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Purpose: Esports players' training takes long periods and they sit for a long time during competitions, which increases their risk of obesity and urges them to develop inappropriate eating behaviors. In this study, we aimed to investigate the night-eating syndrome and food addiction in esports players. Methods: This cross-sectional study was conducted with 248 esports players who were members of a university's esports community. The study data were collected using an online questionnaire consisting of the descriptive information form, Night Eating Questionnaire, and Yale Food Addiction Scale. Results: The mean age of the sports players participating in the study was 22.19 ± 5.97 years. Of them, 55.6% had a normal body weight, 13.4% were obese, 54.4% played esports for 3 years or more, 13.3% experienced night eating syndrome, and 21.4% experienced food addiction. While the weekly duration of playing esports and skipping meals were associated with night eating syndrome, the weekly duration of playing esports and smoking were associated with food addiction (p < 0.05). Additionally, although there was no statistically significant difference, the risk of food addiction was 2.12 times higher in those with poor perceived sleep quality. Conclusion: We observed that night eating syndrome was very common in esports players and that these individuals were at risk in terms of food addiction. Since esports has a more sedentary structure than traditional sports, we suggest that esports players should be evaluated in terms of their unhealthy eating behaviors and risk of eating disorders. [ABSTRACT FROM AUTHOR]

Purpose: Diet-related diseases are advancing as the leading cause of death globally. As self-reporting of diet by patients can be associated with errors, stable isotopes of human tissues can be used to diagnose diseases, understand physiology, and detect change in diet. This study investigates the effect of type and amount of food on the nitrogen and carbon concentration (Nconc and Cconc) and isotopic composition (δ15N and δ13C) in human scalp hair and fingernails. Methods: A total of 100 residents participated in the study whereas only 74 individuals provided complete diet history. Sixty-six food items majorly available to them were also collected. The Nconc, Cconc, δ15N and δ13C values of human hair, nails and food items were determined. Results: The Nconc, Cconc, δ15N and δ13C values between plant-sourced and animal-sourced food items, as well as human hair and nail tissue were significantly different (p < 0.05). The δ15N value of human tissues was distinct between lacto-vegetarians and omnivores by 0.9‰. The δ15N and δ13C values of human tissues increased by 0.4–0.5‰ with every 5% increase in the consumption of animal protein. Conclusions: The study helps to demarcate lacto-vegetarians from omnivores, and estimate the percentage of animal protein in diet based on the dual isotope values of human tissues. It also acts as a reference to determine isotopic composition of hair tissue provided the isotope value of nail tissue is known and vice versa. [ABSTRACT FROM AUTHOR]

Purpose: Increased awareness of the importance of dietary fibre has led to increased interest in 'functional' fibre components like digestion-resistant maltodextrin (RMD). This randomized, placebo-controlled, double-blind study assessed the effects of RMD in the colonic transit time (CTT) and defecation characteristics (frequency, stool volume and consistency). Methods: Sixty-six healthy adult volunteers (32 men) who did not have a daily defecation habit had a 7-day run-in period before the 21-day intervention period with RMD or placebo. CTT and segmental CTT (SCTT) were assessed by a single abdominal X-ray film taken at the end of both periods after radiopaque marker ingestion. Defecation characteristics and intestinal functions were also assessed, which were self-reported by patients. Intragroup comparisons were evaluated by Student's paired t test, Bonferroni test and Chi-square test, while time comparisons by analysis of variance (ANOVA) and time-by-treatment interaction by repeated-measures ANOVA. Results: Fifty-seven subjects were assessed for CTT (placebo, n = 28; RMD, n = 29). In the RMD group, the total CTT, left SCTT and rectosigmoidal SCTT decreased significantly compared to baseline ( p < 0.01 each; −13.3, −4.7, −8.7 h, respectively). Significant differences between groups were observed in total CTT and left SCTT. Significant time-by-treatment interaction was observed in the RMD group for stool volume ( p = 0.014), increasing 56 % compared to baseline ( p < 0.01), while remained unchanged in the placebo group. Stool consistency was improved only in the RMD group ( p < 0.01). No adverse effects related to study products were observed. Conclusions: The results show that RMD improved CTT, stool volume, stool consistency and some intestinal functions in a healthy population. [ABSTRACT FROM AUTHOR]

Purpose: Two objectives were investigated: (1) to assess the risk of micronutrient deficiencies in relation to weight status in Indian women with a focus on iron but also including zinc, vitamin A and B vitamins and (2) to compare fractional iron absorption between obese (OB) and normal weight (NW) women. Methods: Part 1 was a cross-sectional study including 146 healthy, middle-class women from Bangalore, India, with a BMI between 19 and 40 kg/m. Anthropometrics and blood pressure were measured, and a fasting blood sample was obtained for the analysis of vitamin and mineral status, hepcidin, blood lipids and glucose. In part 2, 16 OB and 13 NW women consumed a standardized test meal labeled with the stable iron isotope Fe. Incorporation of the iron isotope into erythrocytes was measured 14 days later. In addition, iron status, hepcidin and inflammatory markers were determined. Results: In part 1, compared to NW women, overweight/OB subjects had significantly higher C-reactive protein, serum ferritin, soluble transferrin receptor (sTfR) and hepcidin concentrations ( p < 0.05). The odds ratio for having high sTfR concentrations (i.e., low iron status) with increasing BMI was 1.09 (95 % CI 1.02-1.17). None of the other micronutrients investigated showed any differences between weight status groups. In part 2, fractional iron absorption was significantly lower in the OB group compared to the NW group even after controlling for differences in iron status (10.0 ± 6.5 vs. 16.7 ± 4.6 %; p = 0.038). Conclusions: OB women in Bangalore have an increased risk of low iron status and absorb less dietary iron; however, their risk of other micronutrient deficiencies was similar to NW women. Our results clearly demonstrate the importance of considering the double burden of malnutrition in the planning of prevention strategies especially in transition countries with emerging obesity epidemics. [ABSTRACT FROM AUTHOR]

Purpose: Epidemiological evidence suggests that coffee consumption is associated with a lower risk of type 2 diabetes. Coffee contains caffeine and several other components that may modulate glucose regulation. The chlorogenic acids (CGA) in coffee have been indicated as constituents that may help to normalize the acute glucose response after a carbohydrate challenge. The aim of this study was to investigate whether two coffee beverages that differ in CGA content due to different roasting degrees will differentially affect glucose regulation. Methods: In a controlled crossover trial, 11 healthy fasted volunteers consumed 300 mL of either light (LIR) or dark (DAR) roasted coffee, or water, followed 30 min later by a 75-g oral glucose tolerance test (OGTT). Blood samples were drawn at baseline, 30, 60, and 120 min. Differences in glucose and insulin responses and insulin sensitivity index (ISI) were analyzed. The CGA and caffeine contents in the coffees were analyzed using UPLC-MS/MS. Results: No differences in glucose area under the curve (AUC) were found between treatments. Glucose concentrations were higher at 60 min after ingestion of DAR compared with water, while ingestion of LIR showed similar glucose concentrations as ingestion of water. Insulin AUC was higher after ingestion of DAR compared with water, and both coffees raised insulin concentrations and reduced ISI compared with water, with no difference between the two coffees. Conclusion: Two coffees with different CGA contents did not differentially affect glucose or insulin responses during an OGTT, but both increased the insulin response compared with water. [ABSTRACT FROM AUTHOR]

Background: Carbohydrate (CHO) supplementation during prolonged exercise is widely acknowledged to blunt in vitro immunoendocrine responses, but no study has investigated in vivo immunity. Purpose: To determine the effect of CHO supplementation during prolonged exercise on in vivo immune induction using experimental contact hypersensitivity with the novel antigen diphenylcyclopropenone (DPCP). Methods: In a double-blind design, 32 subjects were randomly assigned to 120 min of treadmill exercise at 60 % $$\dot{V}{\text{O}}_{2} { \hbox{max} }$$ with CHO (Ex-CHO) or placebo (Ex-PLA) supplementation. Responses were also compared to 16 resting control (CON) subjects from a previous study (for additional comparison with a resting non-exercise condition). Standardised diets (24 h pre-trial) and breakfasts (3.5 h pre-trial) were provided. Subjects received a primary DPCP exposure (sensitisation) 20 min after trial completion, and exactly 28 days later the strength of immune reactivity was quantified by magnitude of the cutaneous response (skin-fold thickness and erythema) to a low dose-series DPCP challenge. Stress hormones and leucocyte trafficking were also monitored. Results: CHO supplementation blunted the cortisol and leucocyte trafficking responses, but there was no difference ( P > 0.05) between Ex-CHO and Ex-PLA in the in vivo immune responses (e.g. both ~46 % lower than CON for skin-fold response). Conclusions: CHO supplementation does not influence the decrease in in vivo immunity seen after prolonged exercise. The effects with more stressful (or fasted) exercise remain to be determined. However, there appears to be no benefit under the conditions of the present study, which have practical relevance to what many athletes do in training or competition. [ABSTRACT FROM AUTHOR]

Purpose: Alkylresorcinols (AR) are phenolic lipids present in the bran of wheat and rye. Plasma AR and their urinary metabolites may be suitable biomarkers of whole-grain (WG) wheat and rye consumption. The objective of this study was to examine plasma AR and urinary AR metabolites in response to WG wheat consumption. Methods: In a randomized crossover study, 19 subjects (10 males, 9 females; BMI 22.0 kg/m; age 26 years) incorporated either 3 servings (48 g) or 6 servings (96 g) of WG wheat daily into their regular diet for 1 week. Subjects completed a 2-week washout period, abstaining from all WG consumption, before each intervention. Fasting blood and 24-h urine were collected before and after each intervention. Plasma AR homologues (C19:0, C21:0, C23:0) were quantified by GC-MS after diethyl ether and solid phase extraction and derivatization. Urinary AR metabolites [3,5-dihydroxybenzoic acid and 3-(3,5-dihydroxyphenyl)-propanoic acid] were determined using HPLC with electrochemical detection after enzymatic deconjugation and ethyl acetate extraction. Results: Urinary total AR metabolites were significantly higher after 6 compared with 3 servings of WG wheat (56 vs. 32 μmol/day, P < 0.001). This dose-response relationship was independent of age, sex, energy intake, and baseline urinary AR metabolite concentration. Plasma total AR tended to be higher after 6 compared with 3 servings of WG wheat (103.0 vs. 86.9 nmol/L), but this difference was not significant ( P = 0.42). Conclusion: The results suggest that urinary AR metabolites from 24-h urine collections may be useful as biomarkers of compliance in intervention studies of WG wheat. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is a global epidemic affecting around 10 % of 5- to 17-year olds. With the causes for obesity being multifactorial, a better understanding of the influencing factors is essential for effective treatment and prevention programs. The aim of this study was therefore to identify specific risk factors for overweight and obesity in children in Switzerland. Methods: A nationally representative sample of children aged 6-12 years was recruited ( n = 2724). Height and weight were measured to calculate BMI (kg/m). In addition, a questionnaire was distributed to all children asking about their physical activity, media consumption, and dietary habits as well as some parental factors. Results: The prevalence of overweight and obesity in boys was 11.8 and 7.5 %, respectively, and in girls, it was 11.9 and 5.7 %. In univariate analyses, a number of parental, dietary, and activity factors were shown to be associated with BMI category. Based on a multinomial logistic regression, parent nationality and media consumption were the most important factors predicting obesity in boys, while in girls it was parental education, nationality, and physical activity. Conclusion: We have demonstrated that parental nationality and education play an important role in the development of childhood obesity, together with media consumption and physical activity. However, risk factors are also different according to child gender. Thus, an important target group for the treatment and prevention of childhood obesity in Switzerland are immigrant families, and the problem needs to be tackled differently in boys and girls as their risk factors are not the same. [ABSTRACT FROM AUTHOR]

Background: Neurodevelopmental effects of omega-3 fatty acids and mercury from fish consumption have been characterized in children. In contrast, neurobehavioral outcomes associated with fish are not well studied in adults. Objective: This study of avid seafood consumers on Long Island (NY, USA) sought to define associations between mercury, seafood consumption, omega-3 fatty acids and neurobehavioral outcomes. Methods: A computer-based test system was used to assess neurobehavioral function. Blood total Hg (Hg) and omega-3 index were measured in 199 adult avid seafood eaters, who also completed the neurobehavioral assessment and an extensive food and fish frequency and demographic questionnaire. Results: For most of the outcomes considered, neither Hg nor omega-3 index was associated with neurobehavioral outcomes after adjustment for key confounding variables. Fish consumption, however, was associated with decreased odds of both self-reported fatigue (OR 0.85; 95 % CI 0.72, 1.01) and a constellation of neurologic symptoms (OR 0.79; 95 % CI 0.66, 0.96). Conclusions: Results from our study provide little evidence that omega-3 fatty acids or Hg is associated with cognitive function in adult avid seafood consumers. Larger studies are needed to confirm our finding of associations between fish consumption and decreased self-reported fatigue and neurologic impairment. [ABSTRACT FROM AUTHOR]

Purpose: To compare dietary intake in 1-year-old infants and their parents between families with high and low obesity risk, and to explore associations between infant dietary intake and relative weight. Methods: Baseline analyses of 1-year-old infants ( n = 193) and their parents participating in a longitudinal obesity intervention (Early STOPP) were carried out. Dietary intake and diet quality indicators were compared between high- and low-risk families, where obesity risk was based on parental weight status. The odds for high diet quality in relation to parental diet quality were determined. Associations between measured infant relative weight and dietary intake were examined adjusting for obesity risk, socio-demographics, and infant feeding. Results: Infant dietary intake did not differ between high- and low-risk families. The parents in high-risk families consumed soft drinks, French fries, and low-fat spread more frequently, and fish and fruits less frequently ( p < 0.05) compared to parents in low-risk families. Paternal intake of vegetables and fish increased the odds for children being consumers of vegetables (OR 1.7; 95 % CI 1.0-2.9) and fish, respectively (OR 2.5; 95 % CI 1.4-4.4). Infant relative weight was weakly associated with a high intake of milk cereal drink ( r = 0.15; p < 0.05), but not with any other aspect of dietary intake, obesity risk, or early feeding patterns. Conclusions: At the age of one, dietary intake in infants is not associated with family obesity risk, nor with parental obesogenic food intake. Milk cereal drink consumption but no other infant dietary marker reflects relative weight at this young age. [ABSTRACT FROM AUTHOR]

Purpose: Selenium is an essential trace mineral and a component of selenoproteins that are involved in the production of thyroid hormones and in regulating the immune response. We aimed to explore the effect of low-dose selenium supplementation on thyroid peroxidase antibody (TPO-Ab) concentration and thyroid function in pregnant women from a mild-to-moderate iodine-deficient population. Methods: Samples and data were from a secondary analysis of Selenium in PRegnancy INTervention (SPRINT), a double-blind, randomized, placebo-controlled study that recruited 230 women with singleton pregnancies from a UK antenatal clinic at 12 weeks of gestation. Women were randomized to receive 60 µg/day selenium or placebo until delivery. Serum thyroid peroxidase antibodies (TPO-Ab), thyrotropin (TSH) and free thyroxine (FT4) were measured at 12, 20 and 35 weeks and thyroglobulin antibodies (Tg-Ab) at 12 weeks. Results: 93.5 % of participants completed the study. Se supplementation had no more effect than placebo in decreasing TPO-Ab concentration or the prevalence of TPO-Ab positivity during the course of pregnancy. In women who were either TPO-Ab or Tg-Ab negative at baseline (Thy-Ab), TSH increased and FT4 decreased significantly throughout gestation ( P < 0.001), with no difference between treatment groups. In women who were Thy-Ab at baseline, TSH tended to decrease and was lower than placebo at 35 weeks ( P = 0.050). FT4 fell more on Se than placebo supplementation and was significantly lower at 35 weeks ( P = 0.029). Conclusions: Low-dose selenium supplementation in pregnant women with mild-to-moderate deficiency had no effect on TPO-Ab concentration, but tended to change thyroid function in Thy-Ab women. [ABSTRACT FROM AUTHOR]

Purpose: Oxidative stress is closely related to cognitive impairment, and the antioxidant system may be a potential therapeutic target to preserve cognitive function in older adults. Selenium plays an important antioxidant role through selenoproteins. This controlled trial aimed to investigate the antioxidant and cognitive effects of the consumption of Brazil nuts, the best selenium food source. Methods: We enrolled 31 older adults with mild cognitive impairment (MCI) who were randomly assigned to ingestion of Brazil nuts or to the control group. Participants of the treatment group consumed one Brazil nut daily (estimated 288.75 µg/day) for 6 months. Blood selenium concentrations, erythrocyte glutathione peroxidase (GPx) activity, oxygen radical absorbance capacity, and malondialdehyde were evaluated. Cognitive functions were assessed with the CERAD neuropsychological battery. Results: Eleven participants of the treated group and nine of the control group completed the trial. The mean age of the participants was 77.7 (±5.3) years, 70 % of whom were female. We observed increased selenium levels after the intervention, whereas the control group presented no change. Among the parameters related to the antioxidant system, only erythrocyte GPx activity change was significantly different between the groups ( p = 0.006). After 6 months, improvements in verbal fluency ( p = 0.007) and constructional praxis ( p = 0.031) were significantly greater on the supplemented group when compared with the control group. Conclusion: Our results suggest that the intake of Brazil nut restores selenium deficiency and provides preliminary evidence that Brazil nut consumption can have positive effects on some cognitive functions of older adults with MCI. [ABSTRACT FROM AUTHOR]

Purpose: More than 95 % of the body carnitine is located in skeletal muscle, where it is essential for energy metabolism. Vegetarians ingest less carnitine and carnitine precursors and have lower plasma carnitine concentrations than omnivores. Principle aims of the current study were to assess the plasma and skeletal muscle carnitine content and physical performance of male vegetarians and matched omnivores under basal conditions and after l-carnitine supplementation. Results: Sixteen vegetarians and eight omnivores participated in this interventional study with oral supplementation of 2 g l-carnitine for 12 weeks. Before carnitine supplementation, vegetarians had a 10 % lower plasma carnitine concentration, but maintained skeletal muscle carnitine stores compared to omnivores. Skeletal muscle phosphocreatine, ATP, glycogen and lactate contents were also not different from omnivores. Maximal oxygen uptake (VOmax) and workload ( P) per bodyweight (bicycle spiroergometry) were not significantly different between vegetarians and omnivores. Sub-maximal exercise (75 % VOmax for 1 h) revealed no significant differences between vegetarians and omnivores (respiratory exchange ratio, blood lactate and muscle metabolites). Supplementation with l-carnitine significantly increased the total plasma carnitine concentration (24 % in omnivores, 31 % in vegetarians) and the muscle carnitine content in vegetarians (13 %). Despite this increase, P and VOmax as well as muscle phosphocreatine, lactate and glycogen were not significantly affected by carnitine administration. Conclusions: Vegetarians have lower plasma carnitine concentrations, but maintained muscle carnitine stores compared to omnivores. Oral l-carnitine supplementation normalizes the plasma carnitine stores and slightly increases the skeletal muscle carnitine content in vegetarians, but without affecting muscle function and energy metabolism. [ABSTRACT FROM AUTHOR]

Purpose: We compared the effects of a eucaloric moderate-fat diet (18 % protein, 36 % fat, and 46 % carbohydrate), a eucaloric low-fat high-carbohydrate diet (18 % protein, 18 % fat, and 64 % carbohydrate), and a low-calorie (33 % reduced) low-fat high-carbohydrate diet on biomarkers of systemic inflammation. Methods: We randomly assigned 102 participants (age 21-76 years and BMI 19.2-35.5 kg/m) to the three different diets for 6 weeks in a parallel design intervention trial. All foods were provided. Ninety-three participants completed all study procedures; 92 were included in the analyses. Endpoints included plasma C-reactive protein (CRP), interleukin-6 (IL-6), soluble tumor necrosis factor receptors I and II (sTNFRI and II), and adiponectin. Results: In the unadjusted primary analyses, none of the endpoints were differentially affected by the dietary interventions despite the significantly greater reductions in body weight and fat mass in participants consuming the low-calorie low-fat diet compared to the eucaloric diets ( p < 0.001). When including weight change in the model in secondary analysis, adiponectin tended to be increased with weight loss (time × weight change interaction, p = 0.051). Adjusted for weight change, adiponectin was reduced in the groups consuming the low-fat diets relative to the moderate-fat diet ( p = 0.008). No effect of the intervention diets or weight loss on CRP, IL-6, or sTNFRI and II was seen in these secondary analyses. Conclusions: In relatively healthy adults, moderate weight loss had minimal effects on systemic inflammation, and raised plasma adiponectin only modestly. A lower dietary fat and higher carbohydrate content had little impact on measures of systemic inflammation, but reduced adiponectin concentrations compared to a moderate-fat diet. The latter may be of concern given the consistent and strong inverse association of plasma adiponectin with many chronic diseases. [ABSTRACT FROM AUTHOR]

Purpose: To propose an index for assessing adherence to a Middle Eastern version of the Mediterranean diet as represented by the Traditional Lebanese Mediterranean diet (LMD), to evaluate the association between the LMD and selected European Mediterranean diets (EMD), and to examine socio-demographic and lifestyle correlates of adherence to Mediterranean diet (MD) among Lebanese adults. Methods: Using nationally representative dietary intake data of Lebanese adults, an index to measure Adherence to the LMD was derived. The choice of foods/food groups used for calculating the LMD score was based on results of previous factor analyses conducted on the same dataset. These foods/food groups included fruits, vegetables, legumes, olive oil, burghol, dairy products, starchy vegetables, dried fruits and eggs. Using Pearson's correlation and scores tertiles distributions agreement, the derived LMD index was compared to previously published EMD indexes from Greece, Spain, Italy, France and EPIC/Europe. Results: Fruits, vegetables and olive oil were common denominators to most MD scores. Food groups, specific to the LMD, included burghol, dried fruits, and eggs. The LMD score significantly correlated with the EMD scores, while being closest to the Italian ( r = 0.56) and farthest from the French ( r = 0.21). Percent agreement between scores' tertile distributions and Kappa statistics confirmed these findings. Multivariate linear regressions showed that older age and higher educational levels were associated with increased adherence to all MDs studied. Conclusion: A novel LMD index was proposed to assess adherence to a Middle Eastern version of MD, complementing international efforts to characterize the MD and its association with disease risk. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to establish the role of angiotensin-converting enzyme gene insertion/deletion (ACE I/D) polymorphism in determining obesity or undernutrition in a child population in Romania. Methods: We assessed 293 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided, according to body mass index (BMI), into three groups: group I, the control group consisting of 126 children, group II patients with undernutrition (85 patients) and group III patients with obesity (82 patients). ACE I/D polymorphisms were performed in all three patient groups, as well as the measuring of anthropometric parameters [middle upper arm circumference (MUAC), tricipital skinfold thickness (TST)]. All patients also underwent paraclinical evaluations (protein and albumin). The cutoffs criteria for moderate undernutrition were: BMI between −2.0 SD and −3.0 SD, severe undernutrition: BMI <−3.0 SD, moderate obesity: BMI between +2.0 SD and +3.0 SD and severe obesity: BMI >+3.0 SD. Results: We observed that DD genotype (64.7 %) was prevalent in the moderate undernutrition group, while ID (35.3 %) and II genotypes were higher in the subgroup of severe undernutrition, with significant correlations in DD and ID genotype groups between BMI and MUAC, protein and albumin ( p < 0.0001). In the obese group, we observed significant correlations in DD genotype, between BMI and MUAC ( p = 0.0014) and TST, and for II genotype, between BMI and TST ( p = 0.0071). II genotype was associated with severe obesity, while D allele carriers were associated with moderate undernutrition and moderate obesity. Conclusion: BMI, MUAC, TST and serum protein levels are correlated with D allele carriers of ACE genes in children with moderate undernutrition and moderate obesity, whereas II genotype is an unfavorable prognostic factor corresponding to severe obesity and severe undernutrition. [ABSTRACT FROM AUTHOR]

Purpose: To describe the intake of water and all other fluids and to evaluate the proportion of adults exceeding the World Health Organisation (WHO) recommendations on energy intake from free sugar, solely from fluids. Methods: A total of 16,276 adults (46 % men, mean age 39.8 years) were recruited in 13 countries from 3 continents. A 24-h fluid-specific record over 7 days was used for fluid assessment. Results: In Spain, France, Turkey, Iran, Indonesia and China, fluid intake was characterised by a high contribution of water (47-78 %) to total fluid intake (TFI), with a mean water intake between 0.76 and 1.78 L/day, and a mean energy intake from fluids from 182 to 428 kcal/day. Between 11 and 49 % of adults exceeded the free sugar WHO recommendations, considering solely fluids. In Germany, UK, Poland and Japan, the largest contributors to TFI were hot beverages (28-50 %) and water (18-32 %). Mean energy intake from fluids ranged from 415 to 817 kcal/day, and 48-62 % of adults exceeded free sugar WHO recommendations. In Mexico, Brazil and Argentina, the contribution of juices and regular sugar beverages (28-41 %) was as important as the water contribution to TFI (17-39 %). Mean energy intake from fluids ranged 565-694 kcal/day, and 60-66 % of the adults exceeded the free sugar WHO recommendation. Conclusions: The highest volumes recorded in most of the countries were for water, mean energy intake from fluids was up to 694 kcal/day, and 66 % of adults exceeded the free sugar WHO recommendation solely by fluids. Actions to create an environment in favour of water consumption and reduce sugar intake from fluids therefore are warranted. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between dietary glycaemic index (GI) and dietary glycaemic load (GL) with cardiovascular disease (CVD) risk factors in a rural elderly population. Methods: A cross-sectional study was conducted in 343 subjects (60-74 years) residing in a Spanish rural area (Priego de Córdoba). Subjects were selected using stratified random sampling. Food intake was assessed using a validated food frequency questionnaire (FFQ). We assigned GI values to each item of the FFQ to estimate dietary GI and GL. Multivariate linear regression models were fitted to assess the association between GI/GL with CVD risk factors (blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A1, body mass index, waist circumference and blood pressure). The potential modifying effect of sex, smoking status, diabetes and medication has been explored. Results: A statistically significant inverse association between dietary GI and blood glucose was found in the multivariate model ( p = 0.029): for every 10 unit increment of GI, serum glucose levels decreased by 0.2 units. However, statistical significance was lost after controlling for diabetes or hypoglycaemic medication. In the crude model, dietary GL was associated with triglycerides ( ß for every 10 GL units increase = 0.70, p = 0.005), but statistical significance was lost in the multivariate model ( p = 0.508). No associations were found between dietary GI/GL and the rest of the variables studied. Conclusions: Neither dietary GI nor GL were associated with CVD risk factors in the study population of Priego de Córdoba. Results obtained suggest the necessity to consider the diagnosis of diabetes in these studies. [ABSTRACT FROM AUTHOR]

Purpose: An aberrant gut microbiome has been suggested to contribute to the worldwide epidemic of obesity. In animal models, the probiotic Lactobacillus paracasei ssp. paracasei F19 (LF19) induced upregulation of genes involved in energy homoeostasis, reduced body fat and altered the serum (S) lipoprotein profile. In our previous report, feeding LF19 to infants during weaning impacted the global plasma metabolome. LF19 lowered palmitoleic acid, a monounsaturated fatty acid associated with hypertriglyceridemia and increased visceral adiposity. Therefore, we assessed if feeding LF19 from 4 to 13 months of age would have long-term effects on body composition, growth and metabolic markers. Methods: Of 179 children included in our baseline study, 120 entered the follow-up at 8-9 years of age, n = 58 in the probiotic and n = 62 in the placebo group. Body composition was measured using dual energy X-ray absorptiometry. Anthropometrics of the child and accompanying parent(s) were assessed. S-lipids, insulin, glucose and transaminases were determined after overnight fasting. Results: LF19 did not affect body mass index z-score, sagittal abdominal diameter, fat-free mass, fat mass index, truncal fat %, android or gynoid fat % and had no long-term impact on any of the assessed metabolic markers ( p > 0.05). Conclusion: Feeding LF19 during infancy did not modulate body composition, growth or any of the assessed metabolic markers at school age. The steady increase in probiotic products targeting infants and children calls for long-term follow-up of initiated probiotic intervention studies. [ABSTRACT FROM AUTHOR]

Purpose: There is evidence that dietary habits contribute to the presence and severity of non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to explore any associations between consumption of grains and the development and severity of NAFLD. Methods: Seventy-three consecutive NAFLD patients were enrolled. Additionally, 58 controls matched for age, sex and body mass index with 58 patients were also included. Consumption of grains was estimated through a semi-quantitative food frequency questionnaire. Medical history, anthropometric indices, body composition analysis, physical activity data, biochemical and inflammatory markers were available for all the participants. Liver stiffness measurement by transient elastography was performed in 58 and liver biopsy in 34 patients. Results: In patients, consumption of whole grains was associated with lower abdominal fat level ( β = −0.24, p = 0.02) and lower levels of insulin resistance index ( β = −0.28, p = 0.009), while it also correlated inversely with interleukin-6 levels ( ρ = −0.23, p = 0.05). Consumption of whole grains was associated with lower likelihood of having histological steatohepatitis (OR 0.97, 95 % CI 0.94-1.000), after adjusting for sex and energy intake, but the association became weaker after further adjusting for abdominal fat or interleukin-6 levels. In the case-control analysis, consumption of refined grains was associated with higher odds of having NAFLD (OR 1.021, 95 % CI 1.001-1.042), after adjusting for age, sex, energy intake, abdominal fat level, HOMA-IR, LDL, adiponectin and TNF-α. Conclusions: Although refined grain consumption increased the likelihood of having NAFLD, whole-grain consumption favorably affected clinical characteristics of patients with NAFLD and tended to be associated with less severe disease. [ABSTRACT FROM AUTHOR]

Purpose: Adipose tissue is central to the regulation of energy balance. Two functionally different fat pads are present in mammals: white adipose tissue, the primary site of triglyceride storage, and brown adipose tissue (BAT), which is specialized in heat production. In this context, new strategies capable of modulating the development and function of white and BAT become relevant. In the present study, we analyzed the influence of resveratrol (sirtuin activator) on energy balance and the expression of thermogenesis markers. Methods: Mice were divided into two groups: standard diet (ST) and standard diet plus resveratrol (ST + RSV). Results: After 2 months of treatment, ST + RSV mice presented significantly decreased fat accumulation in adipose tissue, with diminished total cholesterol and glucose plasma levels. Additionally, increased oxygen consumption was observed in ST + RSV group. Analyses of mRNA of thermogenesis-related genes showed significant increase in UCP1, SIRT1, PTEN and BMP-7 expression in BAT. Conclusion: Our data suggest that improved metabolism produced by oral administration of resveratrol is, at least in part, associated with increased thermogenesis followed by high expression of UCP1 and SIRT1, which can mediate higher energy expenditure and decreased fat accumulation in adipose tissue. [ABSTRACT FROM AUTHOR]

Purpose: There is limited prospective evidence at population scale of the impacts of lifestyle and surrogate measures of general and abdominal adiposity on the transition of a metabolically healthy (absence of a metabolic disorder) overweight/obese (MHOO) phenotype to a metabolically abnormal overweight/obese (MAOO) phenotype. Therefore, we determined the relationship between 10-year body mass index (BMI), waist circumferences (WC), waist to height ratio (WHtR), and lifestyle changes and the transition of the MHOO phenotype. Methods: We conducted a prospective population-based study of 3,052 male and female Spaniards aged 25-74 years who were followed from 2000 through 2009. Diet and leisure-time physical activity were recorded on validated questionnaires. Weight, height, WC, blood lipids, glycemia, and blood pressure were measured. All variables were obtained at baseline (BL) and follow-up (FL). Participants with a BMI ≥ 25 kg/m and free from hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, and low HDL and high LDL cholesterol levels were characterized as the MHOO phenotype. A composite healthy lifestyle index (HLI) was constructed by including temporary changes in 3 lifestyle variables (diet, leisure-time physical activity, and smoking). Results: Initially, 20.8 % of subjects had the MHOO phenotype; 49.2 % of these shifted to MAOO phenotype. In multivariate analysis, changes in BMI, WC, WHtR were positively associated ( p = 0.004, p = 0.018, and p = 0.016, respectively) with this transition. One unit increase in the HLI was associated with a 33 % lower risk ( p = 0.025) to the MAOO phenotype transition after adjusting for age, sex, educational level, and baseline energy intake, BMI, WC, and WHtR. Conclusions: The presence of metabolic disorders in the MHOO phenotype is predicted by an increase in anthropometric surrogate measures of general and abdominal adiposity. In contrast, a healthy lifestyle protects against a transition to the MAOO phenotype. [ABSTRACT FROM AUTHOR]

Purpose: An increased dietary intake of fat, particularly polyunsaturated fatty acids (PUFAs), has been related to an increased risk of breast, prostate and colon cancers. Patients with and without colon cancer were tested for differences in their fatty stores composition. Methods: The fatty acid levels were determined by gas-liquid chromatography in adipose tissue samples, subcutaneous and visceral, obtained intra-operatively from 52 colon cancer and 50 nonneoplastic abdominal disease patients. Statistical analysis was performed using one-way ANOVA, SNK test and Dunnet test. Differences in the composition of saturated, monounsaturated and polyunsaturated fatty acids, in visceral and in subcutaneous samples of colon cancer and nonneoplastic patients, were assessed. Results: The sum of saturated and monounsaturated fatty acids, respectively, in visceral and in subcutaneous samples, was higher in neoplastic patients ( p < 0.001). The sum of some n-6 polyunsaturated fatty acids (PUFAs), the dietary precursor linoleic acid (LA-18:2n-6), and their metabolites, gammalinolenic acid (GLA-18:3n-6) + dihomogammalinolenic acid (DGLA-20:3n-6) + arachidonic acid (AA-22:4n-6), was higher in subcutaneous fat of controls ( p < 0.05). The samples from these patients had a fatty acid composition, both subcutaneous and visceral, with a higher content of alphalinolenic acid (ALA-18:3n-3) and stearidonic acid (SDA-18:4n-3) compared to neoplastic patients ( p < 0.001). These had subcutaneous and visceral fat stores statistically higher in GLA, DGLA and AA ( p < 0.001). Colon cancer patients had subcutaneous adipose stores higher in ALA and LA than visceral sites ( p < 0.001). Conclusions: Fatty acids may be involved in colon carcinogenesis and there is a depot-specific impact on this process by visceral fat. [ABSTRACT FROM AUTHOR]

Purpose: Small fat droplets infused into the gut reduce food intake and hunger more than bigger ones, at levels as low as 6 g, and these effects are hypothesized to occur via satiety hormones such as cholecystokinin. It is, however, unknown whether the effect of droplet size would persist after oral consumption. It is also unknown whether an even smaller droplet size can affect hunger and food intake and at what minimum amount of fat. Therefore, the aim of the study was to test the effect of very fine fat droplets on satiety and food intake in two different quantities. Methods: In a balanced-order 4-way crossover design, 24 volunteers consumed a fat-free meal replacement drink with either 5 or 9 g oil (rapeseed) and either 3 or 0.1 μm droplet size. Appetite scores and plasma cholecystokinin levels (in n = 12 subset) were measured for 180 min, when food intake was assessed during an ad libitum meal. Data were analyzed by ANCOVA, followed by Dunnett's test and paired t test. The behavior of the emulsions was also characterized in a simulated gastrointestinal model. Results: Despite faster in vitro lipolysis of the smallest droplets, neither droplet size nor fat amount affected satiety or food intake. From t = 45-150 min, cholecystokinin response was 50 % higher ( P < 0.05) after the 0.1 versus 3 μm, but only with 9 g fat. Conclusion: When this particular fat at these amounts is delivered in a meal replacement drink, droplet size does not influence appetite or food intake. This effect is independent of the amount of fat or plasma cholecystokinin changes. [ABSTRACT FROM AUTHOR]

Background/objectives: Individuals with type 1 diabetes have a high risk of developing cardiovascular diseases, and it has been reported that they consume a high atherogenic diet. We examined how nutrient intake and adherence to current European nutritional recommendations evolved in a large cohort of European individuals with type 1 diabetes over a period of 7 years. Subjects/methods: We analysed data from the EURODIAB Prospective Complications Study, a European multicentre prospective cohort study. Standardized 3-day dietary records were employed in individuals with type 1 diabetes. One thousand one hundred and two patients (553 men, 549 women, baseline age 33 ± 10 years, duration 15 ± 9 years) had complete nutritional data available at baseline and after 7 years. We calculated mean differences in reported nutrients over time and adjusted these for age, gender, HbA and BMI with ANOVA models. Results: Compared to baseline, there were minor changes in nutrients. Reported protein (−0.35 % energy (en), fat (−1.07 % en), saturated fat (−0.25 % en) and cholesterol (−7.42 mg/1000 kcal) intakes were lower, whereas carbohydrate (+1.23 % en) and fibre (+0.46 g/1000 kcal) intakes were higher at the 7-year follow-up. European recommendations for adequate nutrient intakes were followed in individuals with type 1 diabetes for protein (76 % at baseline and 78 % at follow-up), moderately for fat (34, 40 %), carbohydrate (34, 41 %) and cholesterol (39, 47 %), but poorly for fibre (1.4, 2.4 %) and saturated fat (11, 13 %). Conclusion: European individuals with type 1 diabetes consume a high atherogenic diet as few patients met recommendations for dietary fibre and saturated fat. This study showed minor changes in dietary nutrients and energy intakes over a period of 7 years. Nutrition education needs particular focus on strategies to increase dietary fibre and reduce saturated fat to exploit their potential benefit. [ABSTRACT FROM AUTHOR]

Purpose: The objective of the study is to assess the goodness of fit for the diagnosis of metabolic syndrome in adults of four models with different measures of adiposity using confirmatory factor analysis, to develop a cardio metabolic risk index and to analyze its relationship to physical activity. Methods: Cross-sectional descriptive multicenter study including 636 patients from the EVIDENT study. Considering as fixed variables, triglycerides/HDL-C ratio, HOMA-IR index and mean arterial pressure, we will compare which single-factor model of metabolic syndrome shows better goodness of fit. The models only differ by the measure of adiposity used: waist circumference, waist circumference/height, body mass index or adiposity index. With the factorial weights obtained, we created a quantitative metabolic index and analyzed its relationship to physical activity, quantified with the accelerometer for 1 week and measured at counts/min. Results: The single-factor model including waist circumference in women and body mass index in men were those that were better indicators of goodness of fit. The estimated quantitative metabolic index shows a mean value in men of −0.022 ± 1.29 with a range of values between −3.36 and 4.57 and in women of 0.0001 ± 1.53 with a range of values between −3.17 and 5.55. The quantitative index shows an inverse relationship to physical activity. Conclusions: Waist circumference in women and body mass index in men are the measures of adiposity that were better indicators goodness of fit. This quantitative index may be useful to quantify the risk of metabolic syndrome in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the second most common cancer among women in the Kilimanjaro Region of Tanzania. It was tested within a case-control study in this region whether a specific dietary pattern impacts on the breast cancer risk. Methods: A validated semi-quantitative Food Frequency Questionnaire was used to assess the dietary intake of 115 female breast cancer patients and 230 healthy age-matched women living in the same districts. A logistic regression was performed to estimate breast cancer risk. Dietary patterns were obtained using principal component analysis with Varimax rotation. Results: The adjusted logistic regression estimated an increased risk for a 'Fatty Diet', characterized by a higher consumption of milk, vegetable oils and fats, butter, lard and red meat (OR = 1.42, 95 % CI 1.08-1.87; P = 0.01), and for a 'Fruity Diet', characterized by a higher consumption of fish, mango, papaya, avocado and watery fruits (OR = 1.61, 95 % CI 1.14-2.28; P = 0.01). Both diets showed an inverse association with the ratio between polyunsaturated and saturated fatty acids (P/S ratio). Conclusion: A diet characterized by a low P/S ratio seems to be more important for the development of breast cancer than total fat intake. [ABSTRACT FROM AUTHOR]

Background: Depression is a very common disorder in elderly, especially in those institutionalized. Nutrition could play an important role in the onset and/or progression of depression, since the intake of carbohydrates with a high glycaemic index (GI) or diets with a high glycaemic load (GL) may increase the insulin-induced brain serotonin secretion. Objective: The aim of our study was to analyse the association between dietary GI and GL and the odds of suffering depression in institutionalized elderly people without antidepressant treatment. Methods: This cross-sectional study included 140 institutionalized elderly people from the Madrid region (Spain) (65-90 years of age) whose diets were recorded using a precise weighing method over seven consecutive days. Energy and nutrient intakes were recorded and the GI and GL calculated. The participants' affective capacity was assessed using the Geriatric Depression Scale (GDS). Subjects were grouped into non-depressed (GDS ≤ 5) and depressed (GDS > 5). Since GDS scores and gender were statistically associated ( p < 0.01), the data were grouped considering this association. Results: Dietary GI (51.09 ± 3.80) and GL (97.54 ± 13.46) were considered as medium. The dietary GL was significantly higher in the non-depressed (100.00 ± 12.13) compared with the depressed group (93.97 ± 14.04, p < 0.01). However, a similar GI was observed between non-depressed (51.50 ± 3.29) and depressed groups (50.52 ± 4.46). Additionally, participants with a dietary GL placed in the second and third tertiles had a 67.4 % and 65.3 %, respectively, less odds of suffering depression than those in the first tertile. GDS scores and dietary GL were inversely related; therefore, an increase in one unit in the dietary GL scale decreased the GDS score by 0.058 units. Conclusions: Glyaemic load is associated with a lower odd of depression. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency anaemia (IDA) is the last stage of iron deficiency, consecutive to an imbalance between iron supply through food intake and iron loss through physiological or pathological processes. As well as by haemoglobin levels, IDA is diagnosed by measuring biomarkers of iron stores. Women are most affected by IDA since their teenage years, as menstruation constitutes a chronic iron loss. Oral supplementation with ferrous sulphate is an effective therapy, but gastrointestinal side effects may impair treatment compliance. Methods: The present multicentric randomised controlled trial was designed to assess the non-inferiority of a ferrous sulphate prolonged release formulation called V0355 with the referential ferrous sulphate Ferrograd in a population of Italian women aged 18-50 years diagnosed for IDA. Three hundred and ninety-nine patients were randomised to receive V0355 (80 mg Fe/day) or Ferrograd (105 mg Fe/day). Results: After 12 weeks of treatment, the difference in the mean haemoglobin level between the two groups was 0.081 g/dL ([−2.986;1.361], p = 0.54), which confirmed the hypothesis of non-inferiority. All the other biochemical parameters (serum iron, serum ferritin, transferrin, and soluble transferrin receptor) and haematological parameters (erythrocytes count, reticulocytes count, haematocrit, and mean corpuscular volume), as well as patient's anaemia-related symptoms, were not different between treatment groups throughout the study. Furthermore, the incidence of gastrointestinal adverse events of moderate and severe intensity was significantly lower ( p = 0.007) in the V0355 group (5.6%) than in the Ferrograd group (13.9%). Conclusion: V0355 was as efficient as Ferrograd in the treatment of anaemia and exhibited a better gastrointestinal tolerance profile. [ABSTRACT FROM AUTHOR]

Purpose: The hypothesis of this clinical study was to determine whether glucocorticoid use and immobility were associated with in-hospital nutritional risk. Methods: One hundred and one patients consecutively admitted to the medical wards were enrolled. Current medical conditions, symptoms, medical history, eating and drinking habits, diagnosis, laboratory findings, medications, and anthropometrics were recorded. The Nutrition Risk Score 2002 (NRS-2002) was used as a screening instrument to identify nutritional risk. Results: The results confirmed that glucocorticoid use and immobility are independently associated with nutritional risk determined by the NRS-2002. Constipation could be determined as an additional cofactor independently associated with nutritional risk. Conclusions: Glucocorticoid treatment, immobility, and constipation are associated with nutritional risk in a mixed hospitalized population. The presence of long-time glucocorticoid use, immobility, or constipation should alert the clinician to check for nutritional status, which is an important factor in mortality and morbidity. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of thiamine administration on metabolic profile, cytokines and inflammatory markers in drug-naïve patients with type 2 diabetes mellitus (T2DM). Methods: A randomized, double-blind, placebo-controlled, pilot-scale clinical trial was carried out in 24 patients with T2DM. Twelve subjects received thiamine orally (150 mg), once daily during a fasting state for 1 month. An additional 12 patients (control group) were given placebo for the same period of time. Before and after the intervention, fasting glucose, A1C, creatinine, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, very low-density lipoprotein, high-sensitive C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin and adiponectin levels were estimated. Wilcoxon's signed-rank and Mann-Whitney U test were used for statistical analyses. Results: There were significant decreases in glucose (6.7 ± 1.0 mmol/l vs. 6.0 ± 1.0 mmol/l, p = 0.024) before and after the intervention, respectively, and leptin concentrations (32.9 ± 13.3 ng/ml vs. 26.9 ± 12.8 ng/ml, p = 0.027) before and after the intervention, respectively, with thiamine administration. There were no changes with the rest of the measurements. Conclusions: Thiamine administration for 1 month decreased glucose and leptin concentrations in drug-naïve patients with T2DM. [ABSTRACT FROM AUTHOR]

Purpose: Folate is an essential micronutrient for fetal development because of its role in de novo synthesis of DNA. The aim of this study was to compare neonatal serum folate levels of babies born to smoking and non-smoking mothers. Methods: Infants of consenting pregnant mothers presenting at ≥37 weeks of gestation were enrolled. Subjects were divided into two groups based on their mother's smoking habits. Blood samples were obtained at birth (from the umbilical cord) and 1 month after delivery for the determination of serum folate levels using a chemiluminescence method. Results: Among 140 consenting subjects, 108 (77%) brought their newborns to their scheduled visit 1 month after delivery, 68 of whom were non-smokers and 40 were smokers. Babies born to smoking mothers had significantly lower serum folate levels compared to those born to non-smoking mothers, both at birth (17.2 ± 5 vs. 24.3 ± 4.9; p < 0.01) and 1 month after delivery (11 ± 4.1 vs. 17.5 ± 4.3; p < 0.01). Conclusion: Our study is the first of its kind to demonstrate that smoking results in significant reductions in serum folate levels of newborns. These results suggest that folic acid supplementation may be required for expectant smoking mothers throughout pregnancy, not just during the first trimester. Similar supplementation may also be warranted for infants born to such mothers. [ABSTRACT FROM AUTHOR]