European Journal of Nutrition (v.56, #8)

Body mass index and physical activity and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies by Dagfinn Aune; Abhijit Sen; Michael F. Leitzmann; Teresa Norat; Serena Tonstad; Lars J. Vatten (2423-2438).
We conducted a systematic review and meta-analysis of prospective studies of the association between body mass index (BMI) and physical activity and diverticular disease risk.PubMed and Embase databases were searched up to February 7, 2017. Summary relative risks and 95% confidence intervals (95% CIs) were calculated using a random effects model and nonlinear associations were modeled using fractional polynomial models.Six cohort studies of BMI and diverticular disease risk (28,915 cases, 1,636,777 participants) and five cohort studies of physical activity and diverticular disease risk (2080 cases, 147,869 participants) were included. The summary relative risk (RR) of incident diverticular disease for a 5 unit BMI increment was 1.28 (95% CI: 1.18–1.40, I 2 = 77%, n = 6) for diverticular disease, 1.31 (95% CI: 1.09–1.56, I 2 = 74%, n = 2) for diverticulitis, and 1.20 (95% CI: 1.04–1.40, I 2 = 56%, n = 3) for diverticular disease complications. There was no evidence of a nonlinear association between BMI and diverticular disease risk (p nonlinearity = 0.22), and risk increased even within the normal weight range. Compared to a BMI of 20, the summary RR for a BMI of 22.5, 25.0, 27.5, 30.0, 32.5, 35.0, 37.5, and 40.0 was 1.15 (1.07–1.23), 1.31 (1.17–1.47), 1.50 (1.31–1.71), 1.71 (1.52–1.94), 1.96 (1.77–2.18), 2.26 (2.00–2.54), 2.60 (2.11–3.21), and 3.01 (2.06–4.39), respectively. The summary RR was 0.76 (95% CI: 0.63–0.93, I 2 = 54%, n = 5) for high vs. low physical activity and 0.74 (95% CI: 0.57–0.97, I 2 = 39.5%, p heterogeneity = 0.20, n = 2) for high vs. low vigorous physical activity.These results suggest that even moderate increases in BMI may increase the risk of diverticular disease as well as diverticular disease complications and that a higher level of physical activity may reduce the risk.
Keywords: Body mass index; Physical activity; Diverticular disease; Systematic review; Meta-analysis

Effects of Orthodox religious fasting on human health: a systematic review by Theocharis Koufakis; Spyridon Ν. Karras; Vasiliki Antonopoulou; Eleni Angeloudi; Pantelis Zebekakis; Kalliopi Kotsa (2439-2455).
Different studies have pointed towards a positive effect of religious fasting on human health. Orthodox fasting (OF) regime could be characterized as a periodical vegetarian diet, demonstrating several common characteristics with the typical Mediterranean diet. The present systematic review aimed to synthesize available results regarding the potential impact of OF on human health.Key biomedical databases were searched to identify studies examining the effects of OF on humans. Following implementation of specific criteria, ten studies were included in the analysis and their results were systematically reported and critically appraised in this review.According to the available limited results, OF periods are characterized by a restriction in total energy and fat intake, an increase in carbohydrate and fiber consumption, while in terms of protein intake, results are contradictive. The overall effect of OF on lipids profile seems to be optimal, with the reduction of total cholesterol and LDL-C levels, being a consistent finding across studies (up to 17.8 and 31.4%, respectively). However, the effect on HDL-C is still unclear. Conclusions regarding the impact on body weight and glucose homeostasis cannot be drawn, given that relevant data are limited with conflicting results. Any potential negative aspects of OF, mainly attributed to reduced dietary intake of vitamin D and B12 and minerals (mainly calcium), require further investigation.Given the limitations of available evidence, more studies are required before reaching definite conclusions about the effects of OF on human health.
Keywords: Religious fasting; Macronutrients; Vitamins; Cardiometabolic risk; Musculoskeletal health

Main biomarkers associated with age-related plasma zinc decrease and copper/zinc ratio in healthy elderly from ZincAge study by R. Giacconi; L. Costarelli; F. Piacenza; A. Basso; L. Rink; E. Mariani; T. Fulop; G. Dedoussis; G. Herbein; M. Provinciali; J. Jajte; I. Lengyel; E. Mocchegiani; M. Malavolta (2457-2466).
Zinc (Zn) plays an essential role in many biological processes including immune response. Impaired Zn status promotes immune dysfunction, and it has been associated with enhanced chronic inflammation during aging. It has been suggested that the measurement of circulating Zn by itself could not reflect the real Zn status of an individual. It is therefore necessary to identify other determinants associated with plasma Zn to better understanding how physiopathological conditions during aging may affect the concentration of this metal.We have investigated the association between Zn levels and some biomarkers in 1090 healthy elderly from five European countries to increase the accuracy in the assessment of the Zn status. Stepwise multivariate linear regression models were used to analyze the influence of factors such as age, dietary intake, inflammatory mediators, laboratory parameters and polymorphisms previously associated with Zn homeostasis.Plasma Zn decrement was most strongly predicted by age, while positive correlations were found with albumin, RANTES and Zn intake after adjustment for multiple confounders. HSP70 +1267 AA genotype was an independent factor associated with Zn plasma concentrations. Cu/Zn ratio was positively associated with markers of systemic inflammation and age and negatively associated with albumin serum levels.Our findings show the most important independent determinants of plasma Zn concentration and Cu/Zn ratio variability in elderly population and suggest that the decline with age of Zn circulating levels is more dependent on physiopathological changes occurring with aging rather than to its nutritional intake.
Keywords: Zinc plasma levels; Inflammation; Polymorphisms; Zinc homeostasis; Aging

Amino acids regulate mTOR pathway and milk protein synthesis in a mouse mammary epithelial cell line is partly mediated by T1R1/T1R3 by YanHong Wang; JunQiang Liu; Hui Wu; XingTang Fang; Hong Chen; ChunLei Zhang (2467-2474).
The mechanism of dietary amino acids in regulating milk protein synthesis at the translational level is not well understood. Numerous studies have shown that the amino acid signal is transferred through the mammalian target of rapamycin (mTOR) pathway; however, the extracellular amino acid-sensing mechanism that activates mTOR complex 1 is unknown. We tested the hypotheses that the T1R1/T1R3 heterodimer functions as a direct sensor of the fed state and amino acid availability preceding the mTOR pathway and affects milk protein synthesis in mammary epithelial cells.The expression of T1R1 was repressed by T1R1 siRNA in mouse mammary epithelial cells model (HC11). Western blot was used to analyze activity of the mTOR pathway and β-casein expression, and quantitative real-time RT-PCR was used to analyze the change in mRNA abundance of amino acid transporters.The transcripts and proteins of T1R1 and T1R3 were detected in HC11 cells and mouse mammary gland tissue. siRNA silencing of T1R1 repressed β-casein synthesis in HC11 cells both with and without essential amino acids present in the culture medium. The phosphorylation of mTOR, S6K, and 4EBP1 in T1R1 knockdown HC11 cells declined to 25, 50, and 30 %, indicating T1R1 knockdown repressed the activity of the mTOR pathway. T1R1 knockdown increased the mRNAs coding three important amino acid transporters (SLC1A5 and SLC3A2/SLC7A5). Activation of the mTOR pathway was partially repressed by T1R1 siRNA or SLC7A5/SLC3A2 inhibitor (BCH, 10 mM), and the combination of these two treatments further repressed the activity of this pathway.T1R1/T1R3 serves as sensor of extracellular amino acids in mouse mammary epithelial cells and involved in milk protein synthesis regulation.
Keywords: T1R1; T1R3; Amino acid sensing; mTOR

Lutein’s role on chronic hyperglycemia-induced oxidative stress and associated glucose homeostasis in heart and kidney is limited. Purpose of the study is to investigate the effect of lutein on cardiac and renal polyol pathway enzymes and oxidative stress markers under hyperglycemia-induced oxidative stress condition using streptozotocin (STZ)-injected rat model.STZ-induced hyperglycemic (fasting blood glucose ≥11 mM) male Wistar rats were divided into two groups (n = 11/group). Group 1 received micellar lutein (39 nmol/day/rat) and group 2 (negative control) received micelle without lutein for 8 weeks. A separate group (no STZ injected) served as a positive control (n = 11/group). Oral glucose tolerance test (OGTT), biweekly urine glucose and activities of aldose reductase (AR) and sorbitol dehydrogenase (SDH) enzymes were assessed. Activities of antioxidant enzymes and antioxidant level were also evaluated.Lutein-administered hyperglycemic rats showed better glucose tolerance as evidenced with OGTT and biweekly urine glucose when compared to negative control. Activities of AR and SDH were decreased in heart and kidney of lutein-fed hyperglycemic rats. Also, they had significantly (p < 0.05) decreased malondialdehyde levels (66, 34, and 33 %) and increased reduced glutathione level (81, 18 and 92 %) in serum, heart and kidney, respectively. Altered antioxidant enzyme activities such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione transferase were also affected in serum, heart and kidney of lutein-fed diabetic group.Lutein prevented cardiac and renal injury in STZ-induced hyperglycemic rats due to potential amelioration of altered activities in polyol pathway and oxidative stress markers.
Keywords: Diabetes; Lutein; Nephropathy; Polyol pathway; Oxidative stress

Interesterification of palm stearin and palm kernal (PSt/PK) is widely used by the food industry to create fats with desirable functional characteristics for applications in spreads and bakery products, negating the need for trans fatty acids. Previous studies have reported reduced postprandial lipaemia, an independent risk factor for CVD, following interesterified (IE) palmitic and stearic acid-rich fats that are not currently widely used by the food industry. The current study investigates the effect of the most commonly consumed PSt/PK IE blend on postprandial lipaemia.A randomised, controlled, crossover (1 week washout) double-blind design study (n = 12 healthy males, 18–45 years), compared the postprandial (0–4 h) effects of meals containing 50 g fat [PSt/PK (80:20); IE vs. non-IE] on changes in plasma triacylglycerol (TAG), glucose, glucose-dependent insulinotropic polypeptide (GIP), peptide YY (PYY), insulin, gastric emptying (paracetamol concentrations) and satiety (visual analogue scales).The postprandial increase in plasma TAG was higher following the IE PSt/PK versus the non-IE PSt/PK, with a 51 % greater incremental area under the curve [mean difference with 95 % CI 41 (23, 58) mmol/L min P = 0.001]. The pattern of lipaemia was different between meals; at 4-h plasma TAG concentrations declined following the IE fat but continued to rise following the non-IE fat. Insulin, glucose, paracetamol, PYY and GIP concentrations increased significantly after the test meals (time effect; P < 0.001 for all), but did not differ between test meals. Feelings of fullness were higher following the non-IE PSt/PK meal (diet effect; P = 0.034). No other significant differences were noted.Interesterification of PSt/PK increases early phase postprandial lipaemia (0–4 h); however, further investigation during the late postprandial phase (4–8 h) is warranted to determine the rate of return to baseline as NCT02365987.
Keywords: Interesterified fat; Palm stearin; Palm kernel; Postprandial lipaemia

Circulating ferritin concentrations are differentially associated with serum adipokine concentrations in Japanese men and premenopausal women by Yasumi Kimura; Kazuki Yasuda; Kayo Kurotani; Shamima Akter; Ikuko Kashino; Hitomi Hayabuchi; Masao Sato; Tetsuya Mizoue (2497-2505).
Increased iron storage, as measured by circulating ferritin, has been linked to an increased risk of various diseases including diabetes. We examined the association of circulating ferritin with serum adiponectin, leptin, resistin, plasminogen activator inhibitor-1 (PAI-1), and visfatin levels.We conducted a cross-sectional study among 429 Japanese employees (284 men and 145 premenopausal women, mean age: 42.5 ± 10.5 years). Serum adipokines were measured using Luminex suspension bead-based multiplexed array, and serum ferritin was determined using a chemiluminescence immunoassay. Multivariable regression analysis was performed to calculate mean concentrations of adipokine according to the tertile of ferritin concentrations with adjustment for potential confounders.Leptin and visfatin concentrations increased with increasing ferritin concentrations in men after multivariable adjustment of physical activity, smoking, alcohol use, and body mass index (P for trend = 0.02 and 0.01 for leptin and visfatin, respectively). Serum ferritin concentrations were inversely and significantly associated with adiponectin in women (P for trend = 0.01). Resistin and PAI-1 were not appreciably associated with ferritin concentration.Increased iron storage may be associated with higher circulating concentrations of leptin and visfatin in men and with lower concentrations of adiponectin in women.
Keywords: Iron stores; Ferritin; Adipokine; Adiponectin; Leptin; Japanese

Age and time trends in eating frequency and duration of nightly fasting of German children and adolescents by Sarah Roßbach; Tanja Diederichs; Katja Bolzenius; Christian Herder; Anette E. Buyken; Ute Alexy (2507-2517).
To describe age and time trends in eating occasion frequency (EOF), meal frequency (MF), snack frequency (SF) and duration of nightly fasting (DNF) in German children and adolescents.9757 3-day dietary records of 1246 3–18-year-old participants of the open DONALD cohort study, collected 1985–2014, were analyzed for age and time trends using polynomial mixed-effects regression models. Eating occasions were either assigned to meals or snacks (>10 or ≤10 % of daily total energy intake per eating occasion). DNF was defined as the longest time span without energy intake within one night.EOF, MF and SF decreased with age (EOF: linear, quadratic, cubic trend p < 0.0001; MF: linear trend p < 0.0001; SF: linear, quadratic trend p < 0.0001). Time trend analyses revealed a wavelike time course for EOF (linear trend p = 0.0580, quadratic trend = 0.0039, cubic trend = 0.0015) and SF (linear trend p = 0.0055, quadratic trend p = 0.0005, cubic trend p = 0.0003). MF slightly increased until 2000 and decreased thereafter (linear trend p = 0.0012, quadratic trend p = 0.0047). Effect sizes of time trends in EOF, MF and SF were small. Boys’ and girls’ DNF decreased with age (in both: linear, quadratic, cubic trend p < 0.0001) and increased over the study period (boys: linear trend p = 0.0011, interaction of age and time p < 0.0001; girls: linear trend p = 0.0167).EOF, MF and SF were higher in children than in adolescents, but, in contrast to other studies remained fairly stable over the study period. Decreasing DNF with age could reflect decreasing sleep durations. Additionally, DNF increased over the study period, probably due to an increase in breakfast skipping.
Keywords: Eating frequency; Nightly fasting; Trends; Children; Adolescents

Oral citrulline supplementation protects female mice from the development of non-alcoholic fatty liver disease (NAFLD) by Cathrin Sellmann; Cheng Jun Jin; Anna Janina Engstler; Jean-Pascal De Bandt; Ina Bergheim (2519-2527).
Impairments of intestinal barrier function are discussed as risk factors for the development and progression of non-alcoholic fatty liver disease (NAFLD). Studies suggest an association between arginine/citrulline homeostasis and the development of liver damages. Here, the effect of an oral l-citrulline (Cit) supplement on the development of a Western-style diet (WSD)-induced NAFLD was determined in mice.Female 6- to 8-week-old C57BL/6J mice were either pair-fed a liquid Western-style or control diet (C) ± 2.5 g/kg bodyweight Cit for 6 weeks (C + Cit or WSD + Cit). Indices of liver damage, glucose metabolism, intestinal barrier function and NO synthesis were measured.While bodyweight gain was similar between groups, markers of glucose metabolism like fasting blood glucose and HOMA index and markers of liver damage like hepatic triglyceride levels, number of neutrophils and plasminogen activator inhibitor-1 protein levels were significantly lower in WSD + Cit-fed mice when compared to WSD-fed mice only. Protein levels of the tight junction proteins occludin and zonula occludens-1 in duodenum were significantly lower in mice fed a WSD when compared to those fed a WSD + Cit (−~70 and −~60 %, respectively, P < 0.05), whereas portal endotoxin levels, concentration of 3-nitrotyrosine protein adducts in duodenum and toll-like receptor-4 mRNA expression in livers of WSD + Cit-fed mice were markedly lower than in WSD-fed mice (−~43 %, P = 0.056; −~80 and −~48 %, respectively, P < 0.05).Our data suggest that the protective effects of supplementing Cit on the development of NAFLD in mice are associated with a decreased translocation of endotoxin into the portal vein.
Keywords: Citrulline; Intestinal barrier function; Endotoxin; Occludin; Non-alcoholic fatty liver disease

Estimating safe maximum levels of vitamins and minerals in fortified foods and food supplements by Albert Flynn; Laura Kehoe; Áine Hennessy; Janette Walton (2529-2539).
To show how safe maximum levels (SML) of vitamins and minerals in fortified foods and supplements may be estimated in population subgroups.SML were estimated for adults and 7- to 10-year-old children for six nutrients (retinol, vitamins B6, D and E, folic acid, iron and calcium) using data on usual daily nutrient intakes from Irish national nutrition surveys.SML of nutrients in supplements were lower for children than for adults, except for calcium and iron. Daily energy intake from fortified foods in high consumers (95th percentile) varied by nutrient from 138 to 342 kcal in adults and 40–309 kcal in children. SML (/100 kcal) of nutrients in fortified food were lower for children than adults for vitamins B6 and D, higher for vitamin E, with little difference for other nutrients. Including 25 % ‘overage’ for nutrients in fortified foods and supplements had little effect on SML. Nutritionally significant amounts of these nutrients can be added safely to supplements and fortified foods for these population subgroups. The estimated SML of nutrients in fortified foods and supplements may be considered safe for these population subgroups over the long term given the food composition and dietary patterns prevailing in the respective dietary surveys.This risk assessment approach shows how nutrient intake data may be used to estimate, for population subgroups, the SML for vitamins and minerals in both fortified foods and supplements, separately, each taking into account the intake from other dietary sources.
Keywords: Vitamins; Minerals; Safe maximum levels; Fortified foods; Supplements; Irish national nutrition surveys

Bioavailability of chlorogenic acids in rats after acute ingestion of maté tea (Ilex paraguariensis) or 5-caffeoylquinic acid by Daniela Moura de Oliveira; Geni Rodrigues Sampaio; Carolina Bonin Pinto; Rodrigo Ramos Catharino; Deborah H. Markowicz Bastos (2541-2556).
Yerba maté is widely consumed in South America as different beverages, such as maté tea (roasted leaves) and chimarrão (green dried leaves), and linked to health benefits, mainly attributed to chlorogenic acids (CGAs). Health effects of CGAs depend on their bioavailability, but such data are scarce. The aim of this study was to investigate the distribution of CGAs and metabolites in tissues, hepatic and plasmatic kinetic profile and urinary excretion after ingestion of maté tea or 5-caffeoylquinic acid (5-CQA).Wistar rats ingested maté tea (MT) or 5-CQA (ST) and were killed after 1.5 h for tissue distribution analysis (pilot study) or at 0.5, 1, 2, 4 and 8 h for liver and plasma kinetics (main experiment). Urine was collected in metabolic cages. Biological samples were analyzed by UPLC-DAD-MS with and without incubation with β-glucuronidase and sulfatase.CGAs and metabolites were detected in all tissues. Caffeic acid was the main compound in plasma up to 2 h after ingestion of maté tea, while 5-CQA predominated in ST group. Concentration of microbial metabolites increased 4 h after gavage and reached higher amounts in MT plasma and liver, when compared to ST group. Approximately 4.0 % of compounds ingested by MT and 3.3 % by ST were recovered in urine up to 8 h after the gavage.The study confirms that not only absorption, but also metabolization of CGAs begins in stomach. There were differences in compounds formed from maté tea or isolated 5-CQA, showing that CGAs profile in food may influence qualitatively and quantitatively the metabolites formed in the body.
Keywords: Phenolic compounds; Chlorogenic acids; Ilex paraguariensis ; Bioavailability; Biotransformation; UPLC-DAD-MS

Relationship between soluble receptor for advanced glycation end products (sRAGE), body composition and fat distribution in healthy women by Elena Dozio; Silvia Briganti; Alessandra Delnevo; Elena Vianello; Federica Ermetici; Francesco Secchi; Francesco Sardanelli; Lelio Morricone; Alexis E. Malavazos; Massimiliano M. Corsi Romanelli (2557-2564).
Soluble receptor for advanced glycation end products (sRAGE) is a decoy receptor which sequesters RAGE ligands and acts as a cytoprotective agent. To date, it is unclear whether the lower sRAGE levels observed in obesity are a marker of increased overall adiposity or reflect increases in particular fat depots. Therefore, we evaluated in healthy women the relationship among sRAGE and indicators of adiposity, including abdominal visceral (VAT) and epicardial visceral (EAT) adipose tissues, to explore the potential role of sRAGE as an earlier biomarker of cardiometabolic risk.Plasma sRAGE levels were quantified by an enzyme-linked immunosorbent assay in 47 healthy women. Total fat mass (FM) and fat-free mass were estimated with bioimpedance analysis. Anthropometric measures and biochemical data were recorded. Subcutaneous adipose tissue, VAT and EAT volumes were measured by magnetic resonance imaging.Obese women had lower sRAGE levels compared to normal-weight women. sRAGE levels were also lower in women with a waist circumference (WC) larger than 80 cm. Correlation analyses indicated an inverse association of sRAGE with body mass index and FM. Concerning adipose tissue distribution, sRAGE inversely correlated with WC, EAT and VAT depots. In a multiple stepwise regression analysis, performed to emphasize the role of fat distribution, EAT volume was the only predictor of sRAGE.Lower sRAGE levels reflect accumulation of visceral fat mainly at the epicardial level and are present in advance of metabolic complications in adult women. sRAGE quantification might be an early marker of cardiometabolic risk.
Keywords: Adipose tissue; Adipose tissue distribution; Epicardial adipose tissue; Receptor for advanced glycation end products; Subcutaneous adipose tissue; Visceral adipose tissue

Cheese consumption and risk of cardiovascular disease: a meta-analysis of prospective studies by Guo-Chong Chen; Yan Wang; Xing Tong; Ignatius M. Y. Szeto; Gerrit Smit; Zeng-Ning Li; Li-Qiang Qin (2565-2575).
Cheese contains a high content of saturated fatty acids but also lists of potentially beneficial nutrients. How long-term cheese consumption affects the development of cardiovascular disease (CVD) is unclear. A meta-analysis of prospective observational studies was conducted to evaluate the risks of total CVD, coronary heart disease (CHD), and stroke associated with cheese consumption.Potentially eligible studies were identified by searching PubMed and EMBASE databases and by carefully reviewing the bibliographies of retrieved publications and related reviews. The summary relative risks (RRs) with 95 % confidence intervals (CIs) were calculated using the random-effects model.The final analyses included 15 prospective studies. Most of the studies excluded prevalent CVD at baseline (14/15) and had a duration >10 years (13/15). The summary RR for high vs. low cheese consumption was 0.90 (95 % CI 0.82–0.99) for total CVD (7 studies, 8076 events), 0.86 (95 % CI 0.77–0.96) for CHD (8 studies, 7631 events), and 0.90 (95 % CI 0.84–0.97) for stroke (7 studies, 10,449 events), respectively. The restricted cubic model indicated evidence of nonlinear relationships between cheese consumption and risks of total CVD (P nonlinearity < 0.001) and stroke (P nonlinearity = 0.015), with the largest risk reductions observed at the consumption of approximately 40 g/d.This meta-analysis of prospective studies suggests a nonlinear inverse association between cheese consumption and risk of CVD.
Keywords: Dairy; Cheese; Cardiovascular disease; Meta-analysis

Dietary patterns are associated with depressive symptoms among Chinese adults: a case–control study with propensity score matching by Yang Xia; Na Wang; Bin Yu; Qing Zhang; Li Liu; Ge Meng; Hongmei Wu; Huanmin Du; Hongbin Shi; Xiaoyan Guo; Xing Liu; Chunlei Li; Peipei Han; Renwei Dong; Xiuyang Wang; Xue Bao; Qian Su; Yeqing Gu; Liyun Fang; Fei Yu; Huijun Yang; Li Kang; Yixuan Ma; Shaomei Sun; Xing Wang; Ming Zhou; Qiyu Jia; Qi Guo; Yuntang Wu; Kun Song; Kaijun Niu (2577-2587).
Previous studies have indicated that consumption of particular foods or nutrients is associated with depressive symptoms, but little is known about the role of overall dietary patterns in depressive symptoms. We design this case–control study to evaluate the associations between dietary patterns and high depression symptoms in Chinese adults.A total of 1351 participants with high depressive symptoms were matched with 1351 controls using the 1:1 ratio propensity score matching method. Dietary intake was assessed using a valid self-administered food frequency questionnaire, and high depressive symptoms were assessed with the Zung Self-Rating Depression Scale, wherein cutoff point of 45 was used as a definition of high depressive symptoms.Exploratory factor analysis revealed three dietary patterns (vegetables and fruits pattern; sweets pattern; and animal foods pattern) explaining 25.1 % of the total variance. Compared with the participants in the lowest quartile, the participants in the highest quartile of vegetables and fruits pattern, which was defined as a healthy pattern, were associated with reduced odds of high depressive symptoms (OR 0.65, 95 % CI 0.52–0.83, P for trend <0.001) while the sweets pattern (OR 1.33, 95 % CI 1.06–1.66) and the animal foods pattern (OR 1.79, 95 % CI 1.43–2.24, P for trend <0.0001) were associated with increased prevalence of high depressive symptoms, respectively.The present study adds to the evidence that the sweets pattern and animal foods pattern are positively associated with the prevalence of high depressive symptoms. In contrast, the dietary pattern rich in vegetables, fruits, and soya bean products, but low in animal foods, candied fruits, cakes, ice cream, sugared beverages, and alcoholic drinks is negatively associated with the prevalence of high depressive symptoms.
Keywords: OR; Dietary patterns; Depressive symptoms; Propensity score matching

Factors influencing the reinforcing value of fruit and unhealthy snacks by L. Vervoort; A. Clauwaert; L. Vandeweghe; J. Vangeel; W. Van Lippevelde; L. Goossens; L. Huybregts; C. Lachat; S. Eggermont; K. Beullens; C. Braet; N. De Cock (2589-2598).
The present study investigated the reinforcing value of healthy and unhealthy snack food in adolescents (n = 108, aged 14–16 years). Moderation by access to different foods, sex and the personality trait reward sensitivity is tested.In a computerized Food Reinforcement Task, adolescents could earn portions of a healthy and an unhealthy snack following an identical progressive reinforcement schedule for both food types. Reinforcing value of food was indexed by the number of button presses for each food type. Participants were allocated randomly to two-order condition: fruit–snack versus snack–fruit. Reward sensitivity was assessed with the Dutch age-downward version of Carver and White’s BIS/BAS scale.Results showed that the reinforcing value of an unhealthy snack is higher than that of fruit, with participants making more button presses for unhealthy snacks, M = 1280.40, SD = 1203.53, than for fruit, M = 488.04, SD = 401.45, F(1,48) = 25.37, p < 0.001. This effect is stronger in boys (β = −1367.67) than in girls (β = −548.61). The effect is only present in the snack–fruit condition, not in the fruit–snack condition, indicating that access to food moderates the effect of food type. There is no evidence for moderation by reward sensitivity.Results point to the importance of simultaneously increasing barriers to obtain unhealthy food and promoting access to healthy food in order to facilitate healthy food choices.
Keywords: Reward sensitivity; Adolescents; Reinforcing value of food; Food reward

Trimethylamine-N-oxide and its biological variations in vegetarians by Rima Obeid; Hussain M. Awwad; Markus Keller; Juergen Geisel (2599-2609).
Restriction of animal foods and choline may affect plasma trimethylamine-N-oxide (TMAO). In vegetarians, we investigated the association between TMAO concentrations and the strictness of the diet or sex. We also studied the biological variations of TMAO in vegans.Concentrations of plasma TMAO and choline metabolites were measured in 38 vegans and 67 lacto-ovo-vegetarians (group 1: mean age ± SD = 50 ± 15 years). Group 2 consisted of 66 vegans (29.2 ± 7.3 years) that was tested twice within 3 months of intervention with vitamin B12 or a placebo.In group 1, plasma TMAO did not differ according to the strictness of the diet (both means 3.7 µmol/L). In lacto-ovo-vegetarians, men had higher TMAO and betaine, but lower trimethylamine than women. In group 2, the intervention with vitamin B12 had no effect on plasma TMAO or choline metabolites. The mean within-subject change of TMAO within 3 months was −0.3 (95 % confidence intervals = −0.7–0.1 µmol/L). TMAO increased after 3 months (mean 1.7 to 2.8 µmol/L) in vegans with a lower baseline dimethylglycine (2.2 µmol/L), while it declined (from 2.7 to 1.9 µmol/L) in vegans with a higher dimethylglycine (3.1 µmol/L). The intra-class correlation coefficients were 0.819 for TMAO, 0.885 for betaine and 0.860 for dimethylglycine.Plasma TMAO was not related to the strictness of the vegetarian diet. Metabolisms of TMAO and dimethylglycine are interrelated. Intra-individual variations of TMAO are low in vegans. Changes of fasting plasma TMAO >80 % upon retesting are likely to exceed the biological variations.
Keywords: Choline; Metabolism; Monooxygenase; Trimethylamine N-oxide; Vegan

Iron bioavailability from supplemented formula milk: effect of lactoferrin addition by Sonia Fernández-Menéndez; María L. Fernández-Sánchez; Héctor González-Iglesias; Belén Fernández-Colomer; José López-Sastre; Alfredo Sanz-Medel (2611-2620).
In this work, the absorption and/or bioavailability of iron from two chemical species, 57Fe-Lf (apo-lactoferrin) complex and 57FeSO4 at low and high dose, and in Lf excess were investigated in lactating wistar rats.The methodology used is based on the use of stable isotopes in combination with the approach “isotope pattern deconvolution” and ICP-MS for detection. This approach provides quantitative information about exogenous (57Fe) and endogenous iron (natFe) distribution in fluids and tissues in the iron-supplemented rat groups.The observed results with supplemented rats were compared with those found in rats receiving maternal feeding. Interestingly, differences were found between groups in iron for transport and storage compartments, but not in the functional one, depending upon the dose of iron administered and the chemical species.Considering the results obtained, supplementation with iron salts in excess of Lf appears to be the best way of iron supplementation of formula milk.
Keywords: IPD; ICP-MS; Lf; Iron supplementation; Enriched stable isotopes; Lactating rats; Apparent absorption retention; Endogenous exogenous iron; Body tissues fluids

Cognitive and mood improvements following acute supplementation with purple grape juice in healthy young adults by C. F. Haskell-Ramsay; R. C. Stuart; E. J. Okello; A. W. Watson (2621-2631).
In the original publication of the article, on page 7, paragraph "Discussion", line 12, ‘blackcurrant has been observed to increase digit vigilance reaction time’ should read as ‘blackcurrant has been observed to decrease digit vigilance reaction time’.Berry-derived phenolic compounds found in grapes have been associated with a number of health benefits, including the augmentation of human brain function and cognition. Previous intervention studies of Concord grape juice have demonstrated improvement to memory and driving ability following 3- to 4-month supplementation in middle-aged and older adults. However, no studies to date have demonstrated acute cognitive benefits of grape juice, and investigation of these effects in young adults is lacking.This randomised, placebo-controlled, double-blind, counterbalanced-crossover study, assessed the effects of 230 ml purple grape juice or sugar-matched control in 20 healthy young adults. Computerised measures of episodic memory, working memory, attention and mood were completed at baseline and following a 20-min absorption period.Purple grape juice significantly improved reaction time on a composite attention measure (p = 0.047) and increased calm ratings (p = 0.046) when compared to placebo. Order effects also indicated an enduring positive effect on pre-dose memory reaction time (p = 0.018) and post-dose calm ratings (p = 0.019) when purple grape was consumed first.These findings in a small sample of healthy young adults suggest that purple grape juice can acutely enhance aspects of cognition and mood. No significant effects of juice were observed on memory measures, suggesting that these may be less susceptible to manipulation following acute supplementation in healthy young adults. Potential mechanisms underlying these effects include modulation of cerebral blood flow, glucoregulation and inhibition of monoamine oxidase activity, all of which require further exploration.
Keywords: Cognition; Cognitive; Mood; Grape; Phenolic; Polyphenol; Phytochemical

Erratum to: Cognitive and mood improvements following acute supplementation with purple grape juice in healthy young adults by C. F. Haskell‑Ramsay; R. C. Stuart; E. J. Okello; A. W. Watson (2633-2633).
In the original publication of the article, on page 7, paragraph "Discussion", line 12, ‘blackcurrant has been observed to increase digit vigilance reaction time’ should read as ‘blackcurrant has been observed to decrease digit vigilance reaction time’.