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The Nutrition Society Spring Conference 2018, held in Glasgow, brought together experts focusing on the interaction between different nutrients and how this impacts absorption, metabolism and health from biochemical and physiological perspectives. This cross-cutting theme was examined from a range of perspectives, bringing together experts on topics ranging from food processing to the impact of inflammation on nutrient status. Two plenary lectures provided a food landscape and lifecourse background to the proceedings, with on the first day a focus on processed/ultra-processed foods and their nutrient composition and, on the second day, a plenary lecture exploring the role that nutrient–nutrient interactions within the maternal diet have for the lifelong health of the offspring. The meeting was framed around three symposia, examining the competition and bioavailability of dietary components, nutrient–nutrient interactions and their role in protection from chronic diseases and the mechanisms of nutrient–nutrient interactions. The meeting ended with a round table, and an overall conclusion highlighting the opportunities to derive further understanding of the short- and long-term implications of diets through the study of nutrient–nutrient interactions.

A systematic review of published evidence on micronutrient intake/status with carbohydrate‐restricted diets (CRD) was conducted in Web of Science, Medline, Embase, Scopus, CENTRAL, and ClinicalTrials.gov up to October 2018. We identified 10 studies: seven randomized controlled trials (RCTs) (“Atkins”‐style, n = 5; “Paleolithic” diets, n = 2), two Atkins‐style noncontrolled trials and one cross‐sectional study. Prescribed carbohydrate varied 4% to 34% of energy intake. Only one noncontrolled trial prescribed multivitamin supplements. Dietary intakes/status were reported over 2 to 104 weeks, with weight losses from 2 to 9 kg. No diagnoses of deficiency were reported. Intakes of thiamine, folate, magnesium, calcium, iron, and iodine all decreased significantly (−10% to −70% from baseline) with any CRD types. Atkins diet trials (n = 6; 4%‐34%E carbohydrate) showed inconsistent changes in vitamin A, E, and β‐carotene intakes, while a single “Paleolithic” diet trial (28%E carbohydrate) reported increases in these micronutrients. One other “Paleolithic” diet (30%E carbohydrate) reported a rise in moderate iodine deficiency from 15% to 73% after 6 months. In conclusion, few studies have assessed the impacts of CRD on micronutrients. Studies with different designs point towards reductions in several vitamins and minerals, with potential risk of micronutrient inadequacies. Trial reporting standards are expected to include analysis of micronutrient intake/status. Micronutrients in foods and/or supplements should be considered when designing, prescribing or following CRDs.

Resumen del trabajo presentado al 13th Congress of the International Society of Nutrigenetics/Nutrigenomics (ISNN), celebrado en Cambridge (UK) del 12 al 13 de julio de 2019., [Introduction]: The role of flavanols in terms of gene regulation in various cell models relevant to cardiometabolic disease has never been systematically addressed. Therefore, we conducted a systematic literature search and comprehensive bioinformatic analysis of the genes which expression has been reported as affected by flavanols in the cells defining the cardiometabolic health (hepatocytes, adipocytes, endothelial, smooth muscle and immune cells), to decipher molecular mechanisms of action underlying their cardiometabolic health properties. [Methods]: Literature search was performed in PubMed and Web of Science using pre-defined criteria (pure compounds and metabolites, no extracts, physiologically relevant concentrations). Identified differentially expressed genes were analyzed by several bioinformatic tools including: MetaCore, GeneTrail2 (for access to KEGG and BioCarta databases), Metascape and OmicsNet. [Results]: Analysis of extracted data from the literature identified 54 differentially expressed genes at mRNA level. Gene network analysis revealed that these genes are involved in inflammation, immune response, cell adhesion, apoptosis and cell signaling. Deeper analysis of their functional roles revealed the pathways such as TNF signaling pathway, NF-kappa B signaling pathway, Leukocyte transendothelial migration and Cell adhesion molecules. Studied cell types respond differently on the flavanol exposure, but inflammatory response is a common mechanism. Transcriptional factors, such as PPARG, NFKB1, CREB1 or STAT3, and miRNAs such as mir-335-5p, mir-16-5p, mir-124-3p or mir-26b-5p have been identified as regulators of gene expression by flavanols. [Conclusions]: The results of this systematic analysis of nutrigenomic effects of flavanols will support the future setup of nutrigenetic studies to pave the way for individualized dietary recommendations.

Background: \ud Non-alcoholic fatty liver disease (NAFLD) is a serious health problem affecting ~25% of the global population. While NAFLD pathogenesis is still unclear, multiple NAFLD parameters, including reduced insulin sensitivity, impaired glucose metabolism and increased oxidative stress are hypothesised to foster the formation of advance glycation end-products (AGEs). Given the link of AGEs with end organ damage, there is scope to examine the role of the AGE/RAGE axis activation in liver injury and NAFLD.\ud \ud Methods:\ud Age, sex and body mass index matched normo-glycemic NAFLD adults (n = 58) and healthy controls (n = 58) were enrolled in the study. AGEs were analysed by liquid chromatography-mass spectrometry (CML, CEL), fluorescence (pentosidine, AGE fluorescence), colorimetry (fructosamine) and ELISA (sRAGE). Their association with liver function, inflammation, fibrosis and stage of NAFLD was examined.\ud \ud Results: \ud Early and advanced glycation end-products, except Nε-carboxymethyl-L-lysine (CML), were 10–30% higher, sRAGE levels 1.7-fold lower, and glycation/sRAGE ratios 4-fold higher in the NAFLD cases compared to controls. While AGEs presented weak to moderate correlations with indices of liver function and damage (AST/ALT, HOMA-IR, TNF-α and TGF-β1), including sRAGE to characterize the AGEs/sRAGE axis strengthened the associations observed. High glycation/sRAGE ratios were associated with 1.3 to 14-fold likelihood of lower AST/ALT ratios. The sum of AGEs/sRAGE ratios accurately distinguished between healthy controls and NAFLD patients (area under the curve of 0.85). Elevated AGEs/sRAGE (>7.8 mmol/pmol) was associated with a 12-fold likelihood of the presence of NAFLD.\ud \ud Conclusion:\ud These findings strengthen the involvement of AGEs-RAGE axis in liver injury and the pathogenesis of NAFLD.

Iodine is essential for thyroid hormones synthesis and normal neurodevelopment; however, ~60% of pregnant women do not meet the WHO (World Health Organization) recommended intake. Using a qualitative design, we explored the perceptions, awareness, and experiences of pregnancy nutrition, focusing on iodine. Women in the perinatal period (n = 48) were interviewed and filled in a food frequency questionnaire for iodine. Almost all participants achieved the recommended 150 μg/day intake for non-pregnant adults (99%), but only 81% met the increased demands of pregnancy (250 μg/day). Most were unaware of the importance, sources of iodine, and recommendations for iodine intake. Attitudes toward dairy products consumption were positive (e.g., helps with heartburn; easy to increase). Increased fish consumption was considered less achievable, with barriers around taste, smell, heartburn, and morning sickness. Community midwives were the main recognised provider of dietary advice. The dietary advice received focused most often on multivitamin supplements rather than food sources. Analysis highlighted a clear theme of commitment to change behaviour, motivated by pregnancy, with a desired focus on user-friendly documentation and continued involvement of the health services. The study highlights the importance of redirecting advice on dietary requirements in pregnancy and offers practical suggestions from women in the perinatal period as the main stakeholder group.

Understanding interindividual variability in response to dietary polyphenols remains essential to elucidate their effects on cardiometabolic disease development. A meta-analysis of 128 randomized clinical trials was conducted to investigate the effects of berries and red grapes/wine as sources of anthocyanins and of nuts and pomegranate as sources of ellagitannins on a range of cardiometabolic risk biomarkers. The potential influence of various demographic and lifestyle factors on the variability in the response to these products were explored. Both anthocyanin- and ellagitannin-containing products reduced total-cholesterol with nuts and berries yielding more significant effects than pomegranate and grapes. Blood pressure was significantly reduced by the two main sources of anthocyanins, berries and red grapes/wine, whereas waist circumference, LDL-cholesterol, triglycerides, and glucose were most significantly lowered by the ellagitannin-products, particularly nuts. Additionally, we found an indication of a small increase in HDL-cholesterol most significant with nuts and, in flow-mediated dilation by nuts and berries. Most of these effects were detected in obese/overweight people but we found limited or non-evidence in normoweight individuals or of the influence of sex or smoking status. The effects of other factors, i.e., habitual diet, health status or country where the study was conducted, were inconsistent and require further investigation. published

Understanding interindividual variability in response to dietary polyphenols remains essential to elucidate their effects on cardiometabolic disease development. A meta-analysis of 128 randomized clinical trials was conducted to investigate the effects of berries and red grapes/wine as sources of anthocyanins and of nuts and pomegranate as sources of ellagitannins on a range of cardiometabolic risk biomarkers. The potential influence of various demographic and lifestyle factors on the variability in the response to these products were explored. Both anthocyanin- and ellagitannin-containing products reduced total-cholesterol with nuts and berries yielding more significant effects than pomegranate and grapes. Blood pressure was significantly reduced by the two main sources of anthocyanins, berries and red grapes/wine, whereas waist circumference, LDL-cholesterol, triglycerides, and glucose weremost significantly lowered by the ellagitannin-products, particularly nuts. Additionally, we found an indication of a small increase in HDL-cholesterol most significant with nuts and, in flow-mediated dilation by nuts and berries. Most of these effects were detected in obese/overweight people but we found limited or non-evidence in normoweight individuals or of the influence of sex or smoking status. The effects of other factors, i.e., habitual diet, health status or country where the study was conducted, were inconsistent and require further investigation.

Several randomized controlled trials (RCTs) and meta-analyses support the benefits of flavanols on cardiometabolic health, but the factors affecting variability in the responses to these compounds have not been properly assessed. The objectives of this meta-analysis were to systematically collect the RCTs-based-evidence of the effects of flavanol-containing tea, cocoa and apple products on selected biomarkers of cardiometabolic risk and to explore the influence of various factors on the variability in the responses to the consumption of these products. A total of 120 RCTs were selected. Despite a high heterogeneity, the intake of the flavanol-containing products was associated using a random model with changes (reported as standardized difference in means (SDM)) in body mass index (−0.15, p < 0.001), waist circumference (−0.29, p < 0.001), total-cholesterol (−0.21, p < 0.001), LDL-cholesterol (−0.23, p < 0.001), and triacylglycerides (−0.11, p = 0.027), and with an increase of HDL-cholesterol (0.15, p = 0.005). Through subgroup analyses, we showed the influence of baseline-BMI, sex, source/form of administration, medication and country of investigation on some of the outcome measures and suggest that flavanols may be more effective in specific subgroups such as those with a BMI ≥ 25.0 kg/m2, non-medicated individuals or by specifically using tea products. This meta-analysis provides the first robust evidence of the effects induced by the consumption of flavanol-containing tea, cocoa and apple products on weight and lipid biomarkers and shows the influence of various factors that can affect their bioefficacy in humans. Of note, some of these effects are quantitatively comparable to those produced by drugs, life-style changes or other natural products. Further, RCTs in well-characterized populations are required to fully comprehend the factors affecting inter-individual responses to flavanol and thereby improve flavanols efficacy in the prevention of cardiometabolic disorders.

Several randomized controlled trials (RCTs) and meta-analyses support the benefits of flavanols on cardiometabolic health, but the factors affecting variability in the responses to these compounds have not been properly assessed. The objectives of this meta-analysis were to systematically collect the RCTs-based-evidence of the effects of flavanol-containing tea, cocoa and apple products on selected biomarkers of cardiometabolic risk and to explore the influence of various factors on the variability in the responses to the consumption of these products. A total of 120 RCTs were selected. Despite a high heterogeneity, the intake of the flavanol-containing products was associated using a random model with changes (reported as standardized difference in means (SDM)) in body mass index (−0.15, p < 0.001), waist circumference (−0.29, p < 0.001), total-cholesterol (−0.21, p < 0.001), LDL-cholesterol (−0.23, p < 0.001), and triacylglycerides (−0.11, p = 0.027), and with an increase of HDL-cholesterol (0.15, p = 0.005). Through subgroup analyses, we showed the influence of baseline-BMI, sex, source/form of administration, medication and country of investigation on some of the outcome measures and suggest that flavanols may be more effective in specific subgroups such as those with a BMI ≥ 25.0 kg/m2, non-medicated individuals or by specifically using tea products. This meta-analysis provides the first robust evidence of the effects induced by the consumption of flavanol-containing tea, cocoa and apple products on weight and lipid biomarkers and shows the influence of various factors that can affect their bioefficacy in humans. Of note, some of these effects are quantitatively comparable to those produced by drugs, life-style changes or other natural products. Further, RCTs in well-characterized populations are required to fully comprehend the factors affecting inter-individual responses to flavanol and thereby improve flavanols efficacy in the prevention of cardiometabolic disorders info:eu-repo/semantics/publishedVersion

Cardiovascular diseases (CVD) continue to be the leading cause of morbidity and mortality in most developed countries [1]. Several epidemiological studies have linked flavonols with decreased risk of stroke [2] and CVD [3], whilst human intervention studies have shown improvements in several biomarkers of CVD risk after flavonol consumption [4]. However, some heterogeneity in the individual physiological responses to the consumption of these compounds has been identified. For example, age and stage of hypertension seem to be important factors influencing the blood pressure lowering effect of quercetin [5, 6]. This meta-analysis aims to analyse the effect of flavanol intake on blood lipids, one of the major biomarkers of CVD risk, and factors affecting the inter-individual variability. A systematic search was conducted in PubMed, Web of Science, Scopus and trial registry platforms. Only human randomized controlled trials with measured cardiometabolic outcomes were selected for data extraction of the measured outcomes, individual factors of the participants, characteristics of the study, and study quality. From 671 screened references, 19 studies were selected for data extraction and 16 studies were used for meta-analysis on total cholesterol, LDL, HDL and triacylglycerides (TAG). Inter-individual variability was assessed by subgroup analysis on BMI, age, sex, country and health status. Estimated intervention/control standardized mean differences suggested that consumption of flavonols was associated with significant reductions in total cholesterol (-0.180 mmol/L, 95% CI -0.307, -0.053), LDL (-0.219 mmol/L, 95% CI -0.350, -0.088) and TAG (-0.280 mmol/L, 95% CI -0.408, -0.151) and a significant increase in HDL (0.235 mmol/L, 95% CI 0.104, 0.365). Subgroup analysis showed a more pronounced effect in Asian countries and in participants with normal baseline lipid levels, compared to borderline and high baseline values. Results suggest that ethnicity and health status may influence the effect of flavonol intake on blood lipid levels.

Coffee is consumed by billions of people worldwide and a key source of chlorogenic acids (CGA) in the diet, with 500 mg of CGA attainable daily(1). During roasting, CGA are degraded or incorporated into melanoidins, with roasted instant coffees the most affected(2).Therefore, we evaluated the CGA content in dark roasted instant coffees (DRIC), and the (poly)phenols non-covalently linked to melanoidins after in vitro gastrointestinal digestion. DRIC, selected from local supermarkets (n=20), were brewed (1.8g) in 200mL water (100°C), ultra-filtrated (10kDa cutoff filter), digested in vitro (3) and re-ultrafiltrated. The four fractions; brewed coffee (BC), ultra-filtrated coffee (FC), digested melanoidins (DM), and digested ultra-filtrated melanoidins (DFM), were analysed by UPLC- ExactiveTM Orbitrap MS. CGA content (based on 3-, 4- and 5-O-caffeoylquinic acid, 4-, and 5-O-feruloyquinic acid) in BC ranged from 7.2 to 39.5 (19.98±9.01) mg/g, and was not different from FC (17.61±10.64 mg/g). In vitro digestion frees (poly)phenols non-covalently linked, as such (poly)phenols were not detected in melanoidins (DM and DFM), indicating that CGA might be covalently linked to melanoidins and not bioavailable. The high ratio caffeine/CGA (2.62±1.09) confirmed that the beans were subjected to dark roasting conditions which may have led to CGA incorporation into melanoidins., Journal of International Society of Antioxidants in Nutrition & Health, Vol 3, No 4 (2016)