Nutrients, Volume 9, Issue 2 (February 2017) – 94 articles

The purpose of this study was to examine food choice motives associated with various organic and conventional dietary patterns among 22,366 participants of the NutriNet-Santé study. Dietary intakes were estimated using a food frequency questionnaire. Food choice motives were assessed using a validated 63-item-questionnaire gathered into nine food choice motive dimension scores: “absence of contaminants”, “avoidance for environmental reasons”, “ethics and environment”, “taste”, “innovation”, “local and traditional production”, “price”, “health” and “convenience”. Five consumers’ clusters were identified: “standard conventional food small eaters”, “unhealthy conventional food big eaters”, “standard organic food small eaters”, “green organic food eaters” and “hedonist moderate organic food eaters”. Relationships between food choice motive dimension scores and consumers’ clusters were assessed using analysis of covariance (ANCOVA) models adjusted for sociodemographic factors. “Green organic food eaters” had the highest mean score for the “health” dimension, while “unhealthy conventional food big eaters” obtained the lowest mean score for the “absence of contaminants” dimension. “Standard organic food small eaters”, “green organic food eaters” and “hedonist moderate organic food eaters” had comparable scores for the “taste” dimension. “Unhealthy conventional food big eaters” had the highest mean score for the “price” dimension while “green organic food eaters” had the lowest mean scores for the “innovation” and “convenience” dimensions. These results provide new insights into the food choice motives of diverse consumers’ profiles including “green” and “hedonist” eaters. Full article

Eggs contain high quality protein, vitamins, minerals and antioxidants, yet regular consumption is still met with uncertainty. Therefore, the purpose of this study was to compare the effects of consuming two eggs per day or a heart-healthy oatmeal breakfast on biomarkers of cardiovascular disease (CVD) risk and satiety measures in a young, healthy population. Fifty subjects participated in a randomized crossover clinical intervention; subjects were randomly allocated to consume either two eggs or one packet of oatmeal per day for breakfast for four weeks. After a three-week washout period, participants were allocated to the alternative breakfast. Fasting blood samples were collected at the end of each intervention period to assess plasma lipids and plasma ghrelin. Subjects completed visual analog scales (VAS) concurrent to dietary records to assess satiety and hunger. Along with an increase in cholesterol intake, there were significant increases in both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol following the egg consumption period (p < 0.01). However, there was no difference in the LDL/HDL ratio, a recognized biomarker of CVD risk, nor in the plasma glucose, triglycerides or liver enzymes, between diet periods. Several self-reported satiety measures were increased following the consumption of eggs, which were associated with lower plasma ghrelin concentrations (p < 0.05). These results demonstrate that compared to an oatmeal breakfast, two eggs per day do not adversely affect the biomarkers associated with CVD risk, but increase satiety throughout the day in a young healthy population. Full article

Observational studies suggest an adverse effect of maternal hypovitaminosis D during pregnancy. However, intervention studies failed to show convincing benefit from vitamin D supplementation during pregnancy. With analytical advances, vitamin D can now be measured in ten forms—including as epimers—which were thought to be biologically inactive, but can critically impair immunoassays. The aim of this commentary is to highlight the potential clinical and analytical significance of vitamin D epimers in the interpretation of vitamin D roles in pregnancy. Epimers may contribute a considerable proportion of total vitamin D—especially in the neonate—which renders the majority of common assays questionable. Furthermore, epimers have been suggested to have activity in laboratory studies, and evidence suggests that the fetus contributes significantly to epimer production. Maternal epimer levels contribute significantly to predict neonate circulating 25-hydroxyvitamin D concentrations. In conclusion, the existence of various vitamin D forms (such as epimers) has been established, and their clinical significance remains obscure. These results underscore the need for accurate measurements to appraise vitamin D status, in order to understand the current gap between observational and supplementation studies on the field. Full article

Higher fibre intakes are associated with risk reduction for chronic diseases. This study investigated the effects of supplementation with PolyGlycopleX^® (PGX), a complexed polysaccharide, on insulin, glucose and lipids in overweight and obese individuals. In this double-blind 12 months study, participants were randomised into three groups: control (rice flour); PGX or psyllium (PSY). Participants followed their usual lifestyle and diet but consumed 5 g of their supplement before meals. Insulin was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months and in the PSY group compared to control at 12 months. Serum glucose was significantly lower in the PGX group at 3 months compared to control. Total cholesterol was significantly lower in the PGX and PSY groups compared to control at 3 and 6 months. High density lipoprotein (HDL) cholesterol was significantly increased in the PGX group compared to control at 12 months. low density lipoprotein (LDL) cholesterol was significantly lower in the PGX group at 3 and 6 months compared to control and in the PSY group at 3 months compared to control. A simple strategy of fibre supplementation may offer an effective solution to glucose, insulin and lipid management without the need for other nutrient modification. Full article

Recent characterization of the human microbiome and its influences on health have led to dramatic conceptual shifts in dietary bioactives research. Prebiotic foods that include many dietary fibers and resistant starches are perceived as beneficial for maintaining a healthy gut microbiota. This article brings forward some current perspectives in prebiotic research to discuss why reporting of individual variations in response to interventions will be important to discern suitability of prebiotics as a disease prevention tool. Full article

This study aimed to assess the amount of plate waste and how plate waste was disposed by early adolescent girls using a mobile food record (mFR). Participants were girls nine to thirteen years residing in O’ahu, Hawai’i (n = 93). Foods selected and leftover were estimated using a three day mFR. Each leftover food was then classified as thrown into the trash, fed to a pet, eaten later, or other (e.g., composted). Repeated measures analyses of variance (ANOVA) were conducted and Tukey’s post-hoc test were used to adjust for multiple comparisons between times (breakfast, lunch, dinner, and snack) on leftover food and leftover food thrown into the trash. The percentage of food leftover and thrown into the trash was highest at lunch. The percentage of protein, grain, vegetables, fruit, and dairy leftover at lunch were unexpectedly low compared to previous studies. The median for percentage of food thrown into the trash at lunch was <5% for all food groups, and was consistently low across the day (<10%). Average energy intake was 436 kcal (±216) at lunch, and 80% of caregivers reported total household income as ≥$70,000. Studies in real-time using technology over full days may better quantify plate waste among adolescents. Full article

Hyperaminoacidemia following ingestion of cows-milk may stimulate muscle anabolism and attenuate exercise-induced muscle damage (EIMD). However, as dairy-intolerant athletes do not obtain the reported benefits from milk-based products, A2 milk may offer a suitable alternative as it lacks the A1-protein. This study aimed to determine the effect of A2 milk on recovery from a sports-specific muscle damage model. Twenty-one male team sport players were allocated to three independent groups: A2 milk (n = 7), regular milk (n = 7), and placebo (PLA) (n = 7). Immediately following muscle-damaging exercise, participants consumed either A2 milk, regular milk or PLA (500 mL each). Visual analogue scale (muscle soreness), maximal voluntary isometric contraction (MVIC), countermovement jump (CMJ) and 20-m sprint were measured prior to and 24, 48, and 72 h post EIMD. At 48 h post-EIMD, CMJ and 20-m sprint recovered quicker in A2 (33.4 ± 6.6 and 3.3 ± 0.1, respectively) and regular milk (33.1 ± 7.1 and 3.3 ± 0.3, respectively) vs. PLA (29.2 ± 3.6 and 3.6 ± 0.3, respectively) (p < 0.05). Relative to baseline, decrements in 48 h CMJ and 20-m sprint were minimised in A2 (by 7.2 and 5.1%, respectively) and regular milk (by 6.3 and 5.2%, respectively) vs. PLA. There was a trend for milk treatments to attenuate decrements in MVIC, however statistical significance was not reached (p = 0.069). Milk treatments had no apparent effect on muscle soreness (p = 0.152). Following muscle-damaging exercise, ingestion of 500 mL of A2 or regular milk can limit decrements in dynamic muscle function in male athletes, thus hastening recovery and improving subsequent performance. The findings propose A2 milk as an ergogenic aid following EIMD, and may offer an alternative to athletes intolerant to the A1 protein. Full article

Interest in the health effects of dietary phosphorus is burgeoning, yet sources and trends in phosphorus consumption have not been well characterized. We describe trends in and primary sources of dietary phosphorus in a nationally representative sample of 34,741 US adults, 20+ years old (NHANES 2001–2014). Dietary sources of phosphorus were estimated in nine food groups and 26 food categories. Phosphorus consumption was expressed in absolute intake, phosphorus density, and proportion contributed by dietary sources. Between 2001 and 2014, dietary phosphorus intake increased from 1345 to 1399 mg/day (p-trend = 0.02), while calorie intake slightly declined (p-trend = 0.1). Grains were the largest dietary phosphorus source, followed by meats, and milk products. Soft drinks accounted for just 3.3% of total dietary phosphorus. Phosphorus intake from grains increased 68 mg/day (p < 0.001), 25 mg/day from meats (p = 0.02), and decreased 75 mg/day (p < 0.001) from milk products. Dietary phosphorus intake and the phosphorus density of the diet are increasing. Grains are an important dietary phosphorus source that has increased in total consumption and phosphorus density. Further research is needed to determine if this is due to individuals’ selection of grains or the composition of those available. Full article

As a sugar additive, fructose is widely used in processed foods and beverages. Excessive fructose consumption can cause hepatic steatosis and dyslipidemia, leading to the development of metabolic syndrome. Recent research revealed that fructose-induced nonalcoholic fatty liver disease (NAFLD) is related to several pathological processes, including: (1) augmenting lipogenesis; (2) leading to mitochondrial dysfunction; (3) stimulating the activation of inflammatory pathways; and (4) causing insulin resistance. Cellular signaling research indicated that partial factors play significant roles in fructose-induced NAFLD, involving liver X receptor (LXR)α, sterol regulatory element binding protein (SREBP)-1/1c, acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), stearoyl-CoA desaturase (SCD), peroxisome proliferator–activated receptor α (PPARα), leptin nuclear factor-erythroid 2-related factor 2 (Nrf2), nuclear factor kappa B (NF-κB), tumor necrosis factor α (TNF-α), c-Jun amino terminal kinase (JNK), phosphatidylinositol 3-kinase (PI3K) and adenosine 5′-monophosphate (AMP)-activated protein kinase (AMPK). Until now, a series of natural products have been reported as regulators of NAFLD in vivo and in vitro. This paper reviews the natural products (e.g., curcumin, resveratrol, and (−)-epicatechin) and their mechanisms of ameliorating fructose-induced NAFLD over the past years. Although, as lead compounds, natural products usually have fewer activities compared with synthesized compounds, it will shed light on studies aiming to discover new drugs for NAFLD. Full article

Background: Vitamin D is essential for maintaining bone mineralization and calcium homeostasis, and prevents falls and fractures in older adults. Mexico is undergoing an epidemiologic and demographic transition with increasing obesity rates. The study’s aim was to determine the association of obesity with serum 25-hydroxyvitamin D [25(OH)D] concentrations in older Mexican adults. Methods: Data from 1772 Mexicans, aged ≥50 years, enrolled in a sub-sample of the 3rd wave of the Mexican Health and Aging Study, were included. Serum 25(OH)D concentrations were used to define vitamin D status, and were categorized into tertiles. Body mass index measures were used to categorize older adults into under/normal weight, overweight, and obese groups. Multinomial logistic regression models were used to assess the relationship, adjusting for potential confounders. Results: Approximately 40% and 37% of older Mexican adults were either overweight or obese, respectively. Compared to under/normal weight older Mexicans, obese adults were 1.78 times (95% Confidence Interval (CI) 1.27–2.48) and 1.94 times (95% CI 1.40–2.68) more associated with the first and second tertile concentrations of serum 25(OH)D, respectively. Overweight adults were 1.52 times (95% CI 1.12–2.06) more associated with the second tertile of serum 25(OH)D concentration than under/normal weight adults. Conclusion: Overweight/Obesity was found to be significantly associated with low concentrations of serum 25(OH) in older Mexican adults. Full article

Impairment of bone mineral density (BMD) is frequent in celiac disease (CD) patients on a gluten-free diet (GFD). The normalization of intestinal mucosa is still difficult to predict. We aim to investigate the relationship between BMD and duodenal mucosa healing (DMH) in CD patients on a GFD. Sixty-four consecutive CD patients on a GFD were recruited. After a median period of a 6-year GFD (range 2–33 years), patients underwent repeat duodenal biopsy and dual-energy X-ray absorptiometry (DXA) scan. Twenty-four patients (38%) displayed normal and 40 (62%) low BMD, 47 (73%) DMH, and 17 (27%) duodenal mucosa lesions. All patients but one with normal BMD (23 of 24, 96%) showed DMH, while, among those with low BMD, 24 (60%) did and 16 (40%) did not. At multivariate analysis, being older (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.03–1.18) and having diagnosis at an older age (OR 1.09, 95% CI 1.03–1.16) were associated with low BMD; in turn, having normal BMD was the only variable independently associated with DMH (OR 17.5, 95% CI 1.6–192). In older CD patients and with late onset disease, BMD recovery is not guaranteed, despite a GFD. A normal DXA scan identified CD patients with DMH; thus, it is a potential tool in planning endoscopic resampling. Full article

Ready reckoners are used in the clinical setting as a tool for the estimation of nutrient intake. With increasing opportunities for nutrition research, ready reckoners may provide for a more rapid analysis of nutritional intake than computerised methods, often seen as the gold standard for nutritional analysis. This research aimed to determine the level of agreement between ready reckoner and computerised dietary analysis through a secondary analysis of clinical trial data. Participant food intakes were estimated by trained observers using the one-quarter method. Daily energy and protein intake were estimated by the healthcare network ready reckoner and computerised dietary analysis. Agreement between methods was tested using t-tests, correlations and Bland-Altman plots. A correlation between analysis methods was observed (r = 0.9086 energy, r = 0.8700 protein). Wide limits of agreement were observed for both energy and protein intake. Compared with the computerised method, ready reckoner analysis underestimated energy intake by 600 kJ and protein intake by 5 g. Mean energy and protein intake calculated by each method was significantly different (p < 0.0001 energy; p < 0.0001 protein). No time differences between analysis methods were observed. In the clinical setting, practitioners should be aware of the variability of a ready reckoner compared to computerised dietary analysis. Further investigation into the acceptability of ready reckoners as a reliable method of nutrient intake determination, particularly for analysis of nutrition research, is required. Full article

With technological innovation, comprehensive dietary intake data can be collected in a wide range of studies and settings. The Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool is a web-based system that guides respondents through 24-h recalls. The purpose of this paper is to describe lessons learned from five studies that assessed the feasibility and validity of ASA24 for capturing recall data among several population subgroups in Canada. These studies were conducted within a childcare setting (preschool children with reporting by parents), in public schools (children in grades 5–8; aged 10–13 years), and with community-based samples drawn from existing cohorts of adults and older adults. Themes emerged across studies regarding receptivity to completing ASA24, user experiences with the interface, and practical considerations for different populations. Overall, we found high acceptance of ASA24 among these diverse samples. However, the ASA24 interface was not intuitive for some participants, particularly young children and older adults. As well, technological challenges were encountered. These observations underscore the importance of piloting protocols using online tools, as well as consideration of the potential need for tailored resources to support study participants. Lessons gleaned can inform the effective use of technology-enabled dietary assessment tools in research. Full article

High arachidonic acid (AA; 20:4 n − 6) status may have adverse effects on inflammation and risk of cardiovascular diseases. Concerns about high intake of n − 6 polyunsaturated fatty acids (PUFAs) are based on the premise that endogenous conversion from linoleic acid (LA; 18:2 n − 6) is an important source of AA, but few population-based studies have investigated dietary determinants of AA status. In this study, we examined habitual food consumption in relation to plasma concentrations of AA and other PUFAs in population-based studies. We used cross-sectional data from 269 healthy, ethnic Chinese participants (25–80 years old) with contrasting intakes of fish and red meat from the Singapore Prospective Study Program and 769 healthy participants (44–74 years old) from the Singapore Chinese Health Study as a validation set. Multivariable linear regression was used to examine PUFA intake (% energy) and food sources of PUFA (fish, red meat, poultry, soy and cooking oils) in relation to plasma PUFAs (AA, LA, dihomo-gamma-linolenic acid (DGLA; 20:3 n − 6), alpha-linolenic acid (ALA; 18:3 n − 3), eicosapentaenoic acid (EPA; 20:5 n − 3), and docosahexaenoic acid (DHA; 22:6 n − 3)) concentrations. Higher intake of red meat was associated with higher plasma AA concentrations. High intake of PUFA or PUFA-rich oils was associated with higher plasma ALA but not with plasma AA. Higher intakes of soy were associated with higher ALA and fish with higher DHA and EPA concentrations. These associations were statistically significant (p < 0.05) in both studies. Red meat consumption, but not PUFA or PUFA-rich cooking oil, was associated with circulating AA suggesting that intake of pre-formed AA rather than LA is an important determinant of AA status. A diet high in fish, soy products and polyunsaturated cooking oil, and low in red meat may be associated with an optimal plasma profile of PUFA in this Chinese population. Full article

Cancer is one of the leading causes of deaths worldwide. The agents capable of causing damage to genetic material are known as genotoxins and, according to their mode of action, are classified into mutagens, carcinogens or teratogens. Genotoxins are involved in the pathogenesis of several chronic degenerative diseases including hepatic, neurodegenerative and cardiovascular disorders, diabetes, arthritis, cancer, chronic inflammation and ageing. In recent decades, researchers have found novel bioactive phytocompounds able to counteract the effects of physical and chemical mutagens. Several studies have shown potential antigenotoxicity in a variety of fruits. In this review (Part 1), we present an overview of research conducted on some fruits (grapefruit, cranberries, pomegranate, guava, pineapple, and mango) which are frequentl consumed by humans, as well as the analysis of some phytochemicals extracted from fruits and yeasts which have demonstrated antigenotoxic capacity in various tests, including the Ames assay, sister chromatid exchange, chromosomal aberrations, micronucleus and comet assay. Full article

Background: Non‐celiac wheat sensitivity (NCWS) is a new clinical entity in the world of gluten‐related diseases. Nickel, the most frequent cause of contact allergy, can be found in wheat and results in systemic nickel allergy syndrome and mimics irritable bowel syndrome (IBS). Objective: To evaluate the frequency of contact dermatitis due to nickel allergy in NCWS patients diagnosed by a double‐blind placebo‐controlled(DBPC)challenge,and to identify the characteristics of NCWS patients with nickel allergy. Methods: We performed a prospective study of 60 patients (54 females, 6 males; mean age 34.1 ± 8.1 years) diagnosed with NCWS from December 2014 to November 2016; 80 age‐ and sex‐matched subjects with functional gastrointestina l symptoms served as controls. Patients reporting contact dermatitis related to nickel‐containing objects underwent nickel patch test (Clinicaltrials.gov registration number: NCT02750735).Results: Six out of sixty patients (10%) with NCWS suffered from contact dermatitis and nickel allergy and this frequency was statistically higher (p = 0.04)than observed in the control group(5%. The main clinical characteristic of NCWS patients with nickel allergy was a higher frequency of cutaneous symptoms after wheat ingestion compared to NCWS patients who did not suffer from nickel allergy (p < 0.0001. Conclusions: Contact dermatitis and nickel allergy are more frequent in NCWS patients than in subjects with functional gastrointestinal disorders;furthermore, these patients had a very high frequency of cutaneous manifestations after wheat ingestion. Nickel allergy should be evaluated in NCWS patients who have cutaneous manifestations after wheat ingestion. Full article

The prevalence of obesity has increased at an alarming rate worldwide. Metallic elements are involved in the pathogenesis of obesity and related diseases. To date, whether environmental exposure to metallic elements has effects on obesity in children and adolescents is still unclear. The aim of the current study was to investigate the association of blood metallic elements with obesity in U.S. children and adolescents. This cross-sectional study was performed with 5404 children and adolescents (6–19 years, 2745 males and 2659 females) who participated in the US National Health and Nutrition Examination Survey 2011–2014. Blood lead, mercury, selenium, manganese, copper, and zinc, as well as biochemical parameters including triglyceride (TG), cholesterol, low-density lipoprotein (LDL), and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed for all subjects. Multivariate logistic regression and linear regression were applied to assess associations of metallic elements and overweight, obesity status, and serum metabolites as distinct outcomes adjusted for age, gender, ethnicity, and the poverty income ratio. When stratified by age and sex, significant associations were found between the highest quartile of copper concentrations in blood with obesity status (OR = 9.27, 95% CI: 5.43, 15.82, p_{for trend} < 0.001) and cholesterol (OR = 3.08, 95% CI: 1.43, 6.63, p_{for trend} < 0.001). The highest concentrations of manganese in the blood was associated with obesity in those aged 6–19 years (OR = 2.29, 95% CI: 1.74, 3.02, p_{for trend} < 0.001). Moreover, blood mercury and selenium showed positive relationships with cholesterol. Further, a negative association existed between blood zinc and obesity. The National Health and Nutrition Examination Survey data provide epidemiological evidence that blood metallic elements are positively associated with obesity in children and adolescents. However, the underlying mechanisms still need further exploration. Full article

Lychee seed is a traditional Chinese medicine and possesses many activities, including hypoglycemia, liver protection, antioxidation, antivirus, and antitumor. However, its effect on neuroprotection is still unclear. The present study investigated the effects of lychee seed saponins (LSS) on neuroprotection and associated mechanisms. We established a rat model of Alzheimer’s disease (AD) by injecting Aβ_25–35 into the lateral ventricle of rats and evaluated the effect of LSS on spatial learning and memory ability via the Morris water maze. Neuronal apoptosis was analyzed by hematoxylin and eosin stain and terminal deoxynucleotidyl transferase (Tdt)-mediated dUTP nick-end labeling analysis, and mRNA expression of caspase-3 and protein expressions of Bax and Bcl-2 by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting, respectively. The results showed that LSS remarkably improved cognitive function and alleviated neuronal injury by inhibiting apoptosis in the hippocampus of AD rats. Furthermore, the mRNA expression of caspase-3 and the protein expression of Bax were downregulated, while the protein expression of Bcl-2 and the ratio of Bcl-2/Bax were increased by LSS. We demonstrate that LSS significantly improves cognitive function and prevent neuronal injury in the AD rats via regulation of the apoptosis pathway. Therefore, LSS may be developed as a nutritional supplement and sold as a drug for AD prevention and/or treatment. Full article

The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF) and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls). Calcaneal broadband ultrasound attenuation (c-BUA) was obtained as a marker of bone health. Body composition (fat mass and lean mass) was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI) was calculated. Standing long-jump (SLJ) and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z-score cut off of ≤−1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤−1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass) and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life. Full article

Background. Nutrition in early life is increasingly considered to be an important factor influencing later health. Food preferences are formed in infancy, are tracked into childhood and beyond, and complementary feeding practices are crucial to prevent obesity later in life. Methods. Through a literature search strategy, we have investigated the role of breastfeeding, of complementary feeding, and the parental and sociocultural factors which contribute to set food preferences early in life. Results. Children are predisposed to prefer high-energy, -sugar, and -salt foods, and in pre-school age to reject new foods (food neophobia). While genetically determined individual differences exist, repeated offering of foods can modify innate preferences. Conclusions. Starting in the prenatal period, a varied exposure through amniotic fluid and repeated experiences with novel flavors during breastfeeding and complementary feeding increase children’s willingness to try new foods within a positive social environment. Full article

Mechanical, microstructural properties, mineral content and bone mineral density (BMD) of the femur were evaluated in growing rats fed with Opuntia ficus indica (L.) Mill. (Cactaceae) cladodes at different maturity stages as calcium source. Male weanling rats were fed with cladodes at early maturity stage (25 and 60 days of age, belonging to groups N-60 and N-200, respectively) and cladodes at late maturity stage (100 and 135 days of age, belonging to groups N-400 and N-600, respectively) for 6 weeks. Additionally, a control group fed with calcium carbonate as calcium source was included for comparative purposes. All diets were fitted to the same calcium content (5 g/kg diet). The failure load of femurs was significantly lower (p ≤ 0.05) in groups N-60 and N-200 in comparison to N-400, N-600 and control groups. The cortical width (Ct.Wi) and trabecular thickness (Tb.Th) of the femurs in control and N-600 groups were significantly higher (p ≤ 0.05) than Ct.Wi and Tb.Th of femurs in groups N-60 and N-200. Trabecular separation of the femurs in N-60 and N-200 groups showed the highest values compared with all experimental groups. The highest calcium content in the femurs were observed in control, N-600 and N-400 groups; whereas the lowest phosphorus content in the bones were detected in N-200, N-600 and N-400 groups. Finally, the BMD in all experimental groups increased with age; nevertheless, the highest values were observed in N-600 and control groups during pubertal and adolescence stages. The results derived from this research demonstrate, for the first time, that the calcium found in Opuntia ficus indica cladodes is actually bioavailable and capable of improving mineral density and mechanical and microstructural properties of the bones. These findings suggest that the consumption of cladodes at late maturity stage within the diet might have a beneficial impact on bone health. Full article

Pancreatic cancer is one of the most aggressive human tumors in the United States. Curcumin, a polyphenol derived from the Curcuma longa plant, has been reported to exert its antitumor activity in pancreatic cancer. However, the molecular mechanisms of curcumin-mediated tumor suppressive function have not been fully elucidated. In the current study, we explore whether curcumin exhibits its anti-cancer function through inhibition of oncoprotein cell division cycle 20 (Cdc20) in pancreatic cancer cells. We found that curcumin inhibited cell growth, enhanced apoptosis, induced cell cycle arrest and retarded cell invasion in pancreatic cancer cells. Moreover, we observed that curcumin significantly inhibited the expression of Cdc20 in pancreatic cancer cells. Furthermore, our results demonstrated that overexpression of Cdc20 enhanced cell proliferation and invasion, and abrogated the cytotoxic effects induced by curcumin in pancreatic cancer cells. Consistently, downregulation of Cdc20 promoted curcumin-mediated anti-tumor activity. Therefore, our findings indicated that inhibition of Cdc20 by curcumin could be useful for the treatment of pancreatic cancer patients. Full article

Background: Obesity among pregnant women is common, and their offspring are predisposed to obesity, insulin resistance, and diabetes. The circulating metabolites that are related to insulin resistance and are associated with this decreased tissue-specific uptake are unknown. Here, we assessed metabolite profiles in elderly women who were either female offspring from obese mothers (OOM) or offspring of lean mothers (OLM). Metabolic changes were tested for associations with metrics for insulin resistance. Methods: Thirty-seven elderly women were separated into elderly offspring from obese mothers (OOM; n = 17) and elderly offspring from lean/normal weight mothers (OLM; n = 20) groups. We measured plasma metabolites using proton nuclear magnetic resonance (¹H-NMR) and insulin-dependent tissue-specific glucose uptake in skeletal muscle was assessed. Associations were made between metabolites and glucose uptake. Results: Compared to the OLM group, we found that the docosahexaenoic acid percentage of the total long-chain n-3 fatty acids (DHA/FA) was significantly lower in OOM (p = 0.015). DHA/FA associated significantly with skeletal muscle glucose uptake (GU) (p = 0.031) and the metabolizable glucose value derived from hyperinsulinemic-euglycemic clamp technique (M-value) in the OLM group only (p = 0.050). Conclusions: DHA/FA is associated with insulin-dependent skeletal muscle glucose uptake and this association is significantly weakened in the offspring of obese mothers. Full article

We have studied the uptake of quercetin aglycone into CaCo-2/TC7 cells in the presence and absence of mixed micelles that are present in the human small intestine. The micelles inhibited the transport of quercetin into the cells. To gain an understanding of why this is the case we examined the solubilisation of quercetin in micelles of differing composition and into pure lipid phases. We did this by using the environmental sensitivity of quercetin’s UV-visible absorption spectra and measurement of free quercetin by filtration of the micellar solutions. The nature of the micelles was also studied by pyrene fluorescence. We found that the partitioning of quercetin into simple bile salt micelles was low and for mixed micelles was inhibited by increasing the bile salt concentration. The affinity of quercetin decreased in the order egg phosphatidylcholine (PC) = lysoPC > mixed micelles > bile salts. These results, together with the innate properties of quercetin, contribute to an understanding of the low bioavailability of quercetin. Full article

Magnesium, an essential mineral for human health, plays a pivotal role in the cardiovascular system. Epidemiological studies in the general population have found an association between lower dietary magnesium intake and an elevated risk of cardiovascular events. In addition, magnesium supplementation was shown to improve blood pressure control, insulin sensitivity, and endothelial function. The relationship between magnesium and cardiovascular prognosis among patients with chronic kidney disease (CKD) has been increasingly investigated as it is becoming evident that magnesium can inhibit vascular calcification, a prominent risk of cardiovascular events, which commonly occurs in CKD patients. Cohort studies in patients receiving dialysis have shown a lower serum magnesium level as a significant risk for cardiovascular mortality. Interestingly, the cardiovascular mortality risk associated with hyperphosphatemia is alleviated among those with high serum magnesium levels, consistent with in vitro evidence that magnesium inhibits high-phosphate induced calcification of vascular smooth muscle cells. Furthermore, a harmful effect of high phosphate on the progression of CKD is also attenuated among those with high serum magnesium levels. The potential usefulness of magnesium as a remedy for phosphate toxicity should be further explored by future intervention studies. Full article

The appropriate proportions of macronutritional intake have been controversial in medical nutritional therapy for diabetes, and evidence of the effects of carbohydrate consumption on diabetes complications in prospective settings is sparse. We investigated the relationships between proportions of carbohydrate intake as the % of total energy and diabetes complications in a nationwide cohort of Japanese patients with type 2 diabetes aged 40–70 years with hemoglobin A1c ≥6.5%. The analysis was of 1516 responders to a baseline dietary survey assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes were times to overt nephropathy, diabetic retinopathy, and cardiovascular disease (CVD) after 8 years. Hazard ratios (HRs) for proportions of carbohydrate intake were estimated by Cox regression adjusted for confounders. High carbohydrate intake was significantly related to higher intakes of grain, fruits, and sweets/snacks and lower intakes of soybean and soy products, vegetables, seaweed, meat and processed meat, fish and processed fish, eggs, milk and dairy products, oil, and alcoholic beverages. During the eight-year follow-up, there were 81, 275, and 129 events of overt nephropathy, diabetic retinopathy, and CVD, respectively. After adjustment for confounders, HRs for complications in patients with carbohydrate intake in the second or third tertiles (51.0%–56.4% and ≥56.5%, respectively) compared with carbohydrate intake in the first tertile (<50.9%, referent) were analyzed. No significant associations were shown in the second and third tertiles relative to first tertile (overt nephropathy: 1.05 (95% Confidence Interval, 0.54–2.06) and 0.98 (0.40–2.44); diabetic retinopathy: 1.30 (0.90–1.88) and 1.30 (0.78–2.15); and CVD: 0.95 (0.55–1.63) and 1.37 (0.69–2.72)). By exploring potentially nonlinear relationships, trends for the incidence of diabetes complications according to proportions of carbohydrate intake were not clearly shown. Findings suggested that proportions of carbohydrate intake were not associated with the incidence of diabetes complications among type 2 diabetes patients in Japan. Full article

Image-based dietary assessment (IBDA) may improve the accuracy of dietary assessments, but no formalized training currently exists for skills relating to IBDA. This study investigated nutrition and dietetics students’ and interns’ IBDA abilities, the training and experience factors that may contribute to food identification and quantification accuracy, and the perceived challenges to performing IBDA. An online survey containing images of known foods and serving sizes representing common American foods was used to assess the ability to identify foods and serving sizes. Nutrition and dietetics students and interns from the United States and Australia (n = 114) accurately identified foods 79.5% of the time. Quantification accuracy was lower, with only 38% of estimates within ±10% of the actual weight. Foods of amorphous shape or higher energy density had the highest percent error. Students expressed general difficulty with perceiving serving sizes, making IBDA food quantification more difficult. Experience cooking at home from a recipe, frequent measuring of portions, and having a food preparation or cooking laboratory class were associated with enhanced accuracy in IBDA. Future training of dietetics students should incorporate more food-based serving size training to improve quantification accuracy while performing IBDA, while advances in IBDA technology are also needed. Full article

Background: A strict and lifelong gluten-free diet is the only treatment of celiac disease. Gluten contamination has been frequently reported in nominally gluten-free products. The aim of this study was to test the level of gluten contamination in gluten-free products currently available in the Italian market. Method: A total of 200 commercially available gluten-free products (including both naturally and certified gluten-free products) were randomly collected from different Italian supermarkets. The gluten content was determined by the R5 ELISA Kit approved by EU regulations. Results: Gluten level was lower than 10 part per million (ppm) in 173 products (86.5%), between 10 and 20 ppm in 9 (4.5%), and higher than 20 ppm in 18 (9%), respectively. In contaminated foodstuff (gluten > 20 ppm) the amount of gluten was almost exclusively in the range of a very low gluten content. Contaminated products most commonly belonged to oats-, buckwheat-, and lentils-based items. Certified and higher cost gluten-free products were less commonly contaminated by gluten. Conclusion: Gluten contamination in either naturally or labeled gluten-free products marketed in Italy is nowadays uncommon and usually mild on a quantitative basis. A program of systematic sampling of gluten-free food is needed to promptly disclose at-risk products. Full article

Phytochemicals from fruit and vegetables reduce systemic inflammation. This study examined the effects of an encapsulated fruit and vegetable (F&V) juice concentrate on systemic inflammation and other risk factors for chronic disease in overweight and obese adults. A double-blinded, parallel, randomized placebo-controlled trial was conducted in 56 adults aged ≥40 years with a body mass index (BMI) ≥28 kg/m². Before and after eight weeks daily treatment with six capsules of F&V juice concentrate or placebo, peripheral blood gene expression (microarray, quantitative polymerase chain reaction (qPCR)), plasma tumour necrosis factor (TNF)α (enzyme-linked immunosorbent assay (ELISA)), body composition (Dual-energy X-ray absorptiometry (DEXA)) and lipid profiles were assessed. Following consumption of juice concentrate, total cholesterol, low-density lipoprotein (LDL) cholesterol and plasma TNFα decreased and total lean mass increased, while there was no change in the placebo group. In subjects with high systemic inflammation at baseline (serum C-reactive protein (CRP) ≥3.0 mg/mL) who were supplemented with the F&V juice concentrate (n = 16), these effects were greater, with decreased total cholesterol, LDL cholesterol and plasma TNFα and increased total lean mass; plasma CRP was unchanged by the F&V juice concentrate following both analyses. The expression of several genes involved in lipogenesis, the nuclear factor-κB (NF-κB) and 5′ adenosine monophosphate-activated protein kinase (AMPK) signalling pathways was altered, including phosphomevalonate kinase (PMVK), zinc finger AN1-type containing 5 (ZFAND5) and calcium binding protein 39 (CAB39), respectively. Therefore, F&V juice concentrate improves the metabolic profile, by reducing systemic inflammation and blood lipid profiles and, thus, may be useful in reducing the risk of obesity-induced chronic disease. Full article

Several epidemiological studies have linked flavonols with decreased risk of cardiovascular disease (CVD). However, some heterogeneity in the individual physiological responses to the consumption of these compounds has been identified. This meta‐analysis aimed to study the effect of flavonol supplementation on biomarkers of CVD risk such as, blood lipids, blood pressure and plasma glucose, as well as factors affecting their inter‐individual variability. Data from 18 human randomized controlled trials were pooled and the effect was estimated using fixed or random effects meta‐analysis model and reported as difference in means (DM). Variability in the response of blood lipids to supplementation with flavonols was assessed by stratifying various population subgroups: age, sex, country, and health status. Results showed significant reductions in total cholesterol (DM = −0.10 mmol/L; 95% CI: −0.20, −0.01), LDL cholesterol (DM = −0.14 mmol/L; Nutrients 2017, 9, 117 2 of 21 95% CI: −0.21, 0.07), and triacylglycerol (DM = −0.10 mmol/L; 95% CI: −0.18, 0.03), and a significant increase in HDL cholesterol (DM = 0.05 mmol/L; 95% CI: 0.02, 0.07). A significant reduction was also observed in fasting plasma glucose (DM = −0.18 mmol/L; 95%CI: −0.29, −0.08), and in blood pressure (SBP: DM = −4.84 mmHg; 95% CI: −5.64, −4.04; DBP: DM = −3.32 mmHg; 95% CI: -4.09, -2.55). Subgroup analysis showed a more pronounced effect of flavonol intake in participants from Asian countries and in participants with diagnosed disease or dyslipidemia, compared to healthy and normal baseline values. In conclusion, flavonol consumption improved biomarkers of CVD risk, however, country of origin and health status may influence the effect of flavonol intake on blood lipid levels Full article

Collecting large-scale population data on dietary intake is challenging, particularly when resources and funding are constrained. Technology offers the potential to develop novel ways of collecting large amounts of dietary information while making it easier, more convenient, intuitive, and engaging for users. INTAKE24 is an online multiple pass 24 h dietary recall tool developed for use in national food and nutrition surveys. The development of INTAKE24 was a four-stage iterative process of user interaction and evaluation with the intended end users, 11–24 years old. A total of 80 11–24 years old took part in the evaluation, 20 at each stage. Several methods were used to elicit feedback from the users including, ‘think aloud’, ‘eye tracking’, semi-structured interviews, and a system usability scale. Each participant completed an interviewer led recall post system completion. Key system developments generated from the user feedback included a ‘flat’ interface, which uses only a single interface screen shared between all of the various activities (e.g., free text entry, looking up foods in the database, portion size estimation). Improvements to the text entry, search functionality, and navigation around the system were also influenced through feedback from users at each stage. The time to complete a recall using INTAKE24 almost halved from the initial prototype to the end system, while the agreement with an interviewer led recall improved. Further developments include testing the use of INTAKE24 with older adults and translation into other languages for international use. Our future aim is to validate the system with recovery biomarkers. Full article

Web-based 24-h dietary recalls and questionnaires were obtained from 553 Dutch well-trained athletes. The total energy and macronutrient intake was compared between discipline-categories (endurance, team, and strength) within gender, and dietary inadequacy, i.e., too low or high intakes, according to selected recommendations and guidelines, was evaluated by applying a probability approach. On average, 2.83 days per person were reported with a mean energy intake of 2566–2985 kcal and 1997–2457 kcal per day, for men and women, respectively. Between disciplines, small differences in the mean intake of energy and macronutrients were seen for both men and women. Overall, 80% of the athletes met the suggested lower-limit sport nutrition recommendation of 1.2 g·kg⁻¹ of protein per day. The carbohydrate intake of 50%–80% of athletes was between 3 and 5 g·kg⁻¹ bodyweight, irrespective of the category of their discipline. This can be considered as low to moderate, in view of their daily total exercise load (athletes reported on average ~100 minutes per day). In conclusion, only small differences in the mean energy and macronutrient intake between elite endurance, strength, and team sport athletes, were found. The majority of the athletes were able to meet the generally accepted protein recommendation for athletes, of 1.2 g·kg⁻¹. However, for most athletes, the carbohydrate intake was lower than generally recommended in the existing consensus guidelines on sport nutrition. This suggests that athletes could either optimize their carbohydrate intake, or that average carbohydrate requirements merit a re-evaluation. Full article

Lutein and zeaxanthin (L/Z) are the predominant carotenoids which accumulate in the retina of the eye. The impact of L/Z intake on the risk and progression of age‐related macular degeneration (AMD), a leading cause of blindness in the developed world, has been investigated in cohort studies and clinical trials. The aims of this review were to critically examine the literature and evaluate the current evidence relating to L/Z intake and AMD, and describe important food sources and factors that increase the bioavailability of L/Z, to inform dietary models. Cohort studies generally assessed L/Z from dietary sources, while clinical trials focused on providing L/Z as a supplement. Important considerations to take into account in relation to dietary L/Z include: nutrient‐rich sources of L/Z, cooking methods, diet variety and the use of healthy fats. Dietary models include examples of how suggested effective levels of L/Z can be achieved through diet alone, with values of 5 mg and 10 mg per day described. These diet models depict a variety of food sources, not only from dark green leafy vegetables, but also include pistachio nuts and other highly bioavailable sources of L/Z such as eggs. This review and the diet models outlined provide information about the importance of diet variety among people at high risk of AMD or with early signs and symptoms of AMD. Full article

Metabolic vulnerability is associated with age-related diseases and concomitant co-morbidities, which include obesity, diabetes, atherosclerosis and cancer. Most of the health problems we face today come from excessive intake of nutrients and drugs mimicking dietary effects and dietary restriction are the most successful manipulations targeting age-related pathways. Phenotypic heterogeneity and individual response to metabolic stressors are closely related food intake. Understanding the complexity of the relationship between dietary provision and metabolic consequences in the long term might provide clinical strategies to improve healthspan. New aspects of metformin activity provide a link to many of the overlapping factors, especially the way in which organismal bioenergetics remodel one-carbon metabolism. Metformin not only inhibits mitochondrial complex 1, modulating the metabolic response to nutrient intake, but also alters one-carbon metabolic pathways. Here, we discuss findings on the mechanism(s) of action of metformin with the potential for therapeutic interpretations. Full article

Paternal obesity programs metabolic syndrome in offspring. Low‐impact exercise in obese males improves the metabolic health of female offspring, however whether this occurred in male offspring remained unknown. C57BL/6NHsd (Harlan) mice were fed a control diet (CD; 6% fat, n = 7) or a high‐fat diet (HFD; 21% fat, n = 16) for 18 weeks. After 9 weeks, HFD‐fed mice either remained sedentary (HH, n = 8) or undertook low–moderate exercise (HE, n = 8) for another 9 weeks. Male offspring were assessed for glucose/insulin tolerance, body composition, plasma lipids, pancreatic islet cell morphology and microRNA expression. Founder HH induced glucose intolerance, insulin insensitivity, and hyperlipidaemia in male offspring (p < 0.05). Metabolic health was fully restored in male offspring by founder exercise to control levels. Founder HH reduced pancreatic β‐cell area and islet cell size in male offspring, and altered the expression of 13 pancreatic microRNAs (p < 0.05). Founder HE led to partial restoration of pancreatic islet cell morphology and the expression of two pancreatic microRNAs (let7d‐5p, 194‐5p) in male offspring. Founder HE reduced male offspring adiposity, increased muscle mass, reduced plasma free fatty acids (FFAs), and further altered pancreatic microRNAs (35 vs. HH; 32 vs. CD) (p < 0.05). Low‐impact exercise in obese fathers prior to conception, without dietary change, may be a viable intervention strategy to reduce the illeffects of obesity‐induced paternal programming in male offspring. Full article

Since the early 1990s, maternal folic acid supplementation has been recommended prior to and during the first trimester of pregnancy, to reduce the risk of infant neural tube defects. In addition, many countries have also implemented the folic acid fortification of staple foods, in order to promote sufficient intakes amongst women of a childbearing age, based on concerns surrounding variable dietary and supplementation practices. As many women continue to take folic acid supplements beyond the recommended first trimester, there has been an overall increase in folate intakes, particularly in countries with mandatory fortification. This has raised questions on the consequences for the developing fetus, given that folic acid, a methyl donor, has the potential to epigenetically modify gene expression. In animal studies, folic acid has been shown to promote an allergic phenotype in the offspring, through changes in DNA methylation. Human population studies have also described associations between folate status in pregnancy and the risk of subsequent childhood allergic disease. In this review, we address the question of whether ongoing maternal folic acid supplementation after neural tube closure, could be contributing to the rise in early life allergic diseases. Full article

To evaluate body composition, metabolism and growth as well as their interaction with early nutrition in former extremely low birth weight infants (ELBW), we assessed qualitative and quantitative nutritional intake during initial hospitalization and infantile growth parameters in 61 former ELBW infants with a birth weight <1000 g. In two follow-up exams, physical and biochemical development were measured at 5.7 and at 9.5 years. At the second follow-up, in addition to biochemical reassessment, body composition was analyzed by dual-energy x-ray absorptiometry (DEXA). Protein intake between birth and discharge was associated with weight gain in the first six months of life (r = 0.51; p < 0.01). Weight catch-up preceded height catch-up. Protein intake in early infancy correlated highly significantly with abdominal fat mass (r = 0.49; p < 0.05), but not with lean body mass at 9.5 years (r = 0.30; not significant (n.s.). In contrast to nutrient intake, birth weight was associated with lean body mass (r = 0.433; p < 0.001). Early protein and carbohydrate intake were associated with high-density lipoprotein (HDL)-cholesterol, and early catch-up growth correlated with fasting insulin at follow-up. Stepwise linear regression demonstrated that protein intake predicted fat mass (p < 0.05), whereas only gender and birth weight standard deviation score (SDS) contributed significantly to lean body mass variation (p < 0.05). Our results suggest an important impact of early nutrient intake on body composition and metabolism in later childhood in ELBW children. Full article

Interest is rapidly growing around the role of the human gut microbiota in facilitating beneficial health effects associated with consumption of dietary fiber. An evidence map of current research activity in this area was created using a newly developed database of dietary fiber intervention studies in humans to identify studies with the following broad outcomes: (1) modulation of colonic microflora; and/or (2) colonic fermentation/short-chain fatty acid concentration. Study design characteristics, fiber exposures, and outcome categories were summarized. A sub-analysis described oligosaccharides and bacterial composition in greater detail. One hundred eighty-eight relevant studies were identified. The fiber categories represented by the most studies were oligosaccharides (20%), resistant starch (16%), and chemically synthesized fibers (15%). Short-chain fatty acid concentration (47%) and bacterial composition (88%) were the most frequently studied outcomes. Whole-diet interventions, measures of bacterial activity, and studies in metabolically at-risk subjects were identified as potential gaps in the evidence. This evidence map efficiently captured the variability in characteristics of expanding research on dietary fiber, gut microbiota, and physiological health benefits, and identified areas that may benefit from further research. We hope that this evidence map will provide a resource for researchers to direct new intervention studies and meta-analyses. Full article

The aim of this study was to determine whether an association exists between children’s and parental dietary patterns (DP), and whether the number of shared meals or soft drink availability during meals strengthens this association. In 2013/2014 the I.Family study cross‐sectionally assessed the dietary intakes of families from eight European countries using 24‐h dietary recalls. Usual energy and food intakes from six‐ to 16‐year‐old children and their parents were estimated based on the NCI Method. A total of 1662 child–mother and 789 child–father dyads were included; DP were derived using cluster analysis. We investigated the association between children’s and parental DP and whether the number of shared meals or soft drink availability moderated this association using mixed effects logistic regression models. Three DP comparable in children and parents were obtained: Sweet & Fat, Refined Cereals, and Animal Products. Children were more likely to be allocated to the Sweet & Fat DP when their fathers were allocated to the Sweet & Fat DP and when they shared at least one meal per day (OR 3.18; 95% CI 1.84; 5.47). Being allocated to the Sweet & Fat DP increased when the mother or the father was allocated to the Sweet & Fat DP and when soft drinks were available (OR 2.78; 95% CI 1.80; 4.28 or OR 4.26; 95% CI 2.16; 8.41, respectively). Availability of soft drinks and negative parental role modeling are important predictors of children’s dietary patterns. Full article

The relevance of dietary fatty acids (FA) for blood lipids should be assessed in the context of substituting nutrients. Such evidence is lacking for adolescents. This study describes prospective associations of dietary FA with changes in serum lipids during adolescence, and considers the theoretical isocaloric replacements of saturated FA (SFA) with other FA or carbohydrates (CHO). Children from the GINIplus and LISAplus birth cohorts, with data on FA intakes (at age 10 years) and serum lipids (at age 10 and 15 years), were included (n = 1398). Associations of SFA, monounsaturated FA (MUFA), n-3 polyunsaturated FA (n-3 PUFA) and n-6 PUFA, with changes in low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TAG), and total cholesterol to HDL ratio (TOTAL:HDL), were assessed by linear regression. Substitution models assessed isocaloric replacements of SFA with MUFA, n-3 PUFA, n-6 PUFA or CHO. Higher SFA intakes were associated with decreasing TAG. No associations were observed for fatty acid intakes with LDL, HDL or TOTAL:HDL. In females, replacing SFA with CHO was associated with increasing LDL, TAG and TOTAL:HDL. Our findings confirm observations in adults, although sex-specific determinants seem relevant in our adolescent population. Overlooking the nutrient context when limiting SFA intakes might have detrimental consequences appreciable as early as adolescence. Full article

The study aimed to examine the external validity of the Folate Food Frequency Questionnaire (F-FFQ) designed for assessing the folate intake in Serbian women of reproductive age. The F-FFQ was tested against repeated 24 h dietary recalls and correspondent nutritional biomarkers (red blood cells (RBC) and serum folate concentrations) using the method of triads. In a cross sectional study, 503 women aged 18–49 years completed dietary questionnaires and representative validation subsample (n = 50) provided fasting blood samples for biomarker analyses. Correlation coefficients were calculated between each of the dietary methods and three pair-wise correlations were applied for the calculation of validity coefficients. Correlation coefficients observed between F-FFQ and three 24 h recalls were r = 0.56 (p < 0.001) and r = 0.57 (p < 0.001) for total sample and validation group, respectively. Bland–Altman plot and cross-classification analyses indicated good agreement between methods. High validity coefficients were determined between the true intake (I) and dietary assessment methods, F-FFQ (Q) and 24 h dietary recalls (R) (ρQI_rbc = 0.871 and ρQI_ser = 0.814; ρRI_rbc = 0.652 and ρRI_ser = 0.698), and moderate ones for biomarkers (B) (ρBI_rbc = 0.428 and ρBI_ser = 0.421). The F-FFQ is valid instrument for the assessment of dietary folate intake in women living in Serbia, a country without mandatory folic acid food fortification. Full article

The effectiveness for vasomotor symptoms and sleep disorders plus the long-term safety of a nutraceutical combination of agnus-castus and magnolia extracts combined with soy isoflavones (SI) and lactobacilli were assessed in postmenopausal women. A controlled study was carried out in menopausal women comparing this nutraceutical combination (ESP group) with a formulation containing isoflavones alone (C group) at the dosage recommended. The Kuppermann index, The Pittsburgh Sleep Quality Index (PSQI), and Short Form 36 (SF-36) were determined at baseline, three, six and 12 months. Endometrial thickness, mammary density and liver function were evaluated at baseline and after 12 months. One hundred and eighty women were enrolled in the study (100 in the ESP group and 80 in the C group). At the end of the treatment, mammary density, endometrial thickness, and hepatic function did not show substantial differences between groups. The Kuppermann index and particularly the tendency for hot flashes progressively and significantly decreased in frequency and severity during ESP versus C treatment. At the same time, a significant increase in sleep quality and psychophysical wellness parameters was observed in the ESP versus C groups. No adverse events were observed. Agnus-castus and magnolia, combined with SI + lactobacilli, can effectively and safely be used in symptomatic postmenopausal women, mainly when quality of sleep is the most disturbing complaint. The endometrium, mammary glands and liver function were unaffected after 12 months of treatment. Full article

Orange pomace (OP), a fiber-rich byproduct of juice production, has the potential for being formulated into a variety of food products. We hypothesized that OP would diminish postprandial glycemic responses to a high carbohydrate/fat breakfast and lunch. We conducted an acute, randomized, placebo-controlled, double blind, crossover trial with 34 overweight men who consumed either a 255 g placebo (PLA), a low (35% OP (LOP)), or a high (77% (HOP)) dose OP beverage with breakfast. Blood was collected at 0, 10, 20, 30, and 45 min and at 1, 1.5, 2, 3, 4, 5, 5.5, 6, 6.5, 7, and 8 h. Lunch was consumed after the 5.5-h blood draw. OP delayed the time (T_max1) to the maximum concentration (C_max1) of serum glucose during the 2-h period post breakfast by ≥36% from 33 (PLA) to 45 (HOP) and 47 (LOP) min (p = 0.055 and 0.013, respectively). OP decreased post-breakfast insulin C_max1 by ≥10% and LOP delayed the T_max1 by 14 min, compared to PLA at 46 min (p ≤ 0.05). HOP reduced the first 2-h insulin area under concentration time curve (AUC) by 23% compared to PLA. Thus, OP diminishes postprandial glycemic responses to a high carbohydrate/fat breakfast and the second meal in overweight men. Full article

Background: The National Dietary Survey on the Child and Adolescent Population in Spain (ENALIA) provides data to assess the usual micronutrient intake among Spanish infants, children, and adolescents. Methods: Cross-sectional survey (November 2012–July 2014) of a representative sample of Spanish children and adolescents (six months–17 years) (n = 1862). Dietary information was collected using two non-consecutive one-day food diaries (six months–10 years old) or two 24 h dietary recalls (11 years and older) separated by at least 14 days. Estimates were calculated using the Iowa State University method and PC-SIDE software (version 1.0, department of statistics, center for agricultural and rural development, Ames, IA, USA) to account for within- and between-person variation. Results: Usual intake of vitamin D was insufficient in practically all individuals. Vitamin E, folate, and calcium were insufficient, especially from nine years of age, and magnesium and iodine from 14 years of age. The percentage of subjects with insufficient intakes was higher among females. Sodium intake was excessive in a considerable percentage of the population, especially in males, and it increased with age. Finally, over half of children under four years of age had zinc usual intakes that exceeded the Tolerable Upper Level. Conclusion: Vitamin and mineral intake in Spain should be improved, especially in late childhood and adolescence. Nutritional intervention and educational strategies are needed to promote healthy eating habits and correct micronutrient inadequacies in Spanish children and adolescents. Full article

The presence in the market of food products with nutritional claims is increasing. The objective of this paper is to assess consumers’ valuation of some nutritional claims (‘high in fiber’ and ‘reduced saturated fat’) in a European country and to test for differences among consumers. An artefactual non-hypothetical experiment was carried out in a realistic setting (mock/real brick-and-mortar supermarket) with a sample of 121 Spanish consumers stratified by gender, age, and body mass index. A latent class model was specified and estimated with the data from the experiment. Results indicate that consumers positively valued both nutritional claims, but the valuation was heterogeneous, and three consumer segments were detected. Two of them positively valued both nutritional claims (named ‘nutritional claim seekers’), while the third segment’s valuation was negative (named ‘nutritional claim avoiders’). This last segment is characterized by being younger males with university studies who give the least importance to health, natural ingredients, and the calorie/sugar/fat content when shopping. They pay less attention to nutritional information, and they stated that they use this information to a lesser extent. These consumers showed the least interest in healthy eating, and they reported that they do not have health problems related to their diet. Full article

Advances in technology-enabled dietary assessment include the advent of web-based food frequency questionnaires, which may reduce costs and researcher burden but may introduce new challenges related to internet connectivity and computer literacy. The purpose of this study was to evaluate the intra- and inter-version reliability, feasibility and acceptability of the paper and web Canadian Diet History Questionnaire II (CDHQ-II) in a sub-sample of 648 adults (aged 39–81 years) recruited from Alberta’s Tomorrow Project. Participants were randomly assigned to one of two groups: (1) paper, web, paper; or (2) web, paper, web over a six-week period. With few exceptions, no statistically significant differences in mean nutrient intake were found in the intra- and inter-version reliability analyses. The majority of participants indicated future willingness to complete the CDHQ-II online, and 59% indicated a preference for the web over the paper version. Findings indicate that, in this population of adults drawn from an existing cohort, the CDHQ-II may be administered in paper or web modalities (increasing flexibility for questionnaire delivery), and the nutrient estimates obtained with either version are comparable. We recommend that other studies explore the feasibility and reliability of different modes of administration of dietary assessment instruments prior to widespread implementation. Full article

Several studies have reported that short sleep duration is a risk factor for obesity and metabolic disease. Moreover, both sleep duration and sleep timing might independently be associated with dietary nutrient intake. In this study, we investigated the associations between self-reported sleep duration and dietary nutrient intake, with and without adjustments for variations in sleep timing (i.e., the midpoint of sleep). We conducted a questionnaire survey, comprising a validated brief self-administered diet history questionnaire (BDHQ) and the Japanese version of the Pittsburgh Sleep Quality Index (PSQI) among 1902 healthy Japanese adults and found that the dietary intakes of several nutrients correlated with sleep duration among men regardless of adjustment for the midpoint of sleep. Particularly, (1) small but significant correlations were observed between sleep duration and the percentage of energy from protein, regardless of adjustment for the midpoint of sleep; (2) energy-adjusted intakes of sodium, vitamin D, and vitamin B12 also significantly correlated with sleep duration; and (3) intakes of bread, pulses, and fish and shellfish correlated with sleep duration. In contrast, no significant correlations were observed between sleep duration and dietary intakes among women. This study revealed that after controlling for the midpoint of sleep, sleep duration correlated significantly with the dietary intake of specific nutrients and foods in a population of Japanese men. Full article

This pilot study aimed to investigate the effect of simple sugar ingestion, in amounts typical of common ingestion, on appetite and the gut-derived hormone response. Seven healthy men ingested water (W) and equicaloric solutions containing 39.6 g glucose monohydrate (G), 36 g fructose (F), 36 g sucrose (S), and 19.8 g glucose monohydrate + 18 g fructose (C), in a randomised order. Serum concentrations of ghrelin, glucose dependent insulinotropic polypeptide (GIP), glucagon like peptide-1 (GLP-1), insulin, lactate, triglycerides, non-esterified fatty acids (NEFA), and d-3 hydroxybutyrate, were measured for 60 min. Appetite was measured using visual analogue scales (VAS). The ingestion of F and S resulted in a lower GIP incremental area under the curve (iAUC) compared to the ingestion of G (p < 0.05). No differences in the iAUC for GLP-1 or ghrelin were present between the trials, nor for insulin between the sugars. No differences in appetite ratings or hepatic metabolism measures were found, except for lactate, which was greater following the ingestion of F, S, and C, when compared to W and G (p < 0.05). The acute ingestion of typical amounts of fructose, in a variety of forms, results in marked differences in circulating GIP and lactate concentration, but no differences in appetite ratings, triglyceride concentration, indicative lipolysis, or NEFA metabolism, when compared to glucose. Full article

Vitamin D deficiency is a global concern. Much research has concentrated on the endogenous synthesis of vitamin D in human skin following exposure to ultraviolet‐B radiation (UV‐B, 280–315 nm). In many regions of the world there is insufficient UV‐B radiation during winter months for adequate vitamin D production, and even when there is sufficient UV‐B radiation, lifestyles and concerns about the risks of sun exposure may lead to insufficient exposure and to vitamin D deficiency. In these situations, dietary intake of vitamin D from foods or supplements is important for maintaining optimal vitamin D status. Some foods, such as fatty fish and fish liveroils, certain meats, eggs, mushrooms, dairy, and fortified foods, can provide significant amounts of vitamin D when considered cumulatively across the diet. However, little research has focussed on assessing edible plant foods for potential vitamin D content. The biosynthesis of vitamin D in animals, fungi and yeasts is well established; it is less well known that vitamin D is also biosynthesised in plants. Research dates back to the early 1900s, beginning with in vivo experiments showing the anti‐rachitic activity of plants consumed by animals with induced rickets, and in vitro experiments using analytical methods with limited sensitivity. The most sensitive, specific and reliable method for measuring vitamin D and its metabolites is by liquid chromatography tandem mass spectrometry (LC‐MS/MS). These assays have only recently been customised to allow measurement in foods, including plant materials. This commentary focuses on the current knowledge and research gaps around vitamin D in plants, and the potential of edible plants as an additional source of vitamin D for humans. Full article

We read with interest a study recently published in Nutrients by Nichols et al. [1], which reported that fish oil products available in Australasia are not oxidised and are accurately labelled for content.[...] Full article

The association between maternal vitamin D deficiency and the risk of severe preeclampsia is still debated. In the present study, we aimed to evaluate vitamin D status in Chinese pregnant women and investigate its correlation with the odds of developing severe preeclampsia. A cohort study was performed on 13,806 pregnant women who routinely visited the antenatal care clinics and subsequently delivered at the Wuxi Maternity and Child Health Hospital. All the subjects in the cohort had their serum 25-hydroxyvitamin D (25(OH)D) concentrations measured during pregnancy. A high prevalence of maternal vitamin D deficiency (25(OH)D < 50 nmol/L) was found. Pregnant women who had different BMIs before pregnancy had significantly different serum concentrations of 25(OH)D. There was also a significant difference in the serum 25(OH)D concentration among pregnant women of different ages. The serum 25(OH)D concentration was significantly lower in pregnant women who subsequently developed severe preeclampsia compared with those who did not. Maternal vitamin D deficiency at 23–28 weeks of gestation was strongly associated with increased odds for severe preeclampsia after adjusting for relevant confounders (adjusted OR, 3.16; 95% CI, 1.77–5.65). Further studies are required to investigate whether vitamin D supplementation would reduce the risk of severe preeclampsia and improve pregnancy outcomes. Full article

Sleep disturbance is a frequent and serious complication of hemodialysis (HD). Low serum vitamin D levels have been associated with sleep quality in non-HD subjects. Our aim was to examine the possible association between serum vitamin D levels and the presence of sleep disturbance in HD patients. We recruited 141 HD patients at the HD center of the First Affiliated Hospital of Jiaxing University during 2014–2015. Serum levels of 25-hydroxyvitamin D (25(OH)D) were determined by the competitive protein-binding assay. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Demographic, clinical and laboratory data were recorded. Meanwhile, 117 healthy control subjects were also recruited and underwent measurement of 25(OH)D. Eighty-eight patients (62.4%) had sleep disturbance (PSQI scores ≥ 5). Patients with sleep disturbance showed lower levels of 25(OH)D as compared to those without sleep disturbance (85.6 ± 37.4 vs. 39.1 ± 29.1 nmol/L, p < 0.001). In multivariate analyses, serum levels of 25(OH)D (≤48.0 nmol/L) were independently associated with sleep disturbance in HD patients (OR 9.897, 95% CI 3.356–29.187, p < 0.001) after adjustment for possible variables. Our study demonstrates that low serum levels of vitamin D are independently associated with sleep disturbance in HD patients, but the finding needs to be confirmed in future experimental and clinical studies. Full article

Technological advances have allowed for the evolution of traditional dietary assessment methods. The aim of this review is to evaluate the accuracy of technology-based dietary assessment methods to determine carotenoid and/or fruit and vegetable intake when compared with carotenoid biomarkers. An online search strategy was undertaken to identify studies published in the English language up to July 2016. Inclusion criteria were adults ≥18 years, a measure of dietary intake that used information and communication technologies that specified fruit and/or vegetable intake or dietary carotenoid, a biomarker of carotenoid status and the association between the two. Sixteen articles from 13 studies were included with the majority cross-sectional in design (n = 9). Some studies used multiple dietary assessment methods with the most common: food records (n = 7), 24-h diet recalls (n = 5), food frequency questionnaires (n = 3) and diet quality assessed by dietary screener (n = 1). Two studies were directly web based, with four studies using technology that could be completed offline and data later transferred. Two studies utilised technology in the collection of dietary data, while the majority (n = 11) automated the collection in combination with nutrient analysis of the dietary data. Four studies provided correlation values between dietary carotenoids with biomarkers, ranging from r = 0.13 to 0.62 with the remaining studies comparing a measure of fruit and vegetable intake with biomarkers (r = 0.09 to 0.25). This review provides an overview of technology-based dietary assessment methods that have been used in validation studies with objectively measured carotenoids. Findings were positive with these dietary assessment measures showing mostly moderate associations with carotenoid biomarkers. Full article

Gestational diabetes mellitus (GDM) is a growing concern, affecting an increasing number of pregnant women worldwide. By predisposing both the affected mothers and children to future disease, GDM contributes to an intergenerational cycle of obesity and diabetes. In order to stop this cycle, safe and effective treatments for GDM are required. This study sought to determine the treatment effects of dietary supplementation with myo-inositol (MI) and vitamins B2, B6, B12, and D in a mouse model of GDM (pregnant db/+ dams). In addition, the individual effects of vitamin B2 were examined. Suboptimal B2 increased body weight and fat deposition, decreased GLUT4 adipose tissue expression, and increased expression of inflammatory markers. MI supplementation reduced weight and fat deposition, and reduced expression of inflammatory markers in adipose tissue of mice on suboptimal B2. MI also significantly reduced the hyperleptinemia observed in db/+ mice, when combined with supplemented B2. MI was generally associated with adipose tissue markers of improved insulin sensitivity and glucose uptake, while the combination of vitamins B2, B6, B12, and D was associated with a reduction in adipose inflammatory marker expression. These results suggest that supplementation with MI and vitamin B2 could be beneficial for the treatment/prevention of GDM. Full article

This study investigated whether athletes meet micronutrient recommendations and whether the adequacy of their intake is related to the use of dietary supplements, sport nutrition products or a combination. Micronutrient intakes of 553 Dutch (sub-) elite athletes were assessed using web-based 24-h dietary recalls with accompanying nutritional supplement questionnaires. In the majority of both users and non-users of dietary supplements, vitamin D intake was below the estimated average requirement (AR) if supplements were not included in the analysis. Including dietary supplements improved vitamin D intake, but still a part of the athletes, both men and women, reported an intake below the AR. Non-users of dietary supplements were particularly at risk for low intakes of vitamins B1, B2, B3 and vitamins A, C and selenium. Mean iron intake was reported below the AR in a substantial group of women, both users and non-users. The use of sport nutrition products contributed only slightly to micronutrient intake. A small prevalence of athletes using dietary supplements showed intakes of some micronutrients above the Upper Level. In conclusion, both users and non-users of nutritional supplements reported inadequate intake of micronutrients. For most micronutrients, use of nutritional supplements does not completely compensate for intakes below AR. Athletes should consider making better food choices and the daily use of a low-dosed multivitamin supplement. Full article

Both tocotrienol and statins are suppressors of the mevalonate pathway. Supplementation of tocotrienol among statin users could potentially protect them against osteoporosis. This study aimed to compare the effects of tocotrienol and lovastatin co-supplementation with individual treatments on bone dynamic histomorphometric indices and bone morphogenetic protein-2 (BMP-2) gene expression in ovariectomized rats. Forty-eight female Sprague-Dawley rats were randomized equally into six groups. The baseline was sacrificed upon receipt. All other groups were ovariectomized, except for the sham group. The ovariectomized groups were administered orally daily with (1) lovastatin 11 mg/kg/day alone; (2) tocotrienol derived from annatto bean (annatto tocotrienol) 60 mg/kg/day alone; (3) lovastatin 11 mg/kg/day, and annatto tocotrienol 60 mg/kg/day. The sham and ovariectomized control groups were treated with equal volume of vehicle. After eight weeks of treatment, the rats were sacrificed. Their bones were harvested for bone dynamic histomorphometry and BMP-2 gene expression. Rats supplemented with annatto tocotrienol and lovastatin concurrently demonstrated significantly lower single-labeled surface, but increased double-labeled surface, mineralizing surface, mineral apposition rate and bone formation rate compared to individual treatments (p < 0.05). There was a parallel increase in BMP-2 gene expression in the rats receiving combined treatment (p < 0.05). The combination of annatto tocotrienol and lovastatin exerted either additively or synergistically on selected bone parameters. In conclusion, tocotrienol can augment the bone formation and mineralization in rats receiving low-dose statins. Supplementation of tocotrienol in statin users can potentially protect them from osteoporosis. Full article

Consumer knowledge is understood to play a role in managing risk factors associated with cardiovascular disease and may be influenced by level of education. The association between population knowledge, behaviours and actual salt consumption was explored overall, and for more-educated compared to less-educated individuals. A cross-sectional survey was done in an age-and sex-stratified random sample of 1395 participants from urban and rural areas of North and South India. A single 24-h urine sample, participants’ physical measurements and questionnaire data were collected. The mean age of participants was 40 years, 47% were women and mean 24-h urinary salt excretion was 9.27 (8.87–9.69) g/day. Many participants reported favourable knowledge and behaviours to minimise risks related to salt. Several of these behaviours were associated with reduced salt intake—less use of salt while cooking, avoidance of snacks, namkeens, and avoidance of pickles (all p < 0.003). Mean salt intake was comparable in more-educated (9.21, 8.55–9.87 g/day) versus less-educated (9.34, 8.57–10.12 g/day) individuals (p = 0.82). There was no substantively different pattern of knowledge and behaviours between more-versus less-educated groups and no clear evidence that level of education influenced salt intake. Several consumer behaviours related to use of salt during food preparation and consumption of salty products were related to actual salt consumption and therefore appear to offer an opportunity for intervention. These would be a reasonable focus for a government-led education campaign targeting salt. Full article

The Mediterranean diet has demonstrated efficacy for improving cardiovascular and cognitive health. However, a traditional Mediterranean diet delivers fewer serves of dairy and less dietary calcium than is currently recommended in Australia, which may limit long-term sustainability. The present study aims to evaluate whether a Mediterranean diet with adequate dairy and calcium can improve cardiovascular and cognitive function in an at-risk population, and thereby reduce risk of cardiovascular disease (CVD) and cognitive decline. A randomised, controlled, parallel, crossover design trial will compare a Mediterranean diet supplemented with dairy foods against a low-fat control diet. Forty participants with systolic blood pressure above 120 mmHg and at least two other risk factors of CVD will undertake each dietary intervention for eight weeks, with an eight-week washout period between interventions. Systolic blood pressure will be the primary measure of interest. Secondary outcomes will include measures of cardiometabolic health, dietary compliance, cognitive function, assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), psychological well-being and dementia risk. This research will provide empirical evidence as to whether the Mediterranean diet can be modified to provide recommended dairy and calcium intakes while continuing to deliver positive effects for cardiovascular and cognitive health. The findings will hold relevance for the field of preventative healthcare and may contribute to revisions of national dietary guidelines. Full article

Dietary sugars have been shown to promote excess adiposity among children and adults; however, no study has examined fructose in human milk and its effects on body composition during infancy. Twenty-five mother–infant dyads attended clinical visits to the Oklahoma Health Sciences Center at 1 and 6 months of infant age. Infants were exclusively breastfed for 6 months and sugars in breast milk (i.e., fructose, glucose, lactose) were measured by Liquid chromatography-mass spectrometry (LC-MS/MS) and glucose oxidase. Infant body composition was assessed using dual-energy X-ray absorptiometry at 1 and 6 months. Multiple linear regression was used to examine associations between breast milk sugars and infant body composition at 6 months of age. Fructose, glucose, and lactose were present in breast milk and stable across visits (means = 6.7 μg/mL, 255.2 μg/mL, and 7.6 g/dL, respectively). Despite its very low concentration, fructose was the only sugar significantly associated with infant body composition. A 1-μg/mL higher breast milk fructose was associated with a 257 g higher body weight (p = 0.02), 170 g higher lean mass (p = 0.01), 131 g higher fat mass (p = 0.05), and 5 g higher bone mineral content (p = 0.03). In conclusion, fructose is detectable in human breast milk and is positively associated with all components of body composition at 6 months of age. Full article

Oxyresveratrol has been proven effective in inhibiting adipogenesis in a 3T3-L1 cell model. We investigated the preventive effect of oxyresveratrol supplementation on obesity development in high-fat diet-fed mice. Male C57bl/6 mice were randomly subjected to control (5% fat by weight, LF), high-fat (30% fat by weight, HF), and high-fat supplemented with 0.25% and 0.5% oxyresveratrol (OXY1 and OXY2, respectively) diet groups for eight weeks. Oxyresveratrol supplementation effectively alleviated obesity-associated symptoms such as insulin resistance, hyperglycemia, and hepatic steatosis in high-fat diet-fed mice. Compared to the high-fat diet group, oxyresveratrol supplementation suppressed expression of glucose-6-phosphatase, sterol regulatory element-binding proteins 1, fatty acid synthase and CCAAT/Enhancer-binding proteins α, and elevated AMP-activated protein kinase (α2-catalytic subunit) level in liver, upregulated insulin-dependent glucose transporter type 4 level in adipose tissue, and increased expression of insulin receptor substrate 1, insulin-dependent glucose transporter type 4, AMP-activated protein kinase α, peroxisome proliferator-activated receptor γ coactivator-1α, and sirtuin 1 in muscle to regulate lipid and glucose homeostasis in these tissues. This study demonstrated that oxyresveratrol supplementation effectively ameliorated obesity-associated symptoms in high-fat diet-fed mice, presumably attributed to mediating critical regulators involved in lipid and glucose homeostasis in liver, visceral fat, and muscle. Full article

Due to reduced cost and accessibility, the use of genetic testing has appealed to health professionals for personalising nutrition advice. However, translation of the evidence linking polymorphisms, dietary requirements, and pathology risk proves to be challenging for nutrition and dietetic practitioners. Zinc status and polymorphisms of genes coding for zinc-transporters have been associated with chronic diseases. The present study aimed to systematically review the literature to assess whether recommendations for zinc intake could be made according to genotype. Eighteen studies investigating 31 Single Nucleotide Polymorphisms (SNPs) in relation to zinc intake and/or status were identified. Five studies examined type 2 diabetes; zinc intake was found to interact independently with two polymorphisms in the zinc-transporter gene SLC30A8 to affect glucose metabolism indicators. While the outcomes were statistically significant, the small size of the effect and lack of replication raises issues regarding translation into nutrition and dietetic practice. Two studies assessed the relationship of polymorphisms and cognitive performance; seven studies assessed the association between a range of outcomes linked to chronic conditions in aging population; two papers described the analysis of the genetic contribution in determining zinc concentration in human milk; and two papers assessed zinc concentration in plasma without linking to clinical outcomes. The data extracted confirmed a connection between genetics and zinc requirements, although the direction and magnitude of the dietary modification for carriers of specific genotypes could not be defined. This study highlights the need to summarise nutrigenetics studies to enable health professionals to translate scientific evidence into dietary recommendations. Full article

Fibre supplementation can potentially reduce energy intake and contribute to weight loss. The mechanism may be reduced frequency of eating, resulting in reduced food consumption. The objective of this research was to determine the effectiveness of fibre supplementation with PolyGlycopleX® (PGX®), on body weight and composition, frequency of eating and dietary intake in 118 overweight adults. In a three‐arm, parallel, blind, randomised controlled trial participants were randomised to one of three groups; 4.5 g PGX as softgels (PGXS), 5 g PGX granules (PGXG) or 5 g rice flour (RF) control. Prior to supplementation and at 12 weeks, participants captured before and after images of all food and beverages consumed within 4 days using a mobile food record app (mFR). The mFR images were analysed for food group serving sizes and number of eating occasions. In the PGXG group, per-protocol analysis showed there was a significant reduction in waist circumference (2.5 cm; p = 0.003). Subgroup analysis showed that PGXG supplementation at the recommended dose resulted in a reduction in body weight (−1.4 ± 0.10 kg, p < 0.01), body mass index (BMI) reduction (-0.5 ± 0.10, p < 0.01), reduced number of eating occasions (−1.4 ± 1.2, p < 0.01) and a reduced intake of grain food (-1.52 ± 1.84 serves, p = 0.019). PGXG at the recommended dose resulted in a reduction in weight and BMI which was significantly greater than that for RF (p = 0.001). These results demonstrate the potential benefits of PGX fibre in controlling frequency of eating and in weight loss. Full article

Exocrine pancreatic insufficiency (EPI) results in the maldigestion and malabsorption of nutrients. The digestive processes in humans and other monogastric species like rat and pig are characterized by a predominantly enzymatic digestion within the small intestine and microbial fermentation located in the hindgut. For protein, it is doctrine that only prececally absorbed amino acids can be transferred to the amino acid pool of the host, while postileal absorption of nitrogen‐containing compounds occurs mainly in the form of ammonia, being a burden rather than a benefit for the organism. The pig is an established animal model for humans to study digestive processes. As digestion is markedly impaired in case of EPI the use of an appropriate animal model to study the effects of this disease and to optimize treatment and dietetic measures is of special interest. By using an animal model of experimentally‐induced EPI allowing differentiating between digestive processes in the small as well as in the large intestine by use of ileo‐cecal fistulated animals, marked effects of EPI on prececal digestion of starch and protein could be shown. The data indicatethat estimation of digestibility of nutrients over the entire digestive tract results in a distinct overestimation of enzymatic digestion of starch and protein. Therefore, this model clearly shows that protein and starch digestion are significantly reduced in case of EPI although this cannot be detected on a fecal level. As postileal fermentation of starch is associated not only with energy losses but also with intensive gas production, this is of special interest to minimize meteorism and improve wellbeing of patients. Full article

The Mediterranean diet is a healthy dietary pattern known to actively modulate the cell membrane properties. Phase angle (PhA) is a direct measure by Bioelectrical Impedance Analysis (BIA) used as marker of cell membrane integrity. Both food behaviour and PhA are influenced by age, sex and body weight. The aim of this study was to cross-sectionally evaluate the association between the adherence to Mediterranean diet and PhA in 1013 healthy adult patients stratified according to sex, age, and body mass index (BMI). The adherence to the Mediterranean diet was evaluated using the PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. PhA was calculated by BIA phase-sensitive system (50 kHz BIA 101 RJL, Akern Bioresearch, Florence, Italy Akern). In both sexes, at ROC analysis a PREDIMED score ≥ 6 predicted a PhA beyond the median value. At the multivariate analysis, among PREDIMED score, age, and BMI, the PREDIMED score was the major determinant of PhA, explaining 44.5% and 47.3% of PhA variability, in males and females respectively (p < 0.001). A novel association was reported between the adherence to the Mediterranean diet and PhA, independently of sex, age, and body weight. This association uncovered a new potential benefit of the Mediterranean diet on health outcomes, as in both sexes higher adherence to the Mediterranean diet was associated to larger PhAs, as expression of cell membrane integrity. Full article

Hyperphosphatemia has been associated with adverse outcomes in patients with end stage kidney disease (ESKD). The purpose of this study was to determine risk factors for hyperphosphatemia in ESKD patients treated with peritoneal dialysis (PD). This information will be used to develop a patient specific phosphate binder application to facilitate patient self-management of serum phosphate. Adult PD patients documented their food, beverage, and phosphate binder intake for three days using a dietitian developed food journal. Phosphate content of meals was calculated using the ESHA Food Processor SQL Software (ESHA Research, Salem, UT, USA). Clinic biochemistry tests and an adequacy assessment (Baxter Adequest program) were done. Univariate logistic regression was used to determine predictors of serum phosphate >1.78 mmol/L. A multivariable logistic regression model was then fit including those variables that achieved a significance level of p < 0.20 in univariate analyses. Sixty patients (38 men, 22 women) completed the protocol; they were 60 ± 17 years old, 50% had a history of diabetes mellitus (DM) and 33% had hyperphosphatemia (PO₄ > 1.78 mmol/L). In univariate analysis, the variables associated with an increased risk of hyperphosphatemia with a p-value < 0.2 were male gender (p = 0.13), younger age (0.07), presence of DM (0.005), higher dose of calcium carbonate (0.08), higher parathyroid serum concentration (0.08), lower phosphate intake (0.03), lower measured glomerular filtration rate (0.15), higher phosphate excretion (0.11), and a higher body mass index (0.15). After multivariable logistic regression analysis, younger age (odds ratio (OR) 0.023 per decade, 95% confidence interval (CI) 0.00065 to 0.455; p = 0.012), presence of diabetes (OR 11.40, 95 CI 2.82 to 61.55; p = 0.0003), and measured GFR (OR 0.052 per mL/min decrease; 95% CI 0.0025 to 0.66) were associated with hyperphosphatemia. Our results support that younger age and diabetes mellitus are significant risk factors for hyperphosphatemia. These findings warrant further investigation to determine the potential mechanisms that predispose younger patients and those with DM to hyperphosphatemia. Full article

Dietary fiber (DF), found in whole fruits, vegetables, and whole grains (WG), is considered a nutrient of concern in the US diet and increased consumption is recommended. The present study was designed to highlight this critical importance of the difference between WG, high-fiber WG, and sources of fiber that are not from WG. The study is based on the two-day diets reported consumed by the nationally representative sample of Americans participating in What We Eat In America, the dietary component of the National Health and Nutrition Examination Survey from 2003–2010. Foods consumed were classified into tertiles of DF and WG and the contribution of fiber by differing levels of WG content were examined. Foods containing high amounts of WG and DF only contributed about 7% of total fiber intake. Overall, grain-based foods contributed 54.5% of all DF consumed. Approximately 39% of DF came from grain foods that contained no WG, rather these foods contained refined grains, which contain only small amounts of DF but are consumed in large quantities. All WG-containing foods combined contributed a total of 15.3% of DF in the American diet. Thus, public health messaging needs to be changed to specifically encourage consumption of WG foods with high levels of DF to address both recommendations. Full article

Acute, non-clinical insomnia is not uncommon. Sufferers commonly turn to short-term use of herbal supplements to alleviate the symptoms. This placebo-controlled, double-blind study investigated the efficacy of LZComplex3 (lactium™, Zizyphus, Humulus lupulus, magnesium and vitamin B6), in otherwise healthy adults with mild insomnia. After a 7-day single-blind placebo run-in, eligible volunteers (n = 171) were randomized (1:1) to receive daily treatment for 2 weeks with LZComplex3 or placebo. Results revealed that sleep quality measured by change in Pittsburgh Sleep Quality Index (PSQI) score improved in both the LZComplex3 and placebo groups. There were no significant between group differences between baseline and endpoint on the primary outcome. The majority of secondary outcomes, which included daytime functioning and physical fatigue, mood and anxiety, cognitive performance, and stress reactivity, showed similar improvements in the LZComplex3 and placebo groups. A similar proportion of participants reported adverse events (AEs) in both groups, with two of four treatment-related AEs in the LZComplex3 group resulting in permanent discontinuation. It currently cannot be concluded that administration of LZComplex3 for 2 weeks improves sleep quality, however, a marked placebo response (despite placebo run-in) and/or short duration of treatment may have masked a potential beneficial effect on sleep quality. Full article

Omega-3 long chain polyunsaturated fatty acid supplementation (n-3 LCPUFA) for treatment of Autism Spectrum Disorder (ASD) is popular. The results of previous systematic reviews and meta-analyses of n-3 LCPUFA supplementation on ASD outcomes were inconclusive. Two meta-analyses were conducted; meta-analysis 1 compared blood levels of LCPUFA and their ratios arachidonic acid (ARA) to docosahexaenoic acid (DHA), ARA to eicosapentaenoic acid (EPA), or total n-6 to total n-3 LCPUFA in ASD to those of typically developing individuals (with no neurodevelopmental disorders), and meta-analysis 2 compared the effects of n-3 LCPUFA supplementation to placebo on symptoms of ASD. Case-control studies and randomised controlled trials (RCTs) were identified searching electronic databases up to May, 2016. Mean differences were pooled and analysed using inverse variance models. Heterogeneity was assessed using I² statistic. Fifteen case-control studies (n = 1193) were reviewed. Compared with typically developed, ASD populations had lower DHA (−2.14 [95% CI −3.22 to −1.07]; p < 0.0001; I² = 97%), EPA (−0.72 [95% CI −1.25 to −0.18]; p = 0.008; I² = 88%), and ARA (−0.83 [95% CI, −1.48 to −0.17]; p = 0.01; I² = 96%) and higher total n-6 LCPUFA to n-3 LCPUFA ratio (0.42 [95% CI 0.06 to 0.78]; p = 0.02; I² = 74%). Four RCTs were included in meta-analysis 2 (n = 107). Compared with placebo, n-3 LCPUFA improved social interaction (−1.96 [95% CI −3.5 to −0.34]; p = 0.02; I² = 0) and repetitive and restricted interests and behaviours (−1.08 [95% CI −2.17 to −0.01]; p = 0.05; I² = 0). Populations with ASD have lower n-3 LCPUFA status and n-3 LCPUFA supplementation can potentially improve some ASD symptoms. Further research with large sample size and adequate study duration is warranted to confirm the efficacy of n-3 LCPUFA. Full article

The Research Institute on Nutrition and Food Security at the University of Barcelona (INSA‐UB) was founded in 2005 by twenty‐two research groups from the Faculties of Pharmacy and Food Science; Biology; Chemistry; and Geography and History, as well as other UB‐affiliated centers and hospitals [...] Full article

The Australian Dietary Guidelines recommended “grain (cereal)” core food group includes both refined and whole grain foods, but excludes those that are discretionary (i.e., cakes). We investigated the association between daily serves from the “grain (cereal)” group and its effect on fibre and adiposity. Data from Australian adults in the 2011–2012 National Nutrition and Physical Activity Survey were used (n = 9341). Participants were categorised by serves of core grain foods and general linear models were used to investigate the effect of demographic, socioeconomic, and dietary covariates on waist circumference, body mass index (BMI) and fibre intake. Compared to core grain avoiders (0 serves), high consumers (6+ serves/day) were: more likely male and socially advantaged, had a healthier dietary pattern, less likely dieting, overweight or obese, and were at lower risk of metabolic complications. After adjustment for age, sex and energy intake, there was an inverse relationship between core grain serves intake and BMI (p < 0.001), waist circumference (p = 0.001) and a positive relationship with fibre (p < 0.001). Model adjustments for diet and lifestyle factors resulted in a smaller difference in waist circumference (p = 0.006) and BMI (p = 0.006). Core grain serves was significantly associated with higher fibre, but marginally clinically significant for lower adiposity. Full article

Epidemiological evidence suggests that consumption of flavonoids (usually via fruits and vegetables) is associated with decreased risk of developing depression. One plausible explanation for this association is the well-documented beneficial effects of flavonoids on executive function (EF). Impaired EF is linked to cognitive processes (e.g., rumination) that maintain depression and low mood; therefore, improved EF may reduce depressionogenic cognitive processes and improve mood. Study 1: 21 young adults (18–21 years old) consumed a flavonoid-rich blueberry drink and a matched placebo in a counterbalanced cross-over design. Study 2: 50 children (7–10 years old) were randomly assigned to a flavonoid-rich blueberry drink or a matched placebo. In both studies, participants and researchers were blind to the experimental condition, and mood was assessed using the Positive and Negative Affect Schedule before and 2 h after consumption of the drinks. In both studies, the blueberry intervention increased positive affect (significant drink by session interaction) but had no effect on negative affect. This observed effect of flavonoids on positive affect in two independent samples is of potential practical value in improving public health. If the effect of flavonoids on positive affect is replicated, further investigation will be needed to identify the mechanisms that link flavonoid interventions with improved positive mood. Full article

Vitamin A is an essential micronutrient throughout life. Its physiologically active metabolite retinoic acid (RA), acting through nuclear retinoic acid receptors (RARs), is a potent regulator of patterning during embryonic development, as well as being necessary for adult tissue homeostasis. Vitamin A deficiency during pregnancy increases risk of maternal night blindness and anemia and may be a cause of congenital malformations. Childhood Vitamin A deficiency can cause xerophthalmia, lower resistance to infection and increased risk of mortality. RA signaling appears to be essential for expression of genes involved in developmental hematopoiesis, regulating the endothelial/blood cells balance in the yolk sac, promoting the hemogenic program in the aorta-gonad-mesonephros area and stimulating eryrthropoiesis in fetal liver by activating the expression of erythropoietin. In adults, RA signaling regulates differentiation of granulocytes and enhances erythropoiesis. Vitamin A may facilitate iron absorption and metabolism to prevent anemia and plays a key role in mucosal immune responses, modulating the function of regulatory T cells. Furthermore, defective RA/RARα signaling is involved in the pathogenesis of acute promyelocytic leukemia due to a failure in differentiation of promyelocytes. This review focuses on the different roles played by vitamin A/RA signaling in physiological and pathological mouse hematopoiesis duddurring both, embryonic and adult life, and the consequences of vitamin A deficiency for the blood system. Full article

Grain foods may play an important role in delivering nutrients to the diet of children and adolescents. The present study determined grain food sources of energy/nutrients in U.S. children and adolescents using data from the National Health and Nutrition Examination Survey, 2009–2012. Analyses of grain food sources were conducted using a 24-h recall in participants 2–18 years old (N = 6109). Sources of nutrients contained in grain foods were determined using U.S. Department of Agriculture nutrient composition databases and excluded mixed dishes. Mean energy and nutrient intakes from the total diet and from various grain foods were adjusted for the sample design using appropriate weights. All grains provided 14% ± 0.2% kcal/day (263 ± 5 kcal/day), 22.5% ± 0.3% (3 ± 0.1 g/day) dietary fiber, 39.3% ± 0.5% (238 ± 7 dietary folate equivalents (DFE)/day) folate and 34.9% ± 0.5% (5.6 ± 0.1 mg/day) iron in the total diet in children and adolescents. The current analyses showed that certain grain foods, in particular breads, rolls and tortillas, ready-to-eat cereals and quick breads and bread products, are meaningful contributors of folate, iron, thiamin, niacin and dietary fiber, a nutrient of public health concern as outlined by the 2015–2020 Dietary Guidelines for Americans. Thus, specific grain foods contribute to nutrient density and have the potential to increase the consumption of several under-consumed nutrients in children and adolescents. Full article

Symptomatic uncomplicated diverticular disease (SUDD) is a syndrome characterized by recurrent abdominal symptoms in patients with colonic diverticula. There is some evidence that a high-fiber diet or supplemental fibers may reduce symptoms in SUDD patients and a high-fiber diet is commonly suggested for these patients. This systematic review aims to update the evidence on the efficacy of fiber treatment in SUDD, in terms of a reduction in symptoms and the prevention of acute diverticulitis. According to PRISMA, we identified studies on SUDD patients treated with fibers (PubMed and Scopus). The quality of these studies was evaluated by the Jadad scale. The main outcome measures were a reduction of abdominal symptoms and the prevention of acute diverticulitis. Nineteen studies were included, nine with dietary fiber and 10 with supplemental fiber, with a high heterogeneity concerning the quantity and quality of fibers employed. Single studies suggest that fibers, both dietary and supplemental, could be beneficial in SUDD, even if the quality is very low, with just one study yielding an optimal score. The presence of substantial methodological limitations, the heterogeneity of the therapeutic regimens employed, and the lack of ad hoc designed studies, did not permit a summary of the outcome measure. Thus, the benefit of dietary or supplemental fiber in SUDD patients still needs to be established. Full article

Dietary changes needed to achieve nutritional adequacy for 33 nutrients were determined for 1719 adults from a representative French national dietary survey. For each individual, an iso-energy nutritionally adequate diet was generated using diet modeling, staying as close as possible to the observed diet. The French food composition table was completed with free sugar (FS) content. Results were analyzed separately for individuals with FS intakes in their observed diets ≤10% or >10% of their energy intake (named below FS-ACCEPTABLE and FS-EXCESS, respectively). The FS-EXCESS group represented 41% of the total population (average energy intake of 14.2% from FS). Compared with FS-ACCEPTABLE individuals, FS-EXCESS individuals had diets of lower nutritional quality and consumed more energy (2192 vs. 2123 kcal/day), particularly during snacking occasions (258 vs. 131 kcal/day) (all p-values < 0.01). In order to meet nutritional targets, for both FS-ACCEPTABLE and FS-EXCESS individuals, the main dietary changes in optimized diets were significant increases in fresh fruits, starchy foods, water, hot beverages and plain yogurts; and significant decreases in mixed dishes/sandwiches, meat/eggs/fish and cheese. For FS-EXCESS individuals only, the optimization process significantly increased vegetables and significantly decreased sugar-sweetened beverages, sweet products and fruit juices. The diets of French adults with excessive intakes of FS are of lower nutritional quality, but can be optimized via specific dietary changes. Full article

With recent insight into the development of dietary supplements and functional foods, search of effective phytochemical compounds and their mechanisms involved in prevention and management of diabetes and its complications are now being assessed. Cinnamic acid and its derivatives occur naturally in high levels of plant-based foods. Among various biological activities, cinnamic acid and its derivatives are associated with a beneficial influence on diabetes and its complications. The aim of the review is to summarize the potential mechanisms of these compounds for prevention and management of diabetes and its complications. Based on several in vitro studies and animal models, cinnamic acid and its derivatives act on different mechanism of actions, including stimulation of insulin secretion, improvement of pancreatic β-cell functionality, inhibition of hepatic gluconeogenesis, enhanced glucose uptake, increased insulin signaling pathway, delay of carbohydrate digestion and glucose absorption, and inhibition of protein glycation and insulin fibrillation. However, due to the limited intestinal absorption being a result of low bioavailability of cinnamic acid and its derivatives, current improvement efforts with entrapping into solid and liquid particles are highlighted. Further human clinical studies are needed to clarify the effects of cinnamic acid and its derivatives in diabetic patients. Full article

This paper aims to compare the metabolic effects of glucose-fructose co-ingestion (GLUFRU) with glucose alone (GLU) in exercising individuals with type 1 diabetes mellitus. Fifteen male individuals with type 1 diabetes (HbA1c 7.0% ± 0.6% (53 ± 7 mmol/mol)) underwent a 90 min iso-energetic continuous cycling session at 50% VO_2max while ingesting combined glucose-fructose (GLUFRU) or glucose alone (GLU) to maintain stable glycaemia without insulin adjustment. GLUFRU and GLU were labelled with ¹³C-fructose and ¹³C-glucose, respectively. Metabolic assessments included measurements of hormones and metabolites, substrate oxidation, and stable isotopes. Exogenous carbohydrate requirements to maintain stable glycaemia were comparable between GLUFRU and GLU (p = 0.46). Fat oxidation was significantly higher (5.2 ± 0.2 vs. 2.6 ± 1.2 mg·kg⁻¹·min⁻¹, p < 0.001) and carbohydrate oxidation lower (18.1 ± 0.8 vs. 24.5 ± 0.8 mg·kg⁻¹·min⁻¹ p < 0.001) in GLUFRU compared to GLU, with decreased muscle glycogen oxidation in GLUFRU (10.2 ± 0.9 vs. 17.5 ± 1.0 mg·kg⁻¹·min⁻¹, p < 0.001). Lactate levels were higher (2.2 ± 0.2 vs. 1.8 ± 0.1 mmol/L, p = 0.012) in GLUFRU, with comparable counter-regulatory hormones between GLUFRU and GLU (p > 0.05 for all). Glucose and insulin levels, and total glucose appearance and disappearance were comparable between interventions. Glucose-fructose co-ingestion may have a beneficial impact on fuel metabolism in exercising individuals with type 1 diabetes without insulin adjustment, by increasing fat oxidation whilst sparing glycogen. Full article

Chlorogenic acid (CHA) and caffeic acid (CA) are phenolic compounds found in coffee, which inhibit oxidative stress-induced interleukin (IL)-8 production in intestinal epithelial cells, thereby suppressing serious cellular injury and inflammatory intestinal diseases. Therefore, we investigated the anti-inflammatory mechanism of CHA and CA, both of which inhibited hydrogen peroxide (H₂O₂)-induced IL-8 transcriptional activity. They also significantly suppressed nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) transcriptional activity, nuclear translocation of the p65 subunit, and phosphorylation of IκB kinase (IKK). Additionally, upstream of IKK, protein kinase D (PKD) was also suppressed. Finally, we found that they scavenged H₂O₂-induced reactive oxygen species (ROS) and the functional moiety responsible for the anti-inflammatory effects of CHA and CA was the catechol group. Therefore, we conclude that the presence of catechol groups in CHA and CA allows scavenging of intracellular ROS, thereby inhibiting H₂O₂-induced IL-8 production via suppression of PKD-NF-κB signaling in human intestinal epithelial cells. Full article

Cisplatin is a potent chemotherapeutic agent, but its clinical usage is limited by nephrotoxicity. S‐allylmercaptocysteine (SAMC), one of the water‐soluble organosulfur garlic derivatives, has antioxidant and anti‐inflammatory properties and plays an important role in protecting cells from apoptosis. This study aims to examine the protective effects of SAMC on cisplatin nephrotoxicity and to explore the mechanism of its renoprotection. Rats were treated with cisplatin with or without pre‐treatment with SAMC. Renal function, histological change, oxidative stress markers and antioxidant enzyme activities were investigated. Apoptotic marker, nuclearfactor (NF)‐κB activity, expression of nuclear factor erythroid 2‐related factor 2 (Nrf2), NAD(P)H:quinone oxidoreductase 1 (NQO1) and inflammatory cytokines were also examined. The effect of SAMC on cell viability and apoptosis was examined in cultured human kidney (HK‐2) cells. SAMC was confirmed to significantly attenuate cisplatin‐induced renal damage by using histological pathology and molecular biological method. Pre‐treatment with SAMC reduced NF‐κB activity, up‐regulated Nrf2 and NQO1 expression and down‐regulated inflammatory cytokine levels after cisplatin administration. Cisplatin‐induced apoptosis in HK‐2 cells was significantly attenuated by SAMC. Thus our results suggest that SAMC could be a potential therapeutic agent in the treatment of the cisplatin‐induced nephrotoxicity through its anti‐apoptotic, anti‐oxidant and anti‐inflammatory effects. Full article

Peak exogenous carbohydrate oxidation rates typically reach ~1 g∙min−1 during exercise when ample glucose or glucose polymers are ingested. Fructose co‐ingestion has been shown to further increase exogenous carbohydrate oxidation rates. The purpose of this study was to assess the impact of fructose co‐ingestion provided either as a monosaccharide or as part of the disaccharide sucrose on exogenous carbohydrate oxidation rates during prolonged exercise in trained cyclists. Ten trained male cyclists (VO2peak: 65 ± 2 mL∙kg−1∙min−1) cycled on four different occasions for 180 min at 50% Wmax during which they consumed a carbohydrate solution providing 1.8 g∙min−1 of glucose (GLU), 1.2 g∙min−1 glucose + 0.6 g∙min−1 fructose (GLU + FRU), 0.6 g∙min−1 glucose + 1.2 g∙min−1 sucrose (GLU + SUC), or water (WAT). Peak exogenous carbohydrate oxidation rates did not differ between GLU + FRU and GLU + SUC (1.40 ± 0.06 vs. 1.29 ± 0.07 g∙min−1, respectively, p = 0.999), but were 46% ± 8% higher when compared to GLU (0.96 ± 0.06 g∙min−1: p < 0.05). In line, exogenous carbohydrate oxidation rates during the latter 120 min of exercise were 46% ± 8% higher in GLU + FRU or GLU + SUC compared with GLU (1.19 ± 0.12, 1.13 ± 0.21, and 0.82 ± 0.16 g∙min−1, respectively, p < 0.05). We conclude that fructose co‐ingestion (0.6 g∙min−1) with glucose (1.2 g∙min−1) provided either as a monosaccharide or as sucrose strongly increases exogenous carbohydrate oxidation rates during prolonged exercise in trained cyclists. Full article

Calcium, phosphorus, magnesium and vitamin D have important biological roles in the body, especially in bone metabolism. We aimed to study the reported intake, the disparity between the reported consumption and the level needed for adequacy and food sources of these four nutrients in the Spanish population. We assessed the reported intake for both, general population and plausible reporters. Results were extracted from the ANIBES survey, n = 2009. Three-day dietary reported intake data were obtained and misreporting was assessed according to the European Food Safety Authority (EFSA). Mean ± SEM (range) total reported consumption of calcium, phosphorus, magnesium, and vitamin D for the whole population were 698 ± 7 mg/day (71–2551 mg/day), 1176 ± 8 mg/day, (331–4429 mg/day), 222 ± 2 mg/day (73–782 mg/day), and 4.4 ± 0.1 µg/day (0.0–74.2 µg/day), respectively. In the whole group, 76% and 66%; 79% and 72%; and 94% and 93% of the population had reported intakes below 80% of the national and European recommended daily intakes for calcium, magnesium and vitamin D, respectively; these percentages were over 40% when the plausible reporters were analysed separately. The main food sources were milk and dairy products for calcium and phosphorus, cereals and grains for magnesium and fish for vitamin D. In conclusion, there is an important percentage of the Spanish ANIBES population not meeting the recommended intakes for calcium, magnesium and vitamin D. Full article

In Mexico, infants (0–2 years old) show the highest prevalence of vitamin A deficiency (VAD), measured by serum retinol concentrations. Thus, we consider that low vitamin A (VA) intake through breast milk (BM) combined with poor weaning practices are the main factors that contribute to VAD in this group. We combined the assessment of VA status in lactating women using BM retinol and a stable isotope ‘dose-to-mother’ technique to measure BM production in women from urban and agricultural areas. Infants’ mean BM intake was 758 ± 185 mL, and no difference was observed between both areas (p = 0.067). Mean BM retinol concentration was 1.09 μmol/L, which was significantly lower for the agricultural area (p = 0.028). Based on BM retinol concentration, 57% of women were VAD; although this prevalence fell to 16% when based on fat content. Regardless of the VA biomarker used here, infants from the urban and agricultural areas cover only 66% and 49% of their dietary adequate intake from BM, respectively (p = 0.054). Our data indicate that VAD is still a public health concern in Mexico. Adopting both methods to assess VA transfer from the mother to the breastfed child offers an innovative approach towards the nutritional assessment of vulnerable groups. Full article

Calcium is an important nutrient for child development. The main objective of this study was to assess calcium intake and its adequacy with dietary reference intake (DRI) in Spanish children. The ANIVA (Antropometría y Nutrición Infantil de Valencia) study is a descriptive cross-sectional study. During two academic years 2013–2014 and 2014–2015, 1176 schoolchildren aged 6–9 years were selected from 14 primary schools in Valencia (Spain). Three-day food records were used to assess dietary intake, completed by parents/guardian. Anthropometric data (weight and height) were evaluated in all subjects. Nutritional intake was compared to estimated average requirements (EARs) and adequate intake (AI) values to determine nutritional adequacy. A percentage of 25.77% had inadequate calcium intake, and a significantly higher prevalence was observed in girls (p = 0.006). Adequate calcium intake showed a positive association with the height z-score (p = 0.032). When assessing dietary patterns, schoolchildren with adequate calcium intakes had better nutritional adequacy in all nutrients, except cholesterol (p = 0.086) and fluorine (p = 0.503). These results suggest a public health problem that must be addressed through nutrition education programs to increase intake of calcium-rich food and to correct the associated dietary pattern. Full article

Background: Gal d 1 (ovomucoid) is the dominant allergen in the chicken egg white. Hypoallergenic variants of this allergen can be used in immunotherapy as an egg allergy treatment approach. We hypothesised that disruption of two of the nine cysteine-cysteine bridges by site-directed mutagenesis will allow the production of a hypoallergenic variant of the protein; Methods: Two cysteine residues at C192 and C210 in domain III of the protein were mutated to alanine using site-directed mutagenesis, to disrupt two separate cysteine-cysteine bridges. The mutated and non-mutated proteins were expressed in Escherichia coli (E. coli) by induction with isopropyl β-d-1-thiogalactopyranoside (IPTG). The expressed proteins were analysed using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting to confirm expression. Immunoglobulin E (IgE) reactivity of the two proteins was analysed, by immunoblotting, against a pool of egg-allergic patients’ sera. A pool of non-allergic patients’ sera was also used in a separate blot as a negative control; Results: Mutant Gal d 1 showed diminished IgE reactivity in the immunoblot by showing lighter bands when compared to the non-mutated version, although there was more of the mutant protein immobilised on the membrane when compared to the wild-type protein. The non-allergic negative control showed no bands, indicating an absence of non-specific binding of secondary antibody to the proteins; Conclusion: Disruption of two cysteine bridges in domain III of Gal d 1 reduces IgE reactivity. Following downstream laboratory and clinical testing, this mutant protein can be used in immunotherapy to induce tolerance to Gal d 1 and in egg allergy diagnosis. Full article

This study sought to develop and validate a general nutrition knowledge questionnaire (GNKQ) for Ugandan adults. The initial draft consisted of 133 items on five constructs associated with nutrition knowledge; expert recommendations (16 items), food groups (70 items), selecting food (10 items), nutrition and disease relationship (23 items), and food fortification in Uganda (14 items). The questionnaire validity was evaluated in three studies. For the content validity (study 1), a panel of five content matter nutrition experts reviewed the GNKQ draft before and after face validity. For the face validity (study 2), head teachers and health workers (n = 27) completed the questionnaire before attending one of three focus groups to review the clarity of the items. For the construct and test-rest reliability (study 3), head teachers (n = 40) from private and public primary schools and nutrition (n = 52) and engineering (n = 49) students from Makerere University took the questionnaire twice (two weeks apart). Experts agreed (content validity index, CVI > 0.9; reliability, Gwet’s AC1 > 0.85) that all constructs were relevant to evaluate nutrition knowledge. After the focus groups, 29 items were identified as unclear, requiring major (n = 5) and minor (n = 24) reviews. The final questionnaire had acceptable internal consistency (Cronbach α > 0.95), test-retest reliability (r = 0.89), and differentiated (p < 0.001) nutrition knowledge scores between nutrition (67 ± 5) and engineering (39 ± 11) students. Only the construct on nutrition recommendations was unreliable (Cronbach α = 0.51, test-retest r = 0.55), which requires further optimization. The final questionnaire included topics on food groups (41 items), selecting food (2 items), nutrition and disease relationship (14 items), and food fortification in Uganda (22 items) and had good content, construct, and test-retest reliability to evaluate nutrition knowledge among Ugandan adults. Full article

This study was designed to determine if providing wheat, corn, and rice as whole (WG) or refined grains (RG) under free-living conditions will change parameters of health over a six-week intervention in healthy, habitual non-WG consumers. Measurements of body composition, fecal microbiota, fasting blood glucose, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and triglycerides were made at baseline and post intervention. Subjects were given adequate servings of either WG or RG products based on their caloric need and asked to keep records of grain consumption, bowel movements, and GI symptoms weekly. After six weeks, subjects repeated baseline testing. Significant decreases in total, LDL, and non-HDL cholesterol were seen after the WG treatments but were not observed in the RG treatment. During Week 6, bowel movement frequency increased with increased WG consumption. No significant differences in microbiota were seen between baseline and post intervention, although, abundance of order Erysipelotrichales increased in RG subjects who ate more than 50% of the RG market basket products. Increasing consumption of WGs can alter parameters of health, but more research is needed to better elucidate the relationship between the amount consumed and the health-related outcome. Full article

Background: Folic acid supplementation is effective in reducing the risk of neural tube defects (NTDs). However, the use of folic acid is low among rural women in China. Nutrition education can provide information about folic acid and encourage its use. The primary objective of this study was to test the effectiveness of a village‐based nutrition intervention on folic acid use among rural women. Methods: Sixty villages were randomly selected using multiple‐stage sampling and were divided into control and intervention groups. The intervention included nutritional education at village clinics, written materials, and text messages (SMS). Folic acid use knowledge and behavior was assessed at baseline and after the intervention. Results: Self‐reported compliance with folic acid supplement use increased from 17.0%–29.2% at baseline to 41.7%-59.2% one year post‐intervention. During the same period, the folic acid knowledge score in the intervention group increased from 3.07 to 3.65, significantly higher than the control group (3.11 to 3.35). Multivariate binary logistic regression showed that the women who received folic acid education and SMS intervention were more likely to comply with folic acid supplement recommendations. Conclusions: The results indicated that an integrated village‐based folic acid education intervention may be an effective way of promoting folic acid use for the prevention of NTDs in rural women. Full article