European Journal of Nutrition (v.57, #4)

Antidiabetic plant-derived nutraceuticals: a critical review by Jayapal Naveen; Vallikannan Baskaran (1275-1299).
Diabetes mellitus (DM) is one of the major health problems in the world, especially amongst the urban population. Chemically synthesized drugs used to decrease the ill effects of DM and its secondary complications cause adverse side effects, viz., weight gain, gastrointestinal disturbances, and heart failure. Currently, various other approaches, viz., diet control, physical exercise and use of antidiabetic plant-derived molecules/foods are advocated to manage DM, as they are economical with fewer or no side effects. This review mainly focuses on antidiabetic plants, chemically characterized plant molecules and plant-based foods in the treatment of DM. Very little science-based evidence is available on the mechanism of action of plant-derived food molecules on the DM targets. Critical DM targets include α-amylase, α-glucosidase, DPP-IV, aldose reductase, PPAR-γ, AMP kinase and GLUT4. In-depth studies carried out on a few of those targets with specific mechanisms of action are addressed in this review. This review may help future researchers in identifying a right plant molecule to treat DM or to develop food formulations for DM management.
Keywords: Antidiabetic; Diabetes mellitus; Insulin; Nutraceuticals

In the past, different types of diet with a generally low-carbohydrate content (< 50–< 20 g/day) have been promoted, for weight loss and diabetes, and the effectiveness of a very low dietary carbohydrate content has always been a matter of debate. A significant reduction in the amount of carbohydrates in the diet is usually accompanied by an increase in the amount of fat and to a lesser extent, also protein. Accordingly, using the term “low carb–high fat” (LCHF) diet is most appropriate. Low/very low intakes of carbohydrate food sources may impact on overall diet quality and long-term effects of such drastic diet changes remain at present unknown. This narrative review highlights recent metabolic and clinical outcomes of studies as well as practical feasibility of low LCHF diets. A few relevant observations are as follows: (1) any diet type resulting in reduced energy intake will result in weight loss and related favorable metabolic and functional changes; (2) short-term LCHF studies show both favorable and less desirable effects; (3) sustained adherence to a ketogenic LCHF diet appears to be difficult. A non-ketogenic diet supplying 100–150 g carbohydrate/day, under good control, may be more practical. (4) There is lack of data supporting long-term efficacy, safety and health benefits of LCHF diets. Any recommendation should be judged in this light. (5) Lifestyle intervention in people at high risk of developing type 2 diabetes, while maintaining a relative carbohydrate-rich diet, results in long-term prevention of progression to type 2 diabetes and is generally seen as safe.
Keywords: Low-carbohydrate diet; High-fat diet; Ketogenic diet; Type 2 diabetes; Obesity.

The sensitivity and specificity of thyroglobulin concentration using repeated measures of urinary iodine excretion by Zheng F. Ma; Bernard J. Venn; Patrick J. Manning; Claire M. Cameron; Sheila A. Skeaff (1313-1320).
Iodine deficiency affects 30% of populations worldwide. The amount of thyroglobulin (Tg) in blood increases in iodine deficiency and also in iodine excess. Tg is considered as a sensitive index of iodine status in groups of children and adults, but its usefulness for individuals is unknown. The aim of this study was to determine the diagnostic performance of Tg as an index of iodine status in individual adults.Adults aged 18–40 years (n = 151) provided five spot urine samples for the measurement of urinary iodine concentration expressed as μg/L (UIC), μg/g of creatinine (I:Cre), and μg/day (estimated UIE); the mean of the five samples was used as the reference standard. Participants also provided a blood sample for the determination of Tg, thyroid-stimulating hormone (TSH), and free thyroxine (FT4).The median of UIC, I:Cre, estimated UIE, and Tg was 72 (range 16–350) μg/L, 90 (range 33–371) μg/g, 129 (range 41–646) μg/day, and 16.4 (range 0.8–178.9) μg/L, respectively. Using Tg cut-offs of >10, >11, >13, and >15 μg/L, the sensitivity and specificity for UIC, I:Cre, and estimated UIE ranged from 52 to 79% and 20–48%, respectively, below the acceptable value of ≥80%. Furthermore, receiver-operating characteristic (ROC) curves for Tg using the three measurements of urinary iodine were situated close to the chance line and the area under the curve ranged from 0.49 to 0.52.The results from this cross-sectional study indicate that Tg has low sensitivity and specificity to repeated measures of urinary iodine excretion. Further studies are still needed to investigate the usefulness of Tg as a biomarker of individual iodine status.
Keywords: Iodine deficiency; Biomarker; Diagnostic; Thyroglobulin; Adult

Methyl-donor depletion of head and neck cancer cells in vitro establishes a less aggressive tumour cell phenotype by Vanessa Hearnden; Hilary J. Powers; Abeir Elmogassabi; Rosanna Lowe; Craig Murdoch (1321-1332).
DNA methylation plays a fundamental role in the epigenetic control of carcinogenesis and is, in part, influenced by the availability of methyl donors obtained from the diet. In this study, we developed an in-vitro model to investigate whether methyl donor depletion affects the phenotype and gene expression in head and neck squamous cell carcinoma (HNSCC) cells.HNSCC cell lines (UD-SCC2 and UPCI-SCC72) were cultured in medium deficient in methionine, folate, and choline or methyl donor complete medium. Cell doubling-time, proliferation, migration, and apoptosis were analysed. The effects of methyl donor depletion on enzymes controlling DNA methylation and the pro-apoptotic factors death-associated protein kinase-1 (DAPK1) and p53 upregulated modulator of apoptosis (PUMA) were examined by quantitative-PCR or immunoblotting.HNSCC cells cultured in methyl donor deplete conditions showed significantly increased cell doubling times, reduced cell proliferation, impaired cell migration, and a dose-dependent increase in apoptosis when compared to cells cultured in complete medium. Methyl donor depletion significantly increased the gene expression of DNMT3a and TET-1, an effect that was reversed upon methyl donor repletion in UD-SCC2 cells. In addition, expression of DAPK1 and PUMA was increased in UD-SCC2 cells cultured in methyl donor deplete compared to complete medium, possibly explaining the observed increase in apoptosis in these cells.Taken together, these data show that depleting HNSCC cells of methyl donors reduces the growth and mobility of HNSCC cells, while increasing rates of apoptosis, suggesting that a methyl donor depleted diet may significantly affect the growth of established HNSCC.
Keywords: DNA methylation; Head and neck cancer; Methyl donor; Apoptosis; DAPK

Coffee, tea, caffeine, and risk of hypertension: The Singapore Chinese Health Study by Choy-Lye Chei; Julian Kenrick Loh; Avril Soh; Jian-Min Yuan; Woon-Puay Koh (1333-1342).
The relationship between coffee and tea, and risk of hypertension remains controversial in Western populations. We investigated these associations in an Asian population.The Singapore Chinese Health Study is a population-based prospective cohort that recruited 63,257 Chinese aged 45–74 years and residing in Singapore from 1993 to 1998. Information on consumption of coffee, tea, and other lifestyle factors was collected at baseline, and self-reported physician-diagnosed hypertension was assessed during two follow-up interviews (1999–2004, 2006–2010).We identified 13,658 cases of incident hypertension after average 9.5 years. Compared to those who drank one cup of coffee/day, the hazard ratios (HR) and 95% confidence intervals (CI) were 0.87 (0.83–0.91) for p trend = 0.02).Drinking coffee <1 cup/week or ≥3 cups/day had lower risk than drinking one cup/day. Caffeine may account for increased risk in daily tea drinkers and in those who drank one cup of coffee/day. The inverse U-shaped association with coffee suggests that at higher doses, other ingredients in coffee may offset the effect of caffeine and confer benefit on blood pressure.
Keywords: Hypertension; Coffee; Tea; Caffeine; Prospective study

Influence of trans fatty acids on glucose metabolism in soleus muscle of rats fed diets enriched in or deprived of linoleic acid by Ana C. Fariña; Sandro Hirabara; Juliana Sain; Marcela González; Rui Curi; Claudio Bernal (1343-1355).
Industrial trans fatty acid (TFA) intake leads to impaired glucose metabolism. However, the overall effects reported are inconsistent and vary with the dietary FA composition and TFA isomer type and levels. We investigated TFA effects on glucose uptake, incorporation and oxidation, and glycogen synthesis in incubated soleus muscle under basal conditions or after treatment with insulin and/or palmitate.Male Wistar rats were fed either linoleic acid (LA)-enriched (+LA) or LA-deprived (LA) diet, supplemented (+LA + TFA or LA + TFA) or not with TFA, for 60 days. Soleus muscle glucose metabolism was assessed in the absence or presence of insulin and/or palmitic acid.Under basal conditions, TFA enhanced glucose uptake and oxidation regardless of the LA status. Both TFA-supplemented groups had lower insulin response to glucose metabolism. Under insulin-stimulated conditions, TFA prevented the palmitate inhibition of muscle glucose uptake and metabolism in the +LA + TFA group.Dietary TFA enhanced glucose utilization in incubated soleus muscle under basal conditions and prevented the palmitate-induced inhibition in insulin-stimulated conditions. However, TFA reduced the insulin response to glucose uptake and metabolism. The effects mentioned above were influenced by the FA profile modifications induced by the dietary LA levels, suggesting that lipid metabolization and incorporation into plasma membrane are important determining factors of glucose metabolism and insulin sensitivity.
Keywords: Trans fatty acids; Linoleic acid; Glucose uptake; Glucose incorporation; Glucose oxidation; Glycogen synthesis

Associations of vitamin D status with dietary intakes and physical activity levels among adults from seven European countries: the Food4Me study by Yannis Manios; George Moschonis; Christina P. Lambrinou; Christina Mavrogianni; Lydia Tsirigoti; Ulrich Hoeller; Franz F. Roos; Igor Bendik; Manfred Eggersdorfer; Carlos Celis-Morales; Katherine M. Livingstone; Cyril F. M. Marsaux; Anna L. Macready; Rosalind Fallaize; Clare B. O’Donovan; Clara Woolhead; Hannah Forster; Marianne C. Walsh; Santiago Navas-Carretero; Rodrigo San-Cristobal; Silvia Kolossa; Jacqueline Hallmann; Mirosław Jarosz; Agnieszka Surwiłło; Iwona Traczyk; Christian A. Drevon; Ben van Ommen; Keith Grimaldi; John N. S. Matthews; Hannelore Daniel; J. Alfredo Martinez; Julie A. Lovegrove; Eileen R. Gibney; Lorraine Brennan; Wim H. M. Saris; Mike Gibney; John C. Mathers (1357-1368).
To report the vitamin D status in adults from seven European countries and to identify behavioural correlates.In total, 1075 eligible adult men and women from Ireland, Netherlands, Spain, Greece, UK, Poland and Germany, were included in the study.Vitamin D deficiency and insufficiency, defined as 25-hydroxy vitamin D3 (25-OHD3) concentration of <30 and 30–49.9 nmol/L, respectively, were observed in 3.3 and 30.6% of the participants. The highest prevalence of vitamin D deficiency was found in the UK and the lowest in the Netherlands (8.2 vs. 1.1%, P < 0.05). In addition, the prevalence of vitamin D insufficiency was higher in females compared with males (36.6 vs. 22.6%, P < 0.001), in winter compared with summer months (39.3 vs. 25.0%, P < 0.05) and in younger compared with older participants (36.0 vs. 24.4%, P < 0.05). Positive dose–response associations were also observed between 25-OHD3 concentrations and dietary vitamin D intake from foods and supplements, as well as with physical activity (PA) levels. Vitamin D intakes of ≥5 μg/day from foods and ≥5 μg/day from supplements, as well as engagement in ≥30 min/day of moderate- and vigorous-intensity PA were associated with higher odds (P < 0.05) for maintaining sufficient (≥50 nmol/L) 25-OHD3 concentrations.The prevalence of vitamin D deficiency varied considerably among European adults. Dietary intakes of ≥10 μg/day of vitamin D from foods and/or supplements and at least 30 min/day of moderate- and vigorous-intensity PA were the minimum thresholds associated with vitamin D sufficiency.
Keywords: Vitamin D; 25-Hydroxyvitamin D; Diet; Supplements; Physical activity; Adults Europe

Season, dietary factors, and physical activity modify 25-hydroxyvitamin D concentration during pregnancy by Helena H. Hauta-alus; Elisa M. Holmlund-Suila; Hannu J. Rita; Maria Enlund-Cerullo; Jenni Rosendahl; Saara M. Valkama; Otto M. Helve; Timo K. Hytinantti; Heljä-Marja Surcel; Outi M. Mäkitie; Sture Andersson; Heli T. Viljakainen (1369-1379).
The objectives of this cross-sectional study were to define maternal and umbilical cord blood (UCB) 25-hydroxyvitamin D (25(OH)D) to characterize maternal factors modifying 25(OH)D during pregnancy and predict UCB 25(OH)D in two subgroups with Declined [Δ25(OH)D <0 nmol/l] and Increased [Δ25(OH)D >0 nmol/l] 25(OH)D concentration.A complete dataset was available from 584 women. 25(OH)D was determined at gestational weeks 6–13 and in UCB. Baseline characteristics were collected retrospectively using questionnaires. Δ25(OH)D was calculated as UCB 25(OH)D−early pregnancy 25(OH)D. Dietary patterns were generated with principal component analysis. Multivariate regression models were applied.Vitamin D deficiency was scarce, since only 1% had 25(OH)D concentration <50 nmol/l both in early pregnancy and in UCB. Shared positive predictors of UCB 25(OH)D in the subgroups of Declined and Increased, were early pregnancy 25(OH)D (P < 0.001) and supplemental vitamin D intake (P < 0.04). For the Increased subgroup summer season at delivery (P = 0.001) and “sandwich and dairy” dietary pattern characterized with frequent consumption of vitamin D fortified margarine and milk products (P = 0.009) were positive predictors of UCB 25(OH)D. Physical activity (P = 0.041) and maternal education (P = 0.004) were additional positive predictors in the Declined groupMaternal and newborn vitamin D status was sufficient, thus public health policies in Finland have been successful. The key modifiable maternal determinants for 25(OH)D during pregnancy, and of the newborn, were supplemental vitamin D intake, frequent consumption of vitamin D fortified foods, and physical activity.
Keywords: Maternal vitamin D status; Newborn vitamin D status; 25-hydroxyvitamin D concentration; Pregnancy; Dietary pattern

CaCo-2 colon cancer cells and HepG2 liver cancer cells represent two malignant cell lines, which show a high resistance to apoptosis induced by the conventional anticancer drugs. Vitexin-2-O-xyloside (XVX) and avenanthramides (AVNs) are naturally occurring dietary agents from Beta vulgaris var. cicla L. and Avena sativa L., respectively. The aim of this work was to evaluate the antiproliferative effects and the reduction of the pro-survival mechanisms exerted by XVX and AVNs, used individually and in combination, in CaCo-2 and HepG2 cancer cells.XVX and AVNs were isolated by liquid chromatography and characterized by HPLC–PDA–MS. The XVX and AVN antiproliferative effects were evaluated through sulforhodamine B method, while their pro-apoptotic effects through caspase activity assays. RTqPCR was used to investigate the modulation of the pro-survival factors baculoviral inhibitor of apoptosis repeat-containing 5 (BIRC5), hypoxia inducible factor 1 A (HIF1A), and vascular endothelial growth factor A (VEGFA). Cellular antioxidant activity (CAA) was investigated by means of DCFH-DA assay, whereas chemical antioxidant capacity was evaluated by the ORAC method.XVX and AVNs, both individually and in combination, inhibited the proliferation of CaCo-2 and HepG2 cancer cells, through activation of caspases 9, 8, and 3. XVX and AVNs downregulated the pro-survival genes BIRC5, HIF1A, and VEGFA. The CAA assay showed that AVNs exhibited strong antioxidant activity inside both CaCo-2 and HepG2 cells.The antiproliferative activity of the XVX + AVNs mixture represents an innovative treatment, which is effective against two types of cancer cells characterized by high resistance to the conventional anticancer drugs.
Keywords: Apoptosis; Avenanthramides; CaCo-2 colon cancer cells; Cellular antioxidant activity; HepG2 liver cancer cells; Vitexin-2-O-xyloside

Prospective associations between dietary patterns and high sensitivity C-reactive protein in European children: the IDEFICS study by Esther María González-Gil; Gianluca Tognon; Lauren Lissner; Timm Intemann; Valeria Pala; Claudio Galli; Maike Wolters; Alfonso Siani; Toomas Veidebaum; Nathalie Michels; Denes Molnar; Jaakko Kaprio; Yannis Kourides; Arno Fraterman; Licia Iacoviello; Catalina Picó; Juan Miguel Fernández-Alvira; Luis Alberto Moreno Aznar (1397-1407).
This prospective study explores high sensitivity C-reactive protein (hs-CRP) levels in relation to dietary patterns at two time points in European children.Out of the baseline sample of the IDEFICS study (n = 16,228), 4020 children, aged 2–9 years at baseline, with available hs-CRP levels and valid data from a food frequency questionnaire (FFQ) at baseline (T0) and 2 years later (T1) were included. K-means clustering algorithm based on the similarities between relative food consumption frequencies of the FFQ was applied. hs-CRP was dichotomized according to sex-specific cutoff points. Multilevel logistic regression was performed to assess the relationship between dietary patterns and hs-CRP adjusting for covariates.Three consistent dietary patterns were found at T0 and T1: ‘animal protein and refined carbohydrate’, ‘sweet and processed’ and ‘healthy’. Children allocated to the ‘protein’ and ‘sweet and processed’ clusters at both time points had significantly higher odds of being in the highest category of hs-CRP (OR 1.47; 95% CI 1.03–2.09 for ‘animal protein and refined carbohydrate’ and OR 1.44; 95% CI 1.08–1.92 for ‘sweet and processed’) compared to the ‘healthy’ cluster. The odds remained significantly higher for the ‘sweet and processed’ pattern (OR 1.39; 95% CI 1.05–1.84) when covariates were included.A dietary pattern characterized by frequent consumption of sugar and processed products and infrequent consumption of vegetables and fruits over time was independently related with inflammation in European children. Efforts to improve the quality of the diet in childhood may prevent future diseases related with chronic inflammation.
Keywords: Dietary patterns; Inflammation; C-reactive protein; European; Children; IDEFICS

Alcohol and red wine consumption, but not fruit, vegetables, fish or dairy products, are associated with less endothelial dysfunction and less low-grade inflammation: the Hoorn Study by B. C. T. van Bussel; R. M. A. Henry; C. G. Schalkwijk; J. M. Dekker; G. Nijpels; E. J. M. Feskens; C. D. A. Stehouwer (1409-1419).
Endothelial dysfunction and low-grade inflammation are key phenomena in the pathobiology of cardiovascular disease (CVD). Their dietary modification might explain the observed reduction in CVD that has been associated with a healthy diet rich in fruit, vegetables and fish, low in dairy products and with moderate alcohol and red wine consumption. We investigated the associations between the above food groups and endothelial dysfunction and low-grade inflammation in a population-based cohort of Dutch elderly individuals. Diet was measured by food frequency questionnaire (n = 801; women = 399; age 68.5 ± 7.2 years). Endothelial dysfunction was determined (1) by combining von Willebrand factor, and soluble intercellular adhesion molecule 1 (sICAM-1), vascular cell adhesion molecule 1, endothelial selectin and thrombomodulin, using Z-scores, into a biomarker score and (2) by flow-mediated vasodilation (FMD), and low-grade inflammation by combining C-reactive protein, serum amyloid A, interleukin 6, interleukin 8, tumour necrosis factor α and sICAM-1 into a biomarker score, with smaller FMD and higher scores representing more dysfunction and inflammation, respectively. We used linear regression analyses to adjust associations for sex, age, energy, glucose metabolism, body mass index, smoking, prior CVD, educational level, physical activity and each of the other food groups. Moderate [β (95% CI) −0.13 (−0.33; 0.07)] and high [−0.22 (−0.45; −0.003)] alcohol consumption, and red wine [−0.16 (−0.30; −0.01)] consumption, but none of the other food groups, were associated with a lower endothelial dysfunction biomarker score and a greater FMD. The associations for FMD were, however, not statistically significant. Only red wine consumption was associated with a lower low-grade inflammation biomarker score [−0.18 (−0.33; −0.04)].Alcohol and red wine consumption may favourably influence processes involved in atherothrombosis.
Keywords: Diet; Endothelial dysfunction; Inflammation; Elderly; Red wine

To investigate associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders.Dietary patterns were identified using factor analysis in adults 15 years plus (n = 4657) using 24-h diet recall data from the 2008/09 New Zealand Adult Nutrition Survey. Multivariate regression was used to investigate associations between dietary patterns and age, gender and ethnicity. After controlling for demographic factors, associations between dietary patterns and food insecurity, deprivation, education, and smoking were investigated. Associations between dietary patterns and body mass index and waist circumference were examined adjusting for demographic factors, smoking and energy intake.Two dietary patterns were identified. ‘Healthy’ was characterised by breakfast cereal, low fat milk, soy and rice milk, soup and stock, yoghurt, bananas, apples, other fruit and tea, and low intakes of pies and pastries, potato chips, white bread, takeaway foods, soft drinks, beer and wine. ‘Traditional’ was characterised by beef, starchy vegetables, green vegetables, carrots, tomatoes, savoury sauces, regular milk, cream, sugar, tea and coffee, and was low in takeaway foods. The ‘healthy’ pattern was positively associated with age, female gender, New Zealand European or other ethnicity, and a secondary school qualification, and inversely associated with smoking, food insecurity, area deprivation, BMI and waist circumference. The ‘traditional’ pattern was positively associated with age, male gender, smoking, food insecurity and inversely associated with a secondary school qualification.A ‘Healthy’ dietary pattern was associated with higher socio-economic status and reduced adiposity, while the ‘traditional’ pattern was associated with lower socio-economic status.
Keywords: Dietary patterns; Factor analysis; Obesity; Socio-economic status

Association of the Baltic Sea and Mediterranean diets with indices of sarcopenia in elderly women, OSPTRE-FPS study by Masoud Isanejad; Joonas Sirola; Jaakko Mursu; Toni Rikkonen; Heikki Kröger; Marjo Tuppurainen; Arja T. Erkkilä (1435-1448).
To examine whether higher adherence to Baltic Sea diet (BSD) and Mediterranean diet (MED) have beneficial association with sarcopenia indices in elderly women.In total 554 women, aged 65–72 years belonging to OSTPRE-FPS study answered a questionnaire on lifestyle factors and 3-day food record at baseline in 2002. Food consumptions and nutrient intakes were calculated. Nine components were selected to calculate BSD score. MED score was calculated using eight components. Body composition was measured by dual-energy X-ray absorptiometry. Physical function measures included walking speed 10 m, chair rises, one leg stance, knee extension, handgrip strength and squat at baseline and at year 3. Sarcopenia and short physical performance battery (SPPB) score were defined based on the European working group on sarcopenia criteria. Lower body muscle quality (LBMQ) was calculated as walking speed 10 m/leg muscle mass.Women in the higher quartiles of BSD and MED scores lost less relative skeletal muscle index and total body lean mass (LM) over 3-year follow-up (P trend ≤ 0.034). At the baseline, women in the higher BSD score quartiles had greater LM, faster walking speed 10 m, greater LBMQ, higher SPPB score (P trend ≤ 0.034), and higher proportion of squat test completion. Similarly, women in the higher quartiles of MED sore had significantly faster walking speed 10 m, greater LBMQ (P trend ≤ 0.041) and higher proportion of squat test completion.Better diet quality as measured by higher adherence to BSD and MED might reduce the risk of sarcopenia in elderly women.
Keywords: Baltic Sea diet; Mediterranean diet; Sarcopenia; Muscle mass; Physical function

Greater adherence to the dietary approaches to stop hypertension (DASH) dietary pattern is associated with lower blood pressure in healthy Iranian primary school children by Aida Najafi; Shiva Faghih; Abdollah Hojhabrimanesh; Maryam Najafi; Hadith Tangestani; Masoumeh Atefi; Maryam Teymouri; Mahour Salehi; Majid Kamali; Sasan Amanat; Masoumeh Akhlaghi (1449-1458).
The dietary determinants of children blood pressure (BP) are poorly understood. We examined the association between adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and BP in healthy Iranian primary school children.This cross-sectional study was conducted among a representative sample (n = 407) of healthy Shirazi students aged 6–12 years. Subjects’ systolic and diastolic BP were measured by a validated oscillometric BP monitor. Usual dietary intakes over the past 12 months were assessed using a valid and reproducible 168-item semi-quantitative food frequency questionnaire via face-to-face interviews. A DASH score was calculated for each subject based on his/her energy-adjusted intakes of 8 major dietary components emphasized or minimized in the DASH dietary pattern. The higher the DASH score of a subject, the more his/her adherence to the DASH dietary pattern.After controlling for several potential confounders in the analysis of covariance models, multivariable-adjusted means of systolic and mean BP of subjects in the highest tertile of DASH score were significantly lower than those in the lowest tertile (for systolic BP: mean difference −6.2 mmHg, P = 0.010; and for mean BP: mean difference −5.4 mmHg, P = 0.013). Furthermore, a similar but statistically insignificant difference was found in terms of multivariable-adjusted means of diastolic BP (mean difference −3.9 mmHg, P = 0.146).The findings suggest that greater adherence to the DASH dietary pattern is associated with lower BP in healthy Iranian primary school children. However, future prospective studies of adequate methodological quality are warranted to confirm these findings.
Keywords: Diet; Blood pressure; Iran; Primary school; Children

Tissue distribution of oral vitamin B12 is influenced by B12 status and B12 form: an experimental study in rats by Linda S. Kornerup; Sergey N. Fedosov; Christian B. Juul; Eva Greibe; Christian W. Heegaard; Ebba Nexo (1459-1469).
Hydroxocobalamin (HOCbl) is the dominating Cbl form in food, whereas cyanocobalamin (CNCbl) is common in vitamin pills and oral supplements. This study compares single-dose absorption and distribution of oral HO[57Co]Cbl and CN[57Co]Cbl in Cbl-deficient and normal rats.Male Wistar rats (7 weeks) were fed a 14-day diet with (n = 15) or without (n = 15) Cbl. We compared the uptakes of HO[57Co]Cbl (free or bound to bovine transcobalamin) and free CN[57Co]Cbl administered by gastric gavage (n = 5 in each diet group). Rats were sacrificed after 24 h. Blood, liver, kidney, brain, heart, spleen, intestines, skeletal muscle, 24-h urine and faeces were collected, and the content of [57Co]Cbl was measured. Endogenous Cbl in tissues and plasma was analysed by routine methods.Mean endogenous plasma-Cbl was sevenfold lower in deficient vs. normal rats (190 vs. 1330 pmol/L, p < 0.0001). Cbl depletion increased endogenous Cbl ratios (tissue/plasma = k in/k out) in all organs except for the kidney, where the ratio decreased considerably. Twenty-four-hour accumulation of labelled Cbl showed that HOCbl > CNCbl (liver) and CNCbl > HOCbl (brain, muscle and plasma).The Cbl status of rats and the administered Cbl form influence 24-h Cbl accumulation in tissues and plasma.
Keywords: Hydroxocobalamin; Cyanocobalamin; Intestinal absorption; Cobalamin deficiency; Kinetic modelling

miR-124a expression contributes to the monophasic pattern of insulin secretion in islets from pregnant rats submitted to a low-protein diet by Kariny Cassia de Siqueira; Faena Moura de Lima; Fernanda Souza Lima; Marina Satie Taki; Clarissa Felfili da Cunha; Sílvia Regina de Lima Reis; Rafael Ludemann Camargo; Thiago Martins Batista; Emerielle Cristine Vanzela; Tarlliza Romanna Nardelli; Everardo Magalhães Carneiro; Silvana Bordin; Letícia Martins Ignácio-Souza; Márcia Queiroz Latorraca (1471-1483).
To evaluate the role of miR-124a in the regulation of genes involved in insulin exocytosis and its effects on the kinetics of insulin secretion in pancreatic islets from pregnant rats submitted to a low-protein diet.Adult control non-pregnant (CNP) and control pregnant (CP) rats were fed a normal protein diet (17%), whereas low-protein non-pregnant (LPNP) and low-protein pregnant (LPP) rats were fed a low-protein diet (6%) from days 1 to 15 of pregnancy. Kinetics of the glucose-induced insulin release and measurement of [Ca2+]i in pancreatic islets were assessed by standard protocols. The miR-124a expression and gene transcriptions from pancreatic islets were determined by real-time polymerase chain reaction.In islets from LPP rats, the first phase of insulin release was abrogated. The AUC [Ca2+]i from the LPP group was lower compared with the other groups. miR-124a expression was reduced by a low-protein diet. SNAP-25 mRNA, protein expression, and Rab3A protein content were lower in the LPP rats than in CP rats. Syntaxin 1A and Kir6.2 mRNA levels were decreased in islets from low-protein rats compared with control rats, whereas their protein content was reduced in islets from pregnant rats.Loss of biphasic insulin secretion in islets from LPP rats appears to have resulted from reduced [Ca2+]i due, at least in part, to Kir6.2 underexpression and from the changes in exocytotic elements that are influenced either directly or indirectly by miR-124a.
Keywords: [Ca2+]i ; Insulin secretion; Low-protein diet; miR-124a; Pregnancy

Increased intake of energy-dense diet and negative energy balance in a mouse model of chronic psychosocial defeat by Roberto Coccurello; Adele Romano; Giacomo Giacovazzo; Bianca Tempesta; Marco Fiore; Anna Maria Giudetti; Ilaria Marrocco; Fabio Altieri; Anna Moles; Silvana Gaetani (1485-1498).
Chronic exposure to stress may represent a risk factor for developing metabolic and eating disorders, mostly driven by the overconsumption of easily accessible energy-dense palatable food, although the mechanisms involved remain still unclear. In this study, we used an ethologically oriented murine model of chronic stress caused by chronic psychosocial defeat (CPD) to investigate the effects of unrestricted access to a palatable high fat diet (HFD) on food intake, body weight, energy homeostasis, and expression of different brain neuropeptides. Our aim was to shed light on the mechanisms responsible for body weight and body composition changes due to chronic social stress.In our model of subordinate (defeated), mice (CPD) cohabitated in constant sensory contact with dominants, being forced to interact on daily basis, and were offered ad libitum access either to an HFD or to a control diet (CD). Control mice (of the same strain as CPD mice) were housed in pairs and left unstressed in their home cage (UN). In all these mice, we evaluated body weight, different adipose depots, energy metabolism, caloric intake, and neuropeptide expression.CPD mice increased the intake of HFD and reduced body weight in the presence of enhanced lipid oxidation. Resting energy expenditure and interscapular brown adipose tissue (iBAT) were increased in CPD mice, whereas epididymal adipose tissue increased only in HFD-fed unstressed mice. Propiomelanocortin mRNA levels in hypothalamic arcuate nucleus increased only in HFD-fed unstressed mice. Oxytocin mRNA levels in the paraventricular nucleus and neuropeptide Y mRNA levels within the arcuate were increased only in CD-fed CPD mice. In the arcuate, CART was increased in HFD-fed UN mice and in CD-fed CPD mice, while HFD intake suppressed CART increase in defeated animals. In the basolateral amygdala, CART expression was increased only in CPD animals on HFD.CPD appears to uncouple the intake of HFD from energy homeostasis causing higher HFD intake, larger iBAT accumulation, increased energy expenditure and lipid oxidation, and lower body weight. Overall, the present study confirms the notion that the chronic activation of the stress response can be associated with metabolic disorders, altered energy homeostasis, and changes of orexigenic and anorexigenic signaling. These changes might be relevant to better understand the etiology of stress-induced obesity and eating disorders and might represent a valid therapeutic approach for the development of new therapies in this field.
Keywords: Chronic social defeat; Energy homeostasis; Energy-dense food; Hypothalamus

Fructooligosaccharide intake promotes epigenetic changes in the intestinal mucosa in growing and ageing rats by Glaucia Carielo Lima; Vivian Cristine Correa Vieira; Cinthia Baú Betim Cazarin; Rafaela da Rosa Ribeiro; Stanislau Bogusz Junior; Cibele Lima de Albuquerque; Ramon Oliveira Vidal; Claudia Cardoso Netto; Áureo Tatsumi Yamada; Fabio Augusto; Mário Roberto Maróstica Junior (1499-1510).
The aim of this study was to investigate the relationship between fructooligosaccharide (FOS) intake at different life stages of Wistar rats and its stimulatory effects on intestinal parameters.Recently weaned and ageing female rats were divided into growing and ageing treatments, which were fed diets that partially replaced sucrose with FOS for 12 weeks.Dietary FOS intake induced a significant increase in the numbers of Bifidobacterium and Lactobacillus in growing rats. FOS intake was associated with increased butyric acid levels and a reduced pH of the caecal contents at both ages. Differential gene expression patterns were observed by microarray analysis of growing and ageing animals fed the FOS diet. A total of 133 genes showed detectable changes in expression in the growing rats, while there were only 19 gene expression changes in ageing rats fed with FOS.These results suggest that dietary FOS intake may be beneficial for some parameters of intestinal health in growing rats.
Keywords: Prebiotic; Intestinal health; Youth; Ageing; Gene expression

According to the vast body of evidence demonstrating that the intestinal microbiota is undoubtedly linked with overall health, including cancer risk, searching for functional foods and novel prebiotic influencing on beneficial bacteria is necessary. The present study aimed to investigate the potential of polysaccharides from 53 wild-growing mushrooms to stimulate the growth of Lactobacillus acidophilus and Lactobacillus rhamnosus and to determine the digestibility of polysaccharide fractions.Mushroom polysaccharides were precipitated with ethanol from aqueous extracts. Determination of growth promoting activity of polysaccharides was performed in U-shaped 96-plates in an ELISA reader in relation to the reference strain of L. acidophilus and two clinical strains of L. rhamnosus. The digestibility of mushroom polysaccharides was investigated in vitro by exposing them to artificial human gastric juice.Obtained results revealed that fungal polysaccharides stimulate the growth of Lactobacillus strains stronger than commercially available prebiotics like inulin or fructooligosaccharides. Moreover, selected polysaccharides were subjected to artificial human gastric juice and remain undigested in more than 90%.Obtained results indicate that mushroom polysaccharides are able to pass through the stomach unchanged, reaching the colon and stimulating the growth of beneficial bacteria. Majority of 53 polysaccharide fractions were analysed for the first time in our study. Overall, our findings suggest that polysaccharide fractions from edible mushrooms might be useful in producing functional foods and nutraceuticals.
Keywords: Polysaccharides; Prebiotics; Lactobacillus ; Nutraceuticals; Functional foods

Effect of 8-weeks prebiotics/probiotics supplementation on alcohol metabolism and blood biomarkers of healthy adults: a pilot study by Christopher Irwin; Saman Khalesi; Amanda J. Cox; Gary Grant; Andrew K. Davey; Andrew C. Bulmer; Ben Desbrow (1523-1534).
Modulating gut bacteria via regular prebiotics/probiotics consumption may improve the metabolism of acute alcohol ingestion. This study investigated the impact of 8-weeks prebiotics/probiotics supplementation on microbiome changes and responses to acute alcohol consumption.38 participants (21 females, 23.6 ± 3.4 kg m−2, mean ± SD) attended the laboratory on two occasions separated by an 8-week intervention period. On each of these visits, a dose of alcohol (0.40 ± 0.04 g kg−1, Vodka + Soda-Water) was consumed over 10 min. Breath alcohol concentration was sampled over 5 h and alcohol pharmacokinetics was analysed using WinNonlin non-compartmental modelling (C max, t max, AUClast). For the intervention, participants were randomised to receive Placebo + Placebo (PLA), Placebo + Prebiotics (PRE), Probiotics + Placebo (PRO), or Probiotics + Prebiotics (SYN) in a double-blinded manner. Probiotics were a commercially available source of Lactobacillus acidophilus (NCFM®) and Bifidobacterium lactis (Bi-07). Prebiotics were a commercially available source of Larch Gum (from Larix occidentalis). Placebo was microcrystalline cellulose. Each visit, participants provided a stool sample, which was analysed to determine the presence of L. acidophilus and B. lactis. Differences between trials were analysed using paired samples t tests.Increased counts for at least one bacterial strain (L. acidophilus or B. lactis) were observed for all participants on SYN (n = 10) and PRO (n = 10) trials. No difference in C max or t max was observed between trials when analysed by treatment condition or microbiome outcome. A significant decrease in AUClast was observed between trials for PLA (p = 0.039) and PRE (p = 0.030) treatments, and when increases in at least one bacterial strain (p = 0.003) and no microbiome changes (p = 0.016) were observed.Consumption of probiotics appears to alter faecal counts of supplemental bacterial strains in otherwise healthy individuals. However, translation to any possible beneficial impact on alcohol metabolism remains to be elucidated.
Keywords: Alcohol; Pharmacokinetics; Prebiotics; Probiotics; Synbiotics; Lipids

Dietary polyphenol intake and risk of hypertension in the Polish arm of the HAPIEE study by Giuseppe Grosso; Urszula Stepaniak; Agnieszka Micek; Magdalena Kozela; Denes Stefler; Martin Bobak; Andrzej Pajak (1535-1544).
Dietary polyphenols have been studied for their potential effects on metabolic disorders, but studies on risk of hypertension are scarce. This study aimed to test the association between total and individual classes of dietary polyphenols and incidence of hypertension in the Polish arm of the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study.A total of 2725 participants free of hypertension at baseline were tested for blood pressure or taking hypertensive medication within the last 2 weeks at 2–4-year follow-up visit. A 148-item food frequency questionnaire and the Phenol-Explorer database were used to estimate dietary polyphenol intake. Odds ratios (ORs) and 95% confidence intervals (CIs) of hypertension comparing the various categories of exposure (total and individual classes of polyphenol intake) with the lowest one (reference category) were calculated by performing age- and energy-adjusted and multivariate-adjusted logistic regression models.During follow-up, 1735 incident cases of hypertension occurred. The highest quartile of total polyphenol intake was associated with 31% decreased risk of hypertension compared with the lowest intake (OR 0.69, 95% CI 0.48, 0.98) in women. There was no significant association in men. Among main classes of polyphenols, flavonoids and phenolic acids were independent contributors to this association. The analysis of individual subclasses of polyphenol revealed that, among phenolic acids, hydroxycynnamic acids were independently associated to lower odds of hypertension (OR 0.66, 95% CI 0.47, 0.93), while among flavonoids, most of the association was driven by flavanols (OR 0.56, 95% CI 0.36, 0.87).Certain classes of dietary polyphenols were associated with lower risk of hypertension, but potential differences between men and women should be further investigated.
Keywords: Hypertension; Dietary polyphenols; Flavonoids; Phenolic acids; Flavanols

We studied the combined effect of fish oil and α-lipoic acid on hepatic lipogenesis and fatty acid oxidation and parameters of oxidative stress in rats fed lipogenic diets high in sucrose. A control diet contained a saturated fat (palm oil) that gives high rate of hepatic lipogenesis.Male Sprague–Dawley rats were fed diets supplemented with 0 or 2.5 g/kg α-lipoic acid and containing 0, 20, or 100 g/kg fish oil, for 21 days.α-Lipoic acid significantly reduced food intake during 0–8 days but not the later period of the experiment. Fish oil and α-lipoic acid decreased serum lipid concentrations and their combination further decreased the parameters in an additive fashion. The combination of fish oil and α-lipoic acid decreased the activity and mRNA levels of hepatic lipogenic enzymes in an additive fashion. Fish oil increased the parameters of hepatic fatty acid oxidation enzymes. α-Lipoic acid appeared to antagonize the stimulating effects of fish oil of fatty acid oxidation through reductions in the activity of some fatty acid oxidation enzymes. α-Lipoic acid attenuated fish oil-dependent increases in serum and liver malondialdehyde levels, and this compound also reduced the serum 8-hydroxy-2′-deoxyguanosine level. α-Lipoic acid affected various parameters related to the antioxidant system; fish oil also affected some of the parameters.The combination of fish oil and α-lipoic acid effectively reduced serum lipid levels through the additive down-regulation of hepatic lipogenesis. α-Lipoic acid was effective in attenuating fish oil-mediated oxidative stress.
Keywords: Fish oil; α-Lipoic acid; Hepatic lipogenesis; Antioxidant system

Mangiferin suppresses endoplasmic reticulum stress in perivascular adipose tissue and prevents insulin resistance in the endothelium by Xiaoshan Xu; Yupeng Chen; Junna Song; Fangjie Hou; Xuelian Ma; Baolin Liu; Fang Huang (1563-1575).
Mangiferin is a naturally occurring glucosylxanthone with beneficial effects on glucose and lipid homeostasis. This study investigates the potential therapeutic effect of Mangiferin in perivascular adipose tissue (PVAT) and whether it contributes to regulating insulin action in the endothelium.Palmitate challenge evoked ROS-associated endoplasmic reticulum stress (ER stress) and NLRP3 inflammasome activation in PVAT. The conditioned medium from PA-stimulated PVAT was prepared to induce endothelial insulin resistance, and improved endothelium-dependent vasodilation in response to insulin was detected in vitro and in vivo.Mangiferin treatment enhanced LKB1-dependent AMPK activity and suppressed ER stress with downregulation of TXNIP induction, leading to the inhibition of NLRP3 inflammasome activation evidenced by attenuated NLRP3 and cleaved caspase-1 expression as well as reduced IL-1β secretion. Moreover, Mangiferin restored insulin-mediated Akt and eNOS phosphorylations with increased NO production, immunohistochemistry examination of adipocytes, and endothelial tissue in high-fat diet-fed mice also showed that oral administration of Mangiferin inhibited ER stress and NLRP3 induction in PVAT, and then effectively prevented insulin resistance in the vessel endothelium.Taken together, these results revealed that Mangiferin suppressed ER stress-associated NLRP3 inflammasome activation in PVAT through regulation of AMPK activity, which prevented endothelial insulin resistance. These findings suggested that the amelioration of PVAT dysfunction may be a therapeutic strategy for the prevention of endothelial insulin resistance.
Keywords: Mangiferin; Inflammasome; ER stress; Insulin resistance

α-Lipoic acid prevents the intestinal epithelial monolayer damage under heat stress conditions: model experiments in Caco-2 cells by Soheil Varasteh; Johanna Fink-Gremmels; Johan Garssen; Saskia Braber (1577-1589).
Under conditions of high ambient temperatures and/or strenuous exercise, humans and animals experience considerable heat stress (HS) leading among others to intestinal epithelial damage through induction of cellular oxidative stress. The aim of this study was to characterize the effects of α-Lipoic Acid (ALA) on HS-induced intestinal epithelial injury using an in vitro Caco-2 cell model.A confluent monolayer of Caco-2 cells was pre-incubated with ALA (24 h) prior to control (37 °C) or HS conditions (42 °C) for 6 or 24 h and the expression of heat shock protein 70 (HSP70), heat shock factor-1 (HSF1), and the antioxidant Nrf2 were investigated. Intestinal integrity was determined by measuring transepithelial resistance, paracellular permeability, junctional complex reassembly, and E-cadherin expression and localization. Furthermore, cell proliferation was measured in an epithelial wound healing assay and the expression of the inflammatory markers cyclooxygenase-2 (COX-2) and transforming growth Factor-β (TGF-β) was evaluated.ALA pretreatment increased the HSP70 mRNA and protein expression under HS conditions, but did not significantly modulate the HS-induced activation of HSF1. The HS-induced increase in Nrf2 gene expression as well as the Nrf2 nuclear translocation was impeded by ALA. Moreover, ALA prevented the HS-induced impairment of intestinal integrity. Cell proliferation under HS conditions was improved by ALA supplementation as demonstrated in an epithelial wound healing assay and ALA was able to affect the HS-induced inflammatory response by decreasing the COX-2 and TGF-β mRNA expression.ALA supplementation could prevent the disruption of intestinal epithelial integrity by enhancing epithelial cell proliferation, and reducing the inflammatory response under HS conditions in an in vitro Caco-2 cell model.
Keywords: α-Lipoic acid; Heat stress; Intestinal integrity; Oxidative stress; Inflammatory response

Yogurt consumption, body composition, and metabolic health in the Québec Family Study by Shirin Panahi; Caroline Y. Doyon; Jean-Pierre Després; Louis Pérusse; Marie-Claude Vohl; Vicky Drapeau; Angelo Tremblay (1591-1603).
The aim was to compare the anthropometric and metabolic profiles and lifestyle behaviours of yogurt consumers and non-consumers and to determine if the observed differences persisted after adjustment for diet quality and related variables.Using cross-sectional and follow-up data from the Québec Family Study, men and women were classified into yogurt consumers (n = 269; 96 men and 173 women) and non-consumers (n = 570; 279 men and 291 women), and their anthropometric measurements, metabolic profiles, and lifestyle factors were compared.Men yogurt consumers had a lower body weight, BMI, % body fat, waist circumference and lower plasma insulin, and C-peptide concentrations in response to oral glucose, while women yogurt consumers had lower waist circumference, BMI, % body fat, plasma glucose, insulin, and C-peptide compared with non-consumers (P < 0.05). After adjustment for the Nutrient-Rich Foods (NRF) index, a marker of diet quality, these differences persisted in men and only for glycemic variables in women. Additional adjustment for physical activity participation and % body fat did not abolish the significant differences observed between yogurt consumers and non-consumers for plasma glucose, insulin, and C-peptide responses to oral glucose in women only (P < 0.05). Analyses of data after a 6-year follow-up reinforced these observations, since both men and women yogurt consumers maintained a better metabolic profile compared with non-consumers after adjustments for age and NRF (P < 0.05). In addition, an interaction between group and time for % body fat in men suggests a benefit of yogurt consumption over time on body composition.Yogurt consumption is associated with body composition and metabolic health benefits that are not entirely explained by a global effect of diet quality.
Keywords: Yogurt; Metabolic health; Consumers and non-consumers; Eating behaviours; Lifestyle factors; Body composition

An obesity-preventive lifestyle score is negatively associated with pediatric asthma by Constantina Papoutsakis; Eleni Papadakou; Maria Chondronikola; Georgios Antonogeorgos; Vasiliki Matziou; Maria Drakouli; Evanthia Konstantaki; Kostas N. Priftis (1605-1613).
Lifestyle (diet and physical activity) may increase asthma risk, but evidence in this area is lacking. The aims of the present study were to calculate an obesity-preventive lifestyle score comprising of eating and physical activity behaviors and investigate the overall effect of lifestyle on asthma in children.A cross-sectional case–control study was carried out in 514 children (217 asthma cases and 297 healthy controls). Data were collected on medical history, anthropometry, dietary intake, and physical activity. We constructed an overweight/obesity-preventive score (OPLS) using study-specific quartile rankings for nine target lifestyle behaviors that were either favorable or unfavorable in preventing obesity (i.e., screen time was an unfavorable lifestyle behavior). The score was developed using the recommendations of the Expert Committee of American Academy of Pediatrics. Score values ranged from 0–18 points; the higher the score, the more protective against high body weight.The OPLS was negatively associated with obesity indices (BMI, waist circumference, and hip circumference), (p < 0.05). Control children had a higher score when compared to asthma cases (9.3 ± 2.7 vs. 8.6 ± 2.9, p = 0.007). A high OPLS was protective against physician-diagnosed asthma (OR 0.92; 95% CI 0.86–0.98, p = 0.014), adjusted for several confounders. The OPLS was no longer protective after adjustment for BMI.Higher adherence to an obesity-preventive lifestyle score—consistent with several behaviors for the prevention of childhood overweight/obesity—is negatively associated with obesity indices and lowers the odds for asthma in children. Lifestyle behaviors that contribute to a higher body weight may contribute to the obesity–asthma link. These findings are hypothesis-generating and warrant further investigation in prospective intervention studies.
Keywords: Asthma; Obesity; Lifestyle; Children

Estimation of dietary total antioxidant capacity of Korean adults by Shinyoung Jun; Ock K. Chun; Hyojee Joung (1615-1625).
Dietary total antioxidant capacity (TAC) has been reported to be inversely associated with the risk of chronic diseases. However, little is known about dietary TAC among the Korean population. Therefore, we aimed to estimate the dietary TAC of Korean adults and to document the major food sources.We studied 33,581 Korean adults aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2007–2012. Dietary TAC was estimated from 1-day 24-h dietary recall data using a TAC database comprising antioxidant capacities of 42 dietary antioxidants, developed for common Korean foods.The average dietary TAC of Korean adults was 384.7 mg VCE/d, and the major contributors were flavonoids, followed by vitamin C and E. The energy-adjusted daily TAC level was higher in women, middle-aged adults, non-regular alcohol consumers, current non-smokers, supplement users, and in those with a higher income and education level than in their counterparts (P < 0.001). Fruits (47.3%), vegetables (28.4%), beverages and alcohols (11.2%), and legumes and legume products (5.5%), in particular, grapes, persimmons, mandarins, apples, and green tea, were major food sources of dietary TAC. In addition, the consumption of nutrient-dense foods, such as fruits and vegetables, increased, whereas the intake of energy and fat decreased across quartiles of energy-adjusted dietary TAC.The present study documented the baseline dietary TAC of Korean adults and the major food sources thereof using nationally representative data. Further research on the health effects of dietary TAC among Korean adults is warranted.
Keywords: Total antioxidant capacity; Diet; Food sources; Antioxidant capacity database; KNHANES

Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat by Flávia Xavier Valente; Flávia Galvão Cândido; Lílian Lelis Lopes; Desirrê Morais Dias; Samantha Dalbosco Lins Carvalho; Patrícia Feliciano Pereira; Josefina Bressan (1627-1637).
Virgin coconut oil (VCO) is a medium-chain fatty acid source with popularly attributed benefits on obesity management. However, its role on obesity requires elucidation due to its saturated nature. In the study herein, we investigated acute effects of VCO consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat.Fifteen adult women with excess body fat (37.43 ± 0.83%) participated in this randomized, crossover, controlled study. Two isocaloric mixed breakfasts containing 25 mL of VCO or control (extra-virgin olive oil-C) were evaluated. Resting energy expenditure (REE), fat oxidation rate (FOR), diet induced thermogenesis (DIT) and appetitive subjective responses were assessed at fasting and postprandial periods (up to 240 min). Cardiometabolic risk markers were assessed at fasting and up to 180 min postprandially.VCO did not affect REE, FOR, and DIT compared to C. In addition, VCO did not cause deleterious change in triglycerides, total cholesterol, HDL-c, LDL-c, triglycerides/HDL-c ratio, uric acid, glucose and Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) (P time×treatment > 0.05). However, VCO suppressed less hunger (P time×treatment = 0.003), total satiety (P iAUC = 0.021) and total fullness (P iAUC = 0.035) responses than C.VCO consumption did not acutely change energy metabolism and cardiometabolic risk markers when added to a mixed breakfast but promoted less appetitive responses.
Keywords: Coconut oil; Energy metabolism; Fat oxidation; Cardiometabolic risk markers; Appetite

Epidemiologic evidence on the potential effects of dietary acid load on frailty is lacking. This cross-sectional study examined the association between dietary acid load and frailty.This study was based on self-reported data obtained from 2176 Japanese women aged 65–94 years. Dietary acid load was characterized as potential renal acid load (PRAL) and net endogenous acid production (NEAP), based on information on nutrient intake, obtained from a validated brief diet history questionnaire. Frailty score (0–5) was defined as the sum of slowness/weakness (two points), exhaustion (one point), low physical activity (one point), and unintentional weight loss (one point). A score of ≥3 was classified as indicating frailty.The prevalence of frailty was 17.9%. After adjustment for potential confounding factors, higher PRAL and NEAP were associated with a higher prevalence of frailty. Adjusted OR (95% CI) for frailty in the highest compared to the lowest quintiles was 1.59 (1.08, 2.34) for PRAL (P for trend = 0.048) and 1.42 (0.98, 2.06) for NEAP (P for trend = 0.03). PRAL and NEAP also showed positive associations with the prevalence of slowness/weakness and low physical activity (all P for trend ≤0.03). PRAL (but not NEAP) was positively associated with the prevalence of exhaustion (P for trend = 0.04). There was no association for unintentional weight loss.Dietary acid load was positively associated with the prevalence of frailty, particularly slowness/weakness and low physical activity, in elderly Japanese women.
Keywords: Potential renal acid load; Net endogenous acid production; Frailty; Elderly Japanese women; Epidemiology

Impact of food processing on rye product properties and their in vitro digestion by Daniel P. Johansson; José L. Vázquez Gutiérrez; Rikard Landberg; Marie Alminger; Maud Langton (1651-1666).
Rye products have been reported to elicit postprandial insulin and glucose responses which may be beneficial for prevention of type-2 diabetes. However, mechanisms underlying variations in responses related to processing techniques are not fully understood.Five differently processed rye products (sourdough-fermented bread, fermented and unfermented crispbread, extrusion-cooked rye, and porridge) and refined wheat bread were characterised. Two in vitro methods, a dynamic method simulating digestion in the stomach and small intestine and a static method, simulating conditions in the stomach were used to determine viscosity development, structural changes and release of glucose during digestion.Structural and compositional differences induced by processing influenced product digestion. Gastric disintegration and digesta particle size were related to characteristics of the starch/protein matrix, while digesta viscosity was reduced due to fibre degradation during fermentation. More cohesive boluses were associated with slower glucose release. Sourdough fermentation increased amylose leakage and appeared to inhibit starch hydrolysis despite low digesta viscosity and rapid disintegration.The net release of glucose during digestion of foods is determined by several factors which may vary in their importance depending on product specific properties.
Keywords: In vitro digestion; Glucose release; Microstructure; Dietary fibre; Gastric digestion; Rye

Fish consumption, intake of fats and cognitive decline at middle and older age: the Doetinchem Cohort Study by Astrid C. J. Nooyens; Boukje M. van Gelder; H. Bas Bueno-de-Mesquita; Martin P. J. van Boxtel; W. M. Monique Verschuren (1667-1675).
To get insight in the impact of fish and fat intake in the prevention of accelerated cognitive decline with ageing, we tested associations between fish and different fat intakes and 5-year change in cognitive functions.In 2612 men and women of the Doetinchem Cohort Study, aged 43–70 years at baseline, dietary intake (including fish consumption) and cognitive function were assessed at baseline and at 5-year follow-up. Average fish consumption (frequency) and intakes (as energy percentages) of total fat, saturated, mono unsaturated, and polyunsaturated fatty acids (PUFA), linoleic, docosahexaenoic, eicosapentaenoic, and a-linolenic acid (ALA), and cholesterol were averaged over baseline and follow-up. Intakes were studied in relation to 5-year change in global cognitive function, memory, information processing speed, and cognitive flexibility, using ANCOVA and multivariate linear regression analyses.No consistent association between (fatty) fish consumption and cognitive decline was observed. Higher cholesterol intake was associated with faster cognitive decline (p < 0.05). Higher n-3 PUFA (especially ALA) intake was associated with slower decline in global cognitive function and memory (p < 0.01). Intakes of other fatty acids were not associated with cognitive decline.Higher cholesterol intake was detrimental, while higher ALA intake was beneficial for maintaining cognitive function with ageing, already at middle age.
Keywords: Cognitive decline; Cholesterol; Fatty acids; Fish consumption; Middle age; n-3 PUFA

J-shaped relationship between habitual coffee consumption and 10-year (2002–2012) cardiovascular disease incidence: the ATTICA study by Georgia-Maria Kouli; Demosthenes B. Panagiotakos; Ekavi N. Georgousopoulou; Duane D. Mellor; Christina Chrysohoou; Adela Zana; Constantine Tsigos; Dimitrios Tousoulis; Christodoulos Stefanadis; Christos Pitsavos (1677-1685).
The purpose of this work was to evaluate the association between coffee consumption and 10-year cardiovascular disease (CVD) incidence in the ATTICA study, and whether this is modified by the presence or absence of metabolic syndrome (MetS) at baseline.During 2001–2002, 3042 healthy adults (1514 men and 1528 women) living in the greater area of Athens were voluntarily recruited to the ATTICA study. In 2011–2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Coffee consumption was assessed by a validated food-frequency questionnaire at baseline (abstention, low, moderate, heavy). Incidence of fatal or non-fatal CVD event was recorded using WHO-ICD-10 criteria and MetS was defined by the National Cholesterol Education Program Adult Treatment panel III (revised) criteria.Overall, after controlling for potential CVD risk factors, the multivariate analysis revealed a J-shaped association between daily coffee drinking and the risk for a first CVD event in a 10-year period. Particularly, the odds ratio for low (<150 ml/day), moderate (150–250 ml/day) and heavy coffee consumption (>250 ml/day), compared to abstention, were 0.44 (95% CI 0.29–0.68), 0.49 (95% CI 0.27–0.92) and 2.48 (95% CI 1.56–1.93), respectively. This inverse association was also verified among participants without MetS at baseline, but not among participants with the MetS.These data support the protective effect of drinking moderate quantities of coffee (equivalent to approximately 1–2 cups daily) against CVD incidents. This protective effect was only significant for participants without MetS at baseline.
Keywords: Cardiovascular diseases; Metabolic syndrome; Coffee; Inflammation

Adherence to a Mediterranean-style diet and incident fractures: pooled analysis of observational evidence by Setor K. Kunutsor; Jari A. Laukkanen; Michael R. Whitehouse; Ashley W. Blom (1687-1700).
The Mediterranean diet is associated with decreased morbidity and mortality from various chronic diseases. Adherence to a Mediterranean-style diet has been suggested to have protective effects on bone health and decreases the incidence of bone fractures, but the evidence is not clear. We conducted a systematic review and meta-analysis of available observational studies to quantify the association between adherence to a Mediterranean-style diet, as assessed by the Mediterranean Diet Score (MDS), and the risk of fractures in the general population.Relevant studies were identified in a literature search of MEDLINE, EMBASE, Web of Science, and reference lists of relevant studies to October 2016. Relative risks (RRS) with 95% confidence intervals (CIs) were aggregated using random-effects models.Five observational studies with data on 353,076 non-overlapping participants and 33,576 total fractures (including 6,881 hip fractures) were included. The pooled fully adjusted RR (95% CI) for hip fractures per 2-point increment in adherence to the MDS was 0.82 (0.71–0.96). Adherence to the MDS was not associated with the risk of any or total fractures based on pooled analysis of only two studies.Limited observational evidence supports a beneficial effect of adherence to a Mediterranean-style diet on the incidence of hip fractures. Well-designed intervention studies are needed to elucidate the relationship between adherence to a Mediterranean-style diet and the risk of adverse bone health outcomes such as fractures.
Keywords: Mediterranean diet; Bone; Fractures; Nutrition