The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study of over 23 000 diabetes-free pregnancies has shown that at a population level an unequivocal linear relationship exists between maternal glucose concentrations around the beginning of the third trimester of pregnancy and the risk of their baby being born above the ninetieth centile for weight. With the rising incidence of gestational diabetes (GDM) across the developed world, largely paralleling the increased prevalence of obesity, there has been a sharp increase in the risk of pregnancy complications developing related to the birth of macrosomic babies. The associated additional long-term complications of GDM pregnancies means that in the future there is likely to be a large increase in the incidence of type 2 diabetes and associated conditions in both the mothers and their affected offspring. The present review seeks to highlight recent advances and remaining gaps in knowledge about GDM in terms of its genetics (where some of the recently discovered polymorphic risk factors for type 2 diabetes have also proved to be risk factors for GDM) and its treatment by diet, exercise and drugs.

Canned and bottled tea drinks contain not only green tea epicatechins (GTE), namely (−)-epigallocatechin gallate (EGCG), (−)-epicatechin gallate (ECG), (−)-epigallocatechin (EGC) and (−)-epicatechin (EC), but also four GTE epimers, namely (−)-gallocatechin gallate (GCG), (−)-catechin gallate (CG), (−)-gallocatechin (GC) and (−)-catechin (C). In the present study we examined the antioxidant activity and bioavailability of these epimers compared with their corresponding precursors. The epimerisation reaction was induced by autoclaving GTE extract derived from longjing green tea at 120°C for 20 min. Isolation and purification of each GTE and epimer were accomplished by various column chromatographic and semi-preparative HPLC techniques. The antioxidant activity of each epimer with its corresponding GTE precursor was conducted in the three in vitro systems, namely human LDL oxidation, ferric reducing–antioxidant power (FRAP), and anti-2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical assays. The results of all three assays demonstrated that CG had similar antioxidant activity with its precursor ECG, while GC was less potent as an antioxidant than its precursor EGC. Regarding EGCG and GCG, the antioxidant potency was similar for both LDL oxidation and DPPH free radical assays, but GCG was statistically less effective than EGCG in the FRAP assay. For EC and C, the latter had less anti-free radical activity in the DPPH assay, but in LDL oxidation and FRAP assays the antioxidant activity was similar. Oral and intravenous dosing of GTE–epimer mixture led to increase in total plasma antioxidant capacity in rats. In general, both epicatechins and epimers had low bioavailability (0·08–0·31) and most of the observed differences between epicatechins and their corresponding epimers were small, even if they were statistically significant in some cases. It was concluded that the epimerisation reaction occurring in manufacturing canned and bottled tea drinks would not significantly affect antioxidant activity and bioavailability of total tea polyphenols.

1. An experimental model for the determination of dietary fibre according to the definition of Trowell et al. (1976) is described. Food was subjected to in vivo digestion in ileostomy patients, and the ileostomy contents were collected quantitatively, the polysaccharide components of which were analysed by gas–liquid chromatography and the Klason lignin by gravimetric determination. The model was used for the determination of dietary fibre in AACC (American Association of Cereal Chemists), wheat bran and for studies on the extent of hydrolysis of wheat-bran fibre in the stomach and small intestine. The effect of wheat bran on ileostomy losses of nitrogen, starch and electrolytes was also investigated.

2. Nine patients with established ileostomies were studied during two periods while on a constant low-fibre diet. In the second period 16 g AACC wheat bran/d was added to the diet. The ileostomy contents and duplicate portions of the diet were subjected to determinations of wet weight, dry weight, water content, fibre components, starch, N, sodium and potassium.

3. The wet weight of ileostomy contents increased by 94 g/24 h and dry weight by 10 g/24 h after consumption of bran. The dietary fibre of AACC bran, determined as the increase in polysaccharides and lignin of ileostomy contents after consumption of bran, was 280 g/kg fresh weight (310 g/kg dry matter). Direct analysis of polysaccharides and lignin in bran gave a value of 306 g/kg fresh weight. Of the added bran hemicellulose and cellulose 80–100% and 75–100% respectively were recovered in ileostomy contents. There was no significant difference between the two periods in amount of N, starch and K found in the ileostomy contents. The Na excretion increased during the ‘bran’ period and correlated well with the wet weight of ileostomy contents.

4. In conclusion, it seems probable that determination of dietary fibre by in vivo digestion in ileostomy patients comes very close to the theoretical definition of dietary fibre, as the influence of bacteria in the ileum seems small. Bacterial growth should be avoided by using a technique involving the change of ileostomy bags every 2 h and immediate deep-freezing of the ileostomy contents. True dietary fibre can be determined by direct analysis of polysaccharides and lignin in the food, at least in bran. Very little digestion of hemicellulose and cellulose from bran occurs in the stomach and small bowel. The 10–20% loss in some patients may be due to digestion by the gastric juice or to bacterial fermentation in the ileum, or both. The extra amount of faecal N after consumption of bran, reported by others, is probably produced in the large bowel.

The aim of the present study was to investigate the effects of Bifidobacterium adolescentis (Bif) supplementation on visceral fat accumulation and insulin sensitivity of the metabolic syndrome in HF-diet-fed rats. Adult male Wistar rats (n 10 per group) were fed four different experimental diets for 12 weeks as follows: standard diet; high-fat (HF) diet; a mix of HF diet and Bif; a mix of standard diet and Bif. Liver, mesenteric fat, epididymal fat, retroperitoneal fat, and inguinal fat, pancreas and triceps surae in all four groups of the rats were weighed, while liver steatosis and insulin sensitivity were evaluated at the end point of the study. As the number of intestinal Bifidobacterium species decreased obviously, fat pad weight and body weight increased significantly in the HF group compared with in the other three groups (P <0·05). Addition of Bif led to a reduction in body weight and fat pad weight (P <0·05). With an increase in liver weight, more severe steatosis of hepatocytes was observed in the HF group compared with in the other three groups. A significant decrease of the glucose infusion rate and pancreas weight was found in the HF group (P <0·05). This deleterious effect was alleviated when Bif was added to the diets. Bifidobacterium supplementation ameliorated visceral fat accumulation and insulin sensitivity of the metabolic syndrome in HF-diet-fed rats.

In the last 10 years nutritional research on diabetes has improved dramatically in terms of both number of studies produced and quality of methodologies employed. Therefore, it is now possible to attempt to provide the evidence on which nutritional recommendations for the prevention of type 2 diabetes could be based. We therefore performed a literature search and, among the papers published in indexed journals, we selected relevant epidemiological (mostly prospective) and controlled intervention studies. Lifestyle factors that have, so far, been consistently associated with increased risk of type 2 diabetes are overweight and physical inactivity. However, recent evidence from epidemiological studies has shown that the risk of type 2 diabetes is also associated with diet composition, particularly with: (1) low fibre intake; (2) a high trans fatty acid intake and a low unsaturated:saturated fat intake ratio; (3) absence of or excess alcohol consumption. All these factors are extremely common in Western populations and therefore the potential impact of any intervention on them is large: indeed, >90% of the general population has one or more of these risk factors. The ability to correct these behaviours in the population is estimated to reduce the incidence of diabetes by as much as 87%. Recent intervention studies have shown that type 2 diabetes can be prevented by lifestyle changes aimed at body-weight reduction, increased physical activity and multiple changes in the composition of the diet. Within this context, the average amount of weight loss needed is not large, about 5% initial weight, which is much less than the weight loss traditionally considered to be clinically significant for prevention of type 2 diabetes. In conclusion, new emphasis on prevention by multiple lifestyle modifications, including moderate changes in the composition of the habitual diet, might limit the dramatic increase in incidence of type 2 diabetes envisaged worldwide.

Despite tremendous growth in the consumption of gluten-free (GF) foods, there is a lack of evaluation of their nutritional profile and how they compare with non-GF foods. The present study evaluated the nutritional quality of GF and non-GF foods in core food groups, and a wide range of discretionary products in Australian supermarkets. Nutritional information on the Nutrition Information Panel was systematically obtained from all packaged foods at four large supermarkets in Sydney, Australia in 2013. Food products were classified as GF if a GF declaration appeared anywhere on the product packaging, or non-GF if they contained gluten, wheat, rye, triticale, barley, oats or spelt. The primary outcome was the ‘Health Star Rating’ (HSR: lowest score 0·5; optimal score 5), a nutrient profiling scheme endorsed by the Australian Government. Differences in the content of individual nutrients were explored in secondary analyses. A total of 3213 food products across ten food categories were included. On average, GF plain dry pasta scored nearly 0·5 stars less (P< 0·001) compared with non-GF products; however, there were no significant differences in the mean HSR for breads or ready-to-eat breakfast cereals (P≥ 0·42 for both). Relative to non-GF foods, GF products had consistently lower average protein content across all the three core food groups, in particular for pasta and breads (52 and 32 % less, P< 0·001 for both). A substantial proportion of foods in discretionary categories carried GF labels (e.g. 87 % of processed meats), and the average HSR of GF discretionary foods were not systematically superior to those of non-GF products. The consumption of GF products is unlikely to confer health benefits, unless there is clear evidence of gluten intolerance.

Young women of reproductive age appear to have a greater capacity than men to convert the essential fatty acid α-linolenic acid to DHA. The purpose of this study was to test the hypothesis that gender-related differences in n-3 PUFA metabolism are reflected in the concentrations of n-3 PUFA in plasma lipids. The subjects were healthy men (n 13) and women (n 23) aged 18–35 years consuming their habitual diet. Dietary habits were assessed by food-frequency questionnaire. Venous blood samples were collected following an overnight fast. For the women, blood collection took place on the tenth day of their menstrual cycle. The fatty acid concentrations of plasma phosphatidylcholine, triacylglycerol, NEFA and cholesteryl esters were determined by gas chromatography. There were no significant differences between men and women in their consumption of protein, carbohydrate, total fat, alcohol, individual fatty acids and selected micronutrients. DHA concentration alone was significantly higher in plasma phosphatidylcholine (31%, p=0·02), triacylglycerol (71%, p=0·02) and NEFA (33%, p=0·01), but not cholesteryl esters, in women compared with men. There were no significant differences between men and women in the concentrations of any other fatty acids measured. Overall, the present data support the suggestion that greater DHA synthesis in women than men results in a higher DHA concentration in plasma lipids.

1. The effects of the amount and the type of dietary fibre on the apparent digestibility (AD) by growing pigs of neutral-detergent fibre (NDF) and NDF components, on nitrogen balance and on the rate of passage of digesta were studied using a semi-purified basal diet and fibre in the forms of soya-bean hulls, lupin (Lupinus sp.) hulls, pea (Pisum sativum) hulls, wheat bran, maize hulls, maize cobs, oat hulls and lucerne (Medicago sativa) stems.

2. Both the amount and the type of dietary fibre significantly influenced the AD of dietary dry matter, N and energy. The AD of NDF and of NDF components was markedly affected by the type and the amount of fibre in the diet. The proportion of NDF digested ranged from 0.016 to 0.905, of cellulose from 0.026 to 0.931 and of hemicellulose from 0.010 to 0.999.

3. N retention by the pigs ranged from 12.9 to 25.8 g/d and with some fibres there was a tendency towards increased N retention with increasing intakes of NDF.

4. Rate of passage of digesta, expressed as the 50 and 95% excretion times of stained feed particles, ranged from 22.2 to 85.1 h and 40.0 to 117.1 h respectively. Large individual variations in rate of passage occurred but, in general, the rate of passage tended to increase with increasing intakes of NDF. No strong associations between the rate of passage of digesta and apparent digestibility of NDF components were observed.

5. The results suggest that the extent of fibre digestibility depends predominantly on the origin of the fibre and to a lesser extent on the amount of fibre in the diet.

It is recognised that eating habits established in early childhood may track into adult life. Developing effective interventions to promote healthier patterns of eating throughout the life course requires a greater understanding of the diets of young children and the factors that influence early dietary patterns. In a longitudinal UK cohort study, we assessed the diets of 1640 children at age 3 years using an interviewer-administered FFQ and examined the influence of maternal and family factors on the quality of the children's diets. To describe dietary quality, we used a principal components analysis-defined pattern of foods that is consistent with healthy eating recommendations. This was termed a ‘prudent’ diet pattern and was characterised by high intakes of fruit, vegetables and wholemeal bread, but by low intakes of white bread, confectionery, chips and roast potatoes. The key influence on the quality of the children's diets was the quality of their mother's diets; alone it accounted for almost a third of the variance in child's dietary quality. Mothers who had better-quality diets, which complied with dietary recommendations, were more likely to have children with comparable diets. This relationship remained strong even after adjustment for all other factors considered, including maternal educational attainment, BMI and smoking, and the child's birth order and the time spent watching television. Our data provide strong evidence of shared family patterns of diet and suggest that interventions to improve the quality of young women's diets could be effective in improving the quality of their children's diets.

To examine the association of plant-based food intakes with CVD and total mortality among Japanese. In the Japan Collaborative Cohort Study for Evaluation of Cancer Risk, 25 206 men and 34 279 women aged 40–79 years, whose fruit, vegetable and bean intakes were assessed by questionnaire at baseline in 1988–90, were followed for 13 years. Deaths from total stroke, stroke subtypes, CHD and total CVD, according to the International Classification for Diseases 10th Revision, were registered. During 756 054 person-years of follow-up, there were 559 deaths from total stroke, 258 from CHD, 1207 from total CVD and 4514 from total mortality for men, and for women, 494, 194, 1036 and 3092, respectively. Fruit intake was inversely associated with mortality from total stroke (the multivariable hazard ratio (HR (95 % CI)) in the highest v. lowest quartiles = 0·67 (0·55, 0·81)), total CVD (HR = 0·75 (0·66, 0·85)) and total mortality (HR = 0·86 (0·80, 0·92)). Vegetable intake was inversely associated with total CVD (HR = 0·88 (0·78, 0·99)). Bean intake was inversely associated with other CVD (HR = 0·79 (0·64, 0·98)), total CVD (HR = 0·84 (0·74, 0·95)) and total mortality (HR = 0·90 (0·84, 0·96)). Further adjustment for other plant-based foods did not alter the association of fruit intake with mortality from total stroke, total CVD and total mortality, but attenuated the associations of vegetables and beans with mortality risk. In conclusion, intakes of plant-based foods, particularly fruit intake, were associated with reduced mortality from CVD and all causes among Japanese men and women.

The Finnish national food composition database Fineli® was updated with recent analytical values for plant sterols (PS) (sitosterol, campesterol, stigmasterol, avenasterol, brassicasterols and stanols) and cholesterol. The quality of the new analytical data was assessed. The aims of the present study were: (1) to compare the effect of old and new database values on PS and cholesterol intakes based on average per capita food consumption data; (2) to estimate the current intake and major sources of these compounds in various population groups according to the national FINDIET 1997 survey data. The intake of total PS was 305 mg/d for men and 237 mg/d for women. The respective intakes for cholesterol were 284 mg/d and 201 mg/d. Women had a higher density of PS in their diets than men, whereas the cholesterol density in the diets did not differ between genders. Cereals, margarine, vegetables and vegetable oils were the main food sources of PS. Meat, meat products and eggs were the main sources of cholesterol. A 9 % greater PS intake estimate was obtained with the new PS database compared with the old PS database, probably due to minor methodological differences between the new and old analyses. Notable changes in analytical methods suggest a lower value (−19 %) for cholesterol intake calculated from the new database compared with the old one. We conclude that researchers can have confidence in the new values for PS and cholesterol, because systematic evaluation of the new analytical values showed them to be of high quality.

1. Measurements were made of the nitrogen and energy balances of pigs of 30, 60 and 90 kg given a conventional diet at various daily rates.

2. Body protein synthesis was estimated from the irreversible loss of leucine from the blood following the infusion of [1-14C]leucine, and from the oxidation of the labelled amino acid.

3. Protein synthesis (g/d) increased by 2.17 for each 1 g increase in daily protein accretion and by 1.55 for each 1 g increase in daily protein intake.

4. At 30 kg, pigs close to energy equilibrium synthesized 270 g protein daily compared with 406 g and 512 g when their ration supplied twice and three times their maintenance requirement.

5. There was a close correlation between the daily urinary excretion of urea + ammonia and total amino acid catabolism estimated from the catabolism of leucine, but the latter underestimated the observed excretion by 2.5 g N/d.

6. The results imply that protein turnover accounts for only a proportion of the heat production associated with protein deposition.

1. The amount of selenium in nationally representative samples of prepared and cooked groups of foods, and in a variety of raw individual foods, was determined fluorimetrically.

2. The average British diet was calculated to provide approximately 60 μg Se/d, of which half was derived from cereals and cereal products and another 40% from meat and fish. Milk, table fats, fruit and vegetables provided little or no Se.

3. Individual foods which were particularly rich in Se (>0.2 mg/kg) included ‘bread-making’ and wholemeal flours, kidney, fatty fish, brazil nuts (Bertholletia excelsa) and several other varieties of nut. In contrast, breast milk and other foods for babies (except some cereal products) contained little Se.

4. The total intake, and the amounts of Se in major foods, were lower than in most other studies. This is probably the result of the comparatively low levels of this element in British soil.

1. Anthropometric indices are presented for representative samples of elderly people in South Wales, based on over 1500 subjects seen during community surveys.

2. Body mass index declined with age after 70 years in both men and women. Estimates of fat and muscle volume based on upper arm measurements also showed a decline with age, which was particularly steep for triceps skinfold thickness in women.

3. These indices are in general similar to results that have been reported from other surveys within the UK; they suggest that Welsh old people have less fat and muscle than elderly Americans.

To verify the influence of food consistency on satiety mechanisms we evaluated the effects of the same meal in solid–liquid (SM) and homogenized (HM) form on satiety sensation, gastric emptying rate and plasma cholecystokinin (CCK) concentration. Eight healthy men, aged 21-28 (mean 24·5) years were given two meals (cooked vegetables 250 g, cheese 35 g, croutons 50 g and olive oil 25 g, total energy 2573 kJ, with water 300 ml) differing only in physical state: SM and HM. The subjects consumed the meals in randomized order on non-consecutive days. The sensations of fullness, satiety and desire to eat were evaluated by means of a questionnaire, gastric emptying was assessed by ultrasonographic measurement of antral area, and plasma CCK concentration was measured by radioimmunoassay. The vegetable-rich meal was significantly more satiating (P < 0·05) when in the HM form than when eaten in a SM state. Furthermore, the overall gastric emptying time was significantly slowed (255 (sem 11) min after HM v. 214 (sem 12) min after SM; P < 0·05) and CCK peak occurred later (94 (sem 12) min after HM v. 62 (sem 11) min after SM; NS) when the food was consumed in the HM form. Independently of the type of meal, antral area was significantly related to fullness sensations (r2 0·46, P = 0·004). These results demonstrate that meal consistency is an important physical food characteristic which influences both gastric emptying rate and satiety sensation. Moreover, the relationship observed between antral area and fullness sensation confirms that antral distension plays a part in the regulation of eating behaviour.

1. Steers, equipped with simple rumen cannulas, were given diets of approximately equal parts of rolled barley and straw supplemented with urea. The diets provided sufficientestimated rumen degradable nitrogen (RDN: RDN: metabolizable energy values of 1:3) to maintain maximum microbial synthesis. In some experiments Na235SO4 was introduced into the rumen to label microbial protein.

2. Rumen digesta samples were taken before feeding and mixed rumen bacteria were separated from the solid (solid-associated bacteria; SAB) and liquid (liquid-associated bacteria; LAB) fractions of digesta. The most effective method of removing SAB from the fibre was a combination of homogenizing and pummelling. This process did not affect the physical form or chemical composition of the bacteria.

3. Samples of SAB contained significantly (P ≤ at least 0·05) less ash, total N, RNA and diaminopimelic acid (DAP) and significantly (P ≤ 0·01) more lipid than samples of LAB. Concentrations (g/kg dry matter) of ash, total N, RNA, DAP and lipid in SAB were approximately 87, 70, 35, 2.2 and 245 respectively. Corresponding values for LAB were 157, 80, 50, 3.8 and 124 respectively.

4. RNA-N: total N and DAP-N: total N values in SAB were significantly lower than those in LAB (P ≤ 0·05 and 0·02 respectively). 35S: totalN values were similar in both groups of bacteria. The importance of differences in constituent: total N values in the two groups of bacteria in relation to their use as indices of microbial protein synthesis is discussed.

1. Groups of rainbow trout (Salmo gairdneri; mean weight 5 g) were given diets containing 10, 12, 14, 17, 21, 24 and 26 g lysine/kg diet for 12 weeks.

2. By analysis of the growth values the dietary requirement of lysine in this experiment was found to be 19 g/kg diet. A similar requirement value was obtained from a dose-response curve of expired 14CO2 (following an intraperitoneal injection of L-[U-14C]lysine) v. dietary lysine concentration.

3. Liver concentrations of total lipid and carnitine and activities of lysine-α-ketoglutarate reductase (saccharopine dehydrogenase (NADP+, lysine-forming), EC 1. 5. 1. 8 ) in the liver were not significantly different in fish from the different dietary treatments. Hepatosomatic index, however, was higher in those fish given low levels of dietary lysine.

Although dietary intake over a single 24-h period may be atypical of an individual’s habitual pattern, multiple 24-h dietary assessments can be representative of habitual intake and help in assessing seasonal variation. Web-based questionnaires are convenient for the participant and result in automatic data capture for study investigators. This study reports on the acceptability of repeated web-based administration of the Oxford WebQ – a 24-h recall of frequency from a set food list suitable for self-completion from which energy and nutrient values can be automatically generated. As part of the UK Biobank study, four invitations to complete the Oxford WebQ were sent by email over a 16-month period. Overall, 176 012 (53 % of those invited) participants completed the online version of the Oxford WebQ at least once and 66 % completed it more than once, although only 16 % completed it on all four occasions. The response rate for any one round of invitations varied between 34 and 26 %. On most occasions, the Oxford WebQ was completed on the same day that they received the invitation, although this was less likely if sent on a weekend. Participants who completed the Oxford WebQ tended to be white, female, slightly older, less deprived and more educated, which is typical of health-conscious volunteer-based studies. These findings provide preliminary evidence to suggest that repeated 24-h dietary assessment via the Internet is acceptable to the public and a feasible strategy for large population-based studies.