European Journal of Nutrition (v.54, #3)

Interaction of dietary compounds, especially polyphenols, with the intestinal microbiota: a review by Aleksandra Duda-Chodak; Tomasz Tarko; Paweł Satora; Paweł Sroka (325-341).
The intestinal microbiome plays an important role in the metabolism of chemical compounds found within food. Bacterial metabolites are different from those that can be generated by human enzymes because bacterial processes occur under anaerobic conditions and are based mainly on reactions of reduction and/or hydrolysis. In most cases, bacterial metabolism reduces the activity of dietary compounds; however, sometimes a specific product of bacterial transformation exhibits enhanced properties. Studies on the metabolism of polyphenols by the intestinal microbiota are crucial for understanding the role of these compounds and their impact on our health. This review article presents possible pathways of polyphenol metabolism by intestinal bacteria and describes the diet-derived bioactive metabolites produced by gut microbiota, with a particular emphasis on polyphenols and their potential impact on human health. Because the etiology of many diseases is largely correlated with the intestinal microbiome, a balance between the host immune system and the commensal gut microbiota is crucial for maintaining health. Diet-related and age-related changes in the human intestinal microbiome and their consequences are summarized in the paper.
Keywords: Bioactive metabolites; Bioavailability; Biotransformation; Digestion; Dysbiosis; Health impact

Comparison of two dietary assessment methods by food consumption: results of the German National Nutrition Survey II by Marianne Eisinger-Watzl; Andrea Straßburg; Josa Ramünke; Carolin Krems; Thorsten Heuer; Ingrid Hoffmann (343-354).
To further characterise the performance of the diet history method and the 24-h recalls method, both in an updated version, a comparison was conducted.The National Nutrition Survey II, representative for Germany, assessed food consumption with both methods. The comparison was conducted in a sample of 9,968 participants aged 14–80. Besides calculating mean differences, statistical agreement measurements encompass Spearman and intraclass correlation coefficients, ranking participants in quartiles and the Bland–Altman method.Mean consumption of 12 out of 18 food groups was higher assessed with the diet history method. Three of these 12 food groups had a medium to large effect size (e.g. raw vegetables) and seven showed at least a small strength while there was basically no difference for coffee/tea or ice cream. Intraclass correlations were strong only for beverages (>0.50) and revealed the least correlation for vegetables (<0.20). Quartile classification of participants exhibited more than two-thirds being ranked in the same or adjacent quartile assessed by both methods. For every food group, Bland–Altman plots showed that the agreement of both methods weakened with increasing consumption.The cognitive effort essential for the diet history method to remember consumption of the past 4 weeks may be a source of inaccurateness, especially for inhomogeneous food groups. Additionally, social desirability gains significance. There is no assessment method without errors and attention to specific food groups is a critical issue with every method. Altogether, the 24-h recalls method applied in the presented study, offers advantages approximating food consumption as compared to the diet history method.
Keywords: Diet history method; 24-h recalls; Food consumption; German National Nutrition Survey

Probiotics during weaning: a follow-up study on effects on body composition and metabolic markers at school age by Frida Karlsson Videhult; Inger Öhlund; Hans Stenlund; Olle Hernell; Christina E. West (355-363).
An aberrant gut microbiome has been suggested to contribute to the worldwide epidemic of obesity. In animal models, the probiotic Lactobacillus paracasei ssp. paracasei F19 (LF19) induced upregulation of genes involved in energy homoeostasis, reduced body fat and altered the serum (S) lipoprotein profile. In our previous report, feeding LF19 to infants during weaning impacted the global plasma metabolome. LF19 lowered palmitoleic acid, a monounsaturated fatty acid associated with hypertriglyceridemia and increased visceral adiposity. Therefore, we assessed if feeding LF19 from 4 to 13 months of age would have long-term effects on body composition, growth and metabolic markers.Of 179 children included in our baseline study, 120 entered the follow-up at 8–9 years of age, n = 58 in the probiotic and n = 62 in the placebo group. Body composition was measured using dual energy X-ray absorptiometry. Anthropometrics of the child and accompanying parent(s) were assessed. S-lipids, insulin, glucose and transaminases were determined after overnight fasting.LF19 did not affect body mass index z-score, sagittal abdominal diameter, fat-free mass, fat mass index, truncal fat %, android or gynoid fat % and had no long-term impact on any of the assessed metabolic markers (p > 0.05).Feeding LF19 during infancy did not modulate body composition, growth or any of the assessed metabolic markers at school age. The steady increase in probiotic products targeting infants and children calls for long-term follow-up of initiated probiotic intervention studies.
Keywords: Probiotic; Lactobacillus paracasei ssp. paracasei F19; Overweight; Long-term effects; Children

Association between different obesity measures and the risk of stroke in the EPIC Spanish cohort by Itziar Abete; Larraitz Arriola; Nerea Etxezarreta; Imanol Mozo; Conchi Moreno-Iribas; Pilar Amiano; Nerea Egüés; Estibaliz Goyenechea; Adolfo Lopez de Munain; Maite Martinez; Noemi Travier; Carmen Navarro; Maria-Dolores Chirlaque; Maria-Jose Tormo; Diana Gavrila; Jose Maria Huerta; María-José Sánchez; Esther Molina-Montes; Mar Requena; Maria-Dolores Jiménez-Hernández; Eva Ardanaz; Aurelio Barricarte; Jose Ramon Quiros; Laudina Rodriguez; Miren Dorronsoro (365-375).
There is still a scientific debate on the exact role played by obesity on stroke risk.The aim of the study was to analyze the association between obesity, measured by different indices such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and a new one called A Body Shape Index (ABSI) and the risk of total and ischemic stroke.A total of 41,020 subjects (15,490 men and 25,530 women) aged 29–69 years participated in the study. All participants were recruited between 1992 and 1996 and followed up until 2008 to ascertain incident cerebrovascular disease events. Cox proportional hazards models were designed to estimate the relative risk and 95 % CI between obesity and cerebrovascular disease incidence.After 13.8 years of follow-up, a total of 674 stroke cases (55.3 % in men) were registered (531 ischemic, 79 hemorrhagic, 42 subarachnoid hemorrhage and 22 unspecified). WC fourth quartile (HR 1.95; 95 % CI 1.20–3.19) and WHR fourth quartile (HR 1.58; 95 % CI 1.12–2.25) were positively associated with total stroke only in men. BMI was not associated with stroke incidence. The new index, ABSI, was significantly associated with total stroke incidence only in men (HR 1.54; 95 % CI 1.06–2.23).Data from the Spanish EPIC cohort study show a strong association of WC and WHR with the relative risk of suffering a stroke only in men, while no associations were found for BMI. It supports the suggestion of other authors of using more than one obesity index in the study of stroke risk prediction.
Keywords: Obesity; BMI; Waist circumference; Waist-to-hip ratio; Stroke incidence; Cardiovascular diseases

Pomegranate and green tea extracts protect against ER stress induced by a high-fat diet in skeletal muscle of mice by Julie Rodriguez; Hélène Gilson; Cécile Jamart; Damien Naslain; Nicolas Pierre; Louise Deldicque; Marc Francaux (377-389).
We tested the hypothesis that polyphenol-rich extracts can reduce endoplasmic reticulum (ER) stress induced by a high-fat diet (HFD) in skeletal muscle of mice.Mice were randomly assigned to four groups receiving during 20 weeks either a standard chow control (CTRL), or a HFD supplemented, or not, with pomegranate (HFD + P) or green tea (HFD + GT) extracts. After the nutritional intervention, mice were killed and gastrocnemius muscles were taken. Proteins and mRNA were measured by Western blot and RT-qPCR, respectively.Body weight gain and visceral fat were higher in HFD, HFD + P and HFD + GT than in CTRL. The markers of the unfolded protein response BiP, XBP1u, XBP1s and ATF4 were higher only in HFD. In HFD + P and HFD + GT, this increase was not observed except for CHOP, which was elevated in all HFD groups. HFD increased also markers of ubiquitin–proteasome pathway, autophagy and oxidative stress, which were kept low in HFD + P and HFD + GT groups.Our data provide evidence for a protective effect of pomegranate and green tea extracts against ER stress, oxidative stress and protein degradation induced by HFD in skeletal muscle. They give arguments for a usefulness of these natural nutritional compounds to fight against cellular dysfunctions related to fat excess.
Keywords: High-fat diet; Unfolded protein response; Polyphenols; Protein degradation; Oxidative stress

Effect of fat on serum 25-hydroxyvitamin D levels after a single oral dose of vitamin D in young healthy adults: a double-blind randomized placebo-controlled study by Fabiana Viegas Raimundo; Maria Augusta Britto Lang; Luciano Scopel; Natália Aydos Marcondes; Mirna Griselda Anocibar Araújo; Gustavo Adolpho Moreira Faulhaber; Tania Weber Furlanetto (391-396).
This double-blind placebo-controlled trial evaluated serum 25-hydroxyvitamin D [25(OH)D] levels after the oral intake of a single dose of cholecalciferol during one of the three meals, containing different amounts of fat or placebo.Sixty-four healthy medical residents or students of a university hospital in Porto Alegre, latitude 30°S, Brazil, were divided into four groups. Three groups received a single 50,000 IU oral dose of cholecalciferol during a meal containing 0 g (Group 1), 15 g (Group 2) or 30 g (Group 3) of fat, and one group received placebo (Group 4), according to randomization. Serum 25(OH)D, parathyroid hormone, total calcium, albumin, magnesium, and creatinine levels, and urinary calcium, magnesium, and creatinine levels were measured at baseline and after 14 days. Baseline mean serum 25(OH)D levels were low in all groups. Vitamin D given during breakfast increased the mean change of serum 25(OH)D levels, when compared to placebo. Furthermore, the intake of fat with vitamin D increased the mean change of serum 25(OH)D levels.A single oral dose of vitamin D given with food increased mean serum 25(OH)D levels, after 2 weeks, and the mean increase was larger, when the meal had at least 15 g of fat. These findings can have important implications to oral vitamin D supplementation.
Keywords: 25-Hydroxyvitamin D; Bioavailability; Cholecalciferol; Dietary supplements; Vitamin D

We have previously shown that quercetin modulates the proinflammatory effect of β-carotene (BC) induced by oral benzo[a]pyren (Bap) partly through the regulation of the JNK pathway. In the present study, we determined whether the combination of BC and quercetin regulates the antioxidant enzymes and the activation of NF-κB in Mongolian gerbils exposed to Bap. We also compared the combined effects of BC+ quercetin with that of BC+ ascorbic acid (C)+ α-tocopherol (E).The gerbils were given BC (10 mg/kg) alone or in combination with quercetin (50 or 100 mg/kg) or C (13 mg/kg)+E (92 mg/kg) by gavage 3 times/week for 6 months. During the first 2 months, the gerbils were exposed to Bap by intratracheal instillation once/week. The levels of proinflammatory cytokines, thiobarbituric acid reactive substances, antioxidant enzymes and NF-κB activation in the plasma or the lungs were determined.Bap increased the level of proinflammatory cytokines and oxidative stress in the plasma or lungs, while it decreased the antioxidant systems. Bap also increased nuclear NF-κB levels in the lungs. BC partly recovered the Bap-induced decrease in antioxidant activity, antioxidant enzyme activities and glutathione levels but had no effect on proinflammatory cytokines and NF-κB translocation. BC in combination with quercetin or C+E suppressed all the harmful effects induced by Bap. All the effects of quercetin at 100 mg/kg were similar to the effect of C+E.BC in combination with quercetin or C+E rather than BC alone similarly suppresses the Bap-induced inflammatory reaction that was accompanied by the regulation of antioxidant enzymes and the translocation of NF-κB in vivo.
Keywords: Quercetin; β-Carotene; Benzo[a]pyrene; Mongolian gerbil

The present study analyzes the effect of the replacement of dietary casein by soy protein on the mechanisms underlying dyslipidemia, liver steatosis and altered glucose and lipid metabolism in the skeletal muscle which developed in rats fed long-term a sucrose-rich diet (SRD).Wistar rats were fed a SRD for 4 months. From months 4 to 8, half the animals continued with the SRD, and the other half were fed a SRD in which the source of protein casein was replaced by soy. The control group received a diet with cornstarch as source of carbohydrate.Compared to SRD-fed animals, the rats fed soy showed: A—in the liver: reduction of triglyceride and cholesterol storage and decreased steatosis; normalization of mature forms of the protein mass levels of SREBP-1 and the activities of lipogenic enzymes, while the protein mass level of PPAR-α and fatty acid oxidase activity increased. B—in the gastrocnemius muscle: normalization of the enhanced lipid storage and the altered glucose oxidation, improving glucose phosphorylation; decreasing protein mass level of nPKCθ in the membrane fraction; reversion of the impaired insulin-stimulated glucose transporter Glut-4, and glucose-6-phosphate and glycogen concentrations. Besides, dyslipidemia and glucose homeostasis returned to control values.This study provides new information concerning some key mechanisms related to the effect of dietary soy on hepatic lipid metabolism and insulin action in the skeletal muscle in the presence of pre-existing dyslipidemia and insulin resistance induced by a SRD.
Keywords: Soy protein; Liver; Skeletal muscle; Dyslipidemia; Insulin resistance

Adherence to the DASH diet and prevalence of the metabolic syndrome among Iranian women by Parvane Saneei; Ebrahim Fallahi; Farzaneh Barak; Negar Ghasemifard; Ammar Hassanzadeh Keshteli; Ahmad Reza Yazdannik; Ahmad Esmaillzadeh (421-428).
Epidemiologic data linking adherence to the dietary approaches to stop hypertension (DASH) diet and metabolic abnormalities is sparse and inconsistent. The association between habitual intake of the DASH diet and metabolic syndrome (MetS) has not been investigated in the Middle East. We aimed to determine whether usual adherence to the DASH dietary pattern was associated with MetS in a group of Iranian women.This cross-sectional study was conducted in 2012 among a representative sample of Isfahani female nurses. A validated, dish-based semiquantitative food frequency questionnaire was used for assessing usual dietary intakes. The DASH score was constructed based on 8 main foods and nutrients emphasized or minimized in the DASH diet. The MetS was defined according to the Joint Scientific Statement.After controlling for potential confounders, individuals in the highest tertile of the DASH diet score had 81 % lower odds of MetS than those in the lowest category (OR 0.19; 95 % CI 0.07–0.96). Further, adjustment for body mass index slightly weakened the association (OR 0.37; 95 % CI 0.14–0.91). Participants with the greater adherence to the DASH diet were 54, 73, 78, and 80 % less likely to have enlarged waist circumference, hyperglyceridemia, low HDL-C levels, and high blood pressure, respectively, compared with those in the lowest tertile. No significant association was seen between consumption of a DASH diet and abnormal fasting plasma glucose.Adherence to the DASH eating plan was inversely associated with the odds of MetS and most of its features among a group of Iranian women.
Keywords: DASH diet; Metabolic syndrome; Abdominal obesity; Iran

Folate administration decreases oxidative status and blood pressure in postmenopausal women by Angelo Cagnacci; Marianna Cannoletta; Anjeza Xholli; Ilaria Piacenti; Federica Palma; Beniamino Palmieri (429-435).
The purpose of this study was to evaluate whether folate exerts antioxidant effects in postmenopausal women and whether this effect is related to folate-induced modification of 24-h ambulatory blood pressure (BP). Double-blind placebo-controlled study performed in 30 apparently healthy postmenopausal women recruited at the outpatient service of University Hospital. Women, free from hormones or substances possibly interfering with the investigated parameters, were randomized to receive orally for 3 weeks placebo (n = 15) or 15 mg/day of 5-methyltetrahydrofolate (5-MTHF; n = 15). Whole-blood free oxygen radicals test (FORT), free oxygen radical defence (FORD), lipids, glucose, insulin, insulin resistance [homeostatic model assessment for insulin resistance (HOMA-IR)], homocysteine and 24-h ambulatory BP values were evaluated. In the entire group of women, FORT was independently and inversely related to the day–night difference of diastolic (r = 0.420; p = 0.03) and mean BP (r = 0.497; p = 0.01). Placebo did not affect any biochemical or BP parameter. 5-MTHF reduced FORT (−71.5 ± 98.2; p = 0.02) and increased FORD (0.5 ± 0.9; p = 0.05), decreased insulin (p = 0.01), HOMA-IR (p = 0.0002) and homocysteine (p = 0.008). During 5-MTHF, night-time mean (p = 0.001) and diastolic BP (p = 0.002) decreased of about 5 mmHg and the day–night difference of mean (p = 0.001) and diastolic BP (p = 0.002) contemporaneously increased. FORT reduction was related to the amplification of the nocturnal decline of mean (0.697; p = 0.006) and diastolic BP (r = 0.777; p = 0.002) and to the amplification of the day–night difference of diastolic BP (r = 0.63; p = 0.015).Present data show a clear reduction of oxidative stress during 5-MTHF administration and a strong correlation between this decrease and the nocturnal decline of BP. The possible link between the two is worthy to be explored.
Keywords: Free radicals; Antioxidant; Blood pressure; Lipid; Insulin resistance; Cardiovascular risk

Comparison of two food record-based dietary assessment methods for a pan-European food consumption survey among infants, toddlers, and children using data quality indicators by Heinz Freisling; Marga C. Ocké; Corinne Casagrande; Geneviève Nicolas; Sandra P. Crispim; Maryse Niekerk; Jan van der Laan; Evelien de Boer; Stefanie Vandevijvere; Mieke de Maeyer; Jiri Ruprich; Marcela Dofkova; Inge Huybrechts; Ellen Trolle; Nadia Slimani (437-445).
We aimed (1) to describe and evaluate the “EPIC-Soft DataEntry” application developed as a user-friendly data entry tool for pan-European and national food consumption surveys among infants and children, and (2) to compare two food record-based dietary assessment methods in terms of food description and quantification using data quality indicators. EPIC-Soft DataEntry was used for both methods.Two pilot studies were performed in both Belgium and Czech Republic in a total of 376 children (3 months to 10 year olds): one using a consecutive 3-day food diary; and the second with two non-consecutive 1-day food diaries with data entry during a completion interview. The collected dietary data were compared between the two dietary assessment methods by country and by age groups: (i) <1 year; (ii) 1–3 years; (iii) >3–10 years.Overall, 70 % of the interviewers evaluated the work with EPIC-Soft DataEntry as easy. With both dietary assessment methods, an equally high proportion of specific food names (e.g., “yoghurt, strawberry”) were reported, where only between 5 and 15 % of foods were non-specified (e.g., “yoghurt, n.s.”). The two 1-day food diaries yielded a higher proportion of foods with detailed description. For example, in the age category of 1–3 year olds in Belgium, for 7 out of 16 systematic questions on food description (e.g., “preservation method,”) specific answers were significantly higher (all P < 0.03). The proportion of missing quantities of consumed foods was comparable between the two methods.The EPIC-Soft DataEntry application was positively evaluated by the majority of the interviewers. Two non-consecutive 1-day food diaries with data entry during a completion interview provide a more detailed description of consumed foods as compared with a 3-day food diary.
Keywords: Dietary assessment; EPIC-Soft (GloboDiet); Children; Infants; Data quality; Europe; Dietary surveys; Standardization

Independent positive association of plasma β-carotene concentrations with adiponectin among non-diabetic obese subjects by N. Ben Amara; F. Tourniaire; M. Maraninchi; N. Attia; M. J. Amiot-Carlin; D. Raccah; R. Valéro; J. F. Landrier; P. Darmon (447-454).
Many epidemiological studies find an inverse correlation between carotenoids intake or carotenoids plasma concentrations and body mass index (BMI), insulin resistance or metabolic syndrome in the general population. However, it is not clear whether these relationships occur in obese population.We conducted a cross-sectional study in 108 obese non-diabetic patients.There was an inverse correlation between plasma levels of pro-vitamin A carotenoids (α-carotene, β-carotene and β-cryptoxanthin) and both BMI and insulin resistance (estimated by the HOMA-IR). No correlation between plasma concentrations of lycopene or lutein/zeaxanthin and BMI or insulin resistance was found. The inverse association between the three pro-vitamin A carotenoids and HOMA-IR disappeared after adjustment for BMI and waist circumference. Interestingly, we identified a positive association between concentrations of β-carotene and adiponectin in plasma that was independent of sex, age, smoking status, BMI and waist circumference. To our knowledge, such association has never been described in obese patients.These results suggest the existence of a favourable effect of β-carotene on insulin sensitivity in obese individuals that could involve a positive regulation of adiponectin, either directly or via its pro-vitamin A activity. The demonstration of the potential benefits of β-carotene towards insulin sensitivity would open the way to dietary strategies to prevent metabolic syndrome.
Keywords: Carotenoids; Adiponectin; β-Carotene; Lycopene; HOMA-IR

We investigated whether daily supplementation with low-dose B vitamins in the healthy elderly population improves the Framingham risk score (FRS), a predictor of cardiovascular disease risk.Between 2007 and 2012, a double-blind randomized controlled trial was conducted in a rural area of North China. In all, 390 healthy participants aged 60–74 were randomly allocated to receive daily vitamin C (50 mg; control group) or vitamin C plus B vitamins (400 µg folic acid, 2 mg B6, and 10 µg B12; treatment group) for 12 months. FRSs were calculated for all 390 subjects.Folate and vitamin B12 plasma concentrations in the treatment group increased by 253 and 80 %, respectively, after 6 months, stopped increasing with continued supplementation after 12 months and returned to baseline levels 6 months after supplementation cessation. Compared with the control group, there was no significant effect of B vitamin supplementation on FRSs after 6 months (mean difference −0.38; 95 % CI −1.06, 0.31; p = 0.279), whereas a significant effect of supplementation was evident after 12 months (reduced magnitude 7.6 %; −0.77; 95 % CI −1.47, −0.06; p = 0.033). However, this reduction disappeared 6 months after supplementation stopped (−0.07; 95 % CI −0.80, 0.66; p = 0.855). The reduction in FRS 12 months after supplementation was more pronounced in individuals with a folate deficiency (10.4 %; −1.30; 95 % CI −2.54, −0.07; p = 0.039) than in those without (4.1 %; −0.38; 95 % CI −1.12, 0.36; p = 0.313). B vitamins increased high-density lipoprotein cholesterol by 3.4 % after 6 months (0.04; 95 % CI −0.02, 0.10; p = 0.155) and by 9.2 % after 12 months (0.11; 95 % CI 0.04, 0.18; p = 0.003). Compared with the control group, this change in magnitude decreased to 3.3 % (0.04; 95 % CI −0.02, 0.10; p = 0.194) 6 months after supplementation cessation.Daily supplementation with a low-dose of B vitamins for 12 months reduced FRS, particularly in healthy elderly subjects with a folate deficiency. These reduced effects declined after supplementation cessation, indicating a need for persistent supplementation to maintain the associated benefits.
Keywords: B vitamins; Cardiovascular disease risk; Framingham risk score; Prevention

Effect of acute beer ingestion on the liver: studies in female mice by Giridhar Kanuri; Sabine Wagnerberger; Marianne Landmann; Eva Prigl; Claus Hellerbrand; Stephan C. Bischoff; Ina Bergheim (465-474).
The aim of the present study was to assess whether the effects of acute consumption of stout or pilsner beer on the liver differ from those of plain ethanol in a mouse model.Seven-week-old female C57BL/6J mice received either ethanol, stout or pilsner beer (ethanol content: 6 g/kg body weight) or isocaloric maltodextrin solution. Plasma alanine transaminase, markers of steatosis, lipogenesis, activation of the toll-like receptor-4 signaling cascade as well as lipid peroxidation and fibrogenesis in the liver were measured 12 h after acute ethanol or beer intake.Acute alcohol ingestion caused a marked ~11-fold increase in hepatic triglyceride accumulation in comparison to controls, whereas in mice exposed to stout and pilsner beer, hepatic triglyceride levels were increased only by ~6.5- and ~4-fold, respectively. mRNA expression of sterol regulatory element-binding protein 1c and fatty acid synthase in the liver did not differ between alcohol and beer groups. In contrast, expression of myeloid differentiation primary response gene 88, inducible nitric oxide synthases, but also the concentrations of 4-hydroxynonenal protein adducts, nuclear factor κB and plasminogen activator inhibitor-1 were induced in livers of ethanol treated mice but not in those exposed to the two beers.Taken together, our results suggest that acute ingestion of beer and herein especially of pilsner beer is less harmful to the liver than the ingestion of plain ethanol.
Keywords: Alcohol; Beer; Female sex; iNOS; Liver

Dietary glycemic index, glycemic load and risk of age-related cataract extraction: a case–control study in Italy by Federica Turati; Maria Filomeno; Carlotta Galeone; Diego Serraino; Ettore Bidoli; Carlo La Vecchia (475-481).
Although a role of glycemic index (GI) and glycemic load (GL) in age-related cataract development is plausible, a few studies, all conducted in USA or Australia, provided results on this issue. The aim of the present study was to provide new original data from a Mediterranean population.We analyzed data from an Italian case–control study including 761 cases with cataract extraction and 1,522 hospital controls, frequency-matched with cases by center, sex, and age. Multivariate odds ratios (ORs) for GI and GL intakes were obtained from logistic regression models after allowance for major confounding factors, including non carbohydrate energy intake, smoking, and diabetes.The ORs of cataract extraction for the highest versus the lowest tertile were 1.20 (95 % confidence interval, CI 0.91–1.57) for GI and 1.57 (95 % CI 1.16–2.13) for GL, with a statistically significant trend in risk for GL (p < 0.01). Results were materially unchanged when diabetics were excluded from the analysis. No heterogeneity emerged across strata of sex, age, education, smoking habits and body mass index.The present study supports a positive association between dietary GL and the risk of cataract extraction, independently from diabetes, and a lack of association for GI.
Keywords: Case–control study; Cataract; Diet; Glycemic index; Glycemic load; Dietary carbohydrates

Effects of regular consumption of different forms of almonds and hazelnuts on acceptance and blood lipids by Siew Ling Tey; Conor Delahunty; Andrew Gray; Alexandra Chisholm; Rachel Clare Brown (483-487).
Regular nut consumption is inversely associated with cardiovascular disease risk. No study has compared the effects of regular consumption of different types and forms of nuts on acceptance, which is a crucial determinant of long-term compliance to consume nuts regularly.This study examined the effects of different types and forms of raw, unpeeled nuts on acceptance and the effects of nut consumption on blood lipids through a randomised crossover study with six dietary phases: 30 g/day of ground, sliced, or whole almonds or hazelnuts for 5 days each (n = 74). Acceptance (‘desire’ and ‘liking’) for nuts was measured daily using visual analogue scales. Blood lipids were measured at baseline and week 6.Acceptance was stable over all conditions, but there were differences between nut forms (ground < sliced < whole, P < 0.001 for both ‘desire’ and ‘liking’) with some nut type–nut form interactions. Compared with baseline, week 6 HDL-C was higher (0.06 mmol/L, 95 % CI 0.02–0.10, P = 0.002) while LDL-C and total-C:HDL-C ratio were lower (0.15 mmol/L, 95 % CI 0.06–0.25, P = 0.002 and 0.25, 95 % CI 0.07–0.43, P = 0.006).In conclusion, acceptance was stable for all combinations but was highest for whole nuts. Six weeks of nut consumption improved blood lipids.
Keywords: Nut; Almond; Hazelnut; Form; Acceptance; Cholesterol