women could have debilitating health outcomes when it is not stopped at the right time. Beyond affecting the immediate family, it also affects the society. Pregnancy is the period during which the woman undergoes numerous hormonal changes, her nutrient requirements vary and the mind goes through a sea of conflicting emotions simultaneously. We often hear elderly people advice the pregnant lady to eat for two as she is carrying another human inside but dietary guidelines don’t support this. Still, nutrient requirements increase to meet the needs of the developing fetus and the mother as well and fulfilling these requirements prepares the woman for a healthy delivery and a healthy baby thereafter. But depression brings about changes in her nutrient intakes which finally affects the health of the baby and the mother. Generally, these women eat fewer macronutrients (with the exception of fats), their nutrient levels are lower (with the exception of phosphorus) than recommendations and there are also theories that while these women have sufficient intake of macronutrients they witness a decrease in micronutrient intake.

Often we see people eating according to their mood. We indulge in sweets when we are happy or even refrain from eating when we are sad. Some people cope up with sorrows in life by eating tubs of cheesy fries and it has been shown that mental health of women affects their nutritional intake and also impacts the fetus. Depressed women are at an increased risk of giving birth to neonates with low birth weight (LBW) (this is a leading cause of neonate mortality and morbidity), preterm birth or with an Apgar score of 1-5 some five minutes after birth. Women around the world suffer from antenatal depression with each of them experiencing different outcomes.

A Study on Antenatal Depression in Pakistani Pregnant Women
Pakistan has a maternal mortality rate of 260 for every 1,00,000 live births with almost 18-80% pregnant women suffering from antenatal depression. The study aimed at measuring association of depression with maternal dietary intake and neonate outcomes. Participants were pregnant women aged between 18 and 49 years at the start of their second trimester and having normal nutrient intakes. The study group ensured that those with depression, chronic diseases such as diabetes, anemia, BP and CHD or belonging to the high-risk pregnancy category were excluded from the study. Information about the participants such as demography, husband’s employment, gestational age and expected delivery date was collected using questionnaires. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure the participant’s state of mind. Of the 94 participants who were cleared for the study 12 of them were excluded following no-show during follow up and finally the study was carried out with a sample size of 82.

An EPDS score of 9 indicated absence of depression, a score of 9-12 indicated moderate depression and a score of more than 13 indicated severe depression. Maternal intake was noted using a 24-hour dietary recall and a Food Frequency checklist at the start of the study and the same was repeated at the 36th week of gestation to analyze poor maternal nutrient intake. Food items were classified and their frequency of consumption (between never and 6+ times in a week) was noted. Each of the participants were questioned on their methods of preparation, portion sizes consumed and the types of snacks eaten. The 24-hour dietary recall was used to calculate macronutrient intake. The Healthy Eating Index (HEI) was used to score the 24 h recall with the overall score being reduced to 50 with the score split based on the type of food consumed-total fruit (5 score), whole fruit (5 score), total vegetables (5 score), greens and beans (5 score), whole grain (10 score), dairy (10 score), total protein foods (5 score) and seafood and plant proteins (5 score). Following dietary guidelines protocol to the dot yielded full score, a score ≥40 indicated good diet, a score between 25 and 40 was rated as moderate and a score below 25 was considered poor diet. Cut off points for carbohydrate and protein intake were ≥175 g and ≥71 g while it was ≥55 g for fats. Height, weight and BMI measurements of all the participants were taken and each of them was classified as underweight, normal weight, overweight or obese based on WHO guidelines. Information on the newborn was acquired in the form of fetal growth retardation (FGR), low (score of 6 or less) Apgar score and low birth weight (LBW) scores (<2500 g).

Result
While mean age of the participants was 29 years almost 51% of them were between 24-29 years and 66% of them were between 151 and 160 cm. Mean weight of moms was 70 kg and BMI was 26.6. Results showed that there was a mean difference of only one HEI between depressed and non-depressed women as depressed antenatal women were consuming 151 kcal lesser than non-depressed women at the start. But at the end of the study, there was a difference of 5 HEI between depressed and non-depressed antenatal women. Depressed women ate almost 321 kcal lesser than non-depressed women by the end of cohort. At baseline, the type and quantity of foods consumed by both categories (depressed and non-depressed) of women were almost similar. While consumption of cereal, beans and lentils remained almost constant even after succumbing to antenatal depression usage of eggs decreased drastically (by almost 43% initially up to 75% later). Though 85% women were drinking milk at the start of the study it dropped to 65% later. Similar changes were seen in fruits and vegetables intake too. 60% of depressed antenatal women consumed one serving of fruit at baseline but the figures decreased to 37% by the end of cohort. Sadly, none of them were having green leafy vegetables even once a week. It was seen that almost 62% of poor dietary intake was due to antenatal depression. Protein and fat intake in antenatal depressed women decreased to less than 71g and 55g at the end of cohort.

Mean gestational age (born 2 days earlier), weight (200 g less) and low (0.5lower) Apgar score were low among neonates of depressed antenatal women compared to non-depressed women. FGR, preterm birth and poor Apgar score was predominantly seen among neonates of depressed antenatal women but not LBW and in this, 60% of FGR and poor Apgar score and 54% of preterm births could be attributed to antenatal depression. The study clearly reveals the impact of depression on the nutrient intake of pregnant women and dietary intake must be an important topic of discussion during nutrition counseling in the absence of which birth of a healthy baby and survival of a healthy mother both remain questionable.

References
Effect of Antenatal Depression on Maternal Dietary Intake & Neonatal Outcome: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-016-0184-7
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The Interplay between Maternal Nutrition and Stress during Pregnancy: https://www.karger.com/Article/PDF/457136

Do you remember the boy in the ad with a milk moustache? Then you are probably an 80s or 90s kid who has grown up seeing and hearing about the goodness of consuming dairy and its benefits on bone health-in those days dairy products were the magicians who could provide individuals with stronger bones and muscles. But today, the effects of dairy have been made dark and twisted with the food group being beneficial or harmful depending on the people’s intake and needs. While it might not be the best way to a healthy body dairy indeed is the simplest way to equip yourself with calcium, vitamin D and proteins to enable optimal functioning of the heart, muscles, bones and overall body. Kids are constantly forced to drink between 2 and 3 glasses of milk for sufficient calcium levels and one should also not forget the fact that bones become stronger only up to the age of 3 after which bone mass starts deteriorating. Hence, parents insist that their children consume dairy products like milk, cheese, yoghurt and cottage cheese for maintaining bone density and reducing risk of fracture.
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Fermented foods are the recent health craze and fermented dairy foods are no exception. Cheese and yoghurt are fermented foods that are a part of the Mediterranean diet, a diet that’s acclaimed for its protective nature against cardiovascular diseases (CVD). Dairy products have the capability to provide up to 60% of the recommended daily allowance (RDA) of calcium and fermented dairy products are an excellent source of vitamin K.  We have studies showing that fermented dairy products show beneficial effects on blood lipid profiles and the risk of heart disease compared to regular dairy products as they deliver probiotics that benefit the gut microbiota. The human gut has been the centre of attraction these days as they seem to regulate whole body health. Still, there are not many research studies providing insightful data on the benefits of fermented dairy foods.
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Cardiovascular Benefits of Fermented Dairy Products on Australian Population
Type 2 diabetes mellitus (T2DM) and CVD are spreading like forest fire worldwide and researchers are trying various means to curb their rise. Of late, there has been an increasing interest in the relationship between dairy consumption, specifically fermented dairy foods, and its effect on T2DM and CVD risk.

We have meta-analysis from cohort studies showing that yogurt consumption has a positive effect on T2DM. Yet another meta-analysis of 29 cohort studies showed that consumption of fermented dairy products (such as milk products, cheese and yogurt) was inversely associated with CVD risk. There are not many studies that focus on middle-aged people as study participants and the Australian study discussed below examines the association between fermented dairy products and T2DM and CVD risk in Australian women.

The Australian Longitudinal Study on Women’s Health (ALSWH) is a population-based cohort study examining the health and well-being of >58,000 Australian women. The current study included data from 1946-1951 age cohort and these women were surveyed every 2-3 years since the start of ALSWH in 1996. Information on dietary intake was first collected in survey 3 in 1991 and this was used as a baseline for the present study. Surveys 5-7 once again included dietary intake. After implementing various exclusion criteria, the study was left with 7633 participants in the T2DM subcohort and 7679 participants in the CVD subcohort. T2DM and CVD was self-reported and during every survey, women were asked whether they were diagnosed or treated for diabetes and coronary heart disease (CHD) in the past 3 years. In the present study, CVD was defined as the sum of CHD and stroke and incidence was defined as the onset of T2DM and CVD at surveys 4-8.

Dietary intake was noted down with the help of a food frequency questionnaire (FFQ) that collected information on dairy consumption that included yogurt, cheese (different types of cheese such as hard cheese, soft cheese, firm cheese, ricotta or cottage cheese and low-fat cheese) and milk (including reduced-fat milk, skim milk, soya milk and flavoured milk). All the participants were asked to mark down their frequency of intake of dairy products over the last 12 months through the use of a 10-point scale (which has measurements from never to ≥3 times/d with the intake converted to grams per day) with milk being the only exception here whose intake quantity was reported between none and ≥750 ml/d. All the dairy products were classified as yogurt, total cheese (all types of cheese), total fermented dairy (sum of yogurt and total cheese), total nonfermented dairy (all types of milk) and total dairy (sum of total fermented dairy and nonfermented dairy).

Women self-reported on height, weight and other body measurements; physical activity was calculated according to total metabolic equivalent (MET in min/wk) into ‘sedentary or low physical activity level’ (<600 MET min/wk), ‘moderate physical activity level’ (from 600 to <1200 min/wk) or ‘high physical activity level’ (≥1200 min/wk). BMI measurements were calculated and categorized as underweight (BMI <18.5), healthy weight (BMI from 18.5<25), overweight (BMI from 25-30) and obese (BMI ≥30).

Results
The mean age of 8748 women enrolled in the study was 52.5 years and mean BMI was 26.8. Women belonging to the highest tertile of energy-adjusted total dairy intake were likelier to have a lower BMI, were higher educated, never smoked, rarely drank and were physically active. Above all, they had a lower intake of total energy with median intakes corresponding to 20 g/d for yogurt, 14 g/d for total cheese, 35 g/d for total fermented dairy, 202 g/d for nonfermented dairy and 369 g/d for total dairy. 7633 were diabetes-free at baseline and were followed-up for ≤15 years. During follow-up 701 (9.2%) T2DM cases were reported. Results showed that:

1. Women in the highest tertile of yogurt intake had lower odds of T2DM than those in the lowest tertile
2. Of the 7679 women free of CVD at baseline a total of 835 (10.9%) new cases were reported at follow-up.
3. High intake of yogurt and total fermented dairy intake was associated with a lower risk of CVD compared with the lowest tertile of dairy product intake.
4. Intake of yogurt and fermented dairy products was associated with a lower T2DM and CVD risk in obese women compared to nonobese women.
5. Inverse association between yogurt, total cheese and total fermented dairy and CVD risk was pronounced in women with diabetes than those without it.
   
   

The study proved a significant link between high intake of total fermented dairy and lower CVD risk. Diet intake might be a great contributor to the inverse association between fermented dairy and CVD risk.

Fermented Dairy Intake & CVD Disease Risk in Men
Researchers at the University of Eastern Finland studied 2,000 men for their risk of CVD on consumption of fermented dairy products. All the participants’ dietary habits were assessed at the start of the study (1984-89) and followed up for around 20 years during which 472 of them experienced coronary heart disease event. All the participants were split into four groups depending on how much dairy (that is, fermented dairy products with less than 3.5% fat) they consumed and the researchers compared the groups with the highest and lowest consumption. Results showed that the incidence of coronary heart disease was 26% lower in the highest consumption group compared to the lowest consumption group, sour milk was the commonly used low-fat fermented dairy product and consumption of high-fat fermented dairy products such as cheese was not associated with coronary heart disease risk. On the other hand, increased consumption of non-fermented dairy products (such as milk whose intake was as high as 0.9 litre/day in some individuals) was associated with an increased risk of coronary heart disease. The practise of dairy consumption is changing all over the globe and in Finland (where this study happened) too people are moving away from the consumption of dairy products such as milk and sour milk to those fermented dairy products such as cheese, yogurt and others. Hence, men who eat plenty of fermented dairy products are at a reduced risk of CHD than men who eat less of these products.

A study comparing fermented and non-fermented dairy products in a Swedish cohort found that there was a 32% increased hazard in consuming non-fermented milk compared to fermented milk. In another crossover-controlled study yoghurt consumption increased HDL levels in 29 hypocholesterolaemic women and we have other studies showing that fermented dairy intake has positive or neutral effects on fasting plasma glucose levels. Many studies revolve around the hypothesis that fermented dairy products induce cardioprotective effects due to the intake of bacterial metabolites and probiotics. Fermented dairy seems to be way better in every way compared to non-fermented dairy and individuals should take greater care to consume such products.

References
Total Fermented Dairy Food Intake is Inversely Associated with Cardiovascular Disease Risk in Women: https://academic.oup.com/jn/article/149/10/1797/5514556

Fermented Dairy Products May protect Against Heart Attack, Study Suggests: https://www.sciencedaily.com/releases/2018/10/181030102828.htm

Dairy Fats and Cardiovascular Disease: Do We Really Need to be Concerned? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867544/

Fermented Dairy Food & CVD Risk: https://pdfs.semanticscholar.org/336d/1c0782de6bcf3ee2056c0481119e088380a2.pdf

Puberty and menopause bring in immense changes in a woman’s life which includes both physical and psychological. Her body undergoes staggering hormonal changes which in turn affect her body weight and food intake patterns too. Every girl needs immense care and comfort during her puberty years and every woman needs support and understanding nearing menopause. Ageing can increase body weight despite the individual eating the same number of calories as before. When menopause affects woman alongside ageing it causes double trouble-there are more chances of weight gain around the abdomen especially which pave way for an increased risk of diseases and health problems. Menopause is an indication that the ovaries make very little estrogen and such reduced estrogen levels increase the risk problems such as heart disease, stroke, osteoporosis and urinary incontinence in the years following menopause. Stringent dietary modifications and regular physical activity is recommended to avoid unnecessary weight gain changes in the absence of which overweight/obesity might be a common occurrence.

Diets low in saturated fats and cholesterol are associated with lower CVD rates and studies show that a Mediterranean-type dietary pattern (low-fat dietary pattern) prevented the occurrence of cardiovascular events.

Women’s Health Initiative Dietary Modification Trial
The main aim of the Women’s Health Initiative (WHI) Dietary Modification Trial was to understand whether a dietary pattern low in total fat alongside increase in the intake of vegetables, fruits and grains would decrease the risk of breast and colorectal cancer in postmenopausal women. The secondary aim was to note any link between such dietary intake and reduced risk of CVD. A total of 48,835 women aged between 50 and 79 years were enrolled between 1993 and 1998 in 40 US clinical centres and assigned to either the intervention group (40%) consisting of 19541 participants or the usual-diet comparison group (29,294 participants). While inclusion criteria stated being postmenopausal and consuming fat intake of 32% of total calories exclusion for WHI included prior occurrence of breast or colorectal cancer, medical conditions with survival rate less than 3 years and habits such as alcoholism. People with type 1 diabetes and those eating meals frequently away from home were also included in the exclusion list.

All the participants were monitored for their total fat, vegetable, fruit and whole grain intake, they were supplemented with group activities and were also invited to participate in any one of the WHI controlled trials of hormone therapy (HT). Participation in a trial of calcium and vitamin D supplementation (CaD) was offered after one year. In total, 20,592 (42.2%) participated in the Dietary Modification Trial, 8050 (16.5%) in the Dietary Modification plus HT Trial, 25,210 (51.6%) in the Dietary Modification plus CaD Trial and 5017 (10.3%) in all 3 trials. All the participants were contacted bi-annually for changes in health outcomes while height, weight and BMI measurements were taken annually. Electrocardiograms (ECGs) were taken every 3 years, a medical update questionnaire was given every 6 months to fill and CHD, the outcome variable involved in the study was defined as acute myocardial infarction (MI) that required hospitalization. Adherence assumption included 13% lower consumption of fats in the intervention group compared to the control group one year from baseline decreasing further to 11% energy difference at 9 years.
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Results
The participants’ mean age was 62.3 years, 3.4% reported instances of CVD. In comparison to the participants in the control group those in the intervention group reported significant changes in dietary components paving way for 8.2% lower mean total fat intake and 2.9% lower saturated fat intake which includes decreased intake of trans, mono- and polyunsaturated fat and cholesterol intake with increased consumption of fruits, vegetables, fibre, whole grains and soy. At the end of trial, 2404 women (4.9%) died, 1553 (3.2%) stopped follow-up and 527 (1.1%) were lost to follow-up. 5% in the intervention group and 4% in the control group withdrew, were lost to follow-up or stopped providing answers for more than 18 months during the study period. At 3 years of follow-up, women in the intervention group showed significant decrease in body weight, waist circumference diastolic blood pressure and LDL-C level but showed no effect on triglycerides and HDL-C levels, ratio of total cholesterol to HDL-C, levels of non-HDL-C, lipoprotein, glucose or insulin or insulin resistance as reported by homeostasis. Carotenoid levels that denotes increased vegetable consumption was significantly higher.
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After 8.1 years of follow-up, major CHD incidence levels were 30% lower in the intervention group compared to the control group. Dietary intervention did not bring in significant changes in major CHD or composite CHD rates. Neither total, fatal or nonfatal stroke were influenced by dietary intervention nor were composite measure of CVD. There seemed to be no influence on stroke levels even after 9 years of follow-up and only a nonsignificant trend towards decreased CHD rates in the intervention group in the later years. The WHI trial reduced fat intake by 8.2% at the end of 6 years while increasing vegetable and fruits servings by 1.1 and whole grain servings by 0.5. The trial decreased fat intake and increased produce intake modestly only and did not show any reduction in risk of CHD or stroke.

Diabetes & Heart Disease Risk in Postmenopausal Women
83% participants in the WHI trial agreed for non-intervention follow-up and 86% of participants consented to an open-end follow-up. Analyses over the intervention and cumulative follow-up period identified significant intervention benefits related to breast cancer, CHD and diabetes.

Cancer outcomes were coded the US National Cancer Institute’s SEER system throughout the intervention and postintervention phases. CHD was defined as nonfatal myocardial infarction plus CHD death. Total stroke was defined as ischemic plus haemorrhagic stroke. Total CVD was defined as CHD plus coronary artery bypass graft or percutaneous coronary intervention plus total stroke.

Results showed that fat intake was lower by 11% in the intervention group, carbs intake higher by 10% and protein intake by almost 1%. Vegetable and fruits intake were higher by 1.2 servings to 5.1/d and grains was higher by ∼0.7 servings to 5.4/d in the intervention group. There was a significant reduction in breast cancer risk by 30% followed by death due to any cause. There was also a significant reduction in estrogen receptor positive, progesterone receptor negative and breast cancer incidence over the long-term follow-up. There were 13,498 deaths that happened during this period. A significant reduction in CHD rates happened among baseline normotensive participants while there was no effect seen on hypertensive participants. Total fat reduction in the follow-up of postmenopausal women showed that reduction in total fat was accompanied by increased vegetables, fruits and grains with increases in fiber and total carotenoid intakes. There were small but significant changes observed in blood pressure, LDL cholesterol, insulin, glucose, HOMA-IR and metabolic syndrome score that could help with CHD and diabetes risk.

Replacing fats with carbs in a well-nourished population of postmenopausal women showed ∼24% of energy from fats compared with ∼35% in the comparison group, ∼58% of energy from carbohydrates compared with ∼48% in the comparison group and ∼18% compared with 17% of energy from proteins. While consumption of saturated and unsaturated fats decreased among participants the intervention group started eating more of fruits, vegetables, whole grains, micronutrients and fiber along with increase in sugars. Such dietary modifications proved beneficial for participants at a risk for CHD, diabetes and stroke. Hence, dietary changes decreased breast cancer risk by ∼35% during intervention and 15% over cumulative follow-up; reducing in CHD incidence by ∼30% during intervention and 15% over the cumulative follow-up among normotensive women and reduction in insulin-requiring diabetes by ∼25% during the intervention and 13% over cumulative follow-up.

References
Low-fat Dietary Pattern & Risk of Cardiovascular Disease: https://jamanetwork.com/journals/jama/fullarticle/202339

Low-fat Dietary Pattern Among Postmenopausal Women Influences Long-term Cancer, Cardiovascular Disease and Diabetes Outcomes: https://academic.oup.com/jn/article/149/9/1565/5512736

The early man survived basically on hand-picked fruits, vegetables and nuts (besides hunting down animals) before the discovery of fire. Our ancestors were one of the strongest beings who existed on Earth as they relied mostly on natural produce, pulses and grains to satisfy hunger cues. This is more than enough to reinstate the fact that eating aplenty fruits and vegetables forms the basis for a good healthy life. Even today, doctors advise patients to eat a well-balanced diet where one-half of the plate is filled with veggies and fruits only. But not one single fruit can accomplish all nutrient requirements and we need to eat a variety of colourful fruits and veggies to acquire all the goodness and nutrition of the different foods. A diet rich in fruits and veggies has the potential to lower blood pressure, reduce the risk of heart disease and stroke, prevent some types of cancer, lower risk of eye and digestive problems and also benefit blood sugar levels that in turn can keep one’s appetite in check. The choice of the fruit can also have a great impact on the benefit that you reap. For instance, non-starchy fruits such as apples, pears and green leafy vegetables might promote weight loss as these fruits have low glycemic loads that prevent blood sugar spikes (this can increase hunger levels amounting to weight gain).
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There are at least nine different families of fruits and vegetables each of which have hundreds of different plant compounds that are beneficial to health. What we choose and how we eat are key players in adding benefits to our body. Fruits, according to the Dietary Guidelines for America (DGA) is a nutrient-dense food that’s to be included as part of a healthy eating pattern and consuming them helps individuals balance nutrient needs with energy needs. Quantity recommendations depend on age, gender and physical activity levels: for kids it ranges from 1 cup for 2-3 years of age going up to 2 cups for males 14-18 years of age. While its suggested fresh, frozen, canned or dried fruit can be consumed to meet recommended quantities and so can 100% fruit juice my personal suggestion would always be fresh whole fruits as they are enriched in fibre content and provide maximized benefits. Almost 30-50% total fruit intake by kids aged between 9 and 18 years comes from 100% fruit juice and this has also increased their whole fruit consumption and improved overall diet quality. Despite various benefits and different forms available for consumption 75% kids aged between 9 and 13 years don’t meet recommended levels. Individuals these days lack in a number of nutrients such as fibre, potassium and vitamins, and fruits are indeed rich in all of them apart from being a rich source of phytochemicals making these foods indispensable for a healthy body.

An Apple a Day Keeps Nutrition at Bay
Apple is one of the commonest fruits consumed by almost everyone and it is available throughout the year irrespective of the season. One medium raw apple with skin contains 95 kcals, 19g of total sugar, 4g dietary fibre and 195 mg of potassium with almost close to zero total fat, saturated fatty acids, sodium and cholesterol. Processed apple products don’t have the same nutrient content as its raw form. For instance, apple sauce may or may not have added sugars and ½ cup has only 1.3 g of dietary fibre while 100% fruit juice contains even less-0.2 g of dietary fibre. Still, every apple product contributes towards total fruit intake through the day. Despite apples also being rich sources of phenolics, especially hydroxycinnamic acid derivatives and flavonoids not many kids love to eat this fruit regularly!

Apple Peel Might Diminish Obesity Rates
Most fruits are edible with their peel and we have often heard our parents insist that we eat the fruit with the peel to experience 100% nutrient value. A study by researchers at the University of Iowa shows that a natural substance found in apple peel can partially protect the mice from obesity and some of its harmful effects.

According to the researchers, the study identified that a substance known as ursolic acid reduced obesity and other health problems by increasing muscle and brown fat, two tissues that are well-known for their calorie-burning properties. The study tested ursolic acid on mice on a high-fat diet and found that it increased skeletal muscle while reducing obesity, pre-diabetes and fatty liver disease. Half of the mice received ursolic acid in their high-fat food and these mice actually ate more food than mice not getting any supplements and there was no difference in activity found between the two groups. Still, the mice that received ursolic acid supplement gained less weight and blood sugar levels also remained near normal besides the fact that these mice also did not develop obesity-related fatty liver disease, a condition that affects almost 1 in 5 Americans.

We know that muscle is an excellent source for burning calories and the research proves beyond that increased muscle in ursolic-acid treated mice helped in lowering obesity. Ursolic acid also increases brown fat, another excellent source to burn calories and prevent obesity. While it was believed until now that only infants had brown fat studies show that even adults have very small quantities in the neck and between shoulder blades. The current research also showed that ursolic acid consumption improved skeletal muscle (increasing endurance and strength) and quantity of brown fat. Hence, the presence of ursolic acid improves calorie burning and in turn prevents obesity, pre-diabetes and fatty liver disease, and apple peel contains this nutrient.

Apple Consumption Satisfies Various Nutrient Requirements in Kids
There have been no studies until now that examined the association between apple consumption and diet quality in kids and the study below examines the association between them using the National Health and Nutrition Examination Survey (NHANES). The NHANES provides information about kids in the form of interviews, dietary intake and physical examinations. The study consisted of 13,339 kids aged between 2 and 18 years who participated in the survey from 2003-2010. The participants’ consumption of apple/apple products was determined from a 24-h dietary recall that included whole apples, apple sauce (includes cooked apples), 100% apple juice and total apples (all foods from all these three apple groups).

The Healthy Eating Index (HEI-2010) was used to determine diet quality score where 9 of 12 components that included fruits, vegetables, greens, beans, whole grains, dairy, total protein foods, seafood and plant proteins and fatty acids measure adequacy with higher scores while three other components including refined grains, sodium and empty calories must have higher scores as in this case, a higher score indicates lower consumption. Each of the participant’s height, weight, BMI and waist circumference was measured and kids were categorized according to results: those with a BMI value ≥85th and <95th percentile were considered overweight and kids ≥95th percentile were considered obese. The study showed that almost 26% of population consumed one or the other form of apple product, 14% consumed whole apples, 5% consumed apple sauce and almost 12% consumed 100% apple juice. Most of the children who consumed apple products were younger and less likely to be current smokers. Results showed that:

1. Consumers of apple products had higher total HEI-2010 scores than non-consumers and they also had higher HEI-2010 component scores than non-consumers.
2. Whole apple consumers had higher component scores for total and whole fruit, whole grains and seafood and plant protein as well as empty calories.
3. Apple sauce consumers had higher component scores for total and whole fruit, whereas apple juice consumers had higher component scores for total fruit and empty calories
4. Total apple product consumers had lower prevalence of obesity and overweight/obesity than non-consumers while whole apple consumers only had lower prevalence of obesity than non-consumers.
5. There was no difference found in any measure of weight or adiposity between apple sauce and apple juice consumers in comparison to non-consumers
6. Kids consuming total apple products or whole apples were 25% and 30% less likely to be obese than non-consumers. There was not much difference found when comparing the likelihood of overweight or obesity among apple sauce or apple juice consumers and non-consumers.
   
   

The study clearly shows that consumption of whole fruit or any apple products contributed greatly towards total fruit consumption in kids, was associated with better diet quality and decreased risk of obesity.

References
Apple Peel Compound Boosts Brown Fat, Reduces Obesity in Mice: https://www.sciencedaily.com/releases/2012/06/120620212855.htm

Consumption of Apples is Associated with Better Diet Quality & Reduced Risk of Obesity in Children: https://nutritionj.biomedcentral.com/articles/10.1186/s12937-015-0040-1

Vegetables and Fruits: https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vegetables-and-fruits/