European Journal of Nutrition (v.57, #7)

Zinc deficiency as a mediator of toxic effects of alcohol abuse by Anatoly V. Skalny; Margarita G. Skalnaya; Andrei R. Grabeklis; Anastasia A. Skalnaya; Alexey A. Tinkov (2313-2322).
To review data on the role of ethanol-induced alteration of Zn homeostasis in mediation of adverse effects of alcohol abuse.The scholarly published articles on the association between Zn metabolism and alcohol-associated disorders (liver, brain, lung, gut dysfunction, and fetal alcohol syndrome) have been reviewed.It is demonstrated that alcohol-induced modulation of zinc transporters results in decreased Zn levels in lungs, liver, gut, and brain. Zn deficiency in the gut results in increased gut permeability, ultimately leading to endotoxemia and systemic inflammation. Similarly, Zn deficiency in lung epithelia and alveolar macrophages decreases lung barrier function resulting in respiratory distress syndrome. In turn, increased endotoxemia significantly contributes to proinflammatory state in alcoholic liver disease. Finally, impaired gut and liver functions may play a significant role in alcoholic brain damage, being associated with both increased proinflammatory signaling and accumulation of neurotoxic metabolites. It is also hypothesized that ethanol-induced Zn deficiency may interfere with neurotransmission. Similar changes may take place in the fetus as a result of impaired placental zinc transfer, maternal zinc deficiency, or maternal Zn sequestration, resulting in fetal alcoholic syndrome. Therefore, alcoholic Zn deficiency not only mediates the adverse effects of ethanol exposure, but also provides an additional link between different alcohol-induced disorders.Generally, current findings suggest that assessment of Zn status could be used as a diagnostic marker of metabolic disturbances in alcohol abuse, whereas modulation of Zn metabolism may be a potential tool in the treatment of alcohol-associated disorders.
Keywords: Ethanol; Zinc; Gut permeability; Inflammation; Endotoxemia

Alcohol, alcoholic beverages, and melanoma risk: a systematic literature review and dose–response meta-analysis by Sara Gandini; Giovanna Masala; Domenico Palli; Benedetta Cavicchi; Calogero Saieva; Ilaria Ermini; Federica Baldini; Patrizia Gnagnarella; Saverio Caini (2323-2332).
Several studies in recent years have investigated the relationship between alcohol intake and melanoma risk, with conflicting results. To help clarify this issue, we conducted a literature review and dose–response meta-analysis of studies published until June 30th, 2017, that examined the association between alcohol intake (overall and by beverage type) and melanoma risk.We used random effect models with maximum likelihood estimation to calculate summary relative risk (SRR) and 95% confidence intervals (95%CI).We included 20 independent studies (encompassing 10,555 melanoma cases and over 1.6 million non-cases/controls) published during 1986–2016, of which six had a prospective cohort study design. Adjustment for phenotypic characteristics and sunlight exposure was performed in 11 and nine studies, respectively. Alcohol intake was moderately associated with melanoma risk: the SRR were 1.29 (95% CI 1.14–1.45) for those in the highest vs. lowest category of current alcohol intake, and 1.96 (95% CI 1.02–3.76, I 2 = 0%) for cumulative intake. In the dose–response analysis, the increase in risk associated with a 10 g increment in daily alcohol intake was 1.07 (95% CI 1.03–1.11). Risk estimates did not differ by gender, study design and adjustment for confounders; between-studies heterogeneity was acceptable, and there was no evidence of publication bias.Our findings suggest that alcohol drinking may be moderately associated with increased melanoma risk, although residual confounding and bias cannot be ruled out. Further research is needed to confirm these findings, clarify the role of the different alcohol sources, and investigate the interaction with known melanoma risk factors.
Keywords: Alcohol; Melanoma; Review; Meta-analysis; Dose–response

Association between dietary glycemic index and glycemic load with depression: a systematic review by Mehran Rahimlou; Nava Morshedzadeh; Soheila Karimi; Sima Jafarirad (2333-2340).
A combination of genetic and environmental factors is involved in depression etiology. During the last years, the prevalence of depression has increased in both developed and developing countries. Several studies indicated an association between dietary glycemic index (GI) and glycemic load (GL) with risk of depression. This systematic review was undertaken to summarize the effect of these diet indicators in depression pathogenesis.A comprehensive search strategy was performed in the Pubmed, Embase, Cochrane Library and Scopus databases from 1966 to March 2017. Finally, six studies (three prospective cohort studies and three cross-sectional) were ultimately selected for inclusion in the systematic review.75298 adults and elderly entered the reviewed studies. All of the included studies had high methodological quality. The present study indicated that the intake of foods with higher GI is associated with disease risk. However, the relationship was found to be inverse for GL, though the association was rather weak.Overall, the findings indicated that a diet with lower dietary glycemic index may be effective to reduce the risk or risk of depression.
Keywords: Depression; Glycemic index; Glycemic load; Carbohydrate; Diet

Review of earlier evidence on dietary glycemic index and load and depression needs further attention by Asma Salari-Moghaddam; Bagher Larijani; Ahmad Esmaillzadeh (2341-2342).

Baseline glucoregulatory function moderates the effect of dairy milk and fruit juice on postprandial cognition in healthy young adults by Jason R. Anderson; Misty A. W. Hawkins; John Updegraff; John Gunstad; Mary Beth Spitznagel (2343-2352).
Few studies have examined acute cognitive effects of dairy products. Prior work suggests baseline glucoregulatory function may moderate the relationship between macronutrient profile and postprandial cognition. This study examined the role of glucoregulatory function in postprandial cognition after milk, fruit juice, and a water control. We hypothesized juice would improve cognition in those with lower fasting glucose, while milk would improve cognition in those with higher fasting glucose.86 non-diabetic, non-hypoglycemic young adults attended three 8 AM testing sessions after fasting overnight. Fasting glucose was assessed via fingerstick at each session. Participants consumed 8 oz of 1% milk (12 g carbohydrates), apple juice (29 g carbohydrates), or water in a randomized, counterbalanced order, and completed repeatable standard and running memory continuous performance (SCPT—vigilance; RMCPT–working memory) and go/no-go (GNG–inhibitory control) tasks 30, 90, and 120 min post-ingestion.Participants with fasting glucose above 107.69 mg/dL made significantly fewer GNG commission errors overall after milk versus water, while the converse was observed when fasting glucose was below 70.85 mg/dL (p = 0.003). At 30 min, participants with fasting glucose above 105.80 mg/dL made significantly more RMCPT correct responses per minute after milk versus juice, while the opposite occurred when fasting glucose was below 76.85 mg/dL (p = 0.006). For both tasks, differences greatened as fasting glucose increased or decreased beyond these upper and lower bounds, respectively.Consideration of baseline glucoregulatory function is crucial when assessing postprandial cognition, even in non-diabetic and non-hypoglycemic samples. Dairy milk may improve cognition in persons with higher fasting glucose.
Keywords: Postprandial cognition; Glucoregulatory function; Dairy milk; Young adults; Inhibitory control; Working memory

Neuropathic pain is a common diabetic complication. It is characterized by symptoms of spontaneous and stimulus-evoked pain including hyperalgesia and allodynia. l-Arginine is a common precursor of many metabolites of biological interest, in particular, nitric oxide (NO), ornithine, and hence polyamines. In central nervous system, NO, glutamate, and polyamines share an N-methyl-d-aspartate (NMDA) receptor-mediated effect. We hypothesized that a variation in arginine metabolism caused by diabetes may contribute to development and maintenance of neuropathic pain and to the worsening of clinical and biological signs of diabetes.We examined whether oral l-arginine supplementation (2.58 ± 0.13 g/l in drinking water for 3 weeks) could improve the development of neuropathic pain and the clinical, biological, and metabolic complications of diabetes in streptozocin (STZ)-induced diabetic (D) rats.STZ administration induced classical symptoms of type 1 diabetes. Diabetic rats also displayed mechanical hypersensitivity, tactile, and thermal allodynia. Plasma citrulline and NO levels were increased in diabetic hyperalgesic/allodynic rats. l-Arginine supplementation failed to reduce hyperglycaemia, polyphagia, and weight loss. Moreover, it abolished hyperalgesia and allodynia by normalizing NO plasma concentration and increasing plasma agmatine concentration. l-Arginine supplementation prevented the development of mechanical hyperalgesia, tactile, and thermal allodynia in painful diabetic neuropathy with concomitant reduction of NO and increased agmatine production, offering new therapeutic opportunities for the management of diabetic neuropathic pain.
Keywords: l -Arginine; Nitric oxide; Agmatine; STZ-D rats; Hyperalgesia; Allodynia; Neuropathic pain

Dietary patterns and changes in frailty status: the Rotterdam study by Sandra C. M. de Haas; Ester A. L. de Jonge; Trudy Voortman; Jolien Steenweg-de Graaff; Oscar H. Franco; M. Arfan Ikram; Fernando Rivadeneira; Jessica C. Kiefte-de Jong; Josje D. Schoufour (2365-2375).
To determine the associations between a priori and a posteriori derived dietary patterns and a general state of health, measured as the accumulation of deficits in a frailty index.Cross-sectional and longitudinal analysis embedded in the population-based Rotterdam Study (n = 2632) aged 45 years. Diet was assessed at baseline (year 2006) using food frequency questionnaires. Dietary patterns were defined a priori using an existing index reflecting adherence to national dietary guidelines and a posteriori using principal component analysis. A frailty index was composed of 38 health deficits and measured at baseline and follow-up (4 years later). Linear regression analyses were performed using adherence to each of the dietary patterns as exposure and the frailty index as outcome (all in Z-scores).Adherence to the national dietary guidelines was associated with lower frailty at baseline (β −0.05, 95% CI −0.08, −0.02). Additionally, high adherence was associated with lower frailty scores over time (β −0.08, 95% CI −0.12, −0.04). The PCA revealed three dietary patterns that we named a “Traditional” pattern, high in legumes, eggs and savory snacks; a “Carnivore” pattern, high in meat and poultry; and a “Health Conscious” pattern, high in whole grain products, vegetables and fruit. In the cross-sectional analyses adherence to these patterns was not associated with frailty. However, adherence to the “Traditional” pattern was associated with less frailty over time (β −0.09, 95% CI −0.14, −0.05).No associations were found for adherence to a “healthy” pattern or “Carnivore” pattern. However, Even in a population that is relatively young and healthy, adherence to dietary guidelines or adherence to the Traditional pattern could help to prevent, delay or reverse frailty levels.
Keywords: Dietary patterns; Diet quality; Elderly; Frailty; Frailty index

Dietary total antioxidant capacity and incidence of chronic kidney disease in subjects with dysglycemia: Tehran Lipid and Glucose Study by Golaleh Asghari; Emad Yuzbashian; Sahar Shahemi; Zahra Gaeini; Parvin Mirmiran; Fereidoun Azizi (2377-2385).
We aimed to investigate the association of dietary total antioxidant capacity (TAC) with incidence of CKD in subjects with dysglycemia.We followed-up 1179 subjects aged ≥30 years with dysglycemia from the Tehran Lipid and Glucose Study (TLGS) for 3 years, who were initially free of CKD. Dietary intakes of TAC, vitamin C, vitamin E, and β-carotene were assessed by a food-frequency questionnaire at the baseline. Dietary TAC was estimated using the oxygen radical absorbance capacity method. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease Study equation and CKD was defined as eGFR <60 mL/min/1.73 m2. Odds ratios (ORs) using multivariable logistic regression were reported for the association of incident CKD with dietary TAC.A total of 197 (16.7%) cases of incident CKD were recorded after 3 years of follow-up. After adjustment for age, sex, smoking, physical activity, body mass index, hypertension, and total energy intake, the top tertile of dietary TAC compared to the bottom was associated with 39% [95% confidence interval (CI) = 0.40–0.93] lower risk of incident CKD (P for trend = 0.025). Furthermore, the highest tertile of vitamin C intake compared to the lowest risk of incident CKD was decreased (OR 0.60; 95% CI 0.38–0.93, P trend 0.023). Intakes of vitamin E and β-carotene were not significantly associated with incident CKD risk.Our findings suggest that diets high in TAC are associated with a lower risk of incident CKD among subjects with hyperglycemia after 3 years of follow-up.
Keywords: Total antioxidant capacity; Incident CKD; Vitamin C; Free radical; Oxidative stress

The effect of perinatal fish oil supplementation on neurodevelopment and growth of infants: a randomized controlled trial by Alireza Ostadrahimi; Hanieh Salehi-pourmehr; Sakineh Mohammad-Alizadeh-Charandabi; Seifollah Heidarabady; Azizeh Farshbaf-Khalili (2387-2397).
Long-chain polyunsaturated fatty acids, the most abundant fatty acids in the brain, are essential for the growth and development of the brain and the retina.To evaluate the effect of fish oil supplementation on the development (primary outcome) and growth of 4- and 6-month-old infants.In this triple-blind randomized controlled trial, 150 pregnant women aged 18–35 years, who were referred to healthcare centres of Tabriz-Iran, were randomly allocated into two groups. One group of women consumed fish oil supplementation (containing 120 mg docosahexaenoic acid and 180 mg eicosapentaenoic acid) daily, while the other consumed a placebo from the 20th week of pregnancy till 30 days after childbirth in a parallel design by a computer-generated block randomization scheme. The neurodevelopment of infants was the primary outcome; it was assessed using the ages and stages questionnaire (ASQ) at 4- and a-6 months of age. The growth of these infants was measured using weight, length and head circumference. The participants, the caregivers, and those assessing the outcomes were blind to the group assignment.Only one woman in the placebo group discontinued the intervention because of persistent severe nausea. All 75 neonates aged 4- and a-6 months in the fish oil supplementation group, along with 73 and 71 neonates aged 4 and 6 months, respectively in the placebo group, were followed and analysed. Although the mean scores of neurodevelopment at the end of 4 and 6 months were higher in the supplemented group than in the placebo group in each ASQ domain, a statistically significant difference was observed only in the communication domain at the 4th month (adjusted mean difference 2.63; 95% confidence interval 0.36–4.89). There was no significant difference in weight, length, or head circumference between the two groups of infants aged 4 and 6 months (P ≥ 0.05).Based on the results, perinatal fish oil supplementation is beneficial for the communication domain of neurodevelopment of 4-month-old infants. The study results relating to the supplementation effect on other domains are inconclusive. There ought to be further studies with up-to-date lipidomic analysis to find biochemical correlate compared to an intervention and developmental finding.
Keywords: Fish oil; Supplementation; n-3 LCPUFA; Neurodevelopment; Growth; Infant

Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study by Heinz Freisling; Hwayoung Noh; Nadia Slimani; Véronique Chajès; Anne M. May; Petra H. Peeters; Elisabete Weiderpass; Amanda J. Cross; Guri Skeie; Mazda Jenab; Francesca R. Mancini; Marie-Christine Boutron-Ruault; Guy Fagherazzi; Verena A. Katzke; Tilman Kühn; Annika Steffen; Heiner Boeing; Anne Tjønneland; Cecilie Kyrø; Camilla P. Hansen; Kim Overvad; Eric J. Duell; Daniel Redondo-Sánchez; Pilar Amiano; Carmen Navarro; Aurelio Barricarte; Aurora Perez-Cornago; Konstantinos K. Tsilidis; Dagfinn Aune; Heather Ward; Antonia Trichopoulou; Androniki Naska; Philippos Orfanos; Giovanna Masala; Claudia Agnoli; Franco Berrino; Rosario Tumino; Carlotta Sacerdote; Amalia Mattiello; H. Bas Bueno-de-Mesquita; Ulrika Ericson; Emily Sonestedt; Anna Winkvist; Tonje Braaten; Isabelle Romieu; Joan Sabaté (2399-2408).
There is inconsistent evidence regarding the relationship between higher intake of nuts, being an energy-dense food, and weight gain. We investigated the relationship between nut intake and changes in weight over 5 years.This study includes 373,293 men and women, 25–70 years old, recruited between 1992 and 2000 from 10 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Habitual intake of nuts including peanuts, together defined as nut intake, was estimated from country-specific validated dietary questionnaires. Body weight was measured at recruitment and self-reported 5 years later. The association between nut intake and body weight change was estimated using multilevel mixed linear regression models with center/country as random effect and nut intake and relevant confounders as fixed effects. The relative risk (RR) of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI).On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less weight gain over 5 years (−0.07 kg; 95% CI −0.12 to −0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92–0.98) or obese (RR 0.95; 95% CI 0.90–0.99) (both P trend <0.008).Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.
Keywords: Nut intake; Weight gain; Obesity; Energy balance; Adults; Europe

Micronutrient intake adequacy and depression risk in the SUN cohort study by Almudena Sánchez-Villegas; Aurora Pérez-Cornago; Itziar Zazpe; Susana Santiago; Francisca Lahortiga; Miguel Angel Martínez-González (2409-2419).
The aim of the study was to prospectively assess the association between micronutrient intake adequacy and risk of depression.This dynamic cohort study involves Spanish university graduates (SUN Project). Dietary intake was assessed at baseline and after 10 years of follow-up with a semi-quantitative food frequency questionnaire. Micronutrient intake adequacy for vitamins B1, B2, B3, B6, B12, C, A, D, E, folic acid, zinc, iodine, selenium, iron, calcium, potassium, phosphorus, magnesium and chrome was estimated. Inadequate intake for each nutrient was defined when the intake of the nutrient was below the estimated average requirements (EAR) if available or the adequate intake levels, if EARs were not available. We compared participants with inadequate intake for ≥4 nutrients vs. those with one nutrient. Participants were classified as having incident depression if they had no previous history of depression or antidepressants use at baseline, but they reported during follow-up a new clinical diagnosis of depression by a physician, use of antidepressant drugs, or both. Time-dependent multivariable Cox regression models were fitted.After a median follow-up of 8.5 years, 953 new cases of depression were observed among 13,983 participants. Participants with inadequate intake for ≥4 nutrients showed a significantly higher risk of depression [multivariable hazard ratio (HR) = 1.37; 95% confidence interval (CI) 1.01–1.85]. When the analyses were updated with repeated assessments of intakes, the association was attenuated and it was no longer statistically significant (Multivariable HR = 1.11; 95% CI 0.82–1.51).Micronutrient inadequacy in four or more micronutrients could exert a moderate role in the development of depression.
Keywords: Cohort; Depression; Micronutrients; Nutritional adequacy

IL-10 and TGF-β unbalanced levels in neutrophils contribute to increase inflammatory cytokine expression in childhood obesity by Nayara I. Medeiros; Rafael T. Mattos; Carlos A. Menezes; Rafaelle C. G. Fares; André Talvani; Walderez O. Dutra; Fabrício Rios-Santos; Rodrigo Correa-Oliveira; Juliana A. S. Gomes (2421-2430).
Obesity is a multifactorial disease, associated with metabolic disorders, chronic low-grade inflammation, and impaired immunity. This study aimed to evaluate the childhood obesity-associated effects on neutrophil activation and cytokine production.We evaluated activation and recognition markers and cytokine production in neutrophils from the peripheral blood of children with obesity and normal weight using multicolor flow cytometry.We demonstrate a higher frequency of neutrophils in childhood obesity group (CO) compared to normal-weight group (NW). Our data showed that neutrophils from CO group are capable of antigen recognition and presentation through higher expression of TLR-4 (CD284) and HLA-DR in comparison with neutrophils from NW. On the other hand, neutrophils from CO group are faulty to deliver co-stimulatory signals, through lower expression of co-stimulatory molecules. We showed an increased expression of IL-6, IL-1β, IL-12, and TNF, and decreased expression of IL-8 and IL-10 by neutrophils from CO compared to NW, while TGF-β is equivalently expressed in neutrophils from both groups. Despite this, we observed that TGF-β/inflammatory cytokine ratio was significantly higher than the IL-10/inflammatory cytokine ratio only in CO group. Our analysis showed obesity altering the correlation profile for the expression of co-stimulatory, recognition, and activation molecules, as well as for cytokines by neutrophils, suggesting an association between lower IL-10 expression and inflammation in childhood obesity.The unbalance between the ratio of IL-10 and TGF-β expressions, the IL-10 lower expression, and changes in correlation profile seem to contribute with an inefficient regulation of inflammatory cytokine expression in childhood obesity. However, these changes still not may be considered the sole mechanism that directs inflammation during childhood obesity, once other molecules, pathways, and cells should be evaluated.
Keywords: Childhood obesity; Immune regulation; Innate immunity; Cytokines; Neutrophils

Studies have reported that erythritol, a low or non-glycemic sugar alcohol possesses anti-hyperglycemic and anti-diabetic potentials but the underlying mode of actions is not clear. This study investigated the underlying mode of actions behind the anti-hyperglycemic and anti-diabetic potentials of erythritol using different experimental models (experiment 1, 2 and 3).Experiment 1 examined the effects of increasing concentrations (2.5–20%) of erythritol on glucose absorption and uptake in isolated rat jejunum and psoas muscle, respectively. Experiments 2 and 3 examined the effects of a single oral dose of erythritol (1 g/kg bw) on intestinal glucose absorption, gastric emptying and postprandial blood glucose increase, glucose tolerance, serum insulin level, muscle/liver hexokinase and liver glucose-6 phosphatase activities, liver and muscle glycogen contents and mRNA and protein expression of muscle Glut-4 and IRS-1 in normal and type 2 diabetic animals.Experiment 1 revealed that erythritol dose dependently enhanced muscle glucose ex vivo. Experiment 2 demonstrated that erythritol feeding delayed gastric emptying and reduced small intestinal glucose absorption as well as postprandial blood glucose rise, especially in diabetic animals. Experiment 3 showed that erythritol feeding improved glucose tolerance, muscle/liver hexokinase and liver glucose-6 phosphatase activities, glycogen storage and also modulated expression of muscle Glut-4 and IRS-1 in diabetic animals.Data suggest that erythritol may exert anti-hyperglycemic effects not only via reducing small intestinal glucose absorption, but also by increasing muscle glucose uptake, improving glucose metabolic enzymes activity and modulating muscle Glut-4 and IRS-1 mRNA and protein expression. Hence, erythritol may be a useful dietary supplement for managing hyperglycemia, particularly for T2D.
Keywords: Erythritol; Glucose absorption; Glucose uptake; Type 2 diabetes (T2D); Glut-4; IRS-1

Consumption of extra virgin olive oil improves body composition and blood pressure in women with excess body fat: a randomized, double-blinded, placebo-controlled clinical trial by Flávia Galvão Cândido; Flávia Xavier Valente; Laís Emilia da Silva; Olívia Gonçalves Leão Coelho; Maria do Carmo Gouveia Peluzio; Rita de Cássia Gonçalves Alfenas (2445-2455).
Despite the fact that extra virgin olive oil (EVOO) is widely used in obese individuals to treat cardiovascular diseases, the role of EVOO on weight/fat reduction remains unclear. We investigated the effects of energy-restricted diet containing EVOO on body composition and metabolic disruptions related to obesity.This is a randomized, double-blinded, placebo-controlled clinical trial in which 41 adult women with excess body fat (mean ± SD 27.0 ± 0.9 year old, 46.8 ± 0.6% of total body fat) received daily high-fat breakfasts containing 25 mL of soybean oil (control group, n = 20) or EVOO (EVOO group, n = 21) during nine consecutive weeks. Breakfasts were part of an energy-restricted normal-fat diets (−2090 kJ, ~32%E from fat). Anthropometric and dual-energy X-ray absorptiometry were assessed, and fasting blood was collected on the first and last day of the experiment.Fat loss was ~80% higher on EVOO compared to the control group (mean ± SE: −2.4 ± 0.3 kg vs. −1.3 ± 0.4 kg, P = 0.037). EVOO also reduced diastolic blood pressure when compared to control (–5.1 ± 1.6 mmHg vs. +0.3 ± 1.2 mmHg, P = 0.011). Within-group differences (P < 0.050) were observed for HDL-c (−2.9 ± 1.2 mmol/L) and IL-10 (+0.9 ± 0.1 pg/mL) in control group, and for serum creatinine (+0.04 ± 0.01 µmol/L) and alkaline phosphatase (−3.3 ± 1.8 IU/L) in the EVOO group. There was also a trend for IL-1β EVOO reduction (−0.3 ± 0.1 pg/mL, P = 0.060).EVOO consumption reduced body fat and improved blood pressure. Our results indicate that EVOO should be included into energy-restricted programs for obesity treatment.
Keywords: Extra virgin olive oil; Soybean oil; Body fat; Blood pressure; Adiposity; Monounsaturated fatty acid

Associations between serum calcium, phosphorus and mortality among patients with coronary heart disease by Qian Chen; Yuan Zhang; Ding Ding; Dan Li; Yunou Yang; Qing Li; Xuechen Chen; Gang Hu; Wenhua Ling (2457-2467).
Serum calcium and phosphorus abnormalities are associated with cardiovascular disorders in general population, but evidence among patients with established coronary heart disease (CHD) is limited and controversial. This study aimed to investigate the associations of baseline serum calcium and phosphorus levels with long-term mortality risk among patients with CHD.We conducted a prospective cohort study among 3187 patients with CHD from October 2008 and December 2011 in China. Cox proportional hazards model was used to assess the associations of serum calcium and phosphorus at baseline with the risk of death.During follow-up (mean, 4.9 years), 295 patients died, 193 of which resulted from cardiovascular causes. Multivariable-adjusted hazard ratios (HR) for each 1 mmol/L increase in serum calcium at baseline were 0.27 (95% confidence interval (CI) 0.14–0.51) for all-cause mortality and 0.26 (95% CI 0.12–0.54) for cardiovascular mortality. Patients in the highest compared to the lowest quartile of serum calcium were at lower risk of all-cause mortality (HR, 95% CI 0.57, 0.40–0.82) and cardiovascular mortality (0.50, 0.32–0.79) (both P trend < 0.001). This inverse association between serum calcium and the risk of mortality did not change when participants were stratified by sex, age groups, level of overweight, types of CHD, and history of diabetes. We also observed a graded positive association between baseline serum phosphorus and the risks of mortality.The present study is the first to report that lower serum calcium at baseline is associated with an increased risk of all-cause and cardiovascular mortality in a Chinese coronary heart disease cohort. Further studies are required to investigate the causal relationship and actual mechanisms.
Keywords: Mineral metabolism; Cardiovascular disease; Mortality; Cohort study

Although evidence strongly supports that antioxidant-rich diets reduce risk of chronic disease and mortality, findings from the previous studies on the effect of individual antioxidants on mortality have been inconsistent. The aim of this study was to assess the relationship between dietary total antioxidant capacity (TAC) and all-cause and disease-specific mortality in a representative sample of the US population.A total of 23,595 US adults aged 30 years and older in NHANES 1988–1994 and 1999–2004 were selected for this study. Dietary TAC was calculated from 1-day 24-h diet recall data at baseline and all-cause, cancer and cardiovascular disease (CVD) mortality was assessed through December 31, 2011.During a mean follow-up of 13 years, deaths from all-cause, cancer and CVD were 7157, 1578, and 2155, respectively. Using cause-specific Cox proportional hazards models, inverse associations and linear trends were observed between dietary TAC and all-cause mortality [highest quartile (Q4) versus Q1 ref. HR 0.78; 95% CI 0.71–0.86], cancer mortality (Q4 versus Q1 ref. HR 0.75; 95% CI 0.60–0.93), and CVD mortality (Q4 versus Q1 ref. HR 0.83; 95% CI 0.69–0.99), respectively, after adjusting for age, sex, ethnicity, and total energy intake. The inverse association and linear trend still remained between dietary TAC and all-cause mortality (Q4 versus Q1 ref. HR 0.79; 95% CI 0.71–0.87) and CVD mortality (Q4 versus Q1 ref. HR 0.74; 95% CI 0.61–0.89) when further adjusted for relevant covariates.These findings support that antioxidant-rich diets are beneficial to reducing risk of death from all-cause and CVD.
Keywords: Total antioxidant capacity; Mortality; NHANES; Cardiovascular disease; Cancer

Association between organic food consumption and metabolic syndrome: cross-sectional results from the NutriNet-Santé study by Julia Baudry; Hélène Lelong; Solia Adriouch; Chantal Julia; Benjamin Allès; Serge Hercberg; Mathilde Touvier; Denis Lairon; Pilar Galan; Emmanuelle Kesse-Guyot (2477-2488).
Metabolic syndrome (MetS), a multicomponent condition, is a cardiovascular disease predictor. Although exposure to agricultural pesticides has been suggested as a potential contributor to the rising rates of obesity, type 2 diabetes, and other features of metabolic disorders, no studies have focused on the association between consumption of organic food (produced without synthetic pesticides) and MetS. We aimed to investigate the cross-sectional association between organic food consumption and MetS in French adults to determine whether it would be worth conducting further studies, particularly large prospective and randomised trials.A total of 8174 participants from the NutriNet-Santé study who attended a clinical visit and completed an organic food frequency questionnaire were included in this cross-sectional analysis. We evaluated the association between the proportion of organic food in the diet (overall and by food group) and MetS using Poisson regression models while adjusting for potential confounders.Higher organic food consumption was negatively associated with the prevalence of MetS: adjusted prevalence ratio was 0.69 (95% CI 0.61, 0.78) when comparing the third tertile of proportion of organic food in the diet with the first one (p value <0.0001). Higher consumption of organic plant-based foods was also related to a lower probability of having MetS. In addition, when stratifying by lifestyle factors (nutritional quality of the diet, smoking status, and physical activity), a significant negative association was detected in each subgroup (p values <0.05), except among smokers.Our results showed that a higher organic food consumption was associated with a lower probability of having MetS. Additional prospective studies and randomised trials are required to ascertain the relationship between organic food consumption and metabolic disorders.
Keywords: Metabolic syndrome; Metabolic traits; Organic food consumption; Dietary pattern

Nutrient intake of Swiss toddlers by Thomas A. Brunner; Luca Casetti; Petra Haueter; Pascal Müller; Andreas Nydegger; Johannes Spalinger (2489-2499).
During the first years of life, food preferences are shaped that might last throughout a person’s entire life affecting his/her health in the long term. However, knowledge on early feeding habits is still limited for toddlers. Therefore, the goal of the present study was to: (1) assess toddlers’ nutrient intake; (2) compare the findings to past studies as well as to national feeding recommendations and (3) identify major food sources for energy and macronutrients.A food survey using a 4-day diary was conducted. The dietary software nut.s® was used to analyse the data.A cohort of 188 healthy toddlers (aged 1–3 years) was analysed. The energy intake of most toddlers was below the recommended daily intake (RDI) but in accordance with earlier studies. Protein intake was three- to fourfold higher than the RDI and reached the proposed upper limit of 15% of total energy intake. Fat intake was in accordance with the RDI, but the balance of saturated and unsaturated fatty acids should be improved. Carbohydrate intake met the RDI. For the micronutrients, iron and vitamin D intakes showed critical values.As in other European countries, the diet of Swiss toddlers in general seems adequate but does not meet all nutritional requirements. In particular, the quality of the fats and vitamin D supplementation should be improved. For proteins and iron, additional research is needed to gain more confidence in the recommendations.
Keywords: Toddlers; Nutrient intake; Energy intake; Protein intake; Recommended dietary intake

Energy drinks and their component modulate attention, memory, and antioxidant defences in rats by M. T. Costa Valle; N. S. Couto-Pereira; C. Lampert; D. M. Arcego; A. P. Toniazzo; R. P. Limberger; E. Dallegrave; C. Dalmaz; M. D. Arbo; M. B. Leal (2501-2511).
This study aimed to evaluate the effects of the subchronic consumption of energy drinks and their constituents (caffeine and taurine) in male Wistar rats using behavioural and oxidative measures.Energy drinks (ED 5, 7.5, and 10 mL/kg) or their constituents, caffeine (3.2 mg/kg) and taurine (40 mg/kg), either separately or in combination, were administered orally to animals for 28 days. Attention was measured though the ox-maze apparatus and the object recognition memory test. Following behavioural analyses, markers of oxidative stress, including SOD, CAT, GPx, thiol content, and free radicals, were measured in the prefrontal cortex, hippocampus, and striatum.The latency time to find the first reward was lower in animals that received caffeine, taurine, or a combination of both (P = 0.003; ANOVA/Bonferroni). In addition, these animals took less time to complete the ox-maze task (P = 0.0001; ANOVA/Bonferroni), and had better short-term memory (P < 0.01, Kruskal–Wallis). The ED 10 group showed improvement in the attention task, but did not differ on other measures. In addition, there was an imbalance in enzymatic markers of oxidative stress in the prefrontal cortex, the hippocampus, and the striatum. In the group that received both caffeine and taurine, there was a significant increase in the production of free radicals in the prefrontal cortex and in the hippocampus (P < 0.0001; ANOVA/Bonferroni).Exposure to a combination of caffeine and taurine improved memory and attention, and led to an imbalance in the antioxidant defence system. These results differed from those of the group that was exposed to the energy drink. This might be related to other components contained in the energy drink, such as vitamins and minerals, which may have altered the ability of caffeine and taurine to modulate memory and attention.
Keywords: Energy drinks; Subchronic toxicity; Memory; Attention; Oxidative stress

Barley is a low-glycemic index grain that can help diabetic and obese patients. The effect of barley intake depends on the host and the associated gut microbiota. This study investigated the effect of barley intake on the fecal microbiota, caecal biochemistry, and key biomarkers of obesity and inflammation.Obese db/db mice were fed diets with and without barley during 8 weeks; lean mice were used as lean controls. Fecal microbiota was evaluated using 16S marker gene sequencing in a MiSeq instrument; several markers of caecal biochemistry, obesity, and inflammation were also evaluated using standard techniques.Bacterial richness (i.e., Operational Taxonomic Units) and Shannon diversity indexes were similar in all obese mice (with and without barley) and higher compared to lean controls. Barley intake was associated with increased abundances of Prevotella, Lactobacillus, and the fiber-degraders S24-7 (Candidatus Homeothermaceae) compared to both lean and obese controls. The analysis of unweighted UniFrac distances showed a separate clustering of samples for each experimental group, suggesting that consumption of barley contributed to a phylogenetically unique microbiota distinct from both obese and lean controls. Caecal butyrate concentrations were similar in all obese mice, while succinic acid was lower in the barley group compared to obese controls. Barley intake was also associated with lower plasma insulin and resistin levels compared to obese controls.This study shows that barley intake is associated with a different fecal microbiota, caecal biochemistry, and obesity biomarkers in db/db mice that tend to be more similar to lean controls.
Keywords: Obesity; Diabetes; Barley; Microbiota; 16S rRNA gene; Short-chain fatty acids

Periods of intensified training are associated with immune disturbances, The aim was to investigate the effects of supplementation with Chlorella pyrenoidosa (Chlorella) on secretory IgA (sIgA) responses to 2 days intensified training.Twenty-six subjects (age 29.1 ± 8.7 years; VO2max 53.7 ± 11.7 ml kg min−1) provided resting saliva samples for determination of sIgA, at baseline (week-0) and following 4, 5, and 6 weeks (weeks-4, -5, -6) of daily supplementation with 6 g/day Chlorella (n = 13) or placebo (PLA, n = 13). During week-4 a 2-day intensified training period was undertaken [morning and afternoon sessions each day, respectively: VO2max test; high-intensity interval training (HIIT, 3 × 30 s Wingate sprints); 90 min at ~60% VO2max; 3 × 30 s HIIT]. Chlorella increased resting sIgA secretion rate (trial × time, P = 0.016: no change with PLA but increases with Chlorella at week-4, week-5 and week-6, P = 0.020, <0.001, and 0.016). PLA vs Chlorella: week-0 = 54 ± 33 vs 57 ± 37 µg/min; week-4 = 54 ± 35 vs 83 ± 57 µg/min; week-5 = 63 ± 46 vs 98 ± 47 µg/min; week-6 = 58 ± 35 vs 85 ± 59 µg/min. Minimal acute changes in sIgA were seen in response to individual exercise bouts, but it was higher at some times in the Chlorella group (for bouts 2 and 3).Supplementation with Chlorella has beneficial effects on resting sIgA, which might be beneficial during periods of intensified training.
Keywords: Cycling; Single-celled microalgae; Algae; IgA; Exercise; Nutrition

Overall diet quality and risk of recurrence and progression of non-gallstone-related acute pancreatitis: a prospective cohort study by Viktor Oskarsson; Omid Sadr-Azodi; Andrea Discacciati; Nicola Orsini; Alicja Wolk (2537-2545).
An incident episode of acute pancreatitis is often followed by recurrent attacks and/or progression to chronic pancreatitis, especially if the etiology is non-gallstone-related. We examined whether overall diet quality influences the natural history of non-gallstone-related acute pancreatitis.Three hundred and eighty-six individuals (born 1914–1952) were included in a prospective study, all of whom had an incident diagnosis of non-gallstone-related acute pancreatitis in the Swedish National Patient Register between 1998 and 2013. Participants were already enrolled in two population-based cohorts and had completed a food frequency questionnaire in 1997. Overall diet quality was calculated using a recommended food score (RFS), which was based on 25 food items. Post-diagnosis follow-up was conducted throughout 2014 for recurrence of acute pancreatitis and/or progression to chronic pancreatic disease (including cancer). Hazard ratios were estimated using Cox models.During 1859 person-years of follow-up, 23.3% of the study population (n = 90) developed recurrent or progressive pancreatic disease. An inverse association was observed between the RFS and risk of recurrent and progressive pancreatic disease after adjustment for age and sex (hazard ratio for each 2-unit increase 0.90, 95% confidence interval 0.81–1.01) (P overall association = 0.06). However, the association became weaker and was not statistically significant after adjustment for other potential confounders, including alcohol drinking and cigarette smoking (P overall association = 0.27).In this prospective study of individuals with non-gallstone-related acute pancreatitis, there was no clear association between overall diet quality and risk of recurrent and progressive pancreatic disease.
Keywords: Pancreatitis; Secondary prevention; Diet; Epidemiology; Prospective studies

Antitumor activity and expression profiles of genes induced by sulforaphane in human melanoma cells by Paola Arcidiacono; Francesco Ragonese; Anna Stabile; Alessandra Pistilli; Ekaterina Kuligina; Mario Rende; Ugo Bottoni; Stefano Calvieri; Andrea Crisanti; Roberta Spaccapelo (2547-2569).
Human melanoma is a highly aggressive incurable cancer due to intrinsic cellular resistance to apoptosis, reprogramming, proliferation and survival during tumour progression. Sulforaphane (SFN), an isothiocyanate found in cruciferous vegetables, plays a role in carcinogenesis in many cancer types. However, the cytotoxic molecular mechanisms and gene expression profiles promoted by SFN in human melanoma remain unknown.Three different cell lines were used: two human melanoma A375 and 501MEL and human epidermal melanocytes (HEMa). Cell viability and proliferation, cell cycle analysis, cell migration and invasion and protein expression and phosphorylation status of Akt and p53 upon SFN treatment were determined. RNA-seq of A375 was performed at different time points after SFN treatment.We demonstrated that SFN strongly decreased cell viability and proliferation, induced G2/M cell cycle arrest, promoted apoptosis through the activation of caspases 3, 8, 9 and hampered migration and invasion abilities in the melanoma cell lines. Remarkably, HEMa cells were not affected by SFN treatment. Transcriptomic analysis revealed regulation of genes involved in response to stress, apoptosis/cell death and metabolic processes. SFN upregulated the expression of pro-apoptotic genes, such as p53, BAX, PUMA, FAS and MDM2; promoted cell cycle inhibition and growth arrest by upregulating EGR1, GADD45B, ATF3 and CDKN1A; and simultaneously acted as a potent inhibitor of genotoxicity by launching the stress-inducible protein network (HMOX1, HSPA1A, HSPA6, SOD1).Overall, the data show that SFN cytotoxicity in melanoma derives from complex and concurrent mechanisms during carcinogenesis, which makes it a promising cancer prevention agent.
Keywords: Melanoma; Melanocytes; Sulforaphane; Apoptosis; Transcriptome; RNA-Seq

Nutritional supplements have been used for correction of deficiencies that may occur in patient with autism spectrum disorder (ASD) and to improve core symptoms. We aim to provide current best evidence about supplements for nutritional deficiencies and core symptoms in children with ASD and to evaluate the effectiveness and safety.A systematic literature search of scientific databases was performed to retrieve relevant randomized controlled trials. Risk of bias was assessed for each study.18 randomized controlled trials of five supplements were included. B6/Mg was not helpful for improving ASD symptoms (seven RCTs). Two RCTs of methyl B12 reported some improvement in ASD severity but the effects on the correction of deficiencies were inconclusive. Two RCTs of vitamin D3 both reported increased levels of mean 25(OH)D in serum but inconsistent results in behavioral outcomes. Omega-3 fatty acid supplementation did not affect ASD behaviors but may correct deficiencies (six RCTs). One RCT of folinic acid reported positive results in improving ASD symptoms measured by various behavioral scales.Current evidence for the use of supplements for correcting nutritional deficiencies in children with ASD and to improve the symptoms is little. More studies are needed.
Keywords: Autism spectrum disorder; Core symptoms; Nutritional deficiency; Supplements

Can polymorphisms in the fatty acid desaturase (FADS) gene cluster alter the effects of fish oil supplementation on plasma and erythrocyte fatty acid profiles? An exploratory study by Suzanne J. Meldrum; Yuchun Li; Guicheng Zhang; Alexandra E. M. Heaton; Nina D’Vaz; Judith Manz; Eva Reischl; Berthold V. Koletzko; Susan L. Prescott; Karen Simmer (2583-2594).
The enzymes encoded by fatty acid desaturases (FADS) genes determine the desaturation of long-chain polyunsaturated fatty acids (LCPUFA). We investigated if haplotype and single nucleotide polymorphisms (SNPs) in FADS gene cluster can influence LCPUFA status in infants who received either fish oil or placebo supplementation.Children enrolled in the Infant Fish Oil Supplementation Study (IFOS) were randomly allocated to receive either fish oil or placebo from birth to 6 months of age. Blood was collected at 6 months of age for the measurement of fatty acids and for DNA extraction. A total of 276 participant DNA samples underwent genotyping, and 126 erythrocyte and 133 plasma fatty acid measurements were available for analysis. Twenty-two FADS SNPs were selected on the basis of literature and linkage disequilibrium patterns identified from the HapMap data. Haplotype construction was completed using PHASE.For participants allocated to the fish oil group who had two copies of the FADS1 haplotype consisting of SNP minor alleles, DHA levels were significantly higher compared to other haplotypes. This finding was not observed for the placebo group. Furthermore, for members of the fish oil group only, the minor homozygous carriers of all the FADS1 SNPs investigated had significantly higher DHA than other genotypes (rs174545, rs174546, rs174548, rs174553, rs174556, rs174537, rs174448, and rs174455).Overall results of this preliminary study suggest that supplementation with fish oil may only significantly increase DHA in minor allele carriers of FADS1 SNPs. Further research is required to confirm this novel finding.
Keywords: Fatty acid desaturase (FADS) genes; Fatty acids; LCPUFA supplementation; Haplotypes; Single nucleotide polymorphisms (SNPs)

Plasma enterolactone and risk of prostate cancer in middle-aged Swedish men by Peter Wallström; Isabel Drake; Emily Sonestedt; Bo Gullberg; Anders Bjartell; Håkan Olsson; Herman Adlercreutz; Matti J. Tikkanen; Elisabet Wirfält (2595-2606).
Enterolactone (ENL) is formed in the human gut after consumption of lignans, has estrogenic properties, and has been associated with risk of prostate cancer. We examined the association between plasma ENL levels and prostate cancer in a nested case–control study within the population-based Malmö Diet and Cancer cohort. We also examined the association between plasma ENL and dietary and lifestyle factors.The study population consisted of 1010 cases occurring during a mean follow-up of 14.6 years, and 1817 controls matched on age and study entry date. We used national registers (95%) and hospital records (5%) to ascertain cases. Diet was estimated by a modified diet history method. Plasma ENL concentrations were determined by a time-resolved fluoroimmunoassay. Odds ratios were calculated by unconditional logistic regression.There were no significant associations between plasma ENL and incidence of all prostate cancer (odds ratio 0.99 [95% confidence interval 0.77–1.280] for the highest ENL quintile versus lowest, p for trend 0.66). However, in certain subgroups of men, including men with abdominal obesity (p for interaction = 0.012), we observed associations between high ENL levels and lower odds of high-risk prostate cancer. Plasma ENL was positively associated with consumption of high-fibre bread, fruit, tea, and coffee; with age, and with height, while it was negatively associated with smoking and waist circumference; however, although significant, all associations were rather weak (r ≤ |0.14|).ENL concentration was not consistently associated with lower prostate cancer risk, although it was weakly associated with a healthy lifestyle.
Keywords: Diet; Prostate cancer; Nested case–control; Lignans; Enterolactone

High-dose vitamin D3 supplementation decreases the number of colonic CD103+ dendritic cells in healthy subjects by Nina Friis Bak; M. Bendix; S. Hald; L. Reinert; M. K. Magnusson; J. Agnholt (2607-2619).
Vitamin D may induce tolerance in the intestinal immune system and has been shown to regulate the phenotype of tolerogenic intestinal dendritic cells (DCs) in vitro. It is unknown whether vitamin D supplementation affects human intestinal DCs in vivo, and we aimed to investigate the tolerability and effect on intestinal CD103+DCs of high-dose vitamin D3 treatment in healthy subjects.Ten healthy subjects received a total of 480,000 IU oral vitamin D3 over 15 days and colonic biopsies were obtained before and after intervention by endoscopy. Lamina propria mononuclear cells (LPMCs) were isolated from the biopsies, stained with DC surface markers and analysed with flow cytometry. Snap-frozen biopsies were analysed with qPCR for DC and regulatory T cell-related genes.No hypercalcemia or other adverse events occurred in the test subjects. Vitamin D decreased the number of CD103+ DCs among LPMCs (p = 0.006). Furthermore, vitamin D induced mRNA expression of TGF-β (p = 0.048), TNF-α (p = 0.006) and PD-L1 (p = 0.02) and tended to induce IL-10 expression (p = 0.06). Multivariate factor analysis discriminated between pre- and post-vitamin D supplementation with a combined increased qPCR expression of PD1, PD-L1, TGF-β, IL-10, CD80, CD86, FOXP3, NFATc2 and cathelicidin.High-dose vitamin D supplementation is well tolerated by healthy subjects and has a direct effect on the CD103+ DCs, local cytokine and surface marker mRNA expression in the colonic mucosa, suggestive of a shift towards a more tolerogenic milieu.
Keywords: Vitamin D; CD103+ dendritic cells; Intestinal immune system; PD-L1

Habitual yoghurt consumption and depressive symptoms in a general population study of 19,596 adults by Bin Yu; Qi Zhu; Ge Meng; Yeqing Gu; Qing Zhang; Li Liu; Hongmei Wu; Yang Xia; Xue Bao; Hongbin Shi; Qian Su; Liyun Fang; Fei Yu; Huijun Yang; Shaomei Sun; Xing Wang; Ming Zhou; Qiyu Jia; Qi Guo; Kun Song; Andrew Steptoe; Kaijun Niu (2621-2628).
Epidemiological studies directly examining the association between habitual yoghurt consumption and mental health remain scarce. The aim of this study is to investigate the association of yoghurt consumption with depressive symptoms in adults.This is a cross-sectional study of 19,596 Chinese adults (mean age 41.2, standard deviation 11.8 years; males, 54.3%). Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Dietary intake was obtained through a valid food frequency questionnaire. Multiple logistic regression analysis was conducted to assess the association between yoghurt consumption and depressive symptoms. A number of potential confounders were adjusted in the model.The prevalence of elevated depressive symptoms was 17.1% (SDS ≥45). The multivariable adjusted odds ratios (95% CI) of having elevated depressive symptoms by increasing levels of yoghurt consumption (1–3 times/week, 4–7 times/week, and  ≥twice/day) were 1.05 (0.96, 1.15), 1.02 (0.91, 1.15), and 2.10 (1.61, 2.73) in comparison with lowest consumption group (
Keywords: Yoghurt consumption; Probiotics; Depressive symptoms; Cross-sectional study

Plasma amino acids, adiposity, and weight change after gastric bypass surgery: are amino acids associated with weight regain? by Susanna E. Hanvold; Kathrine J. Vinknes; Nasser E. Bastani; Cheryl Turner; Elin B. Løken; Tom Mala; Helga Refsum; Anne-Marie Aas (2629-2637).
Plasma concentrations of several amino acids (AAs) are positively correlated with obesity. The aim of this study was to examine if selected plasma AAs are associated with weight regain from 2 to 4 years after Roux-en-Y gastric bypass (RYGB).In a prospective study with 165 patients, we examined the relationship between plasma aromatic AAs (AAAs), branched chain AAs (BCAAs), and total cysteine (tCys) 2 years after RYGB, with BMI at 2 years and with weight change from 2 to 4 years after surgery. Analyses were adjusted for relevant covariates.The investigated AAs at 2 years correlated positively with BMI at 2 years (P ≤ 0.003 for all). BCAAs and AAAs at 2 years correlated inversely with % weight loss from 0 to 2 years (P = 0.002 and P = 0.001, respectively), while the association was not significant for tCys (r = −0.14, P = 0.08). Plasma tCys at 2 years correlated positively with BMI at 4 years (P = 0.010) and with weight regain from 2 to 4 years (P = 0.015).Plasma AAAs, BCAAs, and tCys at 2 years were associated with BMI at 2 years. In addition, plasma AAAs and BCAAs at 2 years were associated with weight loss from 0 to 2 years, while tCys at 2 years was associated with weight regain from 2 to 4 years after RYGB. These results suggest that high tCys at 2 years may be used as a prognostic marker for future weight regain. The study was registered in ClinicalTrials.gov (NCT0 1270451).
Keywords: Plasma amino acids; Total cysteine; Aromatic amino acids; Branched chain amino acids; Gastric bypass; Weight change; BMI; Prospective study

Association between fruit and vegetable intake and the risk of hypertension among Chinese adults: a longitudinal study by Ming-wei Liu; Hong-jie Yu; Shuai Yuan; Yong Song; Bo-wen Tang; Zhong-kui Cao; Xu-hao Yang; Samuel D. Towne Jr.; Qi-qiang He (2639-2647).
Fruit and vegetable intake has been inversely associated with the risk of hypertension; however, there is inconsistent evidence on the long-term association. Given this gap in the literature, it is necessary to identify evidence from large prospective studies, especially in China, where insufficient evidence exists. Thus, we examined the association of fruit and vegetable intake with incident hypertension in Chinese adults.We conducted analyses among 5659 Chinese adults aged 18–64 years, free of cardiovascular disease, cancer, and hypertension in the 2006 wave of the China Health and Nutrition Survey. Fruit and vegetable intake was assessed using consecutive 24-h recalls. Incident hypertension was identified from the 2011 wave of the survey.A total of 866 participants developed incident hypertension. The relative risks (RRs) and 95% confidence intervals (CIs) of hypertension were 0.74 (0.55–0.99), 0.65 (0.48–0.88), 0.68 (0.50–0.92), and 0.73 (0.53–0.99) comparing each quintile group of fruit and vegetable intake with the lowest quintile group. These associations attenuated for the change of intake but remained significant for the fourth quintile, of which the RR (95% CI) was 0.65 (0.47–0.89). The magnitude of association was stronger among those who were younger, female, overweight and had prehypertension. When examined separately, fruit intake was more strongly and significantly associated with lowering BP than vegetable intake. Adding body mass index to the models attenuated all associations.Greater long-term intake and increased intake of fruit and vegetables may reduce the risk of developing hypertension in Chinese adults.
Keywords: Hypertension; Prospective studies; Fruit; Vegetable; China

Large artery stiffness is associated with salt intake in young healthy black but not white adults: the African-PREDICT study by Michél Strauss; Wayne Smith; Ruan Kruger; Bianca van der Westhuizen; Aletta E. Schutte (2649-2656).
In the Original publication of the article Fig. 1 was published incorrectly. The correct figure is given below. The original article has been corrected.There is global consensus on the benefits of reducing excessive salt intake. Indeed, lower salt intake associates with reduced arterial stiffness, a well-established predictor of cardiovascular risk, in older populations. Whether high habitual salt intake in healthy normotensive youth may already contribute to increased arterial stiffness is unknown. We, therefore, determined whether estimated salt intake is associated with large artery stiffness in young healthy black and white adults.We included 693 black and white adults (51% black; 42% men), aged 20–30 years. Participants were normotensive based on clinic blood pressure, and no previous diagnosed chronic illnesses. We measured carotid femoral pulse wave velocity (cfPWV) and determined estimated salt intake based on 24 h urinary sodium excretion.We found estimated salt consumption of > 5 g/day in 47% of our population, whereas 21% consumed > 10 g/day. In multivariable-adjusted regression analyses a positive association existed between estimated salt intake and cfPWV in the total group (Adj. R 2 = 0.32; std. β = 0.10; p = 0.007), and black adults (Adj. R 2 = 0.37; std. β = 0.12; p = 0.029). This was independent of age, sex, mean arterial pressure, and other covariates. No association was evident in white individuals (p = 0.19).Excessive salt intake is positively associated with large artery stiffness—independent of blood pressure—in young adults, especially in black individuals. Our results suggest a potential contributory role of salt consumption towards early vascular aging.
Keywords: Arterial stiffness; Black; Estimated salt intake; Healthy; Young

Correction to: Large artery stiffness is associated with salt intake in young healthy black but not white adults: the African-PREDICT study by Michél Strauss; Wayne Smith; Ruan Kruger; Bianca van der Westhuizen; Aletta E. Schutte (2657-2657).
In the Original publication of the article Fig. 1 was published incorrectly. The correct figure is given below. The original article has been corrected.