European Journal of Nutrition (v.55, #2)

Controversies about sugars consumption: state of the science by James M. Rippe; Ascensión Marcos (11-16).
Few topics in nutrition generate more controversy and debate than the putative associations between added sugars and health. With this as background, a group of researchers in the area of sugars and health gathered at the European Nutrition Conference (FENS) in 2015 to discuss these controversies and provide evidence-based science. The purpose of the current article was to provide a brief summary of some of the highlights from each of the presenters and serve as an Introduction to the supplement which contains full articles based on their presentations.
Keywords: Sucrose; High-fructose corn syrup; Isoglucose

The potential impact on health of diets rich in free sugars, and particularly fructose, is of major concern. The focus of this review is the impact of these sugars on insulin resistance and obesity, and the associated risk of developing type 2 diabetes. Much of the concern is focussed on specific metabolic effects of fructose, which are argued to lead to increased fat deposition in the liver and skeletal muscle with subsequent insulin resistance and increased risk of diabetes. However, much of the evidence underpinning these arguments is based on animal studies involving very large intakes of the free sugars. Recent human studies, in the past 5 years, provide a rather different picture, with a clear dose response link between fructose intake and metabolic changes. In particular, the most marked effects are observed when a high sugars intake is accompanied by an excess energy intake. This does not mean that a high intake of free sugars does not have any detrimental impact on health, but rather that such an effect seems more likely to be a result of the high sugars intake increasing the chances of an excessive energy intake rather than it leading to a direct detrimental effect on metabolism.
Keywords: Sugars; Sucrose; Fructose; Glucose; HFCS; Insulin resistance; Diabetes mellitus

Fructose-containing sugars are a focus of attention as a public health target for their putative role in obesity and cardiometabolic disease including diabetes. The fructose moiety is singled out to be the primary driver for the harms of sugars due to its unique endocrine signal and pathophysiological role. However, this is only supported by ecological studies, animal models of overfeeding and select human intervention studies with supraphysiological doses or lack of control for energy. The highest level of evidence from systematic reviews and meta-analyses of controlled trials has not shown that fructose-containing sugars behave any differently from other forms of digestible carbohydrates. Fructose-containing sugars can only lead to weight gain and other unintended harms on cardiometabolic risk factors insofar as the excess calories they provide. Prospective cohort studies, which provide the strongest observational evidence, have shown an association between fructose-containing sugars and cardiometabolic risk including weight gain, cardiovascular disease outcomes and diabetes only when restricted to sugar-sweetened beverages and not for sugars from other sources. In fact, sugar-sweetened beverages are a marker of an unhealthy lifestyle and their drinkers consume more calories, exercise less, smoke more and have a poor dietary pattern. The potential for overconsumption of sugars in the form of sugary foods and drinks makes targeting sugars, as a source of excess calories, a prudent strategy. However, sugar content should not be the sole determinant of a healthy diet. There are many other factors in the diet—some providing excess calories while others provide beneficial nutrients. Rather than just focusing on one energy source, we should consider the whole diet for health benefits.
Keywords: Sugars; Fructose; Obesity; Overweight; Diabetes; Cardiovascular disease; Review

The relationship between sugar consumption and various health-related sequelas is controversial. Some investigators have argued that excessive sugar consumption is associated with increased risk of obesity, coronary heart disease, diabetes (T2D), metabolic syndrome, non-alcoholic fatty liver disease, and stimulation of reward pathways in the brain potentially causing excessive caloric consumption. These concerns have influenced organizations such as the World Health Organization, the Scientific Advisory Committee on Nutrition in England not to exceed 5 % of total energy and the Dietary Guidelines for Americans Advisory Committee 2015 to recommend upper limits of sugar consumption not to exceed 10 % of calories. Data from many randomized control trials (RCTs) do not support linkages between sugar consumption at normal levels within the human diet and various adverse metabolic and health-related effects. Fructose and glucose are typically consumed together in roughly equal proportions from high-fructose corn syrup (also known as isoglucose in Europe) or sucrose. The purpose of this review is to present data from recent RCTs and findings from recent systematic reviews and meta-analyses related to sugar consumption and its putative health effects. This review evaluates findings from recent randomized controlled trials, systematic reviews and meta-analyses into the relationship of sugar consumption and a range of health-related issues including energy-regulating hormones, obesity, cardiovascular disease, diabetes, and accumulation of liver fat and neurologic responses. Data from these sources do not support linkages between sugar consumption at normal levels within the human diet and various adverse metabolic and health-related effects.
Keywords: Sugars; High-fructose corn syrup; Sucrose; Obesity; Cardiovascular disease

Sugar addiction: the state of the science by Margaret L. Westwater; Paul C. Fletcher; Hisham Ziauddeen (55-69).
As obesity rates continue to climb, the notion that overconsumption reflects an underlying ‘food addiction’ (FA) has become increasingly influential. An increasingly popular theory is that sugar acts as an addictive agent, eliciting neurobiological changes similar to those seen in drug addiction. In this paper, we review the evidence in support of sugar addiction.We reviewed the literature on food and sugar addiction and considered the evidence suggesting the addictiveness of highly processed foods, particularly those with high sugar content. We then examined the addictive potential of sugar by contrasting evidence from the animal and human neuroscience literature on drug and sugar addiction.We find little evidence to support sugar addiction in humans, and findings from the animal literature suggest that addiction-like behaviours, such as bingeing, occur only in the context of intermittent access to sugar. These behaviours likely arise from intermittent access to sweet tasting or highly palatable foods, not the neurochemical effects of sugar.Given the lack of evidence supporting it, we argue against a premature incorporation of sugar addiction into the scientific literature and public policy recommendations.
Keywords: Sugar addiction; Obesity; Binge eating; Animal neuroscience; Drug addiction

Dietary patterns and successful ageing: a systematic review by Catherine M. Milte; Sarah A. McNaughton (423-450).
Nutrition is a key determinant of chronic disease in later life. A systematic review was conducted of studies examining dietary patterns and quality of life, physical function, cognitive function and mental health among older adults. Literature searches in MEDLINE complete, Academic Search Complete, CINAHL Complete, Ageline, Global health, PsycINFO, SCOPUS and EMBASE and hand searching from 1980 up to December 2014 yielded 1236 results. Inclusion criteria included dietary pattern assessment via dietary indices or statistical approaches, a sample of community-dwelling adults aged 45 years and over at baseline and a cross-sectional or longitudinal study design. Exclusion criteria included a single 24-h recall of diet, evaluation of single foods or nutrients, clinical or institutionalised samples and intervention studies. Risk of bias was assessed using the six-item Effective Public Health Practice Project’s Quality Assessment Tool for Quantitative Studies.There were 34 articles (11 cross-sectional and 23 longitudinal) included with 23 studies examining dietary indices and 13 studies using empirical analysis. Most studies examined mental health (n = 10) or cognitive function (n = 18), with fewer studies examining quality of life (n = 6) and physical function (n = 8). Although dietary pattern and outcome assessment methods varied, most studies reported positive associations between a healthier diet and better health outcomes.Overall, the number of studies using dietary patterns to investigate diet and successful ageing is small, and further investigation in longitudinal studies is needed, particularly for quality-of-life outcomes. This review provides support for the importance of a healthy diet for the ageing population globally.
Keywords: Ageing; Diet; Epidemiology; Health; Dietary patterns

Effects of inorganic nitrate and beetroot supplementation on endothelial function: a systematic review and meta-analysis by Jose Lara; Ammar W. Ashor; C. Oggioni; A. Ahluwalia; John C. Mathers; Mario Siervo (451-459).
Diets rich in inorganic nitrate are associated with lower blood pressure, an effect that may be mediated by an improvement of endothelial function (EF). Therefore, a systematic review and meta-analysis of randomised controlled trials (RCTs) were conducted to examine the effects of inorganic nitrate and beetroot supplementation on measures of EF.MEDLINE, EMBASE and Scopus databases were searched from inception until November 2014. Specific inclusion criteria were as follows: (1) RCTs; (2) trials comparing inorganic nitrate or beetroot supplementation with placebo control groups; and (3) trials reporting effects of these interventions on outcomes of vascular function. Random-effect models were used to assess the pooled effect sizes showed as standardised mean differences (SMD).Nine crossover trials and three parallel trials met our inclusion criteria. The trials were conducted between 2008 and 2014 and included a total of 246 participants with 10–64 participants per study. The duration of each intervention ranged from 1.5 h to 28 days. Inorganic nitrate and beetroot consumption was associated with an improvement in vascular function (SMD 0.36; 95 % CI 0.16, 0.56; P < 0.001). The effect on EF was significantly associated with the dose of inorganic nitrate (β = 0.04, SE = 0.01, P < 0.001), age (β = −0.01, SE = 0.004, P = 0.02), baseline BMI (β = −0.04, SE = 0.02, P = 0.05) and systolic BP (β = −0.01, SE = 0.005, P = 0.02).Inorganic nitrate and beetroot supplementation was associated with beneficial effects on EF. These effects appear to be reduced in older subjects and in subjects with greater cardiometabolic risk.
Keywords: Endothelial function; Flow-mediated dilation; Beetroot; Inorganic nitrate; Meta-analysis; Cardiovascular risk

Adolescent dietary intakes predict cardiometabolic risk clustering by Lynn L. Moore; Martha R. Singer; M. Loring Bradlee; Stephen R. Daniels (461-468).
To prospectively examine the relation between adolescent dietary intake and cardiometabolic risk (CMR) clustering at the end of adolescence.Data from the NHLBI Growth and Health Study on 1369 girls enrolled at ages 9–10 in 1987–1988 and followed for 10 years were used to estimate the relative risk of having multiple (≥2 or ≥3) risk factors in late adolescence associated with usual food intake patterns from 9 to 17 years of age. Mean food intakes were derived from multiple 3-day diet records and CMR factors included larger waist circumference, insulin resistance, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol, high triglycerides, and elevated systolic or diastolic blood pressures.Of 1369 subjects, 18.4 % girls had 3–6 prevalent risk factors by the end of adolescence and 35.0 % had at least two. Higher intakes of fruit and non-starchy vegetables, dairy, and grains were independently associated with having fewer risk factors as were eating patterns characterized by higher combined intakes of these food groups. After adjusting for age, race, socio-economic status, height, physical activity, and television watching, girls with high intakes of dairy and fruits and non-starchy vegetables (vs. those with lower intakes of both) were nearly 50 % less likely to have three or more CMR factors in late adolescence; girls with higher intakes of grains plus fruits and non-starchy vegetables were nearly 60 % less likely.These results suggest that healthy food consumption patterns during adolescence may prevent accumulation of cardiometabolic risk.
Keywords: Nutrition; Central obesity; Blood pressure; Lipids; Insulin resistance; Youth

Iodine status in healthy pregnant women in Korea: a first report by Yoon Young Cho; Hye Jeong Kim; Soo-young Oh; Suk-Joo Choi; Soo-Youn Lee; Ji Young Joung; Dae Joon Jeong; Seo Young Sohn; Jae Hoon Chung; Cheong-Rae Roh; Sun Wook Kim (469-475).
Proper iodine intake is important during pregnancy for both fetal neurodevelopment and maternal thyroid function. Korea is known as a high iodine intake area. However, there are no data regarding iodine status in pregnant Korean women. Therefore, we evaluated the iodine status of pregnant women in Korea by measuring urine iodine concentration.This study had an observational, prospective design. We enrolled 344 healthy pregnant women who visited Samsung Medical Center in Korea for a routine antenatal checkup between April 2012 and September 2013. We measured iodine and creatinine concentration (Cr) in spot urine samples and TSH level in serum at the time of enrollment.The median urinary iodine concentration (UIC) and UIC adjusted by Cr were 427.3 μg/L and 447.9 μg/gCr, respectively. There was no difference in median UIC according to trimester of pregnancy (P value = 0.953). Serum TSH level was not different according to UIC level when subjects were grouped according to WHO iodine recommendations (P value = 0.401).The median UIC of healthy pregnant women in Korea was 427.3 μg/L and 447.9 μg/gCr, which are more than adequate according to WHO criteria. Considering the wide range of UIC, we recommend active education about adequate iodine intake during pregnancy in areas where iodine intake is more than adequate according to WHO criteria.
Keywords: Iodine; Urine; Pregnancy; Women; Korea

Multiple anti-inflammatory and anti-atherosclerotic properties of red wine polyphenolic extracts: differential role of hydroxycinnamic acids, flavonols and stilbenes on endothelial inflammatory gene expression by Nadia Calabriso; Egeria Scoditti; Marika Massaro; Mariangela Pellegrino; Carlo Storelli; Ilaria Ingrosso; Giovanna Giovinazzo; Maria Annunziata Carluccio (477-489).
The aim of the study was to evaluate the vascular anti-inflammatory effects of polyphenolic extracts from two typical South Italy red wines, the specific contribution of individual polyphenols and the underlying mechanisms of action.Human endothelial cells were incubated with increasing concentrations (1–50 μg/mL) of Primitivo and Negroamaro polyphenolic extracts (PWPE and NWPE, respectively) or pure polyphenols (1–25 μmol/L), including hydroxycinnamic acids (p-coumaric, caffeic and caftaric acids), flavonols (kaempferol, quercetin, myricetin) or stilbenes (trans-resveratrol, trans-piceid) before stimulation with lipopolysaccharide. Through multiple assays, we analyzed the endothelial–monocyte adhesion, the endothelial expression of adhesion molecules (ICAM-1, VCAM-1 and E-Selectin), monocyte chemoattractant protein-1 (MCP-1) and macrophage colony-stimulating factor (M-CSF), as well as ROS intracellular levels and the activation of NF-κB and AP-1.Both PWPE and NWPE, already at 1 μg/mL, inhibited monocyte adhesion to stimulated endothelial cells, a key event in triggering vascular inflammation. They down-regulated the expression of adhesion molecules, ICAM-1, VCAM-1, E-Selectin, as well as MCP-1 and M-CSF, at mRNA and protein levels. All polyphenols reduced intracellular ROS, and everything, except caftaric acid, inhibited the endothelial expression of adhesion molecules and MCP-1, although with different potency. Flavonols and resveratrol significantly reduced also the endothelial expression and release of M-CSF. The decrease in endothelial inflammatory gene expression was related to the inhibition of NF-κB and AP-1 activation but not to intracellular oxidative stress.This study showed multiple anti-inflammatory and anti-atherosclerotic properties of red wine polyphenolic extracts and indentified specific bioactive polyphenols which could counteract inflammatory diseases including atherosclerosis.
Keywords: Macrophage colony-stimulating factor; Monocyte chemoattractant protein-1; Vascular cell adhesion molecule-1; Intercellular adhesion molecule-1; E-Selectin

The induction of apoptosis and autophagy by Wasabia japonica extract in colon cancer by Shu-Wen Hsuan; Charng-Cherng Chyau; Hsiao-Yu Hung; Jing-Hsien Chen; Fen-Pi Chou (491-503).
Wasabia japonica (wasabi) has been shown to exhibit properties of detoxification, anti-inflammation and the induction of apoptosis in cancer cells. This study aimed to investigate the molecular mechanism of the cytotoxicity of wasabi extract (WE) in colon cancer cells to evaluate the potential of wasabi as a functional food for chemoprevention.Colo 205 cells were treated with different doses of WE, and the cytotoxicity was analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide. Apoptosis and autophagy were detected by 4′,6-diamidino-2-phenylindole, 5,5′,6,6′-tetrachloro-1,1′,3,3′-tetraethyl-imidacarbo-yanine iodide and staining for acidic vascular organelles (AVOs), along with Western blotting.The results demonstrated that WE induced the extrinsic pathway and mitochondrial death machinery through the activation of TNF-α, Fas-L, caspases, truncated Bid and cytochrome C. WE also induced autophagy by decreasing the phosphorylation of Akt and mTOR and promoting the expression of microtubule-associated protein 1 light chain 3-II and AVO formation. An in vivo xenograft model verified that tumor growth was delayed by WE treatment.Our studies revealed that WE exhibits anti-colon cancer properties through the induction of apoptosis and autophagy. These results provide support for the application of WE as a chemopreventive functional food and as a prospective treatment of colon cancer.
Keywords: Apoptosis; Autophagy; Colon cancer; RAD001; Wasabia japonica

Nutrient patterns and their relation to general and abdominal obesity in Iranian adults: findings from the SEPAHAN study by Amin Salehi-Abargouei; Ahmad Esmaillzadeh; Leila Azadbakht; Ammar Hassanzadeh Keshteli; Awat Feizi; Christine Feinle-Bisset; Peyman Adibi (505-518).
Few studies have linked major dietary nutrient patterns to chronic diseases. Despite the growing evidence of associations between dietary patterns and obesity, we are aware of no study that examined the association between patterns of nutrient intake and obesity. To identify major nutrient patterns in Iranian adults and investigate their association with general and abdominal obesity.In this cross-sectional study that was conducted under the framework of the Study on the Epidemiology of Psychological Alimentary Health and Nutrition (SEPAHAN), dietary data were collected using a validated dish-based 106-item semi-quantitative food frequency questionnaire in 8691 subjects aged 18–55 years. Complete data of 6724 and 5203 adults were available for general and abdominal obesity, respectively. Data on anthropometric measures were collected through a self-administered questionnaire. General obesity was defined as body mass index ≥ 30 kg/m2, and abdominal obesity as waist circumference > 102 cm for men and >88 cm for women. Daily intakes of 38 nutrients and bioactive compounds were calculated for each participant. Factor analysis, followed by a varimax rotation, was applied to derive major nutrient patterns.Three major nutrient patterns were identified: (1) The first pattern was high in fatty acids (including saturated, monounsaturated and polyunsaturated fatty acids), cholesterol, vitamin B12, vitamin E, zinc, choline, protein, pyridoxine, phosphorus and pantothenic acid; (2) the second pattern was high in thiamine, betaine, starch, folate, iron, selenium, niacin, calcium, and manganese; and (3) the third pattern was high in glucose, fructose, sucrose, vitamin C, potassium, total dietary fiber, copper and vitamin K. Men in the highest quintile of the second pattern were less likely to be generally obese in the fully adjusted model [odds ratio (OR) 0.39, 95 % confidence interval (CI) 0.20–0.76]. After adjustment for potential confounders, a significant positive association was observed between the third pattern and general obesity among men (OR 1.77, 95 % CI 1.04–3.04), but not women (OR 1.18, 95 % CI 0.74–1.88). No overall association was seen between patterns of nutrient intake and abdominal obesity in both genders.Major nutrient patterns were significantly associated with general, but not abdominal obesity among male participants of the SEPAHAN study. Further studies in other populations, along with future prospective studies, are required to confirm these findings.
Keywords: Anthropometry; Obesity; Diet; Nutrient intake; Factor analysis; Fat accumulation

Virgin olive oil rich in phenolic compounds modulates the expression of atherosclerosis-related genes in vascular endothelium by Eliana R. Meza-Miranda; Oriol A. Rangel-Zúñiga; Carmen Marín; Pablo Pérez-Martínez; Javier Delgado-Lista; Carmen Haro; Patricia Peña-Orihuela; Ana I. Jiménez-Morales; María M. Malagón; Francisco J. Tinahones; José López-Miranda; Francisco Pérez-Jiménez; Antonio Camargo (519-527).
Previous studies have shown the anti-inflammatory and antioxidant properties of phenolic compounds of virgin olive oil (VOO). However, the effect of bioavailable phenolic compounds on the vascular endothelium is unknown. We aimed to evaluate the effect of the consumption of virgin olive oil rich in phenolic compounds on the vascular endothelium.We treated HUVEC with human serum obtained in fasting state and after the intake of a breakfast prepared with VOO with a high or low content of phenolic compounds.Treatment of HUVEC with serum obtained 2 h after the intake of the high-phenol VOO-based breakfast decreased p65 and MCP-1 gene expression (p < 0.001 and p = 0.002, respectively) and increased MT-CYB, SDHA and SOD1 gene expression (p = 0.004, p = 0.012 and p = 0.001, respectively), as compared with the treatment of HUVEC with the serum obtained 2 h after the intake of the low-phenol VOO-based breakfast. The treatment with serum obtained 4 h after the intake of the high-phenol VOO-based breakfast decreased MCP-1 and CAT gene expression (p < 0.001 and p = 0.003, respectively) and increased MT-CYB gene expression (p < 0.001), as compared to the treatment with serum obtained 4 h after the intake of the low-phenol VOO-based breakfast.Our results suggest that the consumption of virgin olive oil rich in phenolic compounds may reduce the risk of atherosclerosis development by decreasing inflammation and improving the antioxidant profile in the vascular endothelium.
Keywords: Phenolic compounds; Virgin olive oil; Vascular endothelium; Gene expression; HUVEC

Uroguanylin levels in intestine and plasma are regulated by nutritional status in a leptin-dependent manner by C. Folgueira; E. Sanchez-Rebordelo; S. Barja-Fernandez; R. Leis; S. Tovar; F. F. Casanueva; C. Dieguez; R. Nogueiras; L. M. Seoane (529-536).
Uroguanylin (UGN) is a 16 amino acid peptide produced mainly by intestinal epithelial cells. Nutrients intake increases circulating levels of prouroguanylin that is processed and converted to UGN to activate the guanylyl cyclase 2C receptor (GUCY2C). Given that the UGN-GUCY2C system has been proposed as a novel gut-brain endocrine axis regulating energy balance, the aim of the present study was to investigate the regulation of UGN protein levels in duodenum and circulating levels in lean and obese mice under different nutritional conditions and its potential interaction with leptin.Swiss, C57BL/6 wild-type and ob/ob male adult mice under different nutritional conditions were used: fed ad libitum standard diet (control); 48 h fasting (fasted); 48 h fasting followed by 24 h of feeding (refed); and fed high-fat diet (45 %) during 10 weeks. In addition, peripheral leptin administration was performed. Intestinal uroguanylin expression was studied by Western blot analysis; plasma levels were measured by ELISA.Food deprivation significantly reduced plasma UGN levels, which were correlated with the lower protein levels of UGN in duodenum. These effects were reverted after refeeding and leptin challenge. Consistently, in ob/ob mice UGN expression was decreased, whereas leptin treatment up-regulated UGN levels in duodenum in these genetically modified mice compared to WT. Diet-induced obese mice displayed increased UGN levels in intestine and plasma in comparison with lean mice.Our findings suggest that UGN levels are correlated with energy balance status and that the regulation of UGN by nutritional status is leptin-dependent.
Keywords: Uroguanylin; ob/ob; Leptin; Intestine; Duodenum

Comparison of different approaches to calculate nutrient intakes based upon 24-h recall data derived from a multicenter study in European adolescents by Cristina Julián-Almárcegui; Silvia Bel-Serrat; Mathilde Kersting; German Vicente-Rodriguez; Genevieve Nicolas; Krishna Vyncke; Carine Vereecken; Willem De Keyzer; Laurent Beghin; Stefania Sette; Lena Halström; Eva Grammatikaki; Marcela Gonzalez-Gross; Sandra Crispim; Nadia Slimani; Luis Moreno; Stefaan De Henauw; Inge Huybrechts (537-545).
The European “Healthy Lifestyle in Europe by Nutrition in Adolescence” (HELENA) project evaluated two different approaches to harmonize the matching procedures between 24-h recall data and food composition databases. In the first approach, the 24-h recall data were linked to the local/national food composition databases using standardized procedures, while in the second approach, the 24-h recall data were linked to the German BLS database which includes a larger food list. The aim of this paper was to compare the intakes of energy and eight nutrient components calculated via both approaches. Two non-consecutive 24-h recalls were performed in 1268 adolescents. Energy, carbohydrates, proteins, fat, fiber, water, alcohol, calcium and vitamin C were calculated via the two approaches at individual level. Paired samples t test and Pearson’s correlations were used to compare the mean intakes of energy and the eight mentioned nutrients and to investigate the possible associations between the two approaches.Small but significant differences were found between the intakes of energy and the eight food components when comparing both approaches. Very strong and strong correlations (0.70–0.95) were found between both methods for all nutrients.The dietary intakes obtained via the two different linking procedures are highly correlated for energy and the eight nutrients under study.
Keywords: Food composition database; 24-h dietary recall; Nutrients; Comparative study

Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study by Urszula Stepaniak; Agnieszka Micek; Giuseppe Grosso; Denes Stefler; Roman Topor-Madry; Ruzena Kubinova; Sofia Malyutina; Anne Peasey; Hynek Pikhart; Yuri Nikitin; Martin Bobak; Andrzej Pająk (547-560).
The aim of the study was to assess the relationships between individual-level dietary intakes of antioxidant vitamins C, E and beta-carotene with all-cause and cause-specific mortality in three Central and Eastern European (CEE) populations.Data from the Health, Alcohol and Psychosocial factors in Eastern Europe cohort study were used. At the baseline survey, between 2002 and 2005, 28,945 men and women aged 45–69 years were examined in Novosibirsk (Russia), Krakow (Poland) and seven Czech towns. Deaths in the cohorts were identified through mortality registers. Cox regression was used to estimate the association between vitamin consumption and all-cause, cardiovascular (CVD) disease and cancer mortality.In multivariable-adjusted analyses, there were no clear inverse associations between antioxidant vitamin intakes and mortality, although in some groups, several hazard ratios (HRs) were significant. For example, in men, compared with the lowest quintile of vitamin C intake, all-cause mortality in the third and fourth quintiles was lower by 28 % (HR 0.72; 95 % CI 0.61–0.85) and by 20 % (HR 0.80; 95 % CI 0.68–0.95), respectively. CVD mortality was lower by 35 % (HR 0.65; 95 % CI 0.50–0.84) and by 23 % (HR 0.77; 95 % CI 0.59–0.99) in third and fourth quintile of vitamin C intake, respectively. In women, the third and fourth quintiles of dietary intake of vitamin E were associated with reduced risk of all-cause death by 33 % (HR 0.67; 95 % CI 0.53–0.84) and by 23 % (HR 0.77; 95 % CI 0.61–0.97), respectively. Consumption of vitamin C, vitamin E and beta-carotene was not related to CVD mortality in women and to cancer mortality in either gender.This large prospective cohort study in CEE populations with low prevalence of vitamin supplementation did not find a strong, dose–response evidence for protective effects of antioxidant vitamin intake.
Keywords: Antioxidant vitamin; Mortality; Cardiovascular; Central and Eastern Europe

Increased inflammatory potential of diet is associated with bone mineral density among postmenopausal women in Iran by Nitin Shivappa; James R. Hébert; Mohsen Karamati; Seyedeh-Elaheh Shariati-Bafghi; Bahram Rashidkhani (561-568).
Diet has been shown to be associated with bone mineral density (BMD); however, the inflammatory potential of diet in modulating BMD has not yet been studied. We examined the association between a newly developed dietary inflammatory index (DII) and BMD in a sample of postmenopausal Iranian women. In this cross-sectional study, 160 postmenopausal women aged 50–85 years were studied and their femoral neck and lumbar spine BMDs were measured by dual-energy X-ray absorptiometry. The DII was computed based on dietary intake assessed using a previously validated, 168-item semiquantitative food frequency questionnaire. Logistic and linear regression models were fit to derive beta estimates and odds ratios (ORs), with DII fit as continuous and as a dichotomous variable.After adjusting for potential confounders, women with higher DII scores were more likely to have BMD below the median in the lumbar spine with the DII being used as both a continuous variable [ORcontinuous 1.64, 95 % confidence interval (CI) 1.11–2.43, p value = 0.01; one-unit increase corresponding to ≈17 % of its range in the current study] and a categorical variable (ORDII>−0.06/≤ 2.30, 95 % CI 1.05–5.07, p value = 0.04). Similar associations were observed when lumbar spine BMD was used as a continuous outcome. No significant association was observed with BMD in femoral neck, although the direction was along expected lines.These data suggest a pro-inflammatory diet, as indicated by increasing DII score, may be a risk factor for lower BMD in lumbar spine in postmenopausal Iranian women.
Keywords: Dietary inflammatory index; Inflammation; Bone mineral density; Postmenopausal women; Iran

The relationship between sugar-sweetened beverages and liver enzymes among healthy premenopausal women: a prospective cohort study by Maya K. Shimony; Karen C. Schliep; Enrique F. Schisterman; Katherine A. Ahrens; Lindsey A. Sjaarda; Yaron Rotman; Neil J. Perkins; Anna Z. Pollack; Jean Wactawski-Wende; Sunni L. Mumford (569-576).
To prospectively assess the association between sugar-sweetened beverages (SSB), added sugar, and total fructose and serum concentrations of liver enzymes among healthy, reproductive-age women. A prospective cohort of 259 premenopausal women (average age 27.3 ± 8.2 years; BMI 24.1 ± kg/m2) were followed up for up to two menstrual cycles, providing up to eight fasting blood specimens/cycle and four 24-h dietary recalls/cycle. Women with a history of chronic disease were excluded. Alanine and aspartate aminotransferases (ALT and AST, respectively) were measured in serum samples. Linear mixed models estimated associations between average SSB, added sugar, and total fructose intake and log-transformed liver enzymes adjusting for age, race, body mass index, total energy and alcohol intake, and Mediterranean diet score.For every 1 cup/day increase in SSB consumption and 10 g/day increase in added sugar and total fructose, log ALT increased by 0.079 U/L (95 % CI 0.022, 0.137), 0.012 U/L (95 % CI 0.002, 0.022), and 0.031 (0.012, 0.050), respectively, and log AST increased by 0.029 U/L (−0.011, 0.069), 0.007 U/L (0.000, 0.014), and 0.017 U/L (0.004, 0.030), respectively. Women who consumed ≥1.50 cups/day (12 oz can) SSB versus less had 0.127 U/L (95 % CI 0.001, 0.254) higher ALT [percent change 13.5 % (95 % CI 0.1, 28.9)] and 0.102 (95 % CI 0.015, 0.190) higher AST [percent change 10.8 % (95 % CI 1.5, 20.9)].Sugar-sweetened beverages were associated with higher serum ALT and AST concentrations among healthy premenopausal women, indicating that habitual consumption of even moderate SSB may elicit hepatic lipogenesis.
Keywords: Liver enzymes; Menstrual cycle; Fructose; Dietary sucrose; Sugar-sweetened beverages

Association between yogurt consumption, dietary patterns, and cardio-metabolic risk factors by Hubert Cormier; Élisabeth Thifault; Véronique Garneau; Angelo Tremblay; Vicky Drapeau; Louis Pérusse; Marie-Claude Vohl (577-587).
To examine whether yogurt consumption is associated with a healthier dietary pattern and with a better cardio-metabolic risk profile among healthy individuals classified on the basis of their body mass index (BMI). A 91-item food frequency questionnaire, including data on yogurt consumption, was administered to 664 subjects from the INFOGENE study. After principal component analysis, two factors were retained, thus classified as the Prudent and Western dietary patterns.Yogurt was a significant contributor to the Prudent dietary pattern. Moreover, yogurt consumption was associated with lower body weight, waist-to-hip ratio, and waist circumference and tended to be associated with a lower BMI. Consumers had lower levels of fasting total cholesterol and insulin. Consumers of yogurt had a positive Prudent dietary pattern mean score, while the opposite trend was observed in non-consumers of yogurt. Overweight/obese individuals who were consumers of yogurts exhibited a more favorable cardio-metabolic profile characterized by lower plasma triglyceride and insulin levels than non-consumers within the same range of BMI. There was no difference in total yogurt consumption between normal-weight individuals and overweight/obese individuals. However, normal-weight subjects had more daily servings of high-fat yogurt and less daily servings of fat-free yogurt compared to overweight/obese individuals.Being a significant contributor to the Prudent dietary pattern, yogurt consumption may be associated with healthy eating. Also, yogurt consumption may be associated with lower anthropometric indicators and a more beneficial cardio-metabolic risk profile in overweight/obese individuals.
Keywords: Yogurt; Nutrition; Cardio-metabolic risk factors; Insulin; Triglycerides; Dietary patterns

We recently reported that direct and maternal supplementation with n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) alleviates the metabolic disturbances in adult hamster pups fed with a high-fat diet (HFD). In this study, we hypothesized that these results involved a perinatal modulating effect of sphingolipids by n-3 LC-PUFA.We studied the effect of direct and maternal n-3 LC-PUFA supplementation on sphingolipid contents in liver and muscle, hepatic triglycerides (TG) secretion and glucose tolerance. Offspring male hamsters born from supplemented (Cω) or unsupplemented (C) mothers were subjected after weaning to a HFD during 16 weeks, without (Cω-HF or C-HF) or with direct supplementation with n-3 LC-PUFA (C-HFω). Direct supplementation decreased sphingosine, sphinganine and ceramides in liver and decreased sphingosine, sphinganine, sphingosine-1-phosphate (S1P) and ceramides in muscle in C-HFω compared to C-HF (p < 0.05). Maternal supplementation decreased C20 ceramide and lactosylceramide in liver and sphinganine, S1P and lactosylceramide in muscle (p < 0.05). This supplementation tended to decrease glucosylceramide in liver (p < 0.06) and muscle (p < 0.07) in Cω-HF compared to C-HF. Direct supplementation increased glucose tolerance and decreased hepatic TG secretion and hepatic gene expression levels of diacylglycerol O-acyltransferase 2 (DGAT2), sterol regulatory element-binding protein-1c (SREBP-1c), fatty acid synthase, stearoyl-CoA desaturase-1 (SCD1) and tumor necrosis factor α (TNFα). Maternal supplementation decreased basal glycemia and hepatic TG secretion. We observed a positive correlation between hepatic TG secretion and hepatic ceramide (p = 0.0059), and between basal glycemia and hepatic ceramide (p = 0.04) or muscle lactosylceramide contents (p = 0.001).We observed an improvement of lipids and glucose metabolism in hamster with n-3 LC-PUFA direct supplementation and a decrease in glycemia and hepatic TG secretion with maternal supplementation. These results are probably related to a decrease in both lipogenesis and sphingolipid contents in liver and muscle.
Keywords: n-3 PUFA; Maternal nutrition; Metabolic syndrome; Sphingolipids; Hamster

Resveratrol treatment rescues hyperleptinemia and improves hypothalamic leptin signaling programmed by maternal high-fat diet in rats by J. G. Franco; C. P. Dias-Rocha; T. P. Fernandes; L. Albuquerque Maia; P. C. Lisboa; E. G. Moura; C. C. Pazos-Moura; I. H. Trevenzoli (601-610).
Perinatal high-fat diet is associated with obesity and metabolic diseases in adult offspring. Resveratrol has been shown to exert antioxidant and anti-obesity actions. However, the effects of resveratrol on leptinemia and leptin signaling are still unknown as well as whether resveratrol treatment can improve metabolic outcomes programmed by maternal high-fat diet. We hypothesize that resveratrol treatment in male rats programmed by high-fat diet would decrease body weight and food intake, and leptinemia with changes in central leptin signaling. Female Wistar rats were divided into two groups: control group (C), which received a standard diet containing 9 % of the calories as fat, and high-fat group (HF), which received a diet containing 28 % of the calories as fat. Dams were fed in C or HF diet during 8 weeks before mating and throughout gestation and lactation. C and HF male offspring received standard diet throughout life. From 150 until 180 days of age, offspring received resveratrol (30 mg/Kg body weight/day) or vehicle (carboxymethylcellulose).HF offspring had increased body weight, hyperphagia and increased subcutaneous and visceral fat mass compared to controls, and resveratrol treatment decreased adiposity. HF offspring had increased leptinemia as well as increased SOCS3 in the arcuate nucleus of the hypothalamus, which suggest central leptin resistance. Resveratrol treatment rescued leptinemia and increased p-STAT3 content in the hypothalamus with no changes in SOCS3, suggesting improvement in leptin signaling.Collectively, our data suggest that resveratrol could reverse hyperleptinemia and improve central leptin action in adult offspring from HF mothers attenuating obesity.
Keywords: Obesity; Leptin; Programming; Resveratrol

Age and time trends in the diet of young children: results of the DONALD study by Kristina Foterek; Annett Hilbig; Mathilde Kersting; Ute Alexy (611-620).
To describe age and time trends of energy and macronutrient intake during infancy and toddlerhood and to set a special focus on dietary practices with respect to milk, complementary food, and family food intake.Three-day dietary records (n = 2241) collected at 3, 6, 9, 12, 18, 24, and 36 months (480 subjects) between 2004 and 2013 from the ongoing open cohort DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study were evaluated using repeated-measures regression analyses for trend analysis.Significant age trends were found for macronutrients with a decrease in fat intake (% of energy intake, %E) and an increase in carbohydrates (%E) and protein (%E). Exclusive and partial breastfeeding rates at 3 and 6 months did not differ between 2004 and 2008 and 2009 and 2013 (p > 0.05). Macronutrient pattern was virtually stable over time, whereas food group intake (% of total food intake excluding beverages, % TFI) changed significantly during the study period. Breast/bottle milk (% TFI) intake increased over time in the toddler subgroup, whereas family food (% TFI) decreased.Our data demonstrate a period of stagnation in the last 10 years with respect to breastfeeding duration in infancy. Further breastfeeding promotion in Germany is needed to continue the favourable progress of the previous decades. In toddlerhood, breast/bottle milk remains a substantial part of the diet and has increased during the last 10 years. Parents should be encouraged to implement healthy eating habits during early toddlerhood and to facilitate their child’s participation in appropriate family meals.
Keywords: Dietary intake; Trends; Infants; Toddlers

Risk factors for overweight and obesity in Swiss primary school children: results from a representative national survey by Stefanie B. Murer; Siret Saarsalu; Jasmin Zimmermann; Isabelle Herter-Aeberli (621-629).
Obesity is a global epidemic affecting around 10 % of 5- to 17-year olds. With the causes for obesity being multifactorial, a better understanding of the influencing factors is essential for effective treatment and prevention programs. The aim of this study was therefore to identify specific risk factors for overweight and obesity in children in Switzerland.A nationally representative sample of children aged 6–12 years was recruited (n = 2724). Height and weight were measured to calculate BMI (kg/m2). In addition, a questionnaire was distributed to all children asking about their physical activity, media consumption, and dietary habits as well as some parental factors.The prevalence of overweight and obesity in boys was 11.8 and 7.5 %, respectively, and in girls, it was 11.9 and 5.7 %. In univariate analyses, a number of parental, dietary, and activity factors were shown to be associated with BMI category. Based on a multinomial logistic regression, parent nationality and media consumption were the most important factors predicting obesity in boys, while in girls it was parental education, nationality, and physical activity.We have demonstrated that parental nationality and education play an important role in the development of childhood obesity, together with media consumption and physical activity. However, risk factors are also different according to child gender. Thus, an important target group for the treatment and prevention of childhood obesity in Switzerland are immigrant families, and the problem needs to be tackled differently in boys and girls as their risk factors are not the same.
Keywords: Children; Obesity; Physical activity; Nationality; Diet; Education

Grapefruit juice improves glucose intolerance in streptozotocin-induced diabetes by suppressing hepatic gluconeogenesis by Julia A. Hayanga; Senelisiwe P. Ngubane; Alfred N. Murunga; Peter M. O. Owira (631-638).
Hypoglycemic effects of grapefruit juice (GFJ) are widely recognized, but the mechanism(s) by which GFJ lowers blood glucose levels have not previously been investigated.Wistar rats [250–300 g body weight (BW)] were divided into eight groups (n = 7). Group 1 animals were orally treated with 3.0 ml/kg BW of distilled water for 60 days, while groups 3, 4, 5, 6 were similarly treated with 3.0 ml/kg BW of GFJ. Groups 4 and 7 as well as 2, 5, 6 and 8 were given 45.0 and 60.0 mg/kg BW intraperitoneal injections streptozotocin, respectively, while groups 2 and 6 animals were additionally injected with insulin (4.0 units/kg, S.C., b.d), respectively. Fasting blood glucose (FBG) and glucose tolerance tests were done. Hepatic glycogen content and glucokinase, glucose-6-phosphatase (G6Pase) and phosphoenolpyruvate carboxykinase (PEPCK) activities were measured in homogenized liver tissues.Diabetic rats, groups 2 and 4–8 exhibited significantly reduced weight gain but increased polydipsia compared to controls. FBG was significantly increased in diabetic rats compared to controls but were significantly improved in GFJ-treated—compared to non-treated—diabetic rats. Similarly, diabetic rats showed significant glucose intolerance compared to controls which was improved by GFJ treatment. GFJ treatment did not improve fasting plasma insulin in diabetic rats. GFJ treatment significantly elevated glucokinase activity and hepatic glycogen concentrations but suppressed the activities of G6Pase and PEPCK, respectively, in diabetic animals.These findings show that GFJ is not insulinotropic but improves glucose intolerance in diabetic rats by suppressing hepatic gluconeogenesis.
Keywords: Grapefruit juice; Diabetes; Insulin; Gluconeogenesis

We have previously reported that tyrosol (TYR) promotes lifespan extension in the nematode Caenorhabditis elegans, also inducing a stronger resistance to thermal and oxidative stress in vivo. In this study, we performed a whole-genome DNA microarray in order to narrow down the search for candidate genes or signaling pathways potentially involved in TYR effects on C. elegans longevity.Nematodes were treated with 0 or 250 μM TYR, total RNA was isolated at the adult stage, and derived cDNA probes were hybridized to Affymetrix C. elegans expression arrays. Microarray data analysis was performed, and relative mRNA expression of selected genes was validated using qPCR.Microarray analysis identified 208 differentially expressed genes (206 over-expressed and two under-expressed) when comparing TYR-treated nematodes with vehicle-treated controls. Many of these genes are linked to processes such as regulation of growth, transcription, reproduction, lipid metabolism and body morphogenesis. Moreover, we detected an interesting overlap between the expression pattern elicited by TYR and those induced by other dietary polyphenols known to extend lifespan in C. elegans, such as quercetin and tannic acid.Our results suggest that important cellular mechanisms directly related to longevity are influenced by TYR treatment in C. elegans, supporting our previous notion that this phenol might act on conserved genetic pathways to increase lifespan in a whole organism.
Keywords: Caenorhabditis elegans ; Extra-virgin olive oil; Longevity; Microarray; Tyrosol

The effect of flaxseed dose on circulating concentrations of alpha-linolenic acid and secoisolariciresinol diglucoside derived enterolignans in young, healthy adults by Andrea L. Edel; Amanda F. Patenaude; Melanie N. Richard; Elena Dibrov; J. Alejandro Austria; Harold M. Aukema; Grant N. Pierce; Michel Aliani (651-663).
The primary endpoint was to determine the plasma concentration of alpha-linolenic acid (ALA), and its metabolites, following milled flaxseed consumption at four doses. Secondary outcomes focused on plasma enterolignan concentrations and the effects on tolerability, platelet aggregation, plasma lipids and urinary thromboxane levels. Healthy, younger adults (n = 34; 18–49 years old) were randomized into four groups consuming one muffin daily for 30 days fortified with 10, 20, 30 or 40 g of milled flaxseed. Blood and urine were collected at baseline and 4 weeks.Plasma ALA concentrations increased with all flaxseed doses (P < 0.01), except the 20 g/day dose (P = 0.10), yet there was no significant dose-dependent response (P = 0.81). Only with the 30 g/day diet were n-3 polyunsaturated fatty acids (P = 0.007), and eicosapentaenoic acid (EPA) (P = 0.047) increased from baseline values. Docosapentaenoic acid and docosahexaenoic acid were not detected at any dose. Plasma total enterolignan concentrations significantly increased over time in all treatment groups, yet despite a dose-dependent tendency, no between-group differences were detected (P = 0.22). Flaxseed was well tolerated, even at the highest dose, as there were no reported adverse events, changes in cholesterol, platelet aggregation or urinary 11-dehydro-thromboxane B2.In healthy, younger adults, 10 g/day of milled flaxseed consumption is sufficient to significantly increase circulating ALA and total enterolignan concentrations; however, 30 g/day is required to convert ALA to EPA. Although all doses were well tolerated, 40 g/day is too low to attenuate cholesterol in this population.
Keywords: Alpha-linolenic acid; Enterolignans; Flaxseed; Platelets; Cardiovascular disease

Fructose only in pregnancy provokes hyperinsulinemia, hypoadiponectinemia, and impaired insulin signaling in adult male, but not female, progeny by Lourdes Rodríguez; María I. Panadero; Núria Roglans; Paola Otero; Silvia Rodrigo; Juan J. Álvarez-Millán; Juan C. Laguna; Carlos Bocos (665-674).
Fructose intake from added sugars correlates with the epidemic rise in metabolic syndrome and cardiovascular diseases. However, consumption of beverages containing fructose is allowed during gestation. Recently, we found that an intake of fructose (10 % wt/vol) throughout gestation produces impaired fetal leptin signaling and hepatic steatosis. Therefore, we have investigated whether fructose intake during pregnancy produces subsequent changes in the progeny, when adult.Fed 261-day-old male and female descendants from fructose-fed, control or glucose-fed mothers were used. Plasma was used to analyze glucose, insulin, leptin, and adiponectin. Hepatic expression of proteins related to insulin signaling was determined.Fructose intake throughout pregnancy did not produce alterations in the body weight of the progeny. Adult male progeny of fructose-fed mothers had elevated levels of insulin without a parallel increase in phosphorylation of protein kinase B. However, they displayed an augmented serine phosphorylation of insulin receptor substrate-2, indicating reduced insulin signal transduction. In agreement, adiponectin levels, which have been positively related to insulin sensitivity, were lower in male descendants from fructose-fed mothers than in the other two groups. Furthermore, mRNA levels for insulin-responsive genes were not affected (phosphoenolpyruvate carboxykinase, glucose-6-phosphatase) or they were decreased (sterol response element-binding protein-1c) in the livers of male progeny from fructose-supplemented rats. On the contrary, adult female rats from fructose-fed mothers did not exhibit any of these disturbances.Maternal fructose, but not glucose, intake confined to the prenatal stage provokes impaired insulin signal transduction, hyperinsulinemia, and hypoadiponectinemia in adult male, but not female, progeny.
Keywords: Fructose; Pregnancy; Fetal programming; Metabolic syndrome

Nutritional profile and obesity: results from a random-sample population-based study in Córdoba, Argentina by Laura R. Aballay; Alberto R. Osella; Ana G. De La Quintana; María del Pilar Diaz (675-685).
Obesity is a chronic, heterogeneous, multifactorial disease, which has sharply increased in prevalence in both developed and developing countries. This study aimed to estimate the prevalence of obesity and to identify socio-demographic risk factors associated with it, with special emphasis on diet.Nutritional status, demographic characteristics, lifestyle habits, and food consumption patterns derived from a Food Frequency Questionnaire were investigated. Exhaustive exploratory analyses were performed in order to describe dietary patterns, and logistic regression models were used for odds ratio estimation.The study included 4328 subjects, over 18 years old and resident in Cordoba city. The prevalence of overweight and obesity was 34 and 17 %, respectively, with 60 % in men and 45 % in women of BMI ≥ 25. Obesity risk factors were high intake of sodium, refined grains, starchy vegetables, and snacks. A lower risk of overweight and obesity was associated with an adequate, moderate intake of meats, eggs, alcoholic beverages, sugar and sweets, milk, yogurt, and pulses.A high intake of snacks, refined grains, starchy vegetables and sodium and low intake of yogurt, milk, pulses, and whole grains seem to be associated with the emergence and high prevalence of obesity in Cordoba, Argentina.
Keywords: Overweight; Obesity; Argentina; Odds ratio; Logistic regression

A prospective study of erythrocyte polyunsaturated fatty acid, weight gain, and risk of becoming overweight or obese in middle-aged and older women by Lu Wang; JoAnn E. Manson; Susanne Rautiainen; J. Michael Gaziano; Julie E. Buring; Michael Y. Tsai; Howard D. Sesso (687-697).
ω3 and ω6 fatty acids (FA) may have divergent effects on the development of obesity. We examined the association of baseline erythrocyte ω3 and ω6 FA composition with body weight change and the risk of becoming overweight or obese in the Women’s Health Study (WHS) participants. We identified 534 women who had baseline erythrocyte FA measured and a baseline body mass index (BMI) of 18.5–<25 kg/m2. Body weight was updated at a total of six time points during follow-up. Weight gain during a mean of 10.4-year follow-up increased with increasing quartiles of baseline erythrocyte cis ω6 FA, ω6/ω3 ratio, and trans FA while decreased with increasing cis ω3 FA. After multivariable adjustment including total energy intake and physical activity, the weight gain (kg) in the highest versus the lowest quartile was 3.08 versus 2.32 for erythrocyte cis ω6 FA (p trend 0.04), 2.07 versus 2.92 for cis ω3 FA (p trend 0.08), 2.93 versus 2.05 for ω6/ω3 ratio (p trend 0.046), and 3.03 versus 2.27 for trans FA (p trend 0.06). Among individual FA, the associations were significant for 18:2ω6, 18:3ω6, and trans 18:1 and marginally significant for 20:3ω6 and trans 18:2. The risk of becoming overweight or obese (defined as BMI ≥25 kg/m2 at any follow-up time point) increased across increasing ω6/ω3 ratio (multivariable model p trend 0.04).In this prospective study, we found suggestive evidence that erythrocyte cis ω6 FA may be positively associated, and cis ω3 FA inversely associated with weight gain in initially normal-weight women.
Keywords: Fatty acids; Prospective study; Women; Obesity; Weight gain

Low-level mercury, omega-3 index and neurobehavioral outcomes in an adult US coastal population by Caterina Vacchi-Suzzi; Roxanne Karimi; Danielle Kruse; Susan M. Silbernagel; Keith E. Levine; Diane S. Rohlman; Jaymie R. Meliker (699-711).
Neurodevelopmental effects of omega-3 fatty acids and mercury from fish consumption have been characterized in children. In contrast, neurobehavioral outcomes associated with fish are not well studied in adults. This study of avid seafood consumers on Long Island (NY, USA) sought to define associations between mercury, seafood consumption, omega-3 fatty acids and neurobehavioral outcomes.A computer-based test system was used to assess neurobehavioral function. Blood total Hg (Hg) and omega-3 index were measured in 199 adult avid seafood eaters, who also completed the neurobehavioral assessment and an extensive food and fish frequency and demographic questionnaire.For most of the outcomes considered, neither Hg nor omega-3 index was associated with neurobehavioral outcomes after adjustment for key confounding variables. Fish consumption, however, was associated with decreased odds of both self-reported fatigue (OR 0.85; 95 % CI 0.72, 1.01) and a constellation of neurologic symptoms (OR 0.79; 95 % CI 0.66, 0.96).Results from our study provide little evidence that omega-3 fatty acids or Hg is associated with cognitive function in adult avid seafood consumers. Larger studies are needed to confirm our finding of associations between fish consumption and decreased self-reported fatigue and neurologic impairment.
Keywords: Mercury; Omega-3; n-3 fatty acids; Methylmercury; Neurological test; Neurobehavioral test

Patterns of dietary habits in relation to obesity in Iranian adults by Parvane Saneei; Ahmad Esmaillzadeh; Ammar Hassanzadeh Keshteli; Awat Feizi; Christine Feinle-Bisset; Peyman Adibi (713-728).
Findings from few studies that investigated the relation between dietary behaviors and obesity are inconsistent. We aimed to assess the relation between patterns of dietary habits, identified by latent class analysis (LCA), and obesity in a large sample of Iranian adults.In a cross-sectional study on 7958 adults, dietary behaviors were assessed in five domains (meal patterns, eating rate, intra-meal fluid intake, meal-to-sleep interval, and fatty foods intake) using a pretested questionnaire. LCA was applied to identify classes of diet-related practices. Anthropometric measures were assessed through the use of a validated self-reported questionnaire. General and abdominal obesity were defined as a body mass index ≥30 kg/m2, and a waist circumference ≥88 cm for women and ≥102 cm for men.General and abdominal obesity were prevalent in 9.7 and 27.7 % of the study population, respectively. We identified three distinct classes of eating rates (moderate, moderate to slow, and moderate to fast), two classes of meal patterns (regular and irregular), two classes of intra-meal fluid intake (moderate and more intra-meal drinking), three classes of meal-to-sleep interval (short, moderate, and long meal-to-sleep interval), and three classes of fatty food intake (low to moderate, moderate to high, and low intake of fatty foods). After adjustment for potential confounders, individuals with ‘irregular meal pattern’ were 21, 24, and 22 % more likely to be overweight/obese, abdominally overweight/obese, and abdominally obese, compared with those who had a ‘regular meal pattern.’ Individuals with ‘more intra-meal drinking’ had greater odds of overweight (OR 1.37; 1.19–1.458) and obesity (OR 1.51; 1.16–1.97) than those with ‘moderate intra-meal drinking.’ Moderate-to-high intake of fatty foods was inversely associated with abdominally overweight/obese (OR 0.85; 0.73–1.00) and abdominally obesity (OR 0.80; 0.68–0.96) compared with ‘low-to-moderate intake of fatty foods.’ No significant association was observed between eating rate, meal-to-sleep interval, and general or abdominal obesity, after controlling for confounders.Irregular meal pattern and more intra-meal drinking were associated with increased odds of general and abdominal obesity, whereas moderate-to-high intake of fatty foods was related to the decreased odds of central obesity among Iranian adults.
Keywords: Dietary habits; Obesity; Abdominal obesity; Latent class analysis; Eating rate; Fluid intake; Meal regularity; Meal-to-sleep interval; Fatty food intake

Adaptive response activated by dietary cis9, trans11 conjugated linoleic acid prevents distinct signs of gliadin-induced enteropathy in mice by Paolo Bergamo; Gianna Palmieri; Ennio Cocca; Ida Ferrandino; Marta Gogliettino; Antonio Monaco; Francesco Maurano; Mauro Rossi (729-740).
The beneficial effects of conjugated linoleic acid (CLA) mixture (cis9, trans11, c9; trans10, cis12, t10) against gliadin-induced toxicity in HLA-DQ8-transgenic mice (DQ8) have been associated with improved duodenal cytoprotective mechanisms [nuclear factor-E2-related factor-2, Nrf2; acylpeptide hydrolase (APEH)/proteasome]. The present study was aimed at investigating the ability of individual CLA isomers to improve the efficacy of these defensive mechanisms and to protect against duodenal injury caused by the combined administration of gliadin and indomethacin (GI).Gluten-mediated enteropathy was induced in DQ8 mice by three intra-gastric administration of gliadin (20 mg kg−1/bw) and indomethacin (15 mg L−1) in drinking water for 10 days (GI). C9 or t10 CLA (520 mg kg−1/bw/day) were orally administered for 2 weeks. Pro-oxidant and toxic effects associated with GI treatment, anti-oxidant/detoxifying ability of c9 or t10-CLA and the protective effect induced by c9 pre-treatment (c9 + GI) were evaluated in DQ8 mice duodenum by combining enzymatic, immunoblotting, histological evaluation and quantitative real-time PCR assays.GI treatment produces the time-dependent decline of the considered detoxifying mechanisms thus leading to pro-apoptotic and pro-oxidant effects. APEH/proteasome pathway was not markedly affected by individual CLA isomers, but duodenal redox status and activity/mRNA levels of Nrf2-activated enzymes were significantly improved by c9 administration. c9 pre-treatment protects against GI-mediated accumulation of oxidative stress markers, and histological examination reveals the increase of goblet cells number in mouse duodenum but induces only a partial recovery of APEH/proteasome activity.The activation of and adaptive response by low doses of c9 supplementation prevents distinct signs of gliadin-induced enteropathy in DQ8 mice.
Keywords: Fatty acids; Conjugated linoleic acid; Nrf2; Adaptive response; Gliadin; Celiac disease

Resveratrol reduces amyloid-beta (Aβ1–42)-induced paralysis through targeting proteostasis in an Alzheimer model of Caenorhabditis elegans by Charlotte Regitz; Elena Fitzenberger; Friederike Luise Mahn; Lisa Marie Dußling; Uwe Wenzel (741-747).
Resveratrol is a polyphenol present in red wine for which the capability of directly interfering with the hallmark of Alzheimer’s disease (AD), i.e. toxic β-amyloid protein (Aβ) aggregation, has been shown recently. Since the stimulation of proteostasis could explain reduced Aβ-aggregation, we searched for proteostasis targets of resveratrol.The transgenic Caenorhabditis elegans strain CL2006, expressing Aβ1–42 under control of a muscle-specific promoter and responding to Aβ-toxicity with paralysis, was used as a model. Target identification was accomplished through specific knockdowns of proteostasis genes by RNA interference. Effects of resveratrol on protein aggregation were identified using ProteoStat® Detection Reagent, and activation of proteasomal degradation by resveratrol was finally proven using a specific fluorogenic peptide substrate.Resveratrol at a concentration of 100 µM caused a 40 % decrease in paralysis. UBL-5 involved in unfolded protein response (UPR) in mitochondria proved to be necessary for the prevention of Aβ-toxicity by resveratrol. Also XBP-1, which represents an endoplasmic reticulum-resident factor involved in UPR, was identified to be necessary for the effects of resveratrol. Regarding protein degradation pathways, the inhibition of macroautophagy and chaperone-mediated autophagy prevented resveratrol from reducing paralysis as did the inhibition of proteasomal degradation. Finally, resveratrol reduced the amount of lysosomes, suggesting increased flux of proteins through the autophagy pathways and activated proteasomal degradation.Resveratrol reduces the Aβ-induced toxicity in a C. elegans model of AD by targeting specific proteins involved in proteostasis and thereby reduces the amount of aggregated Aβ.
Keywords: Caenorhabditis elegans ; Resveratrol; Amyloid-β peptide; Unfolded protein response; Autophagy; Proteasome

The aims of this study were to evaluate the antihypertensive effectiveness of different doses of grape seed polyphenols in cafeteria diet-fed hypertensive rats (CHRs) and to establish the mechanism involved in the blood pressure (BP) lowering effect of these compounds in this experimental model of metabolic syndrome (MS).Male 8-week-old Wistar rats were fed cafeteria or standard (ST) diet for 10 weeks. After this, the antihypertensive effect of a single oral administration of a polyphenol grape seed extract (GSPE) was tested at different doses (250, 375 and 500 mg/kg) in CHRs. BP was recorded before and 2, 4, 6, 8, 24 and 48 h post-administration. The hypotensive effect of GSPE was also proved in ST diet-fed rats. Additionally, in other experiment, CHRs were orally administered 375 mg/kg GSPE. Four hours post-administration, the rats were intraperitoneally administrated 30 mg/kg NG-nitro-l-arginine methyl ester (l-NAME) or 5 mg/kg indomethacin [inhibitors of nitric oxide (NO) and prostacyclin synthesis, respectively]. BP was recorded initially and 6 h post-administration.GSPE produced a decrease in SBP and DBP, the most effective dose (375 mg/kg) showing an antihypertensive effect in CHRs similar to the drug captopril, and did not affect BP of ST diet-fed rats. The antihypertensive effect was completely abolished by l-NAME and partially inhibited by indomethacin.GSPE acts as an antihypertensive agent in a rat model of hypertension associated with MS. The change in endothelium-derived NO availability is one of the mechanisms involved in the antihypertensive effect of GSPE in CHRs. Additionally, endothelial prostacyclin contributes to the effect of GSPE on arterial BP.
Keywords: Cafeteria diet; Hypertension; Antihypertensive agent; Endothelial-relaxing factors

Profile of European adults interested in internet-based personalised nutrition: the Food4Me study by Katherine M. Livingstone; Carlos Celis-Morales; Santiago Navas-Carretero; Rodrigo San-Cristobal; Clare B. O’Donovan; Hannah Forster; Clara Woolhead; Cyril F. M. Marsaux; Anna L. Macready; Rosalind Fallaize; Silvia Kolossa; Lydia Tsirigoti; Christina P. Lambrinou; George Moschonis; Magdalena Godlewska; Agnieszka Surwiłło; Christian A. Drevon; Yannis Manios; Iwona Traczyk; Eileen R. Gibney; Lorraine Brennan; Marianne C. Walsh; Julie A. Lovegrove; J. Alfredo Martinez; Wim H. Saris; Hannelore Daniel; Mike Gibney; John C. Mathers (759-769).
Personalised interventions may have greater potential for reducing the global burden of non-communicable diseases and for promoting better health and well-being across the lifespan than the conventional “one size fits all” approach. However, the characteristics of individuals interested in personalised nutrition (PN) are unclear. Therefore, the aim of this study was to describe the characteristics of European adults interested in taking part in an internet-based PN study.Individuals from seven European countries (UK, Ireland, Germany, The Netherlands, Spain, Greece and Poland) were invited to participate in the study via the Food4Me website ( ). Two screening questionnaires were used to collect data on socio-demographic, anthropometric and health-related characteristics as well as dietary intakes. A total of 5662 individuals expressed an interest in the study (mean age 40 ± 12.7; range 15–87 years). Of these, 65 % were female and 97 % were Caucasian. Overall, 13 % were smokers and 47 % reported the presence of a clinically diagnosed disease. Furthermore, 47 % were overweight or obese and 35 % were sedentary during leisure time. Assessment of dietary intakes showed that 54 % of individuals reported consuming at least 5 portions of fruit and vegetables per day, 46 % consumed more than 3 servings of wholegrains and 37 % limited their salt intake to <5.75 g per day.Our data indicate that individuals volunteering to participate in an internet-based PN study are broadly representative of the European adult population, most of whom had adequate nutrient intakes but could benefit from improved dietary choices and greater physical activity. Future use of internet-based PN approaches is thus relevant to a wide target audience.
Keywords: Personalised nutrition; European profile; Tailored intervention; Internet-based; Randomised controlled trial

Ready-to-eat cereals improve nutrient, milk and fruit intake at breakfast in European adolescents by Nathalie Michels; Stefaan De Henauw; Laurent Beghin; Magdalena Cuenca-García; Marcela Gonzalez-Gross; Lena Hallstrom; Anthony Kafatos; Mathilde Kersting; Yannis Manios; Ascensión Marcos; Denes Molnar; Romana Roccaldo; Alba M. Santaliestra-Pasías; Michael Sjostrom; Béatrice Reye; Frank Thielecke; Kurt Widhalm; Mandy Claessens (771-779).
Breakfast consumption has been recommended as part of a healthy diet. Recently, ready-to-eat cereals (RTEC) became more popular as a breakfast item. Our aim was to analyse the dietary characteristics of an RTEC breakfast in European adolescents and to compare them with other breakfast options. From the European multi-centre HELENA study, two 24-h dietary recalls of 3137 adolescents were available. Food items (RTEC or bread, milk/yoghurt, fruit) and macro- and micronutrient intakes at breakfast were calculated. Cross-sectional regression analyses were adjusted for gender, age, socio-economic status and city.Compared to bread breakfasts (39 %) and all other breakfasts (41.5 %), RTEC breakfast (19.5 %) was associated with improved nutrient intake (less fat and less sucrose; more fibre, protein and some micronutrients like vitamin B, calcium, magnesium and phosphorus) at the breakfast occasion. Exceptions were more simple sugars in RTEC breakfast consumers: more lactose and galactose due to increased milk consumption, but also higher glucose and fructose than bread consumers. RTEC consumers had a significantly higher frequency (92.5 vs. 50.4 and 60.2 %) and quantity of milk/yoghurt intake and a slightly higher frequency of fruit intake (13.4 vs. 10.9 and 8.0 %) at breakfast.Among European adolescents, RTEC consumers showed a more favourable nutrient intake than consumers of bread or other breakfasts, except for simple sugars. Therefore, RTEC may be regarded as a good breakfast option as part of a varied and balanced diet. Nevertheless, more research is warranted concerning the role of different RTEC types in nutrient intake, especially for simple sugars.
Keywords: Adolescents; Ready-to-eat cereals; Breakfast; Fruit; Milk; Nutrients

Obesogenic dietary intake in families with 1-year-old infants at high and low obesity risk based on parental weight status: baseline data from a longitudinal intervention (Early STOPP) by Viktoria Svensson; Tanja Sobko; Anna Ek; Michaela Forssén; Kerstin Ekbom; Elin Johansson; Paulina Nowicka; Maria Westerståhl; Ulf Riserus; Claude Marcus (781-792).
To compare dietary intake in 1-year-old infants and their parents between families with high and low obesity risk, and to explore associations between infant dietary intake and relative weight. Baseline analyses of 1-year-old infants (n = 193) and their parents participating in a longitudinal obesity intervention (Early STOPP) were carried out. Dietary intake and diet quality indicators were compared between high- and low-risk families, where obesity risk was based on parental weight status. The odds for high diet quality in relation to parental diet quality were determined. Associations between measured infant relative weight and dietary intake were examined adjusting for obesity risk, socio-demographics, and infant feeding.Infant dietary intake did not differ between high- and low-risk families. The parents in high-risk families consumed soft drinks, French fries, and low-fat spread more frequently, and fish and fruits less frequently (p < 0.05) compared to parents in low-risk families. Paternal intake of vegetables and fish increased the odds for children being consumers of vegetables (OR 1.7; 95 % CI 1.0–2.9) and fish, respectively (OR 2.5; 95 % CI 1.4–4.4). Infant relative weight was weakly associated with a high intake of milk cereal drink (r = 0.15; p < 0.05), but not with any other aspect of dietary intake, obesity risk, or early feeding patterns.At the age of one, dietary intake in infants is not associated with family obesity risk, nor with parental obesogenic food intake. Milk cereal drink consumption but no other infant dietary marker reflects relative weight at this young age.
Keywords: Dietary intake; Food intake; Infant; Parents; Obesity; Infant feeding

Markers of systemic exposures to products of intestinal bacteria in a dietary intervention study by Faith I. Umoh; Ikuko Kato; Jianwei Ren; Phillip L. Wachowiak; Mack T. Ruffin IV; D. Kim Turgeon; Ananda Sen; Dean E. Brenner; Zora Djuric (793-798).
Systemic exposures to intestinal bacteria may play a role in the etiology of the chronic, low-grade inflammation that is associated with western diets. Production of lipopolysaccharide-binding protein (LBP) is one biomarker of increased exposures to intestinal bacteria. This study evaluated whether changes in diet quality could affect serum LBP.This was a randomized, controlled trial of Mediterranean and Healthy Eating diets over 6 months in 120 healthy subjects at increased risk of colon cancer. Blood samples obtained before and after intervention were analyzed for LBP, branched-chain fatty acids characteristic of intestinal bacteria, micronutrients and cytokines. Data were analyzed for changes in LBP over time and for predictors of LBP.Serum concentrations of branched-chain bacterial fatty acids declined significantly in both diet groups. However, there was no significant change in mean serum LBP concentrations with either diet intervention. In serum, LBP was positively associated with CRP and negatively associated with carotenoids both before and after intervention. After intervention, LBP was predicted positively by both CRP and bacterial fatty acid concentrations in serum, and negatively by serum carotenoids and the ω3/ω6 fatty acid ratio. This model accounted for 30 % of the inter-individual variation in serum LBP after intervention.These results indicate that dietary intervention over 6 months was insufficient to alter serum LBP. The relationships with inflammation-related markers, however, indicate that anti-inflammatory strategies other than changes in diet quality, such as weight loss or improved fitness, may have more potential for reducing systemic markers of LPS exposures in well-nourished populations.
Keywords: Intestinal bacteria; Inflammation; Obesity; Mediterranean diet; High fruit and vegetable diets

Maternal fish consumption during pregnancy and BMI in children from birth up to age 14 years: the PIAMA cohort study by Saskia W. van den Berg; Alet H. Wijga; Lenie van Rossem; Ulrike Gehring; Gerard H. Koppelman; Henriette A. Smit; Jolanda M. A. Boer (799-808).
This study aimed to investigate the association between maternal fish consumption during pregnancy and BMI in children and the development of this association between birth and 14 years of age, taking into account relevant mother and child covariates.The study population consisted of 3684 Dutch children born in 1996–1997 who participated in the PIAMA birth cohort study. Maternal fish consumption during pregnancy and the child’s body weight and height (up to 11 times) were reported by questionnaire. Generalized estimating equations were used to investigate whether BMI of children differed according to maternal fish consumption during pregnancy.The crude overall association between maternal fish consumption during pregnancy and BMI in children was non-significant (P = 0.17), but differed by the child’s age (P interaction = 0.03). Children of mothers who consumed fish ≥1×/week during pregnancy (n = 909) had statistically significant lower mean BMI z scores than children of mothers who never consumed fish (n = 1025) at the ages 4, 7, 8.5, and 11.5 years. Adjustment for maternal covariates (particularly pre-pregnancy BMI) attenuated the differences, which remained statistically significant at the age of 7 years only (mean difference in BMI z score: −0.14 95 % CI −0.25; −0.03). Additional adjustment for child covariates hardly affected the results.In a population with relatively low fish consumption, higher fish consumption by pregnant women seems rather an indicator for more healthy maternal characteristics in general than a causal factor for the lower BMI in their children.
Keywords: Maternal consumption; Fish; BMI; Children

Prevalence of thinness among children and adolescents in Shandong, China by Ying-xiu Zhang; Zhao-xia Wang; Mei Wang; Li Xie (809-813).
Thinness in children and adolescents poses a considerable public health problem globally, especially in developing countries. The present study examined the prevalence of thinness among children and adolescents in Shandong, China.Data for this study were obtained from a large cross-sectional survey of schoolchildren. A total of 42,348 students (21,248 boys and 21,100 girls) aged 7–18 years participated in this study. Stature and weight of all subjects were measured; body mass index (BMI) was calculated from their stature and weight. International BMI cutoffs were used to define thinness.The overall prevalences of thinness grade 1, grade 2 and grade 3 among children and adolescents aged 7–18 years were 7.74, 1.43 and 0.61 % for boys and 11.51, 2.54 and 1.03 % for girls, respectively; these figures were all significantly higher in girls than in boys (P < 0.01). Thin children and adolescents had lower stature levels than their counterparts in not thin group in all age groups (7–18 years).The prevalence of childhood thinness is still wide in Shandong Province, and public health and nutritional strategies must give attention to the intervention for thinness, including periodic monitoring, education on pattern of nutrition and healthy dietary behavior.
Keywords: Thinness; Prevalence; Child and adolescent

Immediate pre-meal water ingestion decreases voluntary food intake in lean young males by Robert A. Corney; Caroline Sunderland; Lewis J. James (815-819).
Consuming 375–500 ml of water 30 min before a meal has been shown to reduce energy intake in older, but not younger adults. This study investigated the effects of ingesting a water preload immediately pre-meal (<1 min before eating) on within-meal ad libitum energy intake in non-obese young males.Fourteen healthy males [mean (SD) age 27 (3) years, height 1.83 (0.05) m, body weight 80.47 (9.89) kg, body fat 17.5 (4.0) %, body mass index 24.0 (2.5) kg/m2] completed a familiarisation trial and two experimental trials in randomised counterbalanced order. Subjects arrived at the laboratory overnight fasted and consumed an ad libitum porridge breakfast. Immediately prior to the meal, subjects consumed either a 568 ml (1 pint) water preload (preload trial) or no preload (control trial). Visual analogue scale questionnaires to assess hunger, fullness and satisfaction were completed before and after the meal in both trials, as well as after the water preload.Ad libitum energy intake was greater (P < 0.001) during control [2551 (562) kJ] than preload [1967 (454) kJ]. Ad libitum water intake was also greater (P < 0.001) during control [318 (226–975) ml] than preload [116 (0–581) ml]. The water preload increased fullness and satisfaction and decreased hunger compared to pre-trial (P < 0.001) and the control trial (P < 0.001).This study demonstrates that consumption of a 568 ml water preload immediately before a meal reduces energy intake in non-obese young males. This might therefore be an effective strategy to suppress energy intake in this population and possibly assist with weight management.
Keywords: Appetite; Preload; Fluid; Weight management; Hydration

Probiotic Lactobacillus casei Zhang reduces pro-inflammatory cytokine production and hepatic inflammation in a rat model of acute liver failure by Yuzhen Wang; Jiming Xie; Yunxu Li; Shichao Dong; Huan Liu; Junna Chen; Yan Wang; Shimin Zhao; Yong Zhang; Heping Zhang (821-831).
In this study, we sought to find the effects and mechanisms of probiotic Lactobacillus casei Zhang (L. casei Zhang) on the pro-inflammatory cytokine production and hepatic inflammatory response in a rat model of acute liver failure induced by lipopolysaccharide (LPS) and d-galactosamine (GalN).Male Wistar rats were orally administrated with or without L. casei Zhang for 30 days prior to challenge with LPS and GalN. Dexamethasone administrated group serving as a positive anti-inflammation control. Serum, intestinal and liver samples were collected 8 h after LPS/GalN challenge for histological, molecular and biochemical analysis.LPS/GalN challenge alone resulted in significantly increased production of endotoxin, tumor necrosis factor-α (TNF-α), interleukin-1 beta (IL-1β) and nitric oxide as compared to the normal control rats. Pretreatment with L. casei Zhang not only reduced these changes, but also attenuated hepatic inflammation as shown by improved histological assessment, decreased myeloperoxidase activity and reduced expression of IL-1β and inducible nitric oxide synthase in the liver. L. casei Zhang supplementation significantly inhibited LPS/GalN-triggered phosphorylation of ERK, JNK and p-38 MAPK, but increased the expression of TLR2, TLR9 and PPAR-γ. Moreover, L. casei Zhang treatment prevented intestinal injury and modulated the intestinal ecology by increasing the fecal Lactobacillus and Bifidobacterium levels.Probiotic L. casei Zhang reduces LPS/GalN-induced pro-inflammatory cytokine and hepatic inflammation through modulating the TLR-MAPK-PPAR-γ signaling pathways and intestinal microbiota.
Keywords: Lactobacillus casei ; Inflammation; TNF-α ; PPAR-γ; Microbiota

This study was conducted to: (1) demonstrate an updated method for estimating flavonoid intake of US adults by combining USDA flavonoid databases and NHANES food consumption data; (2) document the intake and major food sources of flavonoids among US adults; and (3) determine whether the intake and major sources of dietary flavonoids have changed during the past decade in the USA.A cross-sectional population-based study. Differences over time in the average daily intake and food sources of flavonoids were estimated using food consumption data from NHANES 1999–2002 (n = 8833) and 2007–2010 (n = 9801).The total flavonoid intake of US adults aged 19 years and older remained unchanged between 1999–2002 (201.9 mg/d) and 2007–2010 (200.1 mg/d), with tea being the top food source of flavonoids. However, intake of anthocyanidins increased during this period, mainly due to greater consumption of berries and wine, which was consistent with the increase in per capita consumption of these foods based on USDA food availability data.The results of this study provide updated information on flavonoid intake and food contributors and warrant further studies on the health implications of flavonoid intake.
Keywords: Diet; Flavonoid; Food sources; USDA flavonoid database; NHANES

Houttuynia cordata aqueous extract attenuated glycative and oxidative stress in heart and kidney of diabetic mice by Cheng-chin Hsu; Hui-ting Yang; Jing-jing Ho; Mei-chin Yin; Jen-ying Hsu (845-854).
The anti-glycative and anti-oxidative effects from Houttuynia cordata leaves aqueous extract (HCAE) in heart and kidney of diabetic mice were examined.HCAE, at 1 or 2 %, was supplied in drinking water for 8 weeks. Plasma glucose and blood urea nitrogen (BUN) levels and creatine phosphokinase (CPK) activity were measured. The production of oxidative and inflammatory factors was determined. Activity and protein expression of associated enzymes or regulators were analyzed.HCAE intake at both doses lowered plasma glucose and BUN levels, and CPK activity and also restored creatinine clearance rate in diabetic mice. HCAE intake, only at 2 %, retained plasma insulin levels (P < 0.05). HCAE reduced reactive oxygen species, protein carbonyl, interleukin-6, tumor necrosis factor-alpha, N ε -(carboxymethyl)-lysine, pentosidine and fructose levels, and reserved glutathione content in heart and kidney of diabetic mice (P < 0.05). Diabetes enhanced aldose reductase (AR) activity and protein expression in heart and kidney (P < 0.05). HCAE intake at both doses decreased renal AR activity and protein expression, but only at 2 % lowered cardiac AR activity and protein expression (P < 0.05). Diabetes increased protein expression of RAGE, p47phox and gp91phox, nuclear factor kappa-B (NF-κB) p50, NF-κB p65 and mitogen-activated protein kinase in heart and kidney (P < 0.05). HCAE intake only at 2 % limited RAGE expression, but at 1 and 2 % downregulated p47phox, NF-κB p65 and p-p38 expression in these organs (P < 0.05).These findings suggest that Houttuynia cordata leaves aqueous extract could ameliorate cardiac and renal injury under diabetic condition.
Keywords: Houttuynia cordata ; Diabetes; Glycation; Polyol pathway; NADPH oxidase

Habitual dietary intake of β-carotene, vitamin C, folate, or vitamin E may interact with single nucleotide polymorphisms on brachial–ankle pulse wave velocity in healthy adults by Clara Yongjoo Park; Sukyoung Jung; Mi Kyung Kim; Bo Youl Choi; Min-Ho Shin; Dong Hoon Shin; Young-Hoon Lee; Byung-Yeol Chun; Kyung-Won Hong; Joo-Yeon Hwang (855-866).
The interaction between genetics and diet may explain the present disagreement in the protective role of vitamin intake on cardiovascular disease. We cross-sectionally assessed the interaction of habitual dietary intake of β-carotene, vitamin C, folate, and vitamin E with single nucleotide polymorphisms (SNPs) on brachial–ankle pulse wave velocity (baPWV), a measure of arterial stiffness.Dietary intakes of β-carotene, vitamin C, folate, and vitamin E were quantified by a food frequency questionnaire in 3198 healthy men and women (≥40 years) from the Korea Multi-Rural communities Cohort study. baPWV was measured, and 19 SNPs were genotyped. The associations and interactions between dietary vitamin intake, SNP genotype, and baPWV were assessed using general linear models.In both men and women, dietary intake of β-carotene, vitamin C, folate, or vitamin E and baPWV were not directly associated. Vitamin C, folate, and vitamin E intake had an interaction with rs4961 (ADD1) genotype on baPWV in men. rs4961 also interacted with folate intake on baPWV in women. In women, rs10817542 (ZNF618) and rs719856 (CD2AP) had an interaction with β-carotene and folate intake and rs5443 (GNB3) had an interaction with vitamin E intake on baPWV. In general, minor allele homozygotes with low vitamin intake had higher baPWV than other subgroups. Results were similar when supplement users were excluded.Higher intake of dietary vitamin C, folate, and vitamin E may be related to high baPWV in healthy Korean men who are minor allele homozygotes of rs4961. In healthy Korean women, dietary folate, β-carotene, and vitamin E intake may affect baPWV differently according to rs4961, rs10817542, rs719856, or rs5443 genotype. Greater dietary intake of these nutrients may protect those that are genetically vulnerable to stiffening of the arteries.
Keywords: Vitamin intake; Gene–nutrient interaction; Arterial stiffness; Pulse wave velocity; Cross-sectional study

Erratum to: Habitual dietary intake of β-carotene, vitamin C, folate, or vitamin E may interact with single nucleotide polymorphisms on brachial-ankle pulse wave velocity in healthy adults by Clara Yongjoo Park; Sukyoung Jung; Mi Kyung Kim; Bo Youl Choi; Min-Ho Shin; Dong Hoon Shin; Young-Hoon Lee; Byung-Yeol Chun; Kyung-Won Hong; Joo-Yeon Hwang (867-867).