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OBJECTIVES: To assess whether the long-term separate ingestions of an encapsulated juice powder concentrate and a plant-based omega fatty acid supplement, or a combined ingestion of the two, can affect biomarkers of cardiovascular health, low-grade inflammation and indicators of aging in the elderly. METHODS: This is a randomised, controlled, open-labelled, parallel-grouped clinical trial, consisting of 4 arms. One hundred and twelve, overweight and obese (BMI 25–35 kg/m(2)) subjects, aged 60 to 80 years will be recruited and randomly allocated to: i) control group; ii) Fruit, Vegetable and Berry (FVB) group, where participants have to ingest a fruit, vegetable and berry supplement (Juice Plus+® capsules); iii) Omega group, where participants have to ingest a plant-based fatty acid supplement (Juice Plus+® Omega Blend); and iv) Fruit, Vegetable, Berry and Omega (FVBO) group, where participants have to ingest the fruit, vegetable and berry supplement, together with the plant-based fatty acid supplement. Participants in all groups will continue their habitual diet and lifestyle. Those allocated to one of the three intervention groups, will be asked to ingest the supplements for a total duration of two years. Participants will be assessed at baseline and at follow-up visits at 6, 12, 18 and 24 months. Primary outcomes include markers of cardiovascular health and low-grade inflammation. Secondary outcomes include selected indicators of aging, cognitive function, immunity and quality of life. Finally, plasma levels of vitamins, carotenoids and fatty acids will also be assessed. RESULTS: N/A CONCLUSIONS: This study will provide evidence whether long-term, plant-based dietary supplementation can support cardiovascular health, anti-inflammatory processes, immunity and nutritional status in aging. FUNDING SOURCES: The Juice Plus + Science Institute received funding by The Juice Plus+® Company for this project.

Background Guidelines recommend reducing saturated fat (SFA) intake to decrease cardiovascular disease (CVD) risk, but there is limited evidence on scalable and effective approaches to change dietary intake, given the large proportion of the population exceeding SFA recommendations. We aimed to develop a system to provide monthly personalized feedback and healthier swaps based on nutritional analysis of loyalty card data from the largest United Kingdom grocery store together with brief advice and support from a healthcare professional (HCP) in the primary care practice. Following a hybrid effectiveness-feasibility design, we tested the effects of the intervention on SFA intake and low-density lipoprotein (LDL) cholesterol as well as the feasibility and acceptability of providing nutritional advice using loyalty card data. Methods and findings The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study is a parallel randomized controlled trial with a 3 month follow-up conducted between 21 March 2018 to 16 January2019. Adults ≥18 years with LDL cholesterol >3 mmol/L (n = 113) were recruited from general practitioner (GP) practices in Oxfordshire and randomly allocated to “Brief Support” (BS, n = 48), “Brief Support + Shopping Feedback” (SF, n = 48) or “Control” (n = 17). BS consisted of a 10-minute consultation with an HCP to motivate participants to reduce their SFA intake. Shopping feedback comprised a personalized report on the SFA content of grocery purchases and suggestions for lower SFA swaps. The primary outcome was the between-group difference in change in SFA intake (% total energy intake) at 3 months adjusted for baseline SFA and GP practice using intention-to-treat analysis. Secondary outcomes included %SFA in purchases, LDL cholesterol, and feasibility outcomes. The trial was powered to detect an absolute reduction in SFA of 3% (SD3). Neither participants nor the study team were blinded to group allocation. A total of 106 (94%) participants completed the study: 68% women, 95% white ethnicity, average age 62.4 years (SD 10.8), body mass index (BMI) 27.1 kg/m2 (SD 4.7). There were small decreases in SFA intake at 3 months: control = −0.1% (95% CI −1.8 to 1.7), BS = −0.7% (95% CI −1.8 to 0.3), SF = −0.9% (95% CI −2.0 to 0.2); but no evidence of a significant effect of either intervention compared with control (difference adjusted for GP practice and baseline: BS versus control = −0.33% [95% CI −2.11 to 1.44], p = 0.709; SF versus control = −0.11% [95% CI −1.92 to 1.69], p = 0.901). There were similar trends in %SFA based on supermarket purchases: control = −0.5% (95% CI −2.3 to 1.2), BS = −1.3% (95% CI −2.3 to −0.3), SF = −1.5% (95% CI −2.5 to −0.5) from baseline to follow-up, but these were not significantly different: BS versus control p = 0.379; SF versus control p = 0.411. There were small reductions in LDL from baseline to follow-up (control = −0.14 mmol/L [95% CI −0.48, 0.19), BS: −0.39 mmol/L [95% CI −0.59, −0.19], SF: −0.14 mmol/L [95% CI −0.34, 0.07]), but these were not significantly different: BS versus control p = 0.338; SF versus control p = 0.790. Limitations of this study include the small sample of participants recruited, which limits the power to detect smaller differences, and the low response rate (3%), which may limit the generalisability of these findings. Conclusions In this study, we have shown it is feasible to deliver brief advice in primary care to encourage reductions in SFA intake and to provide personalized advice to encourage healthier choices using supermarket loyalty card data. There was no evidence of large reductions in SFA, but we are unable to exclude more modest benefits. The feasibility, acceptability, and scalability of these interventions suggest they have potential to encourage small changes in diet, which could be beneficial at the population level. Trial registration ISRCTN14279335., Author summary Why was this study done? Cardiovascular disease (CVD) is the leading cause of death in the UK and is strongly influenced by diet composition. Reducing the intake of saturated fat (e.g., fats from animal sources such as butter or meat), mostly by swapping some key foods in the diet for others that are lower in saturated fat (SFA), can help reduce the “bad” low-density lipoprotein cholesterol (LDL-C) in the blood, and reduce the risk of CVD. Previous studies have achieved success either by providing particular foods to people or by giving them intensive support and advice from nutrition specialists. Currently, there are no practical interventions shown to help large numbers of people improve their diet to reduce the amount of saturated fat they eat. What did the researchers do and find? In this study, we developed a system to provide regular information on the saturated fat content of food purchases and suggest healthier swaps using loyalty card data from the UK largest grocery store. Participants received brief oral and written advice from a healthcare professional (HCP) at their general practitioner (GP) practice alone or in combination with personalized feedback on their food shopping. Our primary aim was to test whether this approach was effective to decrease saturated fat intake compared with usual care, which does not involve any specific advice. We also compared changes in LDL-C and the quality of the grocery shopping. We recruited adults who had a blood test showing they had raised LDL-C from GP practices in Oxfordshire (UK), and we followed them for an average of 3.8 months. We found small decreases in SFA intake as well as the SFA content of food purchases and reductions in LDL-C, but these changes were not significantly different from those observed in the control group. Participants reported positive feedback regarding the brief advice and the personalized feedback on their food shopping, which they received monthly throughout the study. What do these findings mean? Previous studies have shown that self-monitoring and feedback are effective strategies to help people change their behavior. In this study, we were able to use data from supermarket loyalty cards to provide regular feedback and healthier swaps to help people improve the quality of their grocery shopping. Participants valued and used this information together with the brief advice received from primary care practitioners to reduce their saturated fat intake. The trial was designed to detect a clinically significant difference in SFA intake between groups of 3%, and the intervention did not achieve such large effects. However, modeling studies suggest that just replacing 1% of saturated fat with polyunsaturated fat can potentially lead to an 8% reduction in CVD events. With future development and testing, this may be an intervention that could be offered by supermarkets to achieve small improvements in diet with population-level health benefits.

Nutrition is emerging as a key factor in promoting healthy lifestyles in the growing elderly population across Europe. In this study, we examined the non-animal-derived food source consumption among the elderly European population to evaluate the actual contributions of these foods to the diet of the elders. We gathered 21 studies conducted in 17 European countries to evaluate the fruit, vegetable, and legume (along with their derived products) consumption among the elderly (&gt, 65 years) population. Foods&rsquo, nutritional values were calculated and compared to the recommended intakes. A Bayesian multilevel hierarchical analysis was conducted to estimate the caloric intake of food categories and to compare the elderly and general adult populations. Although the lowest consumption was generally associated with the lowest nutrient and fiber intake, the reverse was not always the case. Concerning the general adult population, no differences in the related caloric intake of elders were noticed. Differences were instead evident when foods were divided into subclasses. Elderly populations consume fruit and fruit products, but they drink less fruit and vegetable juices and nectars. In conclusion, elderlies&rsquo, fruit and vegetable consumption showed a peculiar pattern with respect to the general adult population, whose recognition could be helpful to address tailored policies. Constantly updated studies, including all the lifespan ages, are warranted to design tailored effective public health interventions.

The major aim of this controlled, randomised, open-labelled, parallel-grouped, clinical trial was to investigate whether supplementation with different dosages of omega-3 fatty acids (0.5 g/d and 1 g/d) from a plant-based fatty acid supplement affected omega-3-indices (O3I) in well-nourished, healthy people. In addition, the combined ingestion of the plant-based fatty acid supplement, together with an encapsulated fruit, vegetable and berry (FVB) juice powder concentrate, was applied in order to observe the absorption of certain micronutrients and to examine some aspects related to the safe consumption of the products. The data demonstrate that the intake of only 0.5 g/day of omega-3 fatty acids from of a vegan supplement was able to increase the O3I significantly after 8 and 16 weeks. The combined ingestion with the FVB supplement concurrently increased serum concentrations of specific vitamins and carotenoids without effects on hepatic, kidney and thyroid function or changes in blood lipids.

Evidence supports an inverse association between nut consumption and cardiovascular disease (CVD) risk and (poly)phenols have been identified as potential co-mediators of these beneficial effects. This study investigated the acute absorption and the bioavailability of (poly)phenols of a hazelnut skin drink in healthy subjects and assessed its acute impact on vascular/endothelial function. A single-blind, non-randomised unilateral cross-over trial involved 41 healthy adults. Blood and urine were collected resulting in the detection of ten plasma and twenty-four urine metabolites. Bioavailability was estimated about 27%. The acute ingestion of the test drink did not show any statistically significant changes to vascular/endothelial function, although a trend was observed with high-producers of certain secondary metabolites. These results indicate that the hazelnut skin drink contains an important fraction of bioavailable bioactive compounds. However, no significant acute effects of the test drink on vascular/endothelial function were observed. The study has been registered on http://www.isrctn.com .

Abstract. Vitamins and carotenoids are organic compounds that are important for vital functions of the human organism. Since the human body is not able to synthesize most of these micronutrients, they need to be supplied by the intake of food or supplements. The aim of this study was to analyze whether a whole food based, encapsulated fruit, berry, and vegetable juice powder concentrate provides bioavailable carotenoids and vitamins A (all-trans retinol), E and C. Eighteen healthy subjects received 6 capsules a day for 8 weeks, which provided 2.91 mg β-carotene, 490 μg vitamin A, 18.7 mg vitamin E, 159 mg vitamin C, 6.1 mg lutein and 1 mg lycopene. Plasma concentrations of several carotenoids and vitamins before and after supplementation were measured. After 8 weeks of supplementation, the plasma concentration of the following carotenoids increased significantly: α-carotene increased from 59.6 ± 22.4 nmol/L to 85.7 ± 24.2 nmol/L (p = 0.002), β-cryptoxanthin from 106.7 ± 39.8 nmol/L to 151.9 ± 57.9 nmol/L (p = 0.017), and lycopene from 1.2 ± 0.5 μmol/L to 1.7 ± 0.5 μmol/L (p = 0.005). Significant increases were also observed for plasma concentrations of vitamin C from 70 ± 20 μmol/L to 90 ± 10 μmol/L (p

Cardiovascular disease has a multifactorial aetiology with a number of both modifiable and non-modifiable risk factors. Although evidence indicates that dietary intake plays an important role, few studies have focused on the effect of fruit and vegetable consumption on early markers of vascular function. Therefore, we hypothesised that supplementation with capsules containing a combination of fruit and vegetable extracts over 12 weeks can significantly modulate biomarkers of vascular function compared with a control group receiving placebo. This is a double-blind, randomised controlled trial that includes overweight and obese but otherwise healthy participants. Participants are randomly allocated to one of two groups: active supplementation (encapsulated fruit and vegetable powder) or placebo taken twice daily for 12 weeks, whereas both groups will be given the ‘5-A-Day’ dietary advice. The primary outcome is to measure changes to the carotid intima media thickness (cIMT) between the two groups from baseline (test visit 1) to 12 weeks later (test visit 2). The secondary outcomes include macro- and microvascular changes and changes to blood markers. In addition to the primary and secondary objectives, this explanatory trial incorporates potential novel biomarkers such as trimethylamine-N-oxide (TMAO) and lipopolysaccharide (LPS). ISRCTN14315618 . Registration date 27 February 2014.

Background & aims: \ud Unrecognized nutritional issues may delay recovery in hospitalized infants. It has been proposed that nutritional risk screening should be performed at hospital admission, but few tools include infants. The aim of this study was to develop and test a tool to identify sick infants in need of dietetic input.\ud \ud Methods: \ud Hospitalised infants were recruited from hospitals in the United Kingdom (UK), Greece and Iran. Weight, skinfold thickness and mid upper arm circumference (MUAC) were measured, with detailed dietetic assessment in the UK and Greece. Simple screening questions were used in the UK cohort to formulate a score (infant early nutrition warning score-iNEWS) which was then validated in the Greek and Iranian groups.\ud \ud Results: \ud After dietetic assessment, 20 (9.6%) UK and 22 (22%) Greek infants were rated as needing dietetic input. Underweight, poor weight gain/loss and reduced intake were all independent predictors of perceived need for dietetic input in stepwise multivariate regression analysis. The score based on these items (iNEWS), had 84% sensitivity, 91% specificity and 49% positive predictive value to predict need for dietetic input in the UK cohort. In the Greek cohort this was 86%, 78% and 53% respectively. In all three countries, infants with high iNEWS had significantly lower average skinfold thickness (between −1 and −1.8 SD, p < 0.0001) and MUAC (between −1.8 and −2 SD, p < 0.0001) than those at low risk.\ud \ud Conclusions: \ud iNEWS, a simple nutritional risk tool, identifies most hospitalised infants who need dietetic input.\ud \ud Clinical trial registration: \ud https://clinicaltrials.gov/ct2/show/NCT03323957.

Background Interventions to reduce the saturated fat (SFA) content of food purchases may help reduce SFA consumption and lower cardiovascular risk. This factorial RCT aimed to examine the effect of altering the default order of foods and being offered a swap on the SFA content of food selected during an online shopping experiment. Methods UK adults who were the primary grocery shoppers for their household were recruited online and invited to select items in a custom-made experimental online supermarket using a 10-item shopping list. Participants were randomly allocated to one of four groups (i) to see products within a category ranked in ascending order of SFA content, (ii) receive an offer to swap to a product with less SFA, (iii) a combination of both interventions, or (iv) no intervention. The primary outcome was the difference in percentage energy from SFA in the shopping basket between any of the four groups. The outcome assessors and statistician were blinded to intervention allocation. Results Between March and July 2018, 1240 participants were evenly randomised and 1088 who completed the task were analysed (88%). Participants were 65% female and aged 38y (SD 12). Compared with no intervention (n = 275) where the percentage energy from SFA was 25.7% (SD 5.6%), altering the order of foods (n = 261) reduced SFA by [mean difference (95%CI)] -5.0% (− 6.3 to − 3.6) and offering swaps (n = 279) by − 2.0% (− 3.3 to − 0.6). The combined intervention (n = 273) was significantly more effective than swaps alone (− 3.4% (− 4.7 to − 2.1)) but not different than altering the order alone (− 0.4% (− 1.8 to 0.9)), p = 0.04 for interaction. Conclusions Altering the default order to show foods in ascending order of SFA and offering a swap with lower SFA reduced percentage energy from SFA in an experimental online supermarket. Environmental-level interventions, such as altering the default order, may be a more promising way to improve food purchasing than individual-level ones, such as offering swaps. Trial registration ISRCTN13729526 https://doi.org/10.1186/ISRCTN13729526 26th February 2018.

Introduction A diet high in saturated fat (SFA) increases the risk of cardiovascular disease (CVD) and intakes in the UK exceed dietary recommendations. The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study aims to test the effect of an intervention for people with raised low-density lipoprotein (LDL) cholesterol involving health professional (HP) advice alone, or in combination with personalised feedback based on nutritional analysis of grocery store loyalty card data, on SFA intake and blood lipids in comparison with no intervention. Methods and analysis PC-SHOP is a three-arm parallel randomised controlled trial with an allocation ratio of 1:3:3 (‘no intervention’: n=16, ‘brief support’: n=48, ‘brief support plus shopping feedback’: n=48, respectively). Participants with raised LDL will be recruited from general practitioner (GP) practices for a 3-month intervention period. In brief support, an HP will deliver a behaviourally informed 10 min consultation and provide a written self-help guide to inform and motivate people to reduce their SFA intake. In brief support plus shopping feedback, the participants will receive the same HP-led behavioural support and, based on data from their grocery store loyalty card, personalised feedback on the SFA content of their grocery shopping, identifying high SFA purchases and suggesting swaps to similar but lower SFA items. Measurements for the primary and secondary outcomes will be collected at baseline and at follow-up (3 months). The primary outcome measure will be the between-group difference in the reduction of SFA intake between baseline and follow-up. Secondary outcomes include changes in blood lipids and SFA content of food purchases, with process measures to consider the feasibility and acceptability of the intervention. Ethics and dissemination This study has been reviewed and approved by the National Health Service Health Research Authority Research Ethics Committee (Ref: 17/SC/0168). The trial findings will be disseminated to academic and HPs through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results will be communicated to relevant stakeholders, including policymakers and retailers. Trial registration number NCT14279335; Pre-results.

BACKGROUND: Evidence exist that primary care referral to an open-group behavioural programme is an effective strategy for management of obesity, but little evidence on optimal intervention duration is available. We aimed to establish whether 52-week referral to an open-group weight-management programme would achieve greater weight loss and improvements in a range of health outcomes and be more cost-effective than the current practice of 12-week referrals. METHODS: In this non-blinded, parallel-group, randomised controlled trial, we recruited participants who were aged 18 years or older and had body-mass index (BMI) of 28 kg/m(2) or higher from 23 primary care practices in England. Participants were randomly assigned (2:5:5) to brief advice and self-help materials, a weight-management programme (Weight Watchers) for 12 weeks, or the same weight-management programme for 52 weeks. We followed-up participants over 2 years. The primary outcome was weight at 1 year of follow-up, analysed with mixed-effects models according to intention-to-treat principles and adjusted for centre and baseline weight. In a hierarchical closed-testing procedure, we compared combined behavioural programme arms with brief intervention, then compared the 12-week programme and 52-week programme. We did a within-trial cost-effectiveness analysis using person-level data and modelled outcomes over a 25-year time horizon using microsimulation. This study is registered with Current Controlled Trials, number ISRCTN82857232. FINDINGS: Between Oct 18, 2012, and Feb 10, 2014, we enrolled 1269 participants. 1267 eligible participants were randomly assigned to the brief intervention (n=211), the 12-week programme (n=528), and the 52-week programme (n=528). Two participants in the 12-week programme had been found to be ineligible shortly after randomisation and were excluded from the analysis. 823 (65%) of 1267 participants completed an assessment at 1 year and 856 (68%) participants at 2 years. All eligible participants were included in the analyses. At 1 year, mean weight changes in the groups were -3·26 kg (brief intervention), -4·75 kg (12-week programme), and -6·76 kg (52-week programme). Participants in the behavioural programme lost more weight than those in the brief intervention (adjusted difference -2·71 kg, 95% CI -3·86 to -1·55; pINTERPRETATION: For adults with overweight or obesity, referral to this open-group behavioural weight-loss programme for at least 12 weeks is more effective than brief advice and self-help materials. A 52-week programme produces greater weight loss and other clinical benefits than a 12-week programme and, although it costs more, modelling suggests that the 52-week programme is cost-effective in the longer term. FUNDING: National Prevention Research Initiative, Weight Watchers International (as part of an UK Medical Research Council Industrial Collaboration Award).

OBJECTIVES: There is a need for real-world evaluation of dietary supplementation in complex scenarios. We have designed an observational study intended to assess the comparative effectiveness of supplementation with a juice powder concentrate foreseeing multiple exposure groups, multiple primary endpoints and prospective use of propensity score matching. METHODS: Three different exposure groups (Control, “Capsules” and “Shake”) and three primary endpoints have been identified (TNF-α, Homocysteine and Vitamin C). This study design presents a multiplicity problem with two sources of multiplicity. The two supplementation-control comparisons (Capsules vs Control and Shake vs Control) and the between-supplementation comparison (Capsules vs Shake) will serve as the first source of multiplicity. In addition to that, three multiple primary endpoints are tested in each comparison. A formal power analysis is carried out through simulations assuming: i) specific effect sizes per comparison per endpoint; ii) t-test with parallel gatekeeping with truncated Holm test as the multiplicity adjustment procedure; iii) control of the familywise error rate (FWER) at a pre-specified 0.05 level. For a proper comparative analysis of effectiveness, we foresee the use of matching on a propensity score (PS) prospectively. PSs are typically applied in retrospective cohort studies. However we initially developed a Random Forest-based PS model on historical data. The PSs predicted by this tool are used to match patients on an ongoing basis to evaluate the comparative effectiveness of supplementation. RESULTS: With a sample size of 20 subjects per exposure group, the disjunctive power for testing each primary endpoint (i.e., the probability of establishing a significant effect in Capsules vs. Control or Shake vs. Control or Capsules vs. Shake) is 78%, 51%, 97% for TNF-α, Homocysteine and Vitamin C, respectively. CONCLUSIONS: The increasing availability of computational resources and methods allows researchers to conduct comparative effectiveness cohort studies that require prospective data collection, by transporting Pss to new patients. Moreover, simulations allow examining the operating characteristics of complex testing frameworks. FUNDING SOURCES: ZETA RESEARCH S.r.l.

OBJECTIVES: Low- grade inflammation is a pathological feature of a wide range of chronic conditions, including the metabolic syndrome, cardiovascular diseases (CVD)(1, 2) and the accelerated reduction in bone density(3). Previous research shows that diets rich in fruits and vegetables can reduce chronic inflammation(4, 5). To date there is no data on multiyear clinical interventions assessing the effect of plant-based dietary supplements on low-grade inflammation, cardiovascular disease prevention and indicators of biological aging. To assess the long-term effect of two plant based macro- and micronutrient food supplements on low-grade inflammation, cardiovascular disease prevention and indicators of biological ageing in overweight, elderly people. METHODS: This is a 3-arm open labelled, balanced, parallel design, observational study assessing the effectiveness of two different supplements vs control. Ninety overweight and obese volunteers, aged 50–80 years, will be recruited and followed up for the duration of 2 years. Since this is a long term trial and in order to maximize adherence to interventions, we will allow volunteers to choose their preferred treatment and we will implement a propensity score design. More specifically, for each participant an individual score based on certain parameters will be calculated (Table 1) and will be matched with another participant with the same propensity score across the three groups, exerting a ‘post-randomization’ effect. Multiple primary endpoints will be changes in markers of low-grade inflammation, CVD risk and micronutrients status (Table 2). Secondary outcomes will include assessment of Upper Respiratory Tract Symptoms, Gastrointestinal Symptoms, Quality of Life and Anthropometry. Furthermore, Cognitive Function, Bone quality and Leucocyte Telomere length will be assessed as tertiary outcomes. RESULTS: n/a CONCLUSIONS: This study will provide data on the effect of long-term, plant-based supplementation on chronic conditions and nutritional status in aging. In addition, the novel study design implemented might counteract the high dropout rate often observed in long term nutritional interventions and might create a new era with regards to study design approach in the field of nutritional science. FUNDING SOURCES: The Juice Plus+ Science Institute received funding by The Juice Plus+® Company for this project. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

Background:\ud The net clinical benefit of high-energy nutritional supplements (HENSDs) consumption is lower than expected.\ud Objectives:\ud To investigate the extent to which consumption of oral HENSD in the fasted state reduces energy intake in slim females during consecutive breakfast and lunch, and whether this relates to changes in appetite and metabolic appetite regulators.\ud Design:\ud Twenty three females of 24.4 ± 2.8 years with BMI of 18.2 ± 0.8 kg/m2 consumed HENSD (2.5 MJ) or PLACEBO (0.4 MJ) in fasted state in a single blind randomized cross-over study. Appetite and metabolic rate measurements and blood collection were conducted prior to and during 240 min after the intake of the supplements. Energy intake was recorded during ad libitum buffet breakfast and lunch served 60 min and 240 min post supplementation respectively.\ud Results:\ud Energy intake during breakfast was significantly (P < 0.01) lower in the HENSD trial but the net cumulative effect on energy intake was 1.07 ± 0.34 MJ higher in the HENSD compared to PLACEBO. Plasma concentration of CCK and PYY and insulin and were significantly (P < 0.05) higher in the HENSD trial while appetite measures were not significantly different between HENSD and PLACEBO trials. Correlations for the within participant relations between the responses of plasma hormones and appetite scores were significant (P < 0.05) for PYY and insulin but not CCK. The energy expended aboveresting metabolic rate was significantly (P < 0.05) higher in the HENDS trial but relative increase in energy expenditure was not significantly different between the two trials.\ud Conclusion:\ud Oral high-energy nutritional supplements have a partial and relatively short lived suppressive action on energy intake and can be expected to increase net energy intake by approximately half the energy value of the supplement consumed.

The Routine Use of Fecal Calprotectin in Clinical Pediatric Practice: Almost there or Still Issues to Address?

Background: Previous studies have reported inverse association between fruit consumption and cardiovascular risk. Aim: We investigated whether increasing habitual fruit consumption improves capillary blood flow and endothelial function in healthy participants. Methods: Data were collected from 66 individuals (45.7±9.27y; 23M; 43F). Fruit portion consumption ranging from 0-8 was measured using 'FACET' validated questionnaires. Microvascular function was measured using controlled Laser Doppler Iontophoresis (Moor LDI), with acetylcholine (Ach) and sodium nitroprusside (SNP), delivered to dermal forearm vessels, at 100 µA x 60s. Results: Results are presented on a log scale in Table 1. No statistically significant differences were observed with increasing fruit portions when compared to a null reference point. Table 1Model 1*Model 2**Ref coeff (95% CI)Ref coeff (95% CI)Fruit portions10.22 (-0.024 - 0.46)0.22 (-0.04 - 0.49)20.20 (-0.04 - 0.44)0.21 (-0.04 - 0.46)30.06 (-0.17 - 0.30)0.08 (-0.17 - 0.32)4-80.04 (...

Background/objectives: In the era of modern multidisciplinary clinical management, very little is known about the prevalence and presentation of malnutrition in children with gastrointestinal disorders (GastroD) particularly employing composite, global measures of nutritional status. Subjects/methods: Anthropometry, body composition, dietary intake, eating habits and grip strength were assessed with bedside methods in 168 patients from outpatient gastroenterology clinics (n, median (IQR) years; Crohn’s disease (CD): n=53, 14.2 (11.6:15.4); ulcerative colitis (UC): n=27, 12.2 (10.7:14.2); coeliac disease: n=31, 9.3 (7.5:13.6); other GastroD: n=57, 9.8 (7.2:13.8)) and compared with 62 contemporary healthy controls (n, median (IQR): 9.8 (6.9:13.8)) and the results of the recent UK, National Diet and Nutritional Survey (NDNS). Results: Children with CD had lower BMI z-scores than controls (median (IQR): −0.3 (−0.9:0.4) vs 0.3 (−0.6:1.4); P=0.02) but only 2% were classified as thin (BMI z-score

Exposure to large portion sizes has been linked with positive energy balance and weight gain but the mechanism is unclear. Large portions may influence the amount of food we put in our mouth (bite size), how fast we consume it (eating rate), or how this speed is maintained over the course of the meal (deceleration rate). We present preliminary data on the eating rate (ER), bite size (BS) and deceleration rates (DR) among 21 overweight women. Participants attended the laboratory on two occasions at lunch time after a 3 h fast and consumed a small (229 g; 43% below standard) or large (700 g; 75% above standard) portion of a chilli-con-carne meal in random order. Meal eating parameters were measured with the Sussex Ingestion Pattern Monitor. Mean BS for the small and large portions was 8.3 ± 0.6 g and 11.4 ± 1.7 g (mean difference −3.1 ± 1.4 g, 95%CI −6.2 to −0.1, n13). Mean ER did not differ between portion sizes (small 60.2 ± 5.1 vs. large 58.2 ± 5.0 g/min, n19). Median DR was lower for the large compared with the small portion (0.001 vs. 0.004 g/s2, n13). For the small meal, ER (r = 0.53) and DR (r = 0.51) correlated significantly with BMI (n21) and BS correlated with restraint scores (r = 0.56, n13). Compared with a small portion, exposure to a large portion of a hot meal led to an increase in bite size and a reduction in the deceleration rate towards the end of the meal. These changes may contribute to excessive energy intakes with exposure to large portion sizes.