Nutritional rickets in Nigerian children has been effectively treated with Ca supplementation. High values of Ca absorption efficiency have been observed in untreated children, but whether Ca absorption efficiency changes during treatment with Ca is unknown. Our objective in conducting this study was to identify the effect of Ca therapy on Ca absorptive efficiency in children with primary Ca-deficient nutritional rickets. Twelve children with radiographically active rickets, 2 to 14 years of age (median 39 months) participated in the study. We assessed dietary Ca intake via dietary recalls, and measured biochemical markers of Ca and vitamin D homeostasis. Fractional Ca absorption was measured using a dual tracer stable isotope method, before and after 2 weeks of treatment with 15·0 mmol elemental Ca daily. Ten children had adequate urine collection for inclusion in the analysis. Usual dietary Ca intake was 4·2 (sd 1·0) mmol/d. The median Ca absorption prior to treatment was 72 % (range 52–97 %) and decreased significantly to 57 % (31–84 %) (P = 0·004) after 2 weeks of supplementation. We conclude that Nigerian children with rickets adapt to Ca supplementation with a small decrease in Ca absorptive capacity, but retain very high absorptive levels during supplementation. Overall Ca absorption efficiency was comparable with that identified in other populations with low Ca intakes. These data demonstrate that although absorptive capacity is regulated by supplementation, recovery from rickets likely occurs through efficient use of both dietary and supplemental Ca.

The effects of a 7 d high-fructose diet (HFrD) or control diet on lipid metabolism were studied in a group of six healthy lean males. Plasma NEFA and β-hydroxybutyrate concentrations, net lipid oxidation (indirect calorimetry) and exogenous lipid oxidation (13CO2 production) were monitored in basal conditions, after lipid loading (olive oil labelled with [13C]triolein) and during a standardised mental stress. Lactate clearance and the metabolic effects of an exogenous lactate infusion were also monitored. The HFrD lowered plasma concentrations of NEFA and β-hydroxybutyrate as well as lipid oxidation in both basal and after lipid-loading conditions. In addition, the HFrD blunted the increase in plasma NEFA and exogenous lipid oxidation during mental stress. The HFrD also increased basal lactate concentrations by 31·8 %, and lactate production by 53·8 %, while lactate clearance remained unchanged. Lactate infusion lowered plasma NEFA with the control diet, and net lipid oxidation with both the HFrD and control diet. These results indicate that a 7 d HFrD markedly inhibits lipolysis and lipid oxidation. The HFrD also increases lactate production, and the ensuing increased lactate utilisation may contribute to suppress lipid oxidation.

We examined the association of dietary carbohydrates, protein, fat (including fatty acid subtypes) and alcohol with the metabolic syndrome and its components, in a cross-sectional study of 1626 patients with at least one cardiovascular risk factor. Multivariate nutrient density substitution models were used to examine the associations between macronutrients (assessed by 24 h dietary recall) and the metabolic syndrome. These models express the effects of ‘substituting’ one macronutrient for another without altering total energy intake. Increases in carbohydrates offset by isoenergetic decreases in either fat or protein were associated with a decrease in the prevalence of the metabolic syndrome (OR 0·87 (95 % CI 0·81, 0·93), P < 0·0001; OR 0·70 (95 % CI 0·61, 0·79), P < 0·0001, per 5 % energy intake respectively). Increased intake of dietary fat at the expense of dietary protein was also associated with a decreased prevalence of the metabolic syndrome (OR 0·80 (95 % CI 0·70, 0·92), P = 0·002 per 5 % energy intake). There were no statistically significant differences between fatty acid subtypes (P>0·10). Consumption of up to one standard alcoholic drink per d was associated with a lower prevalence of the metabolic syndrome when compared with non-drinkers (OR 0·67 (95 % CI 0·50, 0·89), P = 0·006); however, these benefits were weakened with higher levels of alcohol intake (P = 0·10 for one to three drinks and P = 0·29 for >three drinks). Thus, a diet high in carbohydrates, low in fat and protein, with low-to-moderate alcohol intake, is associated with a reduced prevalence of the metabolic syndrome.

Severe anaemia is associated with increased low birth weight and Barker's hypothesis of ‘fetal origins’ proposes that a nutritional insult during critical periods of development results in adaptations that predispose individuals to adult onset diseases. We hypothesize that endocrine alterations may occur in the maternal–fetal milieu as a consequence of nutritional anaemia during pregnancy. We examined the quantitative variations in hormonal profiles in paired maternal and cord blood samples obtained from mothers and their neonates who were classified based on maternal anaemia status. Our results show that: (1) 74·6 % of the mothers enrolled in the study were anaemic, of which 85·2 % had moderate anaemia and 14·7 % had severe anaemia; (2) anthropometric parameters measured in the mothers indicate that severely anaemic mothers had a significantly low pre- and post-pregnancy weight, a significantly decreased maternal fundal height and abdominal circumference; (3) anthropometric measures in the neonates born to severely anaemic mothers show a significant reduction in ponderal index, birth weight and placental weight; (4) significant increase in both maternal, fetal insulin-like growth factor 1, ferritin levels and increased maternal erythropoietin levels were observed with an increase in severity of anaemia; (5) decreased T3 and increased prolactin levels were observed in the maternal blood of severely anaemic mothers as compared with the control group. An insight into the endocrine modulation to overcome a growth disadvantage due to nutritional anaemia in pregnancy may lead to a better understanding of fetal adaptations invoked when the maternal-placental nutrient supply fails to meet the fetal nutrient demand.

Vitamin D insufficiency is common particularly during wintertime. After the recommendation by the Ministry of Social Affairs and Health, Finnish fluid milks and margarines have been fortified with vitamin D since February 2003. The aims of the present study were to examine the impact of vitamin D fortification of food supplies on serum 25-hydroxyvitamin D (S-25(OH)D) concentrations and on daily dietary vitamin D intake among adolescent females. One hundred and forty-two girls of Caucasian ethnicity aged 12–18 years completed semi-quantitative FFQ from which the dietary vitamin D and Ca intakes were calculated. S-25(OH)D was measured by radioimmunoassay. The study was performed from February–March 2000 to February–March 2004, one year after the initiation of fortification. The mean dietary intake of vitamin D was < 7·5 μg in 91·5 % of the adolescent girls in 2000 and 83·8 % in 2004. The midwinter mean S-25(OH)D concentration did not change significantly during the follow-up period (48·3 v. 48·1 nmol/l, NS). The proportion of participants who had S-25(OH)D concentration < 50 nmol/l was 60·6 % in 2000 and 65·5 % in 2004. Only 7·0 % of the participants had an adequate S-25(OH)D ( ≥ 75 nmol/l) level in 2000 or 4 years later. The vitamin D fortification of fluid milks and margarines was inadequate to prevent vitamin D insufficiency. There are numerous adolescent girls and women who are not reached by the current fortification policy. Therefore new innovative and feasible ways of improving vitamin D nutrition are urged.

Based on the hypothesis that isoflavones are absorbed more efficiently from fermented than from non-fermented soya foods, we compared the urinary isoflavonoid excretion (UIE) after intake of miso soup or soya milk. We recruited twenty-one women with Japanese ancestry who consumed standardized soya portions containing 48 mg isoflavones. On day 1, half the women consumed soya milk, the other half started with miso soup. On day 3, the subjects ate the other soya food and on day 5, they repeated the first food. Each participant collected a spot urine sample before and an overnight urine sample after soya food intake. All urine samples were analysed for daidzein, genistein and equol using LC–MS and were expressed as nmol/mg creatinine. We applied mixed models to evaluate the difference in UIE by food while including the baseline values and covariates. Relative to baseline, both groups experienced significantly higher UIE after consuming any of the soya foods. We observed no significant difference in UIE when soya milk was compared to miso soup (P = 0·87) among all women or in the seven equol producers (P = 0·88). Repeated intake of the same food on different days showed high reproducibility within subjects. These preliminary results indicate similar UIE after consuming a fermented soya food (miso) as compared to a non-fermented soya food (soya milk). Therefore, recommendations favouring fermented soya foods are not justified as long as the intestinal microflora is capable of hydrolysing the isoflavone glucosides from non-fermented soya foods.

The association between black tea consumption and iron status was investigated in a sample of African adults participating in the cross-sectional THUSA (Transition and Health during Urbanization of South Africans) study in the North West Province, South Africa. Data were analysed from 1605 apparently healthy adults aged 15–65 years by demographic and FFQ, anthropometric measurements and biochemical analyses. The main outcome measures were Hb and serum ferritin concentrations. No associations were seen between black tea consumption and concentrations of serum ferritin (men P = 0·059; women P = 0·49) or Hb (men P = 0·33; women P = 0·49). Logistic regression showed that tea consumption did not significantly increase risk for iron deficiency (men: OR 1·36; 95 % CI 0·99, 1·87; women: OR 0·98; 95 % CI 0·84, 1·13) nor for iron deficiency anaemia (men: OR 1·28; 95 % CI 0·84, 1·96; women: OR 0·93; 95 % CI 0·78, 1·11). Prevalence of iron deficiency and iron deficiency anaemia was especially high in women: 21·6 and 14·6 %, respectively. However, the likelihood of iron deficiency and iron deficiency anaemia was not significantly explained by tea consumption in sub-populations which were assumed to be at risk for iron deficiency. Regression of serum ferritin levels on tea consumption in women ≤ 40 years, adults with a daily iron intake ≤ 5·80 mg and adults with ferritin levels ≤ 26·60 μg/l, respectively, showed P values in the range of 0·28–0·88. Our findings demonstrate that iron deficiency and iron deficiency anaemia is not significantly explained by black tea consumption in a black adult population in South Africa. Tea intake was also not shown to be related to iron status in several sub-populations at risk for iron deficiency.

Recent increases in obesity prevalence among children in developed countries are of policy concern. While significant positive associations between households' food insecurity status and body weights have been reported for adults, it is known from the energy physiology literature that energy requirements depend on BMR, anthropometric measures and physical activity. It is therefore important to model the bi-directional relationships between body weights and households' food insecurity scores especially for children that have evolving nutrient and energy requirements. The present paper estimated dynamic random effects models for children's body weights and BMI, and households' food insecurity scores using longitudinal data on 7635 children in the USA enrolled in 1st, 3rd and 5th grades (1999–2003) of the Early Childhood Longitudinal Study-Kindergarten. The main findings were, first, physical exercise and numbers of siblings were significantly (P < 0·05) negatively associated with body weights, while households' food insecurity score was not a significant predictor. Moreover, children's body weights were significantly lower in households with higher parental education and incomes; time spent watching television and in non-parental care were positively associated with weights. Second, models for households' food insecurity scores showed that poverty and respondents' poor emotional and physical health significantly increased food insecurity. Moreover, households with children who were taller and heavier for their ages faced significantly higher food insecurity levels. Overall, the results showed that household food insecurity was unlikely to exacerbate child obesity in the USA and it is important that children receive balanced school meals and perform higher physical activity.

The objective of this study was to examine the association between the scores of the Children's Eating Behaviour Questionnaire (CEBQ) and BMI in a sample of Portuguese children. Using a cross-sectional design, a sample of 240 children (123 females and 117 males) aged 3–13 years were recruited from clinic and community-based settings. Parents completed the CEBQ to indicate their child's eating style for three ‘food approach’ and four ‘food avoidant’ sub-scales. Factor analyses revealed an underlying structure similar to the original CEBQ. Children's height and weight were measured to calculate BMI and Centre for Disease Control BMI z-scores. Hierarchical regression analyses controlling for gender, age and socioeconomic status indicated that all CEBQ sub-scales were significantly associated with BMI z-scores (P = 0·03 to < 0·001). Food approach scales were positively related to BMI z-scores (β = 0·33–0·51) and food avoidance negatively related (β = − 0·17 to − 0·46). Our results support the use of the CEBQ to further understand eating style as a behavioural pathway to obesity.

New strategies to improve Ca absorption and bone health are needed to address the current state of osteoporosis prevention and management. Inulin-type fructans have shown great promise as a dietary intervention strategy, but have not yet been tested in a young female model. Our objective was to investigate the effect of long chain (LC) inulin on bone mineralization and density in growing, female rats, as well as the quality of growth. Weanling Sprague–Dawley rats were assigned to inulin or cellulose treatments for either 4 or 8 weeks. Growth was measured weekly and quality of growth assessed using fat pad weights and dual-energy X-ray absorptiometry (DXA). Whole body (WB) and selected regions were analysed for bone mineral density (BMD) and body composition by DXA. Serum markers of bone turnover were assessed by enzyme-linked immunosorbent assays. Ca and P concentrations were determined in excised femurs by inductively coupled plasma spectrometry. Feeding inulin resulted in 4 % higher femoral weight (adjusted for body weight) and 6 % less feed intake. Inulin did not affect WB or regional BMD, but was associated with a 28 % lower parametrial fat pad mass, 21 % less WB fat mass and 5 % less WB mass. In summary, LC-inulin lowered body fat mass, without consequence to bone density in growing female rats.