European Journal of Nutrition

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Determination of digestive properties of A. ghanensis on Gluten. Growth of A. ghanensis on culture medium (MCG-1) with gluten (A) and without gluten (B) was determined. Data are representative of three independent experiments with similar results
Protective effects of A. ghanensis on the intestinal epithelial cell barrier. TEER values were determined at 15-min intervals for 90 min in Caco-2 cells co-cultivated with PBMCs following exposure of Caco-2 cells with PT-gliadin (1 mg/mL) alone or in combination with A. ghanensis (10⁸ CFU/mL). Data analyzed by two-way ANOVA are given as mean ± SEM of six independent experiments; n = 6 for each group with three independent biological replications. A significant interaction effect between time and treatment group was found (p < 0.0001). Tukey’s multiple comparison test was then performed to determine significant differences between groups. #p < 0.05, ##p < 0.01, and ####p < 0.0001 compared to the control group at the same measurement time. *p < 0.05, **p < 0.01, and ****p < 00,001 compared to the PT-gliadin group at the same measurement time
Suppressive effects of A. ghanensis on TJ-Associated Gene Expression. The mRNA expression levels of genes encoding zonulin (A), occludin (B), ZO-1 (C), and claudin-1 (D) were determined in Caco-2 cells co-cultivated with PBMCs after Caco-2 cells were exposed to PT-gliadin (1 mg/mL) alone or in combination with A. ghanensis (10⁸ CFU/mL) for 90 min. The mRNA expression levels of the target genes were assessed by qRT-PCR and normalized to expression of CYPA. The 2−ΔΔCt analysis method was used to calculate fold changes in mRNA expressions of the target genes relative to the control group. Data analyzed by one-way ANOVA are given as mean ± SEM of six independent experiments; n = 6 for each group with the exception of n = 5 for G + A analyzed for the mRNA expression of claudin-1. Three biological replicates were examined for each group and qRT-PCR analysis was performed in duplicate for each group. Statistical differences between two compared groups are depicted on the tops of bars as follows: *p < 0.05, **p < 0.01, ***p < 0.001, ****p < 0.0001
Effects of A. ghanensis on Inflammation-Associated Gene Expression in Caco-2 Cells. The mRNA expression levels of tTG-2 (A) and IL-15 (B) were assessed in Caco-2 cells co-cultivated with PBMCs after exposure to PT-gliadin (1 mg/mL) alone or in combination with A. ghanensis (10⁸ CFU/mL) for 90 min. The mRNA abundance of the target genes relative to the control group was determined by the 2−ΔΔCt analysis method after normalizing to the expression of CYPA. Data are given as means ± SEM of six independent experiments analyzed by nonparametric Kruskal–Wallis rank-sum test followed by Dunn’s post hoc test when groups were compared; n = 6 for each group with three independent biological replications and qRT-PCR analysis conducted in duplicate for each group
Suppressive effects of A. ghanensis on proinflammatory cytokine release from PBMCs Co-Cultured with Caco-2 cells in response to PT-gliadin concentrations of proinflammatory cytokines TNFα (A) and IL-6 (B) in the supernatants of PBMCs co-cultured with Caco-2 cells were determined with subsequent treatment of Caco-2 cells with PT-gliadin (1 mg/mL) alone or in combination with A. ghanensis (10⁸ CFU/mL) for 90 min. Values are expressed as fold changes of target cytokines in each experimental group relative to the control group. Data analyzed by the nonparametric Kruskal–Wallis rank-sum test are given as means ± SEM of six independent experiments. Dunn’s post hoc test was used for the comparisons of groups; n = 6 for each group with three independent biological replications and ELISA assay performed in duplicate for each group
  • Caglar DoguerCaglar Doguer
  • Hande AkalanHande Akalan
  • Nazan Tokatlı DemirokNazan Tokatlı Demirok
  • [...]
  • Turker BilgenTurker Bilgen
Purpose The aim of this study was to establish whether Acetobacter ghanensis, the probiotic characteristics of which were evaluated previously, attenuates gliadin-induced toxicity in intestinal epithelial cells with gluten-digestive and immunoregulatory properties. Methods A co-culture model of human intestinal epithelial cell (Caco-2) monolayers on top of peripheral blood mononuclear cells (PBMCs) obtained from patients with celiac disease (CD) was established. The gluten-digestive properties of A. ghanensis were determined by checking bacterial growth in a medium containing gluten as the main nitrogen source. The mRNA levels of genes encoding TJ-associated proteins were measured by quantitative real-time PCR (qRT-PCR). The concentrations of IL-6 and TNFα were determined by enzyme-linked immunosorbent assay (ELISA). Results We found that PT-gliadin disrupted intestinal barrier integrity by modulating the expression of TJ-associated genes encoding zonulin (increased by ~ 60%), zonula occludens-1 (ZO-1) (decreased by ~ 22%), and occludin (decreased by ~ 28%) in Caco-2 cells. Furthermore, PT-gliadin treatment in Caco-2 cells was associated with increased concentrations of IL-6 (~ 1.6-fold) and TNFα (~ twofold) from PBMCs. These modulatory effects of PT-gliadin, however, were suppressed when Caco-2 cells were subjected to A. ghanensis in the presence of PT-gliadin. As a factor underlying these protective effects, we showed that A. ghanensis could digest gluten peptides. Conclusions To our knowledge, the current study is the first to demonstrate that A. ghanensis improves intestinal barrier functions by attenuating the modulatory effects of PT-gliadin with immunoregulatory and gluten-digestive properties.
 
  • Simou WuSimou Wu
  • Lei RenLei Ren
  • Jinxing LiJinxing Li
  • [...]
  • Ruyue ChengRuyue Cheng
Purpose This study was aimed to determine how delivery mode and feeding pattern influence the infant’s gut microbiota construction and the variation of fecal microbial metabolites from a birth cohort. Methods Fecal samples collected from 61 full-term born Chinese infants at four time points: day 0, day 7, month 1, and month 3. Based on delivery mode (vaginal delivery [V] or cesarean section [C]) and feeding pattern (breastfeeding [B] or mixed feeding [M]), infants were divided into four groups, namely VB, CB, VM, and CM groups. The gut microbiota composition and bacterial diversity were assessed using 16S rRNA sequencing. Short-chain fatty acid (SCFA) concentrations were determined via gas chromatography–mass spectrometry (GC–MS). Results The CM group had a significantly higher relative abundance of Firmicutes (day 0 and month 1), Enterococcaceae (month 3), and Enterococcus (month 3) than the VB group and a significantly higher abundance of Firmicutes (month 1) and Blautia (month 3) than the CB group. The VB and CB groups exhibited a stable SCFA variation and a significantly lower level of propionate compared with the VM and CM groups. All groups showed an intense transition of enterotypes within 1 month and became stable at 3 months. The correlation between SCFA and enterotypes showed a significant positive correlation between Bifidobacteriaceae and acetate in the CB group (day 7 and month 3) and a significant positive correlation between Clostridiaceae and butyrate in the CB and VB groups (day 7 and month 3), respectively. Conclusion These results indicated that C-section was associated with higher abundance of the phylum Firmicutes and family Enterococcaceae, and intense fluctuation of SCFA, at least propionate. And breastfeeding might partially contribute to gut microbiota construction and stabilization propionate metabolism in cesarean-section infants.
 
  • Jeroen H. F. de BaaijJeroen H. F. de Baaij
  • Detlef BockenhauerDetlef Bockenhauer
  • Felix Claverie-MartinFelix Claverie-Martin
  • [...]
  • Rosa Vargas PoussouRosa Vargas Poussou
Flowchart of the participants included in the analysis
Association between the VNR-test diet and the PGS in 104,895 participants from the UK Biobank. Coefficient estimates and P values were obtained from linear regression models adjusted for age, sex, education, the Townsend deprivation index, and PC 1–20. PC principal component, PGS polygenic risk score, VNR-test verbal-number-reasoning test
Purpose Research suggests that diet influences cognitive function and the risk for neurodegenerative disease. The present study aimed to determine whether a recently developed diet score, based on recommendations for dietary priorities for cardio metabolic health, was associated with fluid intelligence, and whether these associations were modified by individual genetic disposition. Methods This research has been conducted using the UK Biobank Resource. Analyses were performed using self-report data on diet and the results for the verbal-numerical reasoning test of fluid intelligence of 104,895 individuals (46% male: mean age at recruitment 57.1 years (range 40–70)). For each participant, a diet score and a polygenic score (PGS) were constructed, which evaluated predefined cut-offs for the intake of fruit, vegetables, fish, processed meat, unprocessed meat, whole grain, and refined grain, and ranged from 0 (unfavorable) to 7 (favorable). To investigate whether the diet score was associated with fluid intelligence, and whether the association was modified by PGS, linear regression analyses were performed. Results The average diet score was 3.9 (SD 1.4). After adjustment for selected confounders, a positive association was found between baseline fluid intelligence and PGS (P < 0.001). No association was found between baseline fluid intelligence and diet score (P = 0.601), even after stratification for PGS, or in participants with longitudinal data available (n = 9,482). Conclusion In this middle-aged cohort, no evidence was found for an association between the investigated diet score and either baseline or longitudinal fluid intelligence. However, as in previous reports, fluid intelligence was strongly associated with a PGS for general cognitive function.
 
Study flowchart according to CONSORT (Consolidated Standards of Reporting Trials)
continued)
Purpose This study aimed to assess the effect of dietary consumption of olive pomace oil (OPO) on blood lipids (primary outcome) and other cardiovascular disease (CVD) risk factors (blood pressure, inflammation and endothelial function as secondary outcomes). Methods A randomized, controlled, blind, crossover intervention was carried out in healthy and at-risk (hypercholesterolemic) subjects. Participants consumed daily 45 g of OPO or high-oleic acid sunflower oil (HOSO) as control oil during 4 weeks. Results OPO significantly reduced low-density lipoprotein cholesterol (LDL-C; P = 0.003) and apolipoprotein B (Apo B; P = 0.022) serum concentrations, and LDL/HDL ratio ( P = 0.027) in healthy and at-risk volunteers. These effects were not observed with HOSO. Blood pressure, peripheral artery tonometry (PAT), endothelial function and inflammation biomarkers were not affected. Conclusions Regular consumption of OPO in the diet could have hypolipidemic actions in subjects at cardiovascular risk as well as in healthy consumers, contributing to CVD prevention. Clinical trial registry NCT04997122, August 8, 2021, retrospectively registered.
 
A, B Median and interquartile range for daily dietary iron intake (mg day⁻¹) from food sources only: females aged 11–14 and 15–18 years across income quintiles (IQ). Kruskal—Wallis test was performed in IBM SPSSv26 to evaluate the potential influence of equivalised household income on daily iron intake, post-hoc Mann–Whitney test performed when significance detected at the Kruskal–Wallis stage. Lower bound values for income quintiles are as follows: (IQ1) < £12,152.43, (IQ2) ≥ £12,152.43, (IQ3) ≥ £19,230.42, (IQ4) ≥ £27,541.95, (IQ5) ≥ £43,402.43. Dotted line represents Lower Reference Nutrient Intake (LRNI), dashed line represents Reference Nutrient Intake (RNI). Number of participants included in the analysis with a valid income female 11–14 years IQ1 n = 23, IQ2 n = 17, IQ3 n = 24, IQ4 n = 28, IQ5 n = 22. Females 15–18 years IQ1 n = 21, IQ2 n = 34, IQ3 n = 19, IQ4 n = 28, IQ5 n = 15. *Significant at the P < 0.05 level. C, D Median and interquartile ranges for daily dietary zinc intakes (mg day⁻¹) from food sources only: females aged 11–14 and 15–18 years across income quintiles (IQ). Kruskal–Wallis test was performed in IBM SPSSv26 to evaluate the potential influence of equivalised household income on daily zinc intake, post-hoc Mann–Whitney test was performed when significance detected at the Kruskal–Wallis stage. Lower bound values for income quintiles are as follows: (IQ1) < £12,152.43, (IQ2) ≥ £12,152.43, (IQ3) ≥ £19,230.42, (IQ4) ≥ £27,541.95, (IQ5) ≥ £43,402.43. Dotted line represents Lower Reference Nutrient Intake (LRNI), dashed line represents Reference Nutrient Intake (RNI). Number of participants included in the analysis with a valid income female 11–14 years IQ1 n = 23, IQ2 n = 17, IQ3 n = 24, IQ4 n = 28, IQ5 n = 22. Females 15–18 years IQ1 n = 21, IQ2 n = 34, IQ3 n = 19, IQ4 n = 28, IQ5 n = 15. *Significant at the P < 0.05 level. E Percentage of females aged 11–14 and 15–18 years with daily iron and zinc intakes below the Lower Reference Nutrient Intake (LRNI) and above or below the Reference Nutrient Intake (RNI). Data sourced from the National Diet Nutrition Survey (NDNS) years 7 & 8 of the rolling programme. Number of participants: females, 11–14 years n = 130 and females 15–18 years n = 142
Purpose A negative socio-economic gradient exists for diet and health outcomes. Since cheaper diets are associated with increased energy and lower nutrient density, we investigated the influence of income on iron and zinc intakes and overall diet quality for adolescent (DQI-A) females aged 11–18 years. Methods National Diet and Nutrition Survey (NDNS years 7 and 8) data for iron and zinc intake and overall diet quality was assessed by household income quintile across females aged 11–18 years. Results Equivalised household income positively correlated with Diet quality index for adolescents (DQI-A) (P < 0.001) Females aged 15–18 years in income quintiles (IQs) I and 2, had a greater proportion of respondents with low to intermediate DQI-A score compared to higher IQs (P = 0.002). NDNS data showed intake was negatively influenced by income amongst females aged 11–14 years for iron (P = 0.009) and zinc (P = 0.001) with those from the lowest incomes consistently consuming significantly less than those from the highest. DQI-A was positively correlated with iron intakes for 11–14 (P = 0.001) and 15–18 years (P < 0.001). Forty-one percent of 15–18-year-olds plasma ferritin stores were below the 15 µg L⁻¹ and 21% had some form of anaemia. Cereal and cereal products were the greatest contributors to iron in all groups. Conclusion Females in the lowest income groups are at greater risk of lower overall diet quality and inadequate iron and zinc intakes. Amongst older adolescents, there is evidence of iron stores being depleted and an increased prevalence of anaemia.
 
The present study aimed to determine the prevalence of adiposity-based chronic disease (ABCD) and its association with anthropometric indices in the Mexican population. A cross-sectional study was conducted in 514 adults seen at a clinical research unit. The American Association of Clinical Endocrinology/AACE/ACE criteria were used to diagnose ABCD by first identifying subjects with BMI≥25 kg/m2 and those with BMI of 23-24.9 kg/m2 and waist circumference≥80 cm in women or≥90 cm in men. The presence of metabolic and clinical complications associated with adiposity, such as factors related to metabolic syndrome, prediabetes, type 2 diabetes, dyslipidaemia, and arterial hypertension, were subsequently evaluated. Anthropometric indices related to cardiometabolic risk factors were then determined. The results showed the prevalence of ABCD was 87.4% in total, 91.5% in men, and 86% in women. The prevalence of ABCD stage 0 was 2.4%, stage 1 was 33.7%, and stage 2 was 51.3%. The prevalence of obesity according to BMI was 57.6%. The waist/hip circumference index (prevalence ratio (PR)=7.57; 95% CI 1.52-37.5) and the conicity index (PR=3.46; 95% CI 1.34-8.93) were better predictors of ABCD, while appendicular skeletal mass % and skeletal muscle mass % decreased the risk of developing ABCD (PR=0.93; 95% CI 0.90-0.96; and PR=0.95; 95% CI 0.93-0.98). Conclusion, the prevalence of ABCD in our study was 87.4%. This prevalence increased with age. It is important to emphasise that one out of two subjects had severe obesity-related complications (ABCD stage 2).
 
Prevalence of physical multimorbidity by food insecurity status (overall and by country)Multimorbidity referred to ≥ 2 chronic conditions
Purpose Food insecurity and multimoribidity (i.e., ≥ 2 chronic conditions) may be linked bidirectionally, but there are no studies on this topic from LMICs. Therefore, the aim of the present study was to examine the association between food insecurity and physical multimorbidity in a large representative sample of older adults from six LMICs. Methods Cross-sectional, community-based data on adults aged ≥ 50 years from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa were analyzed. A total of 11 chronic physical conditions were assessed. Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted to assess the associations. Results Data on 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 47.9% males] were analyzed. After adjustment for potential confounders, in the overall sample, compared to being food secure, moderate and severe food insecurity were associated with 1.29 (95% CI 1.06–1.56) and 1.56 (95% CI 1.13–2.16) times higher odds for multimorbidity, respectively Conclusion Food insecurity was associated with greater odds for multimorbidity in older adults from LMICs. Addressing food insecurity in the general population may reduce risk for multimorbidity, while screening for food insecurity and addressing it among those with multimorbidity may lead to better clinical outcomes, pending future longitudinal research.
 
a Multivariable-adjusted odds ratios with corresponding 95% confidence intervals (CIs) for incident open-angle glaucoma (iOAG) per 10-percent increase in MIND diet adherence and per quartile. Model 1: adjusted for body mass index, energy intake, physical activity, and follow-up time. Model 2: model 1 additionally adjusted for education level and smoking status. Model 3: model 1 additionally adjusted for intraocular pressure. b Graphic presentation of the multivariable-adjusted dose–response relation between adherence to the MIND diet and iOAG. Dotted lines represent 95% CIs. The reference value is the value associated with the mean MIND diet adherence for all participants. MIND Mediterranean-DASH Intervention for Neurodegenerative Delay
Multivariable-adjusted odds ratios with corresponding 95% confidence intervals (CIs) for incident open-angle glaucoma per 10-percent increase in MIND diet adherence, and food component analyses. Results of model 1 are depicted. Model 1: adjusted for body mass index, energy intake, physical activity, follow-up time and adherence to components of interest. Arrowheads indicate the direction in which the association changed by removing the specific food component as compared to the association with the total MIND diet adherence. Size and color vary according to the corresponding effect size. The two dotted vertical lines represent the cut-off value that was used to assess the effect of excluding a single component from the total MIND diet adherence. MIND Mediterranean-DASH Intervention for Neurodegenerative Delay
Purpose To assess the association between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and the incidence of open-angle glaucoma (iOAG), as well as the association between iOAG and two other well-established diets in the Netherlands, i.e., the Mediterranean diet and Dutch dietary guidelines. Methods In the Rotterdam Study, participants were followed for iOAG since 1991, with intervals of approximately 5 years. A total of 170 participants developed iOAG during follow-up. Participants with iOAG were matched with healthy controls on age and sex in a case:control ratio of 1:5. The associations between food frequency questionnaire-derived diet adherences (baseline) and iOAG were analyzed using multivariable conditional logistic regression analyses. The associations between the diet adherences and intraocular pressure (IOP; a risk factor for OAG) were assessed using multivariable linear regression analyses. Results Greater adherence to the MIND diet was associated with a decreased iOAG risk (odds ratio [95% confidence interval]: 0.80 [0.66 to 0.96], for each 10-percent increase in adherence). Food component analyses showed that, in particular a higher intake of green leafy vegetables, berries and fish tended to be protective for iOAG. No significant associations were observed between adherence to the Mediterranean diet or Dutch dietary guidelines and iOAG. Moreover, none of the three examined diets were associated with IOP. Conclusion Adherence to the MIND diet was significantly associated with a lower incidence of OAG in contrast to adherence to the Mediterranean diet or the Dutch dietary guidelines. As this association was IOP-independent, the MIND diet may be particularly relevant for the prevention of neurodegeneration in the eye.
 
Association of three a-posteriori dietary patterns with MHO, MUNW, and MUO phenotype. All models were adjusted for confounders mentioned above using multinomial logistic regression (MHNW as the reference group). Q2-Q5 represent the second to fifth quintile of the diet score of each dietary pattern. The dots represent the estimated odds ratios, and the vertical lines represent the 95% confidence intervals
Stratified analysis for associations of the Yunnan-Guizhou Plateau dietary pattern with MHO and the Sichuan Basin dietary pattern with MUO according to predefined demographic and socioeconomic factors by comparing the highest with the lowest quintiles. All models were adjusted for confounders mentioned above using multinomial logistic regression (MHNW as the reference group)
PurposeDietary behavior is an important part of lifestyle interventions for obesity and its cardiovascular comorbidities. However, little is known about associations between dietary patterns and obesity phenotypes in Southwest China, a region with unique dietary patterns and significant heterogeneity in obesity.Methods Data from the baseline survey of the China Multi-Ethnic Cohort in Southwest China were analyzed (n = 64,448). Dietary intakes during the past year were measured with the semi-quantitative Food Frequency Questionnaire (s-FFQ). Principal component factor analysis (PCFA) was used to identify dietary patterns. Multinomial logistic regressions were used to examine the associations between dietary patterns and obesity phenotypes and stratified analyses were performed to assess whether the associations differed across demographic variables.ResultsThree dietary patterns were identified and then named according to their apparent regional gathering characteristics: the Sichuan Basin dietary pattern (characterized by high intakes of various foods), the Yunnan-Guizhou Plateau dietary pattern (characterized by agricultural lifestyles), and the Qinghai-Tibet Plateau dietary pattern (characterized by animal husbandry lifestyles), respectively. Higher adherence to the Sichuan Basin dietary pattern was positively associated with metabolically healthy overweight/obesity (MHO, OR 1.13, 95% CI 1.05–1.21) but negatively associated with metabolically unhealthy normal weight (MUNW, OR 0.78, 95% CI 0.65–0.95). Higher adherence to the other two dietary patterns was positively associated with MHO and metabolically unhealthy overweight/obesity (MUO). Besides, differences in socioeconomic status also affected the relationship between dietary patterns and obesity phenotypes.Conclusions Adherence to the more diverse Sichuan basin dietary pattern performed a mixed picture, while the other two may increase the risk of obesity phenotypes, which indicates nutritional interventions are urgently needed.
 
Odds ratios (OR)a of colorectal cancer and corresponding 95% confidence intervals (CI) according to raffinose and stachyose intake in strata of age, sex, body mass index and colorectal cancer subsites. Italy, 1992–1996. aOR for an increase of intake equal to the difference between the upper cutpoints of the 4th (i.e., the 80th percentile) and the 1st quintiles (i.e., the 20th percentile), adjusted for age, sex, study center, education, body mass index (BMI), physical activity, smoking habits, alcohol intake, age at menopause and use of hormone replacement therapy, diabetes, regular aspirin use, family history of intestinal cancer, and total energy intake, unless the variable was the stratification factor
Purpose To evaluate the association between the intake of specific fibers with prebiotic activity, namely inulin-type fructans (ITFs), fructooligosaccharides (FOSs) and galactooligosaccharides (GOSs), and colorectal cancer risk. Methods Within the PrebiotiCa study, we used data from a multicentric case–control study conducted in Italy and including 1953 incident, histologically confirmed, colorectal cancer patients and 4154 hospital controls. The amount of six prebiotic molecules [ITFs, nystose (FOS), kestose (FOS), 1F-β-fructofuranosylnystose (FOS), raffinose (GOS) and stachyose (GOS)] in a variety of foods was quantified via laboratory analyses. Subjects’ prebiotic fiber intake was estimated by multiplying food frequency questionnaire intake by the prebiotic content of each food item. The odds ratios (OR) of colorectal cancer for quintiles of intakes were derived from logistic regression models including terms for major confounders and total energy intake. Results GOSs intake was inversely associated with colorectal cancer risk. The OR for the highest versus the lowest quintile of intake were 0.73 (95% confidence interval, CI 0.58–0.92) for raffinose and 0.64 (95% CI 0.53–0.77) for stachyose, with significant inverse trends across quintiles. No association was found with total ITFs and FOSs. The association with stachyose was stronger for colon (continuous OR = 0.74, 95% CI 0.66–0.83) than rectal cancer (OR = 0.89, 95% CI 0.79–1.02). Conclusion Colorectal cancer risk was inversely associated with the intake of dietary GOSs, but not ITFs and FOSs.
 
Spearman correlation matrix for stable isotope ratios (δ15N, δ13C) in urine and serum with age, BMI, dietary intake and serum or plasma variables (lipids, 15:0 and 1-methylhistidine) in vegans (n = 36) and omnivores (n = 36). δ15N nitrogen stable isotope ratio, δ13C carbon stable isotope ratio, 15:0 pentadecanoic acid;
Scatter plots of δ15N and δ13C in urine and serum, separated for the two dietary groups
Receiver characteristic curve for δ15N, δ13C, 15:0, 1-methylhistidine to distinguish between vegans (n = 36) and omnivores (n = 36). (TPR = true positive rate, FPR = false positive rate)
Purpose Dietary biomarkers can potentially overcome the limitations of self-reported dietary data. While in ecology and archaeology, stable isotope ratios of carbon and nitrogen are widely used as biomarkers, this is not the case in nutrition research. Since the abundance of the 13C and the 15N isotope differ in food sources from plant and animal origin, stable isotope ratios of carbon and nitrogen (δ13C and δ15N) may differ in human biological material. Here, we investigated the stable isotope ratios of nitrogen and carbon in serum and urine from vegans and omnivores. Method Measurement of δ15N and δ13C in serum and 24 h urine was performed by Elemental Analyzer–Isotope Ratio Mass Spectrometer in the cross-sectional study “Risks and Benefits of a Vegan Diet”. The study included 36 vegans and 36 omnivores with a median age of 37.5 years (matched for age and sex), who adhered to their diet for at least 1 year. Results Both δ15N and δ13C were significantly lower in both the serum and 24 h urine of vegans compared to omnivores. δ15N either in serum or urine had 100% specificity and sensitivity to discriminate between vegans and omnivores. Specificity of δ13C was also > 90%, while sensitivity was 93% in serum and 77% in urine. Conclusion δ15N both in serum and urine was able to accurately identify vegans and thus appears to be a promising marker for dietary habits.
 
Study flowchart.GA: gestational age, BMI: body mass index
PurposeThis study aimed at evaluating the effectiveness of a nutritional counselling intervention based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed products, and the practice of physical activities to prevent excessive gestational weight gain in overweight pregnant women.Methods This was a two-armed, parallel, randomized controlled trial conducted in primary health units of a Brazilian municipality from 2018 to 2021. Overweight, adult pregnant women (n = 350) were randomly assigned to control (CG) or intervention groups (IG). The intervention consisted of three individualized nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods rather than ultra-processed products, following the NOVA food classification system, and the practice of physical activities. The primary outcome was the proportion of women whose weekly gestational weight gain (GWG) exceeded the Institute of Medicine guidelines. Adjusted logistic regression models were employed.ResultsComplete data on weight gain were available for 121 women of the IG and 139 of the CG. In modified intention-to-treat analysis, there was a lower chance of the IG women having excessive GWG [OR 0.56 (95% CI 0.32, 0.98), p = .04], when compared to the CG. No between-group differences were observed for the other maternal outcomes investigated.Conclusion The present study was unprecedented in demonstrating that nutritional counselling based on the NOVA food classification system, together with encouraging the practice of physical activity, is effective in preventing excessive weight gain in overweight pregnant women.Trial registrationRegistered on July 30th 2018 at Brazilian Registry of Clinical Trials (RBR-2w9bhc).
 
Flowchart of participants in the SUN Project, 1999–2019
A, B OR and 95% confidence interval of unmet ≥ 4 or 8 Dietary Reference Intakes (DRI) respectively according to the deciles of protein source quality index in 17,535 participants of the SUN project (probabilistic approach). OR were adjusted for age (continuous), sex and education level (graduate, master, doctorate), energy intake (continuous), Mediterranean diet score (continuous), BMI (continuous), physical activity (metabolic equivalents-h/week), smoking status (no smoking, former, current < 15 cig/d, current ≥ 15 cig/d) and dietary supplement use (yes/no)
A, B OR and 95% CI of unmet ≥ 4 or 8 Dietary Reference Intakes respectively according to PQI and adherence to Mediterranean diet (MedDiet) in 17,535 participants of the SUN Project. OR were adjusted for age (continuous), sex and education level (graduate, master, doctorate), energy intake (continuous), BMI (continuous), physical activity (MET-h/week), smoking status (no smoking, former, current < 15 cig/d, current ≥ 15 cig/d) and dietary supplement use (yes/no). Abbreviations: Q, Quintiles, MDS, Mediterranean Diet
Purpose There is no evidence of a dietary index that measures not only the quantity but also the quality of protein. The aim is to investigate the association between a new dietary protein quality index (PQI) and micronutrient intake adequacy in a Mediterranean cohort. Design We assessed 17,535 participants’ diet at baseline using a semi-quantitative FFQ. The PQI was calculated according to the ratio of protein (g/d) sources: [fish, seafood, lean meat, pulses, eggs, nuts, low-fat dairy, and whole grains]/[red and ultra-processed meats, whole-fat or semi-skimmed dairy, potatoes and refined grains]. Participants were classified into quintiles of PQI. We evaluated the intakes of Fe, Cr, I, K, Mg, Ca, P, Na, Se, Zn and vitamins A, B1, B2, B3, B6, B12, C, E and folic acid. Micronutrient adequacy was evaluated using DRIs. Logistic regression analysis was used to assess the micronutrient adequacy according to quintiles of PQI. Results In this cross-sectional analysis, a total of 24.2% and 4.3% participants did not to meet DRIs in ≥ 4 and ≥ 8 micronutrients, respectively. The odds of failing to meet ≥ 4 and ≥ 8 DRI were lower in participants in the highest quintile of protein quality (OR = 0.22; IC 95% = 0.18, 0.26; P-trend < 0.001; and OR = 0.08; IC 95% = 0.05, 0.14; P-trend < 0.001, respectively) as compared to participants in the lowest quintile. Conclusion Higher PQI was found to be strongly associated with better micronutrient intake adequacy in this Mediterranean cohort. The promotion of high-quality protein intake may be helpful for a more adequate intake of micronutrients. The odds of failing to meet certain numbers of DRIs were lower rather than saying lower risk.
 
Mean of serum/ plasma concentration (µg/l) pulled from various studies reporting the selenium status of people in Germany over the last 50 years. Green line indicates weighted arithmetic mean of serum/ plasma selenium of all studies included (82 µg/l) for a total number of 8010 healthy adults living in Germany. Possible related health effects from deficiency to toxicity adapted from Fairweather-Tait et al. [5]
Overview of collected selenium data of various food items, selenium intake per portion with the percentage of daily intake recommendation for men and women
Introduction Selenium is important for human health. However, the selenium status and selenium intake of the German population has not been recorded in a representative study so far. Material and Methods Thus, literature from the last 50 years was screened in a systematic way and the results of various studies were pulled together to shed light on the selenium status of the German population. Moreover, the selenium content of selected food items that were either found on the German market or grown in Germany was researched and evaluated. Results Of 3542 articles identified, 37 studies met the inclusion criteria. These 37 studies comprised a total of 8,010 healthy adults living in Germany with a weighted arithmetic mean of 82 μg/l selenium in plasma or serum. The results will form a basis for interpreting upcoming results from national food consumption surveys. Furthermore, 363 selenium values for 199 food items were identified out of 20 data sources—published or analysed between 2002 and 2019. An estimation of the selenium intake of the German population will be possible with this data in future nutrition surveys.
 
Fractional synthesis rate (FSR) and absolute synthesis rate (ASR) in liver (A, C) and muscle (B, D) in WT-AMPK, KO-AMPK, WT-GCN2 and KO-GCN2 mice fed NP, LP or HP diets. a,b,cDifferent letters within a line mean statistically different values between test diets (post hoc Bonferonni tests for multiple comparisons, P < 0.05). Data are mean ± SEM (n = 7–9)
PurposeProtein synthesis and proteolysis are known to be controlled through mammalian target of rapamycin, AMP-activated kinase (AMPK) and general control non-derepressible 2 (GCN2) pathways, depending on the nutritional condition. This study aimed at investigating the contribution of liver AMPK and GCN2 on the adaptation to high variations in protein intake.Methods To evaluate the answer of protein pathways to high- or low-protein diet, male wild-type mice and genetically modified mice from C57BL/6 background with liver-specific AMPK- or GCN2-knockout were fed from day 25 diets differing in their protein level as energy: LP (5%), NP (14%) and HP (54%). Two hours after a 1 g test meal, protein synthesis rate was measured after a 13C valine flooding dose. The gene expression of key enzymes involved in proteolysis and GNC2 signaling pathway were quantified.ResultsThe HP diet but not the LP diet was associated with a decrease in fractional synthesis rate by 29% in the liver compared to NP diet. The expression of mRNA encoding ubiquitin and Cathepsin D was not sensitive to the protein content. The deletion of AMPK or GCN2 in the liver did not affect nor protein synthesis rates and neither proteolysis markers in the liver or in the muscle, whatever the protein intake.In the postprandial state, protein level alters protein synthesis in the liver but not in the muscle.Conclusions Taken together, these results suggest that liver AMPK and GCN2 are not involved in this adaptation to high- and low-protein diet observed in the postprandial period.
 
PurposeAbnormal acetylation modification is a common epigenetic change in tumorigenesis and is closely related to the progression of colorectal cancer (CRC). Our previous studies have suggested that black raspberry (BRB) anthocyanins have a significant chemopreventive effect against CRC. This study investigated whether protein acetylation plays an important role in BRB anthocyanins-mediated regulation of CRC progression.Methods We used the AOM-induced CRC mouse model and the CRC cell lines SW480 and Caco-2 to explore the potential role of acetylation of histone H4 and NF-κB signaling pathway-related proteins (non-histone proteins) in the antitumor process mediated by BRB anthocyanins. The expression of related proteins was detected by western blot. ROS level was detected by immunofluorescence.ResultsBRB anthocyanins affected the acetylation level by down-regulating the expression of Sirtuin1 (SIRT1) and up-regulating the expression of MOF and EP300. The acetylation level of lysine sites on histone H4 (H4K5, H4K12 and H4K16) was increased. Furthermore, following BRB anthocyanins treatment, the expression of ac-p65 was significantly up-regulated and the NF-κB signal pathway was activated, which in turn up-regulated Bax expression and inhibited Bcl-2, cyclin-D1, c-myc and NLRP3 expression to promote CRC cell cycle arrest, apoptosis and relieve inflammation.Conclusion The findings suggested that protein acetylation could play a critical role in BRB anthocyanins-regulated CRC development.
 
Changes in eating habits and food intake (total sample)
Changes in eating habits according to patterns of change
Changes in food intake according to patterns of change
Changes in body weight
a/b Changes in everyday activity (a) and sports activity (b)
Purpose The COVID-19 pandemic and public measures have a direct impact on the nutrition situation; studies show changes in food consumption, eating behavior or body weight but complex pattern analyses of changes rarely exist. Methods During the first German lockdown, a web-based survey was conducted among adults. It included 33 questions about changes in food intake, eating habits and physical activity, as well as anthropometrics and sociodemographic factors. Patterns of change were calculated based on changes in food intake and eating habits using two-step cluster analysis. To identify influencing factors for assignment to the patterns of change, binary logistic regression analyses were performed. Results Data from 2103 participants (81% female, 40 ± 14 years) were considered for analysis. Increased stockpiling, cooking, and variation in preparation was reported by 50–70%. The constant pattern (C-P, 36%) reported little change besides the above. The health-oriented pattern (HO-P; 37%) reported eating more healthy foods, avoiding unhealthy foods, and eating less and less frequently. The emotional-driven pattern (ED-P; 28%) exhibits higher influence of emotions on eating behavior, less avoidance of unhealthy foods, and increased consumption of sweets, pastries, and alcohol. The odds of changing eating behavior either to HO-P or ED-P were higher in women, people with migration background, younger participants, and increased with BMI categories. Conclusion Both, the ED-P and HO-P, exhibit distinctive reactions in eating habits and food intake when dealing with a distressing experience. In subgroups, these may lead to disturbances in eating behavior and increase the risk for eating disorders and obesity.
 
Exercise workload (a), energy expenditure rate (b), fat oxidation rate (c), carbohydrate oxidation rate (d), heart rate (e) and rating of perceived exertion (f) during 1 h of cycling at self-paced intensity after the ingestion of 3 mg/kg body mass of caffeine or a placebo. (*) Significant differences between caffeine and placebo at P < 0.050. a.u. arbitrary units
Aim Oral caffeine intake has been deemed as an effective supplementation strategy to enhance fat oxidation during aerobic exercise with a steady-state intensity. However, in real exercise scenarios, individuals habitually train with autoregulation of exercise intensity. This study aimed to analyze the effect of oral caffeine intake during self-paced cycling on autoregulated exercise intensity and substrate oxidation. Methods Fifteen young and healthy participants (11 men and 4 women) participated in a double-blind, randomized, cross-over investigation. Each participant took part in 2 experimental days consisting of pedaling for 1 h with a self-selected wattage. Participants were told that they had to exercise at a moderate intensity to maximize fat oxidation. On one occasion participants ingested 3 mg/kg of caffeine and on the other occasion ingested a placebo. Energy expenditure, fat oxidation rate, and carbohydrate oxidation rate were continuously measured during exercise by indirect calorimetry. Results In comparison to the placebo, caffeine intake increased the self-selected wattage (on average, 105 ± 44 vs 117 ± 45 W, respectively, P < 0.001) which represented a higher total work during the cycling session (377 ± 157 vs 422 ± 160 kJ, P < 0.001). Caffeine increased total energy expenditure (543 ± 161 vs 587 ± 155 kcal, P = 0.042) but it did not affect total fat oxidation (24.7 ± 12.2 vs 22.9 ± 11.5 g, P = 0.509) or total carbohydrate oxidation (87.4 ± 22.4 vs 97.8 ± 32.3 g, P = 0.101). Conclusion Acute caffeine ingestion before an exercise session with an individual's freedom to regulate intensity induces a higher self-selected exercise intensity and total work. The selection of a higher exercise intensity augments total energy expenditure but eliminates the effect of caffeine on substrate oxidation during exercise.
 
Fold changes in the expression levels of CTTN gene were compared among tertiles of dietary patterns scores across clinicopathological features. Abbreviations: ALNM axillary lymph node metastasis; ANCOVA one-way analysis of covariance; CTTN, cortactin; ER estrogen receptor; OCP oral contraceptive pill; PR progesterone receptor. Adjusted for aWeight(kg), the age at first pregnancy(year), and mean duration of OCP use(month); bX-ray exposure(number); cX-ray exposure(number), abortion(number), and physical activity(MET-h/week); dX-ray exposure(number) and age at diagnosis(year); eWeight(kg), and the age at diagnosis(year); fWeight(kg), the age at diagnosis(year), abortion(number), and the age at first pregnancy(year); gWeight(kg), and the age at first pregnancy(year); hWeight(kg), the age at first pregnancy(year), and mean duration of OCP use(month); ⁱWeight(kg) and the age at menarche(year); jWeight(kg), the age at first pregnancy(year), energy intake(kcal/d), mean duration of OCP use(month), abortion(number), and physical activity(MET-h/week); kWeight(kg), mean duration of OCP use(month), and the age at first pregnancy(year); lWeight(kg) and mean duration of OCP use(month). P values were obtained from ANCOVA (post hoc Bonferroni method)
Fold changes in the expression levels of RhoA gene were compared among tertiles of dietary patterns scores across clinicopathological features. Abbreviations: ALNM axillary lymph node metastasis; ANCOVA one-way analysis of covariance; ER estrogen receptor; OCP oral contraceptive pill; PR progesterone receptor; RhoA ras homolog gene family member-A. Adjusted for aEnergy intake(kcal/d), weight(kg), mean duration of OCP use(month), abortion(number), and pregnancy(number); bAge at first pregnancy(year); cMean duration of OCP use(month), energy intake(kcal/d), weight(kg), hip circumference(cm), lactation(number), and the age at menarche(year); dMean duration of OCP use(month); ePregnancy(number); fPregnancy(number), energy intake(kcal/d), weight(kg), waist to hip ratio, mean duration of OCP use(month), and abortion(number); gAge at diagnosis(year); hAge at diagnosis(year), mean duration of OCP use(month), abortion(number), and pregnancy(number); ⁱEnergy intake(kcal/d) and mean duration of estradiol exposure(month); jEnergy intake(kcal/d), mean duration of OCP use(month), waist to hip ratio, abortion(number), and pregnancy(number); kEnergy intake(kcal/d), pregnancy(number), waist circumference(cm), the age at diagnosis(year), mean duration of OCP use (month), and abortion(number); lEnergy intake(kcal/d) and pregnancy(number). P values were obtained from ANCOVA (post hoc Bonferroni method)
Fold changes in the expression levels of ROCK gene were compared among tertiles of dietary patterns scores across clinicopathological features. Abbreviations: ALNM axillary lymph node metastasis; ANCOVA one-way analysis of covariance; ER estrogen receptor; OCP oral contraceptive pill; PR progesterone receptor; ROCK, rho-associated kinase. Adjusted for aAge at diagnosis(year), mean duration of OCP use(month), waist to hip ratio, pregnancy(number), and X-ray exposure(number); bAge at first pregnancy(year); cAge at first pregnancy(year), mean duration of OCP use(month), and X-ray exposure (number); dMean duration of OCP use(month); eHip circumference(cm); fWaist circumference(cm), abortion(number), pregnancy(number), and the age at menarche(year); gEnergy intake(kcal/d) and x-ray exposure(number); hEnergy intake(kcal/d), X-ray exposure(number), the age at menarche(year), and the age at first pregnancy(year); ⁱX-ray exposure(number); jX-ray exposure(number), waist circumference (cm), the age at first pregnancy(year), and lactation(number); kWeight(kg), mean duration of estradiol exposure(month), mean duration of OCP use(month), and lactation(number); lAge at first pregnancy(year) and lactation(number). P values were obtained from ANCOVA (post hoc Bonferroni method)
Purpose Metastasis is a major leading cause of mortality in female breast cancer (BrCa). Cellular motility is a pathological process of metastasis remarked by the overexpression of cortactin (CTTN), Ras homolog family member-A (RhoA), and Rho-associated kinase (ROCK) genes. Their balance is responsible for upholding the integrity of healthy epithelial cell junctions. This study aimed to explore the associations between a posteriori dietary patterns and the expression levels of pro-metastatic genes in primary BrCa. Methods In this consecutive case series, 215 eligible women, newly diagnosed with histologically confirmed non-metastatic BrCa (stage I-IIIA), were recruited from Hospitals in Tabriz, Northwestern Iran (2015–2017). The tumoral expression levels of genes were quantified using real-time reverse transcription-polymerase chain reaction. Dietary data assessment was carried out using a validated food frequency questionnaire. Results Three dietary patterns were identified using principal component analysis (KMO = 0.699). Adherence to the “vegan” pattern (vegetables, fruits, legumes, nuts, seeds, and whole grains) was inversely associated with the expression levels of RhoA (ORAdj.T3vs.T1 = 0.24, 95%CI 0.07–0.79) and ROCK (ORAdj.T3vs.T1 = 0.26, 95%CI 0.08–0.87). In addition, the highest adherence to the “prudent” pattern (spices, seafood, dairy, and vegetable oils) decreased the odds of overexpressions at RhoA (ORAdj.T3vs.T1 = 0.26, 95%CI 0.08–0.84) and ROCK genes (ORAdj.T3vs.T1 = 0.29, 95%CI 0.09–0.95). The highest adherence to “Western” pattern (meat, processed meat, hydrogenated fat, fast food, refined cereals, sweets, and soft drinks) was a risk factor associated with the overexpression of RhoA (ORAdj.T3vs.T1 = 3.15, 95%CI 1.12–8.85). Conclusion Adherence to healthy dietary patterns was significantly associated with the downregulation of pro-metastatic genes. Findings provided new implications to advance the nutrigenomic knowledge to prevent the odds of over-regulations in pro-metastatic genes of the primary BrCa.
 
Association between adherence to the Danish Dietary Guidelines Index and spontaneous abortion, fitted by restricted cubic splines. The analyses were adjusted for maternal and paternal age, educational attainment, BMI, BMI-adjusted waist circumference, metabolic equivalents, MET-hours/week, sedentary activity, alcohol intake, smoking status and gravidity. The curve is based on data from the first imputed data set and plotted for index values between the 5th and the 95th percentiles of the distribution using a score of 3 as the reference
Association between adherence to the Danish Dietary Guidelines Index and spontaneous abortion stratified by body mass index, fitted by restricted cubic splines. The analyses were adjusted for maternal and paternal age, educational attainment, BMI, BMI-adjusted waist circumference, metabolic equivalents, MET-hours/week, sedentary activity, alcohol intake, smoking status and gravidity. The curve is based on data from the first imputed data set and plotted for index values between the 5th and the 95th percentiles of the distribution using a score of 3 as the reference
Association between adherence to the Healthy Nordic Food Index and spontaneous abortion, fitted by restricted cubic splines. The analyses were adjusted for maternal and paternal age, educational attainment, BMI, BMI-adjusted waist circumference, metabolic equivalents, MET-hours/week, sedentary activity, alcohol intake, smoking status and gravidity. The curve is based on data from the first imputed data set using a score of 2 as the reference
Association between the Healthy Nordic Food Index and spontaneous abortion stratified by body mass index, fitted by restricted cubic splines. The analyses were adjusted for maternal and paternal age, educational attainment, BMI, BMI-adjusted waist circumference, metabolic equivalents, MET-hours/week, sedentary activity, alcohol intake, smoking status and gravidity. The curve is based on data from the first imputed data set using a score of 2 as the reference
Purpose Evidence on the influence of modifiable risk factors on spontaneous abortion (SAB) is scarce. We investigated associations for adherence to national dietary guidelines and a healthy Nordic diet with first-trimester (≤ 12 weeks’ gestation) SAB in a Danish cohort of couples trying to conceive. Methods Participants completed a questionnaire on sociodemographics, lifestyle and reproductive history and a validated food frequency questionnaire (FFQ). We ascertained pregnancies from follow-up questionnaires and restricted analyses to 3,043 women who became pregnant. We assessed adherence to the Danish Dietary Guidelines Index (DDGI, range of 0–6, from low to high), covering intake of fruit, vegetables, fish, red and processed meat, whole grains, saturated fat and added sugar. The Healthy Nordic Food Index (HNFI, range 0–6) covered intake of fish, cabbage, rye bread, apples, pears, root vegetables and oatmeal. Pregnancy outcomes were identified through Danish medical registries or self-reported. We used Cox proportional hazards regression to compute hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for sociodemographics and lifestyle. Results Fifteen percent of participants had a first-trimester SAB. Compared with a DDGI score < 3, adjusted HRs (95% CIs) for scores 3 to < 4, 4 to < 5 and ≥ 5 were 0.85 (0.59–1.23), 0.78 (0.54–1.12) and 0.71 (0.44–1.13), respectively. Compared with an HNFI score < 2, adjusted HRs (95% CIs) for scores 2 to < 3, 3 to < 4, 4 to < 5 and ≥ 5 were 0.84 (0.62–1.15), 0.88 (0.66–1.19), 0.94 (0.69–1.28) and 0.69 (0.49–0.96), respectively. Conclusion Greater pre-pregnancy adherence to Danish dietary guidelines or a healthy Nordic diet was associated with a lower rate of first-trimester SAB, although estimates were imprecise.
 
Association of plasma DHPPA concentrations with MetS. The restricted cubic spline regression was performed with the use of four knots (20th, 40th, 60th, and 80th percentiles of plasma DHPPA concentrations), and adjusted for sex, age, body mass index, smoking status, alcohol drinking status, physical activity, and education level. Solid lines represent odds ratios and dashed lines represent 95% confidence intervals. DHPPA 3-(3, 5-Dihydroxyphenyl)-1-propanoic acid, MetS metabolic syndrome, OR odds ratio
Purpose Whole-grain intake assessed through self-reported methods has been suggested to be inversely associated with the metabolic syndrome (MetS) risk in epidemiological studies. However, few studies have evaluated the association between whole-grain intake and MetS risk using objective biomarkers of whole-grain intake. The aim of this study was to examine the association between plasma 3-(3,5-Dihydroxyphenyl)-1-propanoic acid (DHPPA), a biomarker of whole-grain wheat and rye intake, and MetS risk in a Chinese population. Methods A case–control study of 667 MetS cases and 667 matched controls was conducted based on baseline data of the Tongji-Ezhou Cohort study. Plasma DHPPA concentrations were assessed by high-performance liquid chromatography–tandem mass spectrometry. The MetS was defined based on criteria set by the Joint Interim Statement. Results Plasma DHPPA was inversely associated with MetS risk. After adjustment for age, sex, body mass index, smoking status, alcohol drinking status, physical activity and education level, the odds ratios (ORs) for MetS across increasing quartiles of plasma DHPPA concentrations were 1 (referent), 0.86 (0.58–1.26), 0.77 (0.52–1.15), and 0.59 (0.39–0.89), respectively. In addition, the cubic spline analysis revealed a potential nonlinear association between plasma DHPPA and MetS, with a steep reduction in the risk at the lower range of plasma DHPPA concentration. Conclusion Our study revealed that individuals with higher DHPPA concentrations in plasma had lower odds of MetS compared to those with lower DHPPA concentrations in plasma. Our findings provided further evidence to support health benefits of whole grain consumption.
 
Associations of erythrocyte PUFAs with risk of ischemic stroke by restricted cubic splines from Cox proportional hazards models. Model was adjusted for age, sex, study areas, education, smoking, alcohol drinking, family history of cardiovascular diseases, and physical activity. The solid lines represent the HRs, and the shaded areas represent 95% CIs, relative to the reference level (50th percentile)
Purpose There is limited and inconsistent evidence about the relationships of erythrocyte polyunsaturated fatty acids (PUFAs) with stroke and stroke types, particularly in China where the stroke rates are high. We aimed to investigate the associations of different erythrocyte PUFAs with incidence of total stroke, ischemic stroke (IS), and intracerebral hemorrhage (ICH) in Chinese adults. Methods In the prospective China Kadoorie Biobank, erythrocyte PUFAs were measured using gas chromatography in 10,563 participants who attended 2013–14 resurvey. After a mean follow-up of 3.8 years, 412 incident stroke cases (342 IS, 53 ICH) were recorded among 8,159 participants without prior vascular diseases or diabetes. Cox regression yielded adjusted hazard ratios (HRs) for stroke associated with 13 PUFAs. Results Overall, the mean body mass index was 24.0 (3.4) kg/m² and the mean age was 58.1 (9.9) years. In multivariable analyses, 18:2n–6 was positively associated with ICH (HR = 2.33 [95% CIs 1.41, 3.82] for top versus bottom quintile, Ptrend = 0.007), but inversely associated with IS (0.69 [0.53,0.90], Ptrend = 0.027), while 20:3n-6 was positively associated with risk of IS (1.64 [1.32,2.04], Ptrend < 0.001), but not with ICH. Inverted-U shape curve associations were observed of 20:5n–3 with IS (Pnonlinear = 0.002) and total stroke (Pnonlinear = 0.008), with a threshold at 0.70%. After further adjustment for conventional CVD risk factors and dietary factors, these associations remained similar. Conclusion Among relatively lean Chinese adults, erythrocyte PUFAs 18:2n–6, 20:3n–6 and 20:5n–3 showed different associations with risks of IS and ICH. These results would improve the understanding of stroke etiology.
 
Median urine iodine concentration in (a) normal and hyperglycemic participants, and in (a) normal and hypertensive participants. DM, diabetes mellitus; HTN, hypertension; IFG, impaired fasting glucose; UIC, urine iodine concentration
Purpose Iodine is a vital trace element for systemic metabolic control as well as thyroid hormone synthesis. Though iodine has significant antioxidant and anti-inflammatory effects, reports on its effects on metabolic disorders are limited and inconsistent. Methods Impact of urinary iodine concentrations (UICs) on fasting blood glucose (FBG) levels and blood pressure (BP) in the general Korean population was evaluated adjusting for covariates including thyrotropin level and presence of thyroid diseases. Results The median UIC was 302.3 μg/L in all participants and was significantly lower in those with dysglycemia (303.6 μg/L in normal participants, 285.1 μg/L in participants with FBG levels of 100–125 mg/dL, and 261.8 μg/L in participants with FBG levels ≥ 126 mg/dL; p = 0.002). Similarly, the UIC was lower in participants with higher BP (311.6 μg/L in normal participants, 288.7 μg/L in prehypertensive participants, and 265.8 μg/L in hypertensive participants; p < 0.001). The multiple linear regression model showed a negative correlation between the UIC and FBG levels (p = 0.002), and the UIC and systolic BP (p < 0.001). One standard deviation increase in the UIC showed odds ratios of 0.84 (95% confidence interval [CI] = 0.73–0.98) for elevated FBG levels (≥ 100 mg/dL) and 0.94 (95% CI = 0.88–0.99) for elevated SBP (≥ 120 mm Hg) after full adjustment. Conclusion Higher UICs were associated with lower FBG and BP levels, independent of thyroid function and other confounding factors in Korea, an iodine-replete country.
 
Purpose Nutrition transition (NT) has modified the way that the Mexican population eats, while their body composition has also been modified. These changes have been linked with environmental impacts; however, little is known regarding water footprint (WF). The objective of this paper was to analyze the NT process in Mexico and evaluate its impact on WF using principal component analysis (PCA). Methods A validated Food Consumption Frequency Questionnaire (FCFQ) was modified and applied to 400 adults from the Metropolitan Zone of Guadalajara, Mexico. The WF was calculated according to the WF Assessment Method. PCA and tertiles analysis was carried out to define dietary patterns WFs (DPWF). Questions covering sociodemographic and socioeconomic factors, as well as body composition data and physical activity levels were measured. Results The average DPWF was 6619.58 ± 3182.62 L per person per day (L p⁻¹d⁻¹). We found three DPWF by PCA: Medium NT (55% from the total sample), Healthy plant-based (28%), and High in animal protein (17%). The highest energy consumption, western and Mexican foods intake, and dietary WF were found in Medium NT DPWF, as well as obesity prevalence. Fruits and vegetable consumption was higher in Healthy plant-based DPWF. Muscle mass percentage was higher in the High in animal protein DPWF. Conclusions Although most of the population is currently on Medium NT, new dietary patterns have emerged, where there was found a trend to plant-based diets but also diets high in animal food sources that can influence nutritional status.
 
Experimental protocol of the study. 2 m-na, 2 months/normal adiposity; 2 m-ha, 2 months/high adiposity; 11 m-na, 11 months/normal adiposity; 11 m-ha: 11 months/high adiposity
Incorporation of dietary nitrogen to plasma proteins over the 6-h postprandial period. Values are mean ± SD, n = 7–8 rats. £ indicating a significant difference (P < 0.05) between the 2 m (-na and -ha) and 11 m (-na and -ha) groups and $ indicating a significant difference (P < 0.05) between every groups. 2 m-na, 2 months/normal adiposity; 2 m-ha, 2 months/high adiposity; 11 m-na, 11 months/normal adiposity; 11 m-ha: 11 months/high adiposity
Fractional synthesis rate (FSR) in the gastrocnemius muscle (A), skin (B), liver (C), kidney (D) 6 h after meal ingestion. Values are mean ± SD, n = 7–8 rats. The effects of age and adiposity and their interaction were tested with a two-way ANOVA model. Values with different letters within a graph are statistically different. n.s, not significant. 2 m-na, 2 months/normal adiposity; 2 m-ha, 2 months/high adiposity; 11 m-na, 11 months/normal adiposity; 11 m-ha: 11 months/high adiposity
Purpose: Physiological parameters such as adiposity and age are likely to influence protein digestion and utilization. The aim of this study was to evaluate the combined effects of age and adiposity on casein protein and amino acid true digestibility and its postprandial utilization in rats. Methods: Four groups were included (n = 7/8): 2 months/normal adiposity, 2 months/high adiposity, 11 months/normal adiposity and 11 months/high adiposity. Rats were given a calibrated meal containing 15N-labeled casein (Ingredia, Arras, France) and were euthanized 6 h later. Digestive contents were collected to assess protein and amino acid digestibilities. 15N enrichments were measured in plasma and urine to determine total body deamination. Fractional protein synthesis rate (FSR) was determined in different organs using a flooding dose of 13C valine. Results: Nitrogen and amino acid true digestibility of casein was around 95-96% depending on the group and was increased by 1% in high adiposity rats (P = 0.04). Higher adiposity levels counteracted the increase in total body deamination (P = 0.03) that was associated with older age. Significant effects of age (P = 0.006) and adiposity (P = 0.002) were observed in the muscle FSR, with age decreasing it and adiposity increasing it. Conclusion: This study revealed that a higher level of adiposity resulted in a slight increase in protein and individual amino acid true digestibility values and seemed to compensate for the metabolic postprandial protein alterations observed at older age.
 
Total fruit and vegetable, total fruit and total vegetable intake of women and men at baseline (n = 6961), follow-up 1 (n = 5077) and follow-up 2 (n = 3626). Values are medians with vertical error bars representing 75% percentiles. *Significant differences between sexes using median test. Significant differences between follow-up occasions using Wilcoxon test in: both sexes **, only in women *#, only in men #*, neither men nor women ##; significance level set at P < 0.05
Purpose To investigate the association between fruit and vegetable intake (FVI) and the risk of developing prediabetes and type 2 diabetes (T2D) in a Swedish prospective cohort study. Methods Subjects were 6961 men and women aged 35–56 years old at baseline, participating in the Stockholm Diabetes Prevention Program cohort. By design, the cohort was enriched by 50% with subjects that had family history of diabetes. Anthropometric measurements, oral glucose tolerance tests and questionnaires on lifestyle and dietary factors were carried out at baseline and two follow-up occasions. Cox proportional hazard models were used to estimate hazard ratios with 95% CIs. Results During a mean follow-up time of 20 ± 4 years, 1024 subjects developed T2D and 870 prediabetes. After adjustments for confounders, the highest tertile of total FVI was associated with a lower risk of developing T2D in men (HR 0.76, 95% CI 0.60–0.96). There was also an inverse association between total fruit intake and prediabetes risk in men, with the HR for the highest tertile being 0.76 (95% CI 0.58–1.00). As for subtypes, higher intake of apples/pears was inversely associated with T2D risk in both sexes, whereas higher intakes of banana, cabbage and tomato were positively associated with T2D or prediabetes risk in either men or women. Conclusion We found an inverse association between higher total FVI and T2D risk and between higher fruit intake and prediabetes risk, in men but not in women. Certain fruit and vegetable subtypes showed varying results and require further investigation.
 
Participant selection flowchart. AAs amino acids
Aim Plasma total cysteine (tCys) is associated with fat mass and insulin resistance, whereas taurine is inversely related to diabetes risk. We investigated the association of serum sulfur amino acids (SAAs) and related amino acids (AAs) with incident diabetes. Methods Serum AAs were measured at baseline in 2997 subjects aged ≥ 65 years. Diabetes was recorded at baseline and after 4 years. Logistic regression evaluated the association of SAAs [methionine, total homocysteine (tHcy), cystathionine, tCys, and taurine] and related metabolites [serine, total glutathione (tGSH), glutamine, and glutamic acid] with diabetes risk. Results Among 2564 subjects without diabetes at baseline, 4.6% developed diabetes. Each SD increment in serum tCys was associated with a 68% higher risk (95% CI 1.27, 2.23) of diabetes [OR for upper vs. lower quartile 2.87 (1.39, 5.91)], after full adjustments (age, sex, other AAs, adiposity, eGFR, physical activity, blood pressure, diet and medication); equivalent ORs for cystathionine were 1.33 (1.08, 1.64) and 1.68 (0.85, 3.29). Subjects who were simultaneously in the upper tertiles of both cystathionine and tCys had a fivefold risk [OR = 5.04 (1.55, 16.32)] of diabetes compared with those in the lowest tertiles. Higher serine was independently associated with a lower risk of developing diabetes [fully adjusted OR per SD = 0.68 (0.54, 0.86)]. Glutamic acid and glutamine showed positive and negative associations, respectively, with incident diabetes in age- and sex-adjusted analysis, but only the glutamic acid association was independent of other confounders [fully adjusted OR per SD = 1.95 (1.19, 3.21); for upper quartile = 7.94 (3.04, 20.75)]. tGSH was inversely related to diabetes after adjusting for age and sex, but not other confounders. No consistent associations were observed for methionine, tHcy or taurine. Conclusion Specific SAAs and related metabolites show strong and independent associations with incident diabetes. This suggests that perturbations in the SAA metabolic pathway may be an early marker for diabetes risk.
 
Hazard ratios (95% CIs) of all-cause mortality for intake of carbohydrate (% kcal) and fiber (g/1000 kcal), using restricted cubic spline regression in the National Health and Nutrition Examination Survey (NHANES 2001–2014)a. BMI body mass index, Cls confidence intervals, HR hazard ratio. aSpline analysis was adjusted for age, sex, total energy, race/ethnicity, education level, family income to poverty ratio, marital status, drinking status, smoking status, physical activity, BMI, and diabetes
Hazard ratios (95% CIs) of all-cause mortality for the carbohydrate-to-fiber ratios, using restricted cubic spline regression in the National Health and Nutrition Examination Survey (NHANES 2001–2014)a. BMI body mass index, Cls confidence intervals, HR hazard ratio. aSpline analysis was adjusted for age, sex, total energy, race/ethnicity, education level, family income to poverty ratio, marital status, drinking status, smoking status, physical activity, BMI, and diabetes
Subgroup analysis of carbohydrates-to-total fiber ratio (per 1 SD increment) and the risk of all-cause mortality in the National Health and Nutrition Examination Survey (NHANES 2001–2014)a. BMI body mass index, Cls Confidence intervals, HR hazard ratio.aModels were adjusted for age, sex, total energy, race/ethnicity, education level, family income to poverty ratio, marital status, drinking status, smoking status, physical activity, BMI, and diabetes. Of note, variables examined in this figure were not adjusted
Purpose To investigate the associations between carbohydrate intake and the risk of overall and specific-cause mortality in a prospective cohort study. Methods Diet was measured using 24 h dietary recalls. Underlying cause of death was identified through linkage to the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. Results During a median follow-up of 7.1 years among 35,692 participants who aged 20–85 years, a total of 3854 deaths [783 cardiovascular disease (CVD)-specific and 884 cancer-specific death] were identified. Carbohydrate intake was not associated with risk of overall mortality (multivariable-adjusted HR comparing extreme quartiles 1.03, 95% CI 0.94, 1.13, ptrend = 0.799), while higher fiber intake was associated with lower mortality risk (HR 0.86, 95% CI 0.77, 0.95, ptrend = 0.004). Replacing 5% of energy from carbohydrate with both plant fat and plant protein was associated with 13% (95% CI 8%, 17%) and 13% (95% CI 3%, 22%) lower risk of total and CVD mortality, respectively. Whereas a positive or null association was found when replacing carbohydrate with both animal fat and animal protein. Higher carbohydrate-to-fiber ratio was associated with increased risk of overall (HR 1.20, 95% CI 1.09, 1.33, ptrend < 0.001) and cancer-specific (HR 1.17, 95% CI 0.95, 1.44, ptrend = 0.031) mortality. Conclusions Our findings suggested that high fiber diet or diet with low carbohydrate-to-fiber ratio was associated with lower long-term death risk, and provided evidence for the health benefit from dietary substitution of both plant fat and plant protein for carbohydrate.
 
Plasma concentration of fructosamine in those with active treatment compared with placebo after six and 42 months
Plasma concentration of copeptin in the active treatment group, compared with placebo at inclusion and after 48 months
Structural equation model of the relations between Selenium (Selenium/age), the second-order factor Infl/Oxid. Stress, Fibrosis and Myocardium. Ellipses depict latent variables or factors and squares manifest or measured variables. All effects (Beta-values italicized) and factor loadings are significant (p < .001). Model fit: Chi-square = 56.43, df = 57, p = 0.497, RMSEA = 0.000, CFI = 0.99
The obtained changes in factor weights between the factors “Inflammation” before and after intervention with selenium and coenzyme Q10
A linear regression smoothing plane optimizing the fit of data points in a three-dimensional space. The figure is based on the regression equation predicting ”CV age” from logarithmized values of NT-proBNP and Selenium. X = LogNT-proBNP, Y = ”CV age”, and Z = logselenium
Purpose Selenium and coenzyme Q10 have synergistic antioxidant functions. In a four-year supplemental trial in elderly Swedes with a low selenium status, we found improved cardiac function, less cardiac wall tension and reduced cardiovascular mortality up to 12 years of follow-up. Here we briefly review the main results, including those from studies on biomarkers related to cardiovascular risk that were subsequently conducted. In an effort, to explain underlying mechanisms, we conducted a structured analysis of the inter-relationship between biomarkers. Methods Selenium yeast (200 µg/day) and coenzyme Q10 (200 mg/ day), or placebo was given to 443 elderly community-living persons, for 48 months. Structural Equation Modelling (SEM) was used to investigate the statistical inter-relationships between biomarkers related to inflammation, oxidative stress, insulin-like growth factor 1, expression of microRNA, fibrosis, and endothelial dysfunction and their impact on the clinical effects. The main study was registered at Clinicaltrials.gov at 30th of September 2011, and has the identifier NCT01443780. Results In addition to positive clinical effects, the intervention with selenium and coenzyme Q10 was also associated with favourable effects on biomarkers of cardiovascular risk. Using these results in the SEM model, we showed that the weights of the first-order factors inflammation and oxidative stress were high, together forming a second-order factor inflammation/oxidative stress influencing the factors, fibrosis (β = 0.74; p < 0.001) and myocardium (β = 0.65; p < 0.001). According to the model, the intervention impacted fibrosis and myocardium through these factors, resulting in improved cardiac function and reduced CV mortality. Conclusion Selenium reduced inflammation and oxidative stress. According to the SEM analysis, these effects reduced fibrosis and improved myocardial function pointing to the importance of supplementation in those low on selenium and coenzyme Q10.
 
Flowchart of participants from baseline (week 0) until the end of intervention (week 12)
Urinary proteomic biomarker scores for coronary artery disease (CAD238), chronic kidney disease (CKD273) at weeks 0, 6 and 12 of the intervention. Data are presented as medians (IQR). Horizontal line indicates cut-off value for biomarker score (CKD273: 0.343, CAD238: 0.428). ¹Kruskal-Wallis investigating concentration differences between groups at baseline. One-way ANCOVA investigated scoring differences between groups at weeks 6 and 12, after adjusting for baseline. ²Kruskal-Wallis investigating differences between groups in concentration change from baseline at weeks 6 and 12. A CKD273, B CAD238
Plasma lipid concentrations (triglycerides, total cholesterol, HDL cholesterol, LDL cholesterol and fasting blood glucose) at week 0, 6 and 12 of the intervention. Grey area indicates normal range for each biomarker. A Triglycerides, B total cholesterol, C HDL cholesterol, D LDL cholesterol, E glucose. Plasma samples were missing from 10 participants at baseline (4 RO, 3 SO, 3 control), 14 participants at week 6 (5 RO, 5 SO, 4 control) and 10 participants at week 12 (4 RO, 4 SO, 2 control)
Purpose The perceived benefits and risks associated with seed oil intake remain controversial, with a limited number of studies investigating the impact of intake on a range of compounds used as cardiometabolic markers. This study aimed to explore the proteomic and cardiometabolic effects of commonly consumed seed oils in the UK, with different fatty acid profiles. Methods In a parallel randomised control design, healthy adults ( n = 84), aged 25–72 with overweight or obesity were randomised to one of three groups: control (habitual diet, CON); 20 mL rapeseed oil per day (RO), or 20 mL sunflower oil per day (SO). Blood, spot urine and anthropometric measures were obtained at 0, 6 and 12 weeks. Proteomic biomarkers analysis was conducted for coronary arterial disease (CAD) and chronic kidney disease (CKD) using capillary electrophoresis coupled to mass spectrometry (CE-MS). Blood lipids, fasting blood glucose, glycative/oxidative stress and inflammatory markers were also analysed. Results No differences in change between time points were observed between groups for CAD or CKD peptide fingerprint scores. No change was detected within groups for CAD or CKD scores. No detectable differences were observed between groups at week 6 or 12 for the secondary outcomes, except median 8-isoprostane, ~ 50% higher in the SO group after 12-weeks compared to RO and CON groups ( p = 0.03). Conclusion The replacement of habitual fat with either RO or SO for 12 weeks does not lead to an improvement or worsening in cardiovascular health markers in people with overweight or obesity. Trial registration Trial registration clinicaltrials.gov NCT04867629, retrospectively registered 30/04/2021.
 
Peak cycling power output, mean cycling power output and post-exercise blood lactate concentration during a 15-s Wingate test with the oral administration of 3 mg/kg of caffeine or a placebo. (*) Caffeine different from placebo at P < 0.050. The bars represent mean values for 15 moderately trained participants. Each line represents values with placebo vs caffeine for each participant; continuous lines depict participants with values with caffeine with respect to placebo and the dashed lines depict individuals with values with caffeine with respect to placebo
Muscle oxygen saturation during a 15-s Wingate test with the oral administration of 3 mg/kg of caffeine or a placebo. Data are mean ± standard deviation for 15 moderately trained participants
Purpose The ergogenic effect of oral caffeine administration on short-term all-out exercise performance is well established. However, the potential mechanisms associated with caffeine’s ergogenicity in this type of exercise are poorly understood. The aim of this study was to investigate whether caffeine intake modifies muscle oxygen saturation during the 15-s Wingate Anaerobic Test. Methods Fifteen moderately trained individuals (body mass = 67.4 ± 12.3 kg; height 171.3 ± 6.9 cm; age 31 ± 6 years) took part in two identical experimental trials after the ingestion of (a) 3 mg/kg of caffeine or (b) 3 mg/kg of cellulose (placebo). After 60 min for substances absorption, participants performed a 15-s Wingate test on a cycle ergometer against a load representing 7.5% of participant’s body mass. Muscle oxygen saturation was continuously measured during exercise with near-infrared spectroscopy and blood lactate concentration was measured 1 min after exercise. Results In comparison to the placebo, the oral administration of caffeine increased peak power by 2.9 ± 4.5% (from 9.65 ± 1.38 to. 9.92 ± 1.40 W/kg, P = 0.038; effect size (ES), 95% confidence intervals = 0.28, 0.05–0.51), mean power by 3.5 ± 6.2% (from 8.30 ± 1.08 to 8.57 ± 1.12 W/kg, P = 0.044; ES = 0.36, 0.01–0.71) and blood lactate concentration by 20.9 ± 24.7% (from 12.4 ± 2.6 to 14.8 ± 4.0 mmol/L, P = 0.005; ES = 0.59, 0.16–1.02). However, caffeine did not modify the curve of muscle oxygen desaturation during exercise (lowest value was 23.1 ± 14.1 and 23.4 ± 14.1%, P = 0.940). Conclusion Caffeine’s ergogenic effect during short-term all-out exercise seems to be associated with an increased glycolytic metabolism with no influence of enhanced muscle oxygen saturation.
 
Associations between changes in Protein Diet score and kidney function. A Multivariable adjusted β-coefficients and 95%CI for changes in eGFR (ml/min/1.73m²) across categories of changes to the protein diet score adherence after 1 year of follow-up. B Multivariable adjusted odd ratios and 95%CI for eGFR decline (> 10%) across categories of changes to the protein diet score adherence after 1 year of follow-up. Decr/Maint, Decrease/Maintenance; eGFR, Estimated glomerular filtration rate; Decr/Maint, Decrease/Maintenance. aMean changes in eGFR (ml/min/1.73m²): Decr/Maint (− 0.71; − 1.02 to − 0.41), tertile 1 of changes (− 1.05; − 1.52 to − 0.57), tertile 2 of changes (− 1.31; − 1.96 to − 0.65), tertile 3 of changes (− 1.61; − 2.38 to − 0.84). bPercentage of participants with eGFR decline(> 10%): Decr/Maint (n = 507; % = 15.54), tertile 1 of changes (n = 196; % = 16.27), tertile 2 of changes (n = 106; % = 15.57), tertile 3 of changes (n = 98; % = 18.60). All models were adjusted for baseline eGFR (except for eGFR decline > 10%), sex, age, BMI, smoking habits (never, current or former smoker), educational level (primary, secondary education, graduate), leisure time physical activity (METS/min/week), diabetes prevalence (yes/no), hypertension prevalence (yes/no), hypercholesterolemia prevalence (yes/no), center (categorized into quartiles by number of participants), intervention group and energy intake (kcal/day) and 1-year changes in body weight
Purpose To assess the association between three different a priori dietary patterns adherence (17-item energy reduced-Mediterranean Diet (MedDiet), Trichopoulou-MedDiet and Dietary Approach to Stop Hypertension (DASH)), as well as the Protein Diet Score and kidney function decline after one year of follow-up in elderly individuals with overweight/obesity and metabolic syndrome (MetS). Methods We prospectively analyzed 5675 participants (55–75 years) from the PREDIMED-Plus study. At baseline and at one year, we evaluated the creatinine-based estimated glomerular filtration rate (eGFR) and food-frequency questionnaires-derived dietary scores. Associations between four categories (decrease/maintenance and tertiles of increase) of each dietary pattern and changes in eGFR (ml/min/1.73m ² ) or ≥ 10% eGFR decline were assessed by fitting multivariable linear or logistic regression models, as appropriate. Results Participants in the highest tertile of increase in 17-item erMedDiet Score showed higher upward changes in eGFR ( β : 1.87 ml/min/1.73m ² ; 95% CI: 1.00–2.73) and had lower odds of ≥ 10% eGFR decline (OR: 0.62; 95% CI: 0.47–0.82) compared to individuals in the decrease/maintenance category, while Trichopoulou-MedDiet and DASH Scores were not associated with any renal outcomes. Those in the highest tertile of increase in Protein Diet Score had greater downward changes in eGFR ( β : − 0.87 ml/min/1.73m ² ; 95% CI: − 1.73 to − 0.01) and 32% higher odds of eGFR decline (OR: 1.32; 95% CI: 1.00–1.75). Conclusions Among elderly individuals with overweight/obesity and MetS, only higher upward change in the 17-item erMedDiet score adherence was associated with better kidney function after one year. However, increasing Protein Diet Score appeared to have an adverse impact on kidney health. Trial Registration Number: ISRCTN89898870 (Data of registration: 2014).
 
Individual changes in s-B12 from baseline
Purpose The main aim of the present study was to examine the effect of a fish protein supplement made from by-products from production of Atlantic salmon, on blood concentration of micronutrients. Methods We conducted an 8-week double-blind parallel-group randomised controlled trial. In total, 88 adults were randomised to a salmon fish protein supplement or placebo, and 74 participants were included in the analysis of vitamin D, omega-3, vitamin B12, selenium, folate, zinc, homocysteine and mercury. Results During the intervention period, geometric mean (GSD) of serum vitamin B12 concentrations increased from 304 (1.40) to 359 (1.42) pmol/L in the fish protein group ( P vs. controls = 0.004) and mean (SD) serum selenium increased from 1.18 (0.22) to 1.30 (0.20) μmol/L ( P vs. controls = 0.002). The prevalence of low vitamin B12 status (B12 < 148–221 > pmol/L) decreased from 15.4 to 2.6% in the fish protein group, while increasing from 5.9 to 17.6% in the placebo group ( P = 0.045). There was no difference between the groups in serum levels of the other micronutrients measured. Conclusion Including a salmon fish protein supplement in the daily diet for 8 weeks, increases serum vitamin B12 and selenium concentrations. From a sustainability perspective, by-products with high contents of micronutrients and low contents of contaminants, could be a valuable dietary supplement or food ingredient in populations with suboptimal intake. Trail Registration The study was registered at ClinicalTrials.gov (ID: NCT03764423) on June 29th 2018.
 
Steps to update the sodium content of 261 food items
Purpose To simulate the potential impact of the HeartSAFE 2020 programme, a food reformulation initiative by the New Zealand (NZ) Heart Foundation, on sodium intake in the NZ adult population. Methods A representative sample of NZ adults aged 15 years and older completed a 24-h diet recall survey, with 25% of participants completing a second diet recall, in the 2008/09 New Zealand Adult Nutrition Survey (n = 4721). These data were used to estimate sodium intakes of participants. The effect of altering the sodium content of 840 foods in 17 categories and 35 sub-categories included in the NZ HeartSAFE 2020 programme was simulated. The simulated sodium intake reductions in each food sub-category for the entire sample were calculated. Using sampling weights, simulated reductions in population sodium intake and by sociodemographic subgroups were also analysed. Results Sodium intake from foods included in the HeartSAFE 2020 programme was 1307 mg/day (95% CI 1279, 1336) at baseline. After applying the HeartSAFE 2020 targets, potential sodium intake was 1048 mg/day (95% CI 1024, 1027). The absolute sodium reduction was 260 mg/day (95% CI 252, 268), corresponding to 20% sodium reduction for the foods included in the NZ HeartSAFE programme. Conclusion Current sodium targets featured in the NZ HeartSAFE programme will not meet the 30% sodium intake reduction set out by the WHO Global Action Plan. A more comprehensive strategy consistent with the WHO SHAKE Technical Package is needed to advance the goal of sodium intake reduction.
 
Flow chart of study subjects
Purpose Colorectal cancer (CRC) is a heterogeneous disease caused by complex interplay among the diet, the environment, and genetics involving numerous molecules and pathological pathways. This study aimed to determine whether methyl donor nutrients are associated with CRC and how these associations are altered by DNA mismatch repair (MMR) genes. Methods In total, 626 cases and 838 age- and sex-matched controls were recruited for this case-control study. A validated food frequency questionnaire was used to assess seven methyl donor nutrients (vitamin B2, niacin, B6, folate, B12, methionine, and choline). MMR polymorphisms were genotyped using an Illumina MEGA-Expanded Array. For the 626 patients, the microsatellite instability status and immunohistochemical expression of MMR proteins were analyzed. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Among the methyl donor nutrients, B2, niacin, B6, folate, and methionine were inversely associated with CRC risk, while a high intake of choline increased CRC. Regarding MMR genes, three hMSH3 polymorphisms (rs32952 A > C, rs41097 A > G, and rs245404 C > G) reduced CRC risk. Regarding gene-diet interactions, a stronger interaction effect was observed in G allele carriers of hMSH3 rs41097 with high niacin intake than in AA carriers with low niacin intake (OR, 95% CI = 0.49, 0.33–0.72, P for interaction = 0.02) in subgroups of patients with distal colon cancer (P for interaction = 0.008) and MMR proficiency with microsatellite stability (P for interaction = 0.021). Conclusions Methyl donor nutrients may affect CRC risk leading to a balance in the MMR machinery.
 
Fasting and postprandial plasma concentrations of IL-1β (A) and IL-6 (B) for high and low inflammation groups. +  +  + P < 0.001 for time effect. *P < 0.05; **P < 0.01 for group effect. IL-1β; interleukin-1β; IL-6, interleukin-6; MED, Mediterranean diet-like meal; WDHC, Western diet-like high-carbohydrate meal; WDHF, Western diet-like high-fat meal
Fasting and postprandial plasma glucose concentration after Western diet-like high-carbohydrate (WDHC) meal intake in high and low inflammation groups. **P < 0.01 for differences between high and low inflammation groups
Purpose Low-grade inflammation in obesity is associated with insulin resistance and other metabolic disturbances. In response to high-energy meal intake, blood concentrations of inflammatory markers, glucose and insulin rise. The aim of this study was to examine whether a basal inflammatory state influences postprandial responses. Methods A randomized crossover trial was performed in 60 participants with a cardiometabolic risk phenotype (age 70 ± 5 years; BMI 30.9 ± 3.1 kg/m ² ). Each participant consumed three different iso-energetic meals (4300 kJ): a Western diet-like high-fat meal (WDHF), a Western diet-like high-carbohydrate meal (WDHC) and a Mediterranean diet-like meal (MED). Blood samples were collected when fasted and hourly for 5 h postprandially and analyzed for glucose, insulin, interleukin-1β (IL-1β), interleukin-6 (IL-6) and endothelial adhesion molecules. Based on fasting serum C-reactive protein (CRP) concentrations, participants were assigned to a high inflammation (CRP ≥ 2.0 mg/L; n = 30) or low inflammation (CRP < 2.0 mg/L; n = 30) group, and postprandial outcomes were compared. Results Plasma IL-6, glucose and serum insulin increased after all meals, while IL-1β and endothelial adhesion molecules were unchanged. The high inflammation group had higher fasting and postprandial IL-6 concentrations than the low inflammation group, although the IL-6 response slope was similar between groups. In response to the WDHC meal, participants in the high inflammation group experienced a higher glycaemic response than those in the low inflammation group. Conclusion A basal proinflammatory state results in higher absolute fasting and postprandial IL-6 concentrations, but the increase in IL-6 relative to basal levels is not different between high and low inflammation groups. Elevated glycaemic response in the high inflammation group may be due to inflammation-induced short-term insulin resistance. The trial was registered at http://www.germanctr.de and http://www.drks.de under identifier DRKS00009861 (registration date, January 22, 2016).
 
Flow chart of Participants from the CORDIOPREV trial included in this substudy
Relatives changes in food intake after 1- and 7-year follow-up according to randomization group in the CORDIOPREV study
Relatives changes in total energy and nutrient density after 1- and 7-year follow-up according to randomization group in the CORDIOPREV study
Background Cardiovascular disease (CVD) is the leading cause of disease burden in the world by non-communicable diseases. Nutritional interventions promoting high-quality dietary patterns with low caloric intake value and high nutrient density (ND) could be linked to a better control of CVD risk and recurrence of coronary disease. This study aims to assess the effects of a dietary intervention based on MedDiet or Low-Fat dietary intervention over changes in ND and food intake after 1 and 7 years of follow-up of the CORDIOPREV study. Methods We prospectively analyzed the results of the 802 coronary patients randomized to two healthy dietary patterns (MedDiet = 425, Low-Fat Diet = 377) who completed the 7 years of follow-up and had all the dietary data need. Dietary intake information obtained from a validated 137-item Food Frequency Questionnaire was used to calculate 1- and 7-year changes in dietary intake and ND (measured as nutrient intake per 1000 kcal). T test was used to ascertain differences in food intake and ND between groups across follow-up time. Within-subject (dietary allocation group) differences were analyzed with ANOVA repeated measures. Results From baseline to 7 years of follow-up, significant increases of vegetables, fruits, and whole cereals within groups ( p < 0.001) was found. We found a higher increase in dietary intake of certain food groups with MedDiet in comparison with Low-Fat Diet for vegetables (46.1 g/day vs. 18.1 g/day, p < 00.1), fruits (121.3 g/day vs. 72.9 g/day), legumes (4.3 g/day vs. 0.16 g/day) and nuts (7.3 g/day vs. − 3.7 g/day). There was a decrease in energy intake over time in both groups, slightly higher in Low-Fat Diet compared to MedDiet group (− 427.6 kcal/day vs. − 279.8 kcal/day at 1st year, and − 544.6 kcal/day vs. − 215.3 kcal/day after 7 years of follow-up). ND of all the nutrients increased within group across follow-up time, except for Saturated Fatty Acids (SFA), cholesterol and sodium ( p < 0.001). Conclusions A comprehensive dietary intervention improved quality of diet, reducing total energy intake and increasing the intake of healthy food groups and overall ND after 1 year and maintaining this trend after 7 years of follow-up. Our results reinforce the idea of the participation in trials, enhance nutrition literacy and produces better nutritional outcomes in adult patients with established CVD. Clinical trial registry The trial was registered in 2009 at ClinicalTrials.gov (number NCT00924937).
 
The flow diagram of the study
Effect of hypocaloric DASH diet (gray bars) and the hypocaloric legume-based DASH diet (white bars) on changes in glycemic indices at week 16. P value/q value are for comparison between the 2 dietary intervention groups after adjustment for baseline values, gender and oral antidiabetic medications. DASH Dietary Approach to Stop Hypertension, HOMA-IR Homeostatic Model Assessment for Insulin Resistance, HOMA-β Homeostatic Model Assessment of β-cell Function. q value were calculated by Benjamini–Hochberg correction and q < 0.1 is significant
Effect of hypocaloric DASH diet (gray bars) and the hypocaloric legume-based DASH diet (white bars) on changes in lipid profiles and anthropometric measurements at week 16. P value/q value are for comparison between the 2 dietary intervention groups after adjustment for baseline values, gender, oral antidiabetic medications, and lipid lowering drugs. DASH Dietary Approach to Stop Hypertension. q value were calculated by Benjamini–Hochberg correction and q < 0.1 is significant
Purpose The current study aimed to investigate the effects of legumes inclusion in the hypocaloric dietary approaches to stop hypertension (DASH) diet on fasting plasma glucose (FPG) and cardiometabolic risk factors in overweight and obese patients with type 2 diabetes over 16 weeks. Also, the modulatory effects of rs7903146 variant in the transcription factor 7 like 2 (TCF7L2) gene that is associated with the risk of diabetes, were assessed on these cardiometabolic risk factors. Methods This study was a randomized controlled trial. Three-hundred participants, aged 30–65 years, whose TCF7L2 rs7903146 genotype was determined, were studied. The participants were randomly assigned to receive either the hypocaloric DASH diet or a hypocaloric legume-based DASH diet. The primary outcome was the difference in FPG change from baseline until the 16-week follow-up between the two dietary interventions. The secondary outcomes were differences in insulin resistance and lipid profile changes between the dietary intervention diets. Results A reduction in FPG, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride, total cholesterol, and low-density lipoprotein cholesterol (LDL-C) was observed at week 16 in both hypocaloric dietary interventions. Compared to the DASH diet, the legume-based DASH diet decreased the FPG and HOMA-IR. There is no interaction between rs7903146 and intervention diets on glycemic parameters. Conclusion The DASH diet, enrich in legumes, could improve the glycemic parameters in participants with type 2 diabetes, regardless of having rs7903146 risk or non-risk allele. Registration number of Clinical Trial Iranian Registry of Clinical Trials (IRCT) (code: IRCT20090203001640N17).
 
Distribution (%) of the self-reported weight change during the COVID-19 pandemic according to the self-reported weight status
Changes in food consumption of participants during the COVID-19 pandemic
Purpose This study aims to examine the effects of the COVID-19 pandemic on the body weight, nutritional habits, physical activity, and food consumption of adults living in Turkey and evaluate the effects of changes in these health behaviours on body weight. Methods A cross-sectional study was conducted with an online questionnaire. Data were collected through social media platforms using the snowball sampling method. A self-reported questionnaire included socio-demographic information, anthropometric data, dietary habits, food consumption, and lifestyle changes. In this study, 4181 people were included. Logistic regression analysis was used to evaluate the variables associated with the increase in body weight. Results The findings obtained in this study showed that the bodyweight of 58.5% of the participants increased during the COVID-19 pandemic, and this increase was the highest (66.3%) among the obese. The rate of those who stated that their physical activity decreased was 69.5%. The foods consumed the most by individuals were homemade desserts (54%), nuts (53.8%) and fresh fruits (52.3%). Those whose serving size increased [OR = 4.98 (3.76–6.60)], those whose physical activity decreased or increased [OR = 2.94 (2.38–3.63) or 2.52 (1.84–3.45), respectively], and those whose number of main meals consumed increased [OR = 2.17 (1.72) − 2.75)], those with increased consumption of white bread (OR = 1.63 (1.20–2.22) and those with increased consumption of packaged sweet products [OR = 1.53 (1.23–1.89)] were more likely to gain weight. Conclusion The results of this study show that there are significant changes in the body weight, physical activities, and eating habits of the participants during the COVID-19 pandemic. It is necessary to provide and follow-up specific guidance and support services for different groups to protect public health, improve and prevent nutrition-related diseases.
 
a Energy per meal (kcal); b mean adequacy ratio (MAR) (% for 2000 kcal) and c Greenhouse Gas Emissions (GHGE) (kg CO2 eq.) of meals, in the series of 20 meals (n = 100) generated with ‘5C’, 4C’, ‘5C-4Veg-FR’ and ‘4C-4Veg-FR’ scenarios. Energy, MAR, and GHGE were compared between two scenarios using t test. ***p value < 0.001, **p value < 0.01, *p value < 0.05, ns not significant. The boxplots show the distribution of data based on five sets (minimum, first quartile, median, third quartile, maximum) and the star represents the mean. For example, for energy per meal a in ‘5C’ scenario, minimum = 659 kcal, first quartile = 719 kcal, median = 748 kcal, third quartile = 778 kcal, maximum = 928 kcal and mean = 753 kcal
a Energy per meal (kcal); b mean adequacy ratio (MAR) (% for 2000 kcal) and c greenhouse gas emissions (GHGE) (kg CO2 eq. per meal), in the series of 20 meals (n = 100) generated with the five-component (5C) scenarios. Energy, MAR, and GHGE were compared between two scenarios using t test. ***p value < 0.001, **p value < 0.01, *p value < 0.05, Ref. reference scenario, ns not significant. All the scenarios were significantly different from the reference scenario (5C-4Veg-FR) except the ones labeled ns
a Protein, fiber, and omega 3 fatty acid; b mineral and c vitamin content of meals, in the series of 20 meals (n = 100) generated with the five components (5C) scenarios, expressed as percentage of the daily recommendation per meal. The error bars represent the confidence intervals
Purpose: School meals have the potential to promote more sustainable diets. Our aim was to identify the best trade-off between nutrition and the environment by applying four levers to school meals: (i) reducing the number of meal components, (ii) complying with the French school nutritional guidelines, (iii) increasing the number of vegetarian meals, and/or (iv) avoiding ruminant meat. Methods: Levers were analyzed alone or in combination in 17 scenarios. For each scenario, 100 series of 20 meals were generated from a database of 2316 school dishes using mathematical optimization. The nutritional quality of the series was assessed through the mean adequacy ratio (MAR/2000 kcal). Seven environmental impacts were considered such as greenhouse gas emissions (GHGE). One scenario, close to series usually served in French schools (containing four vegetarian meals, at least four ruminant meat-based meals, and at least four fish-based meals) was considered as the reference scenario. Results: Reducing the number of meal components induced an important decrease of the energy content but the environmental impact was little altered. Complying with school specific nutritional guidelines ensured nutritional quality but slightly increased GHGE. Increasing the number of vegetarian meals decreased GHGE (from 11.7 to 61.2%) but decreased nutritional quality, especially when all meals were vegetarian (MAR = 88.1% against 95.3% in the reference scenario). Compared to the reference scenario, series with 12 vegetarian meals, 4 meals containing fish and 4 meals containing pork or poultry reduced GHGE by 50% while maintaining good nutritional quality (MAR = 94.0%). Conclusion: Updating French school nutritional guidelines by increasing the number of vegetarian meals up to 12 over 20 and serving non-ruminant meats and fish with the other meals would be the best trade-off for decreasing the environmental impacts of meals without altering their nutritional quality.
 
Study participant flow
Percentage of precipitated iron after in vitro digestion in a 20 µg Fe/g solution with the PPS and other food powders at different doses of 1 g, 2 g and 3 g. Shown are means ± SD. Significant differences between doses within a PP
source are indicated with * (one-way ANOVA with Bonferroni corrections, p < 0.05)
Correlation of percentage precipitated iron with measured PP content (mg) as gallic acid equivalent (GAE). Spearman’s rho = 0.629, p < 0.001 (1-tailed)
A FIA from test meals and B test drinks consumed either with the PPS (Meal-PPS & Drink-PPS) or with the placebo supplement (Meal-Placebo & Drink-Placebo). Shown are individual datapoints and the geometric mean with the 95% CI, p = 0.026, and 0.002, respectively, paired samples T test
Objectives We developed a natural polyphenol supplement that strongly chelates iron in vitro and assessed its effect on non-heme iron absorption in patients with hereditary hemochromatosis (HH). Methods We performed in vitro iron digestion experiments to determine iron precipitation by 12 polyphenol-rich dietary sources, and formulated a polyphenol supplement (PPS) containing black tea powder, cocoa powder and grape juice extract. In a multi-center, single-blind, placebo-controlled cross-over study, we assessed the effect of the PPS on iron absorption from an extrinsically labelled test meal and test drink in patients (n = 14) with HH homozygous for the p.C282Y variant in the HFE gene. We measured fractional iron absorption (FIA) as stable iron isotope incorporation into erythrocytes. Results Black tea powder, cocoa powder and grape juice extract most effectively precipitated iron in vitro. A PPS mixture of these three extracts precipitated ~ 80% of iron when 2 g was added to a 500 g iron solution containing 20 µg Fe/g. In the iron absorption study, the PPS reduced FIA by ~ 40%: FIA from the meal consumed with the PPS was lower (3.01% (1.60, 5.64)) than with placebo (5.21% (3.92, 6.92)) (p = 0.026)), and FIA from the test drink with the PPS was lower (10.3% (7.29 14.6)) than with placebo (16.9% (12.8 22.2)) (p = 0.002). Conclusion Our results indicate that when taken with meals, this natural PPS can decrease dietary iron absorption, and might thereby reduce body iron accumulation and the frequency of phlebotomy in patients with HH. Trial registry: clinicaltrials.gov (registration date: 9.6.2019, NCT03990181).
 
Flow chart of the sample selection
Weighted proportion of infants consuming long-chain polyunsaturated fatty acid (LC-PUFA)-enriched formula (n = 9372)
Longitudinal trajectories of LC-PUFA enrichment of infant formula (n = 7557)
Purpose For decades, consistent associations between breastfeeding and children’s neurodevelopment have been attributed to breastmilk content in long-chain polyunsaturated fatty acids (LC-PUFAs). However, the beneficial effect of LC-PUFA enrichment of infant formula on neurodevelopment remains controversial. This study examined the association of LC-PUFA enrichment of infant formulas with neurodevelopment up to age 3.5 years. Methods Analyses were based on 9372 children from the French nationwide ELFE birth cohort. Monthly from 2 to 10 months, parents declared their infant’s feeding mode, including breastfeeding and the name of the infant formula, which allowed for identifying formulas enriched in arachidonic (ARA), eicosapentaenoic (EPA) and/or docosahexaenoic (DHA) acids. Neurodevelopment was assessed at age 1 and 3.5 years with the Child Development Inventory (CDI-1 and CDI-3.5); at 2 years with the MacArthur-Bates Communicative Development Inventories (MB-2); and at 3.5 years with the Picture Similarities subtest of the British Ability Scale (BAS-3.5). Associations were assessed by linear regression adjusted for any breastfeeding duration and main confounding factors, including socioeconomic characteristics. Results One-third of formula-fed infants consumed LC-PUFA-enriched formulas. Most of these formulas were enriched in both DHA and ARA, and about 10% of infants consumed formula further enriched in EPA. LC-PUFA enrichment of infant formula was not associated with neurodevelopmental scores at age 1 (CDI-1, − 0.16 [− 0.39, 0.07]), age 2 (MB-2, 0.78 [− 0.33, 1.89]), or age 3.5 (CDI-3.5, − 0.05 [− 0.27, 0.17]; BAS-3.5, − 0.93 [− 2.85, 0.98]). Conclusion In the ELFE study, LC-PUFA enrichment of infant formula was not associated with neurodevelopmental scores up to 3.5 years.
 
Purpose Accumulating evidence suggests that vitamin D deficiency increases the risk of adverse perinatal outcomes. However, the dose–response relationship between maternal vitamin D status and adverse birth outcomes remains unclear. Focusing on prospective observational studies, we aimed to explore the dose–response relationship of vitamin D status with the risk of low birth weight (LBW), macrosomia (MA), preterm birth (PTB), small for gestational age (SGA), and intrauterine growth restriction (IUGR). Methods Databases including PubMed, Embase, Scopus, and Web of Science were used up to 19 January 2021 to search for observational studies that fulfilled criteria as follows: cohort studies, case–cohort studies, or nested case–control studies. Random-effects models were used to pool relative risks (RRs) and 95% confidence intervals (CIs) in the observational studies. Results A total of 72 publications were included in this systematic review and 71 in the meta-analysis. Maternal 25-hydroxyvitamin D (25(OH)D) concentrations were inversely associated with the risk of LBW (RR: 0.65; 95% CI 0.48–0.86), PTB (RR: 0.67; 95% CI 0.57–0.79), and SGA (RR: 0.61; 95% CI 0.49–0.76) in the highest versus lowest meta-analysis, but not associated with MA and IUGR. Linear dose–response analysis showed that each 25 nmol/L increase in 25(OH)D was associated with a 6% and 10% reduction in the risk of PTB (RR: 0.94; 95% CI 0.90–0.98) and SGA (RR: 0.90; 95% CI 0.84–0.97), respectively. Conclusion Our study suggests that a sufficient vitamin D status during pregnancy is protective against the risk of LBW, PTB, and SGA.
 
Purpose We assessed the effect of the current iodine fortification level (20 µg/g household salt and salt included in bread and bakery products) on inadequate and excessive intake in the general Danish population. Intake models with/without the contribution from food supplements and effects of excluding specific food groups were evaluated. Method Data from the Danish National Survey of Dietary Habits and Physical Activity in 2011–13 (N = 3946, aged 4–75 years) stratified by age-group and sex were used to estimate habitual dietary iodine intakes, and compared with established dietary reference values. Results The proportion with an estimated inadequate iodine intake was ≤ 3% for males and ≤ 5% for females, except for 15–17-year-old girls, where the probable prevalence of an inadequate intake was 11%. Including the contribution from food supplements gave similar results (10%). High intakes (as defined by 95th percentile) from food sources generally did not exceed the tolerable upper intake level (UL). However, for the youngest age-groups (4–6-year-old boys/girls and 7–10-year-old boys), the 95th percentiles exceeded the UL with 11%, 4% and 7%, respectively, when food supplements were included in the estimates. Especially exclusion of dairy products and bread led to an inadequate intake for both boys and girls. Conclusion The current fortification level may provide an inadequate iodine intake for some females and on the other hand lead to excessive intakes in the youngest age-groups. The study shows the importance of choosing iodine-rich alternatives when excluding major sources of iodine in the Danish diet.
 
Top-cited authors
Matthias Schulze
  • German Institute of Human Nutrition
Manfred James Müller
  • Christian-Albrechts-Universität zu Kiel
Dirk Haller
  • Technische Universität München
Sabine Ellinger
  • University of Bonn
Eva Leschik-Bonnet
  • Deutsche Gesellschaft für Ernährung