Artificial nutrition is an inherent part of management in acute pancreatitis. However, there is no consensus regarding the optimal time of the commencement of feeding in these patients. Our aim was to compare the effect of enteral v. parenteral nutrition with regard to the time points when they were administered in the randomised controlled trials. The search was undertaken in the Cochrane Central Register of Controlled Trials, MEDLINE and Science Citation Index as well as in the proceedings of major gastroenterology meetings. The summary estimate of the effect associated with artificial nutrition was calculated using a random-effects model and presented as a risk ratio (RR) and 95 % CI. A total of eleven randomised controlled trials were included. When started within 48 h of admission, enteral nutrition, in comparison with parenteral nutrition, resulted in a statistically significant reduction in the risks of multiple organ failure (RR 0·44; 95 % CI 0·23, 0·84), pancreatic infectious complications (RR 0·46; 95 % CI 0·27, 0·77) and mortality (RR 0·46; 95 % CI 0·20, 0·99). After 48 h of admission, enteral nutrition, in comparison with parenteral nutrition, did not result in a statistically significant reduction in the risks of multiple organ failure (RR 0·73; 95 % CI 0·33, 1·63), pancreatic infectious complications (RR 0·31; 95 % CI 0·07, 1·34) and mortality (RR 0·67; 95 % CI 0·22, 2·10). Enteral nutrition is more effective than parenteral nutrition in reducing the risk of multiple organ failure, pancreatic infectious complications and mortality in patients with acute pancreatitis. The magnitude of these benefits may depend on the timing of the commencement of nutrition.

1. The extent to which ammonia-N (NH3-N) serves as a starting point for synthesis of microbial nitrogenous compounds was assessed when 15N as (15NH4)2SO4 was continuously infused into the rumen of a sheep for periods of 78–98 h. Steady states were reached in the composition of the rumen contents because the animal was fed equal parts of its ration at hourly intervals. Concentrations of 15N in bacterial-N, protozoal-N and rumen NH3-N were compared.

2. In two trials with a low-N diet consisting largely of wheaten hay the 15N concentration in bacterial N was 76 and 78% of that in the NH3-N. For protozoa the values were more variable —64 and 43%.

In two trials with a higher-N diet (lucerne hay), the corresponding values were lower—bacterial-N 62 and 64%, protozoal-N 41 and 35%.It was concluded that synthesis of microbial protein was more dependent on ammonia as a starting point with the low-N diet than with the higher-N diet.

3. Entry and exit rates for ammonia into and out of the rumen system were determined, and the results, in combination with those obtained for bacterial-N in the first part of the work, allowed calculations to be made of the production of microbial-N/d formed from NH3-N, and this in turn allowed calculation of minimal values for conversion of plant-N to microbial-N in the lumen. Minimal extent of conversion was 68% for the low-N diet and 53–55% for the higher-N diet.

4. Total production of microbial-N in relation to the amount of N given was also calculated by using previously reported values for the relative proportions of protozoal-N and bacterial-N in sheep given diets similar to those used here. These values for extent of conversion were 73% for the low-N diet and 58–59% for the higher-N diet.

To evaluate the effects of synbiotic supplementation on insulin resistance and lipid profile in individuals with the metabolic syndrome, we conducted a randomised, double-blind, placebo-controlled pilot study on thirty-eight subjects with the metabolic syndrome; they were supplemented with either synbiotic capsules containing 200 million of seven strains of friendly bacteria plus fructo-oligosaccharide or placebo capsules twice a day for 28 weeks. Both the synbiotic (G1) and the placebo (G2) groups were advised to follow an energy-balanced diet and physical activity recommendations. Parameters related to the metabolic syndrome and insulin resistance were measured every 7 weeks during the course of the study. After 28 weeks of treatment, the levels of fasting blood sugar and insulin resistance improved significantly in the G1 group (P< 0·001). Both the G1 and G2 groups exhibited significant reductions in TAG levels ( − 71·22 v. − 10·47 mg/dl ( − 0·80 v. − 0·12 mmol/l) respectively; P< 0·001) and total cholesterol levels ( − 21·93 v. − 14·2 mg/dl ( − 0·57 v. − 0·37 mmol/l) respectively; P= 0·01), as well as increases in HDL levels (+7·7 v. +0·05 mg/dl (+0·20 v. +>0·01 mmol/l) respectively; P< 0·001). The mean differences observed were greater in the G1 group. No significant changes were observed in LDL levels, waist circumference, BMI, metabolic equivalent of task and energy intake between the groups. The present results indicate that synbiotic supplementation increases the efficacy of diet therapy in the management of the metabolic syndrome and insulin resistance.

Public health recommendations do not distinguish between vitamin D2 and vitamin D3, yet disagreement exists on whether these two forms should be considered equivalent. The objective of the present study was to evaluate the effect of a daily physiological dose of vitamin D2 or vitamin D3 on 25-hydroxyvitamin D (25(OH)D) status over the winter months in healthy adults living in Dunedin, New Zealand (latitude 46°S). Participants aged 18–50 years were randomly assigned to 25 μg (1000 IU) vitamin D3 (n 32), 25 μg (1000 IU) vitamin D2 (n 31) or placebo (n 32) daily for 25 weeks beginning at the end of summer. A per-protocol approach, which included ≥ 90 % supplement compliance, was used for all analyses. Serum 25-hydroxyvitamin D3 (25(OH)D3), 25-hydroxyvitamin D2 (25(OH)D2) and parathyroid hormone (PTH) were measured at baseline and at 4, 8, 13 and 25 weeks. Geometric mean total serum 25(OH)D concentrations (sum of 25(OH)D2 and 25(OH)D3) at baseline was 80 nmol/l. After 25 weeks, participants randomised to D2 and placebo had a significant reduction in serum 25(OH)D3 concentrations over the winter months compared with vitamin D3-supplemented participants (both P< 0·001). Supplementation with vitamin D2 increased serum 25(OH)D2 but produced a 9 (95 % CI 1, 17) nmol/l greater decline in the 25(OH)D3 metabolite compared with placebo (P< 0·036). Overall, total serum 25(OH)D concentrations were 21 (95 % CI 14, 30) nmol/l lower in participants receiving vitamin D2 compared with those receiving D3 (P< 0·001), among whom total serum 25(OH)D concentrations remained unchanged. No intervention-related changes in PTH were observed. Daily supplementation of vitamin D3 was more effective than D2; however, the functional consequence of the differing metabolic response warrants further investigation.

For conducting effective risk management in long-stay elderly people at a health service facility, we performed an open case-controlled study to evaluate the effect of the intake of probiotic-fermented milk containing Lactobacillus casei strain Shirota (LcS-fermented milk) on norovirus gastroenteritis occurring in the winter season during the intake period. A total of seventy-seven elderly people (mean age 84 years) were enrolled in the study. During a 1-month period, there was no significant difference in the incidence of norovirus gastroenteritis between the LcS-fermented milk-administered (n 39) and the non-administered (n 38) groups; however, the mean duration of fever of >37°C after the onset of gastroenteritis was 1·5 (sd 1·7) d in the former and 2·9 (sd 2·3) d in the latter group, showing a significant shortening in the former group (P < 0·05). RT-quantitative PCR analysis targeting ribosomal RNA showed both Bifidobacterium and Lactobacillus to be significantly dominant, whereas Enterobacteriaceae decreased in faecal samples from the administered group (n 10, mean age 83 years), with a significant increase in faecal acetic acid concentration. Continuous intake of LcS-fermented milk could positively contribute to the alleviation of fever caused by norovirus gastroenteritis by correcting the imbalance of the intestinal microflora peculiar to the elderly, although such consumption could not protect them from the disease.

β-Glucans have been identified as natural biomolecules with immunomodulatory activity. The first objective of the present study was to compare the effects of purified β-glucans derived from Laminariadigitata, L. hyperborea and Saccharomyces cerevisiae on piglet performance, selected bacterial populations and intestinal volatile fatty acid (VFA) production. The second aim was to compare the gene expression profiles of the markers of pro- and anti-inflammation in both unchallenged and lipopolysaccharide (LPS)-challenged ileal and colonic tissues. β-Glucans were included at 250 mg/kg in the diets. The β-glucans derived from L. hyperborea, L. digitata and S. cerevisiae all reduced the Enterobacteriaceae population (P < 0·05) without influencing the lactobacilli and bifidobacteria populations (P>0·05) in the ileum and colon. There was a significant interaction between gastrointestinal region and β-glucan source in the expression of cytokine markers, IL-1α (P < 0·001), IL-10 (P < 0·05), TNF-α (P < 0·05) and IL-17A (P < 0·001). β-Glucans did not stimulate any pro- or anti-inflammatory cytokine markers in the ileal epithelial cells. In contrast, the expression of a panel of pro- and anti-inflammatory cytokines (IL-1α, IL-10, TNF-α and IL-17A) was down-regulated in the colon following exposure to β-glucans from all the three sources. However, the data suggest that the soluble β-glucans derived from L. digitata may be acting via a different mechanism from the insoluble β-glucans derived from L. hyperborea and S. cerevisiae, as the VFA profile was different in the L. digitata-treated animals. There was an increase in IL-8 gene expression (P < 0·05) in the gastrointestinal tract from the animals exposed to L. digitata following an LPS ex vivo challenge that was not evident in the other two treatment groups. In conclusion, β-glucans from both seaweed and yeast sources reduce Enterobacteriaceae counts and pro-inflammatory markers in the colon, though the mechanisms of action may be different between the soluble and insoluble fibre sources.

Deuterium dilution for the measurement of total body water (TBW) has been conducted using varying protocols for equilibration. We measured TBW from deuterium dilution in urine samples in twenty-eight subjects using three protocols: (1) early morning dosage without breakfast, measuring deuterium in a second voiding at 4h and 6h; (2) early morning dosage with breakfast with the same measurement times; (3) dosage as last consumption before overnight sleep, measuring deuterium in a second voiding at 10 h. Results were compared with TBW estimates from underwater weighing (UWW). Because UWW is an indirect measure of TBW, it is used as an independent reference method in order to compare only relative discrepancies between the two methods. TBW values in the fasted state were not significantly different from those obtained in the fed state. The urinary deuterium enrichment was higher at 4 h than at 6 h (resulting TBW differences: 0·6 (SD 0·4)I). At 4h and 6h, differences in TBW measurements from deuterium and densitometry were positively related to the amount of TBW, indicating incomplete equilibration in larger water compartments. At 10h no such relationship existed, indicating complete mixing of deuterium. It is concluded that 10h equilibration is preferable to the shorter 4h and 6h, for the determination of TBW.

The effects of live yeast (LY) and mannan-oligosaccharide (MOS) supplementation on intestinal disruption induced by Escherichia coli in broilers were investigated. The experimental design was a 3×2 factorial arrangement with three dietary treatments (control, 0·5 g/kg LY (Saccharomyces cerevisiae, 1·0×1010 colony-forming units/g), 0·5 g/kg MOS) and two immune treatments (with or without E. coli challenge from 7 to 11 d of age). Samples were collected at 14 d of age. The results showed that E. coli challenge impaired (P<0·05) growth performance during the grower period (1–21 d) and the overall period (1–35 d) of broilers, increased (P<0·05) serum endotoxin and diamine oxidase levels coupled with ileal myeloperoxidase and lysozyme activities, whereas reduced (P<0·05) maltase activity, and compromised the morphological structure of the ileum. Besides, it increased (P<0·05) the mRNA expressions of several inflammatory genes and reduced occludin expression in the ileum. Dietary treatment with both LY and MOS reduced (P<0·05) serum diamine oxidase and ileal myeloperoxidase levels, but elevated villus height (P<0·10) and the ratio of villus height:crypt depth (P<0·05) of the ileum. It also alleviated (P<0·05) E. coli-induced increases (P<0·05) in ileal Toll-like receptor 4, NF-κB and IL-1β expressions. Moreover, LY supplementation reduced (P<0·05) feed conversion ratio of birds during the grower period and enhanced (P<0·05) the community diversity (Shannon and Simpson indices) of ileal microbiota, whereas MOS addition counteracted (P<0·05) the decreased ileal IL-10 and occludin expressions in challenged birds. In conclusion, both LY and MOS supplementation could attenuate E. coli-induced intestinal disruption by alleviating intestinal inflammation and barrier dysfunction in broilers. Moreover, LY addition could improve intestinal microbial community structure and feed efficiency of broilers.

The present review assesses the potential of the Phaseolus vulgaris α-amylase inhibitor isoform 1 (α-AI1) starch blockers as a widely used remedy against obesity and diabetes. Consumption of the α-amylase inhibitor causes marginal intraluminal α-amylase activity facilitated by the inhibitor's appropriate structural, physico-chemical and functional properties. As a result there is decreased postprandial plasma hyperglycaemia and insulin levels, increased resistance of starch to digestion and increased activity of colorectal bacteria. The efficacy and safety of the amylase inhibitor extracts, however, depend on the processing and extraction techniques used. The extracts are potential ingredients in foods for increased carbohydrate tolerance in diabetics, decreased energy intake for reducing obesity and for increased resistant starch. Research developments in the distribution and biosynthesis of the α-amylase inhibitor, relevant physico-chemical properties, the molecular starch-blocking mechanism, anti-obesity and anti-diabetes effects, safety of extracts and the need for research into their potential anti-colorectal cancer effect are discussed.

1. The frequency of association between methanogenic bacteria and ovine rumen ciliates was studied in the rumen fluid of a fistulated sheep.

2. A period of fasting and flushing of the rumen content with nitrogen resulted in a relatively high association, whereas the intake of food and flushing with hydrogen caused a detachment of the methanogenic bacteria from the ciliates.

3. The changes in the frequency of association can be correlated with the relative attribution to the H2 production by hydrogenogenic bacteria and rumen ciliates.

Based on the potential benefits of cis-9, trans-11-conjugated linoleic acid (CLA) for human health there is interest in developing sustainable nutritional strategies for enhancing the concentration of this fatty acid in ruminant-derived foods. Most evidence to date suggests that endogenous synthesis is the major source of cis-9, trans-11 in milk fat and ruminal outflow is limited and largely independent of dietary 18 : 2n-6 supply. Four lactating cows fitted with a rumen cannula were used in a 4 × 4 Latin square with 14 d experimental periods to examine the effects of sunflower-seed oil (SFO) as a source of 18 : 2n-6 on ruminal lipid metabolism. Cows were offered grass silage-based diets supplemented with 0, 250, 500 or 750 g SFO/d. Supplements of SFO had no effect on DM intake, milk fat or protein secretion, but increased linearly (P < 0·01) milk yield and milk lactose output and shifted (P < 0·001) rumen fermentation towards propionate at the expense of acetate. SFO supplements increased linearly (P < 0·05) the flow of 18 : 0, 18 : 1, 18 : 2n-6 and total CLA at the omasum and enhanced ruminal cis-9-18 : 1, 18 : 2n-6 and 18 : 3n-3 metabolism. Flows of all-trans- (Δ4–16) and cis- (Δ9–16) 18 : 1 isomers were elevated, while increases in ruminal CLA outflow were confined to trans-8, trans-10 and geometric 9,11 and 10,12 isomers. It is concluded that supplementing grass silage-based diets with plant oils rich in 18 : 2n-6 enhances ruminal outflow of trans-11-18 : 1 and cis-9, trans-11-CLA in lactating cows.

Epidemiological data suggest that those who consume a diet rich in quercetin-containing foods may have a reduced risk of CVD. Furthermore, in vitro and ex vivo studies have observed the inhibition of collagen-induced platelet activation by quercetin. The aim of the present study was to investigate the possible inhibitory effects of quercetin ingestion from a dietary source on collagen-stimulated platelet aggregation and signalling. A double-blind randomised cross-over pilot study was undertaken. Subjects ingested a soup containing either a high or a low amount of quercetin. Plasma quercetin concentrations and platelet aggregation and signalling were assessed after soup ingestion. The high-quercetin soup contained 69mg total quercetin compared with the low-quercetin soup containing 5mg total quercetin. Plasma quercetin concentrations were significantly higher after high-quercetin soup ingestion than after low-quercetin soup ingestion and peaked at 2·59 (sem 0·42) μmo/. Collagen-stimulated (0·5μ/l) platelet aggregation was inhibited after ingestion of the high-quercetin soup in a time-dependent manner. Collagen-stimulated tyrosine phosphorylation of a key component of the collagen-signalling pathway via glycoprotein VI, Syk, was significantly inhibited by ingestion of the high-quercetin soup. The inhibition of Syk tyrosine phosphorylation was correlated with the area under the curve for the high-quercetin plasma profile. In conclusion, the ingestion of quercetin from a dietary source of onion soup could inhibit some aspects of collagen-stimulated platelet aggregation and signalling ex vivo. This further substantiates the epidemiological data suggesting that those who preferentially consume high amounts of quercetin-containing foods have a reduced risk of thrombosis and potential CVD risk.

The diet quality index (DQI) for preschool children is a new index developed to reflect compliance with four main food-based dietary guidelines for preschool children in Flanders. The present study investigates: (1) the validity of this index by comparing DQI scores for preschool children with nutrient intakes, both of which were derived from 3 d estimated diet records; (2) the reproducibility of the DQI for preschoolers based on a parentally reported forty-seven-item FFQ DQI, which was repeated after 5 weeks; (3) the relative validity of the FFQ DQI with 3 d record DQI scores as reference. The study sample included 510 and 58 preschoolers (2·5–6·5 years) for validity and reproducibility analyses, respectively. Increasing 3 d record DQI scores were associated with decreasing consumption of added sugars, and increasing intakes of fibre, water, Ca and many micronutrients. Mean FFQ DQI test–retest scores were not significantly different: 72 (sd 11) v. 71 (sd 10) (P = 0·218) out of a maximum of 100. Mean 3 d record DQI score (66 (sd 10)) was significantly lower than mean FFQ DQI (71 (sd 10); P < 0·001). The reproducibility correlation was 0·88. Pearsons correlation (adjusted for within-person variability) between FFQ and 3 d record DQI scores was 0·82. Cross-classification analysis of the FFQ and 3 d record DQI classified 60 % of the subjects in the same category and 3 % in extreme tertiles. Cross-classification of repeated administrations classified 62 % of the subjects in the same category and 3 % in extreme categories. The FFQ-based DQI approach compared well with the 3 d record approach, and it can be used to determine diet quality among preschoolers.

Our recent study has shown that beetroot juice protects against N-nitrosodimethylamine (NDEA)-induced liver injury and increases the activity of phase II enzymes, suggesting the activation of the nuclear factor erythroid-2-related factor 2 (Nrf2)–antioxidant response element (ARE) pathway. The aim of the present study was to further explore the mechanism of the activity of beetroot by evaluating the cytoprotective effects of its major component. The influence of betanin (BET) on the activation of Nrf2 and the expression of GSTA, GSTP, GSTM, GSTT, NQO1 and HO-1 was assessed in two hepatic cell lines: non-tumour THLE-2 and hepatoma-derived HepG2 cell lines. The level of the tumour suppressor p53 in both cell lines and the methylation of GSTP in HepG2 cells were also evaluated. Treatment of both cell lines with 2, 10 and 20 μm of BET resulted in the translocation of Nrf2 from the cytosol to the nucleus. The mRNA and nuclear protein levels of Nrf2 and the binding of Nrf2 to ARE sequences were increased only in the THLE-2 cells and were accompanied by the phosphorylation of serine/threonine kinase (AKT), c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK). BET also significantly increased the mRNA and protein levels of GSTP, GSTT, GSTM and NQO1 in these cells. Conversely, besides the translocation of Nrf2 from the cytosol to the nucleus, BET did not modulate any of the other parameters measured in the HepG2 cells. BET did not change the methylation of GSTP1 in these cells either. These results indicate that BET through the activation of Nrf2 and subsequent induction of the expression of genes controlled by this factor may exert its hepatoprotective and anticarcinogenic effects. Moreover, the activation of mitogen-activated protein kinases may be responsible for the activation of Nrf2 in the THLE-2 cells.

Cancer is a disease that is characterized by the loss of genetic control over cell growth and proliferation, mainly as a result of the exposure to environmental factors. Cessation of smoking and a high consumption of fruits and vegetables are the most important means of reducing the risk of cancer in our society. Like fruits and vegetables, nuts are a source of vegetable protein, monounsaturated fatty acids, vitamin E, phenolic compounds, selenium, vegetable fibre, folic acid and phytoestrogens. There are numerous mechanisms of action by which these components can intervene in the prevention of cancer, although they have not been fully elucidated. There are very few epidemiological studies analyzing the relationship between nuts consumption and risk of cancer. One of the greatest difficulties in interpreting the results is that the consumption of nuts, seeds and legumes are often presented together. The most commonly studied location is the colon/rectum, an organ in which the effect of nuts is biologically plausible. Although the results are not conclusive, a protective effect on colon and rectum cancer is possible. Likewise, some studies show a possible protective effect on prostate cancer, but there is insufficient data on other tumour locations. New epidemiological studies are required to clarify the possible effects of nuts on cancer, particularly prospective studies that make reliable and complete estimations of their consumption and which make it possible to analyse their effects independently of the consumption of legumes and seeds.

In addition to short sleep duration, reduced sleep quality is also associated with appetite control. The present study examined the effect of sleep fragmentation, independent of sleep duration, on appetite profiles and 24 h profiles of hormones involved in energy balance regulation. A total of twelve healthy male subjects (age 23 (sd 4) years, BMI 24·4 (sd 1·9) kg/m2) completed a 24 h randomised crossover study in which sleep (23.30–07.30 hours) was either fragmented or non-fragmented. Polysomnography was used to determine rapid-eye movement (REM) sleep, slow-wave sleep (SWS) and total sleep time (TST). Blood samples were taken at baseline and continued hourly for the 24 h period to measure glucose, insulin, ghrelin, leptin, glucagon-like peptide 1 (GLP-1) and melatonin concentrations. In addition, salivary cortisol levels were measured. Visual analogue scales were used to score appetite-related feelings. Sleep fragmentation resulted in reduced REM sleep (69·4 min compared with 83·5 min; P< 0·05) and preservation of SWS without changes in TST. In fragmented v. non-fragmented sleep, glucose concentrations did not change, while insulin secretion was decreased in the morning, and increased in the afternoon (P< 0·05), and GLP-1 concentrations and fullness scores were lower (P< 0·05). After dinner, desire-to-eat ratings were higher after fragmented sleep (P< 0·05). A single night of fragmented sleep, resulting in reduced REM sleep, induced a shift in insulin concentrations, from being lower in the morning and higher in the afternoon, while GLP-1 concentrations and fullness scores were decreased. These results may lead to increased food intake and snacking, thus contributing to a positive energy balance.

1. Sheep, cows and calves fitted with rumen cannulas were given diets mostly containing 10–16 g nitrogen/kg dry matter and consisting of roughage and cereals. Mixed bacteria were separated from samples of their rumen contents.

2. Bacteria taken 4–6 h after a feed from calves which were kept in an experimental calf-house with no contact with adult animals (environment A) contained more α-dextran, less total N and higher nucleic acid:total N ratios than similar bacteria from calves reared in contact with adult sheep (environment C) but otherwise treated in an identical way.

3. Mixed bacteria taken 4–6 h after a feed from sheep and cows were similar in composition, with respect to nitrogenous components, to those from the ‘environment C’ calves. This composition did not vary significantly when diets containing differing proportions of roughage were given.

4. The ‘environment A’ calves were free of ciliate protozoa. When they were placed in contact with, and were inoculated with rumen contents from, adult cattle (environment B), they rapidly developed a normal protozoal population and the chemical composition of their rumen bacteria became like that of the bacteria from the ‘environment C’ calves.

5. Mixed bacteria taken just before a feed, from either cows or ‘environment A’ calves, showed significantly lower RNA-N:total N ratios and slightly (but not usually significantly) higher DNA-N:total N ratios than bacteria taken 4–6 h after feeding. Total N contents of the bacteria did not change consistently with time after feeding.

6. The possible significance of these differences in relation to the nutrition of the host animal is discussed.

Production and manufacturing methods and the food carrier may influence the properties of probiotic strains, and have an impact on the outcome of clinical intervention studies. The aim of the present study was to establish whether the properties of a specific probiotic strain, Lactobacillus rhamnosus GG, may differ depending on the product and source of the strain. In total, fifteen different L. rhamnosus isolates, among them fourteen labelled as L. rhamnosus GG, were isolated from specific probiotic products. The micro-organisms were phenotypically and genotypically characterised. Their adhesion properties were compared using the human intestinal mucus model, and the ability of the isolates to influence model pathogen adhesion to human colonic mucus was assessed. All L. rhamnosus isolates used were confirmed as members of the species L. rhamnosus. Except the reference strain OL, all L. rhamnosus isolates showed randomly amplified polymorphic DNA, enterobacterial repetitive intergenic consensus and pulsed-field gel electrophoresis profiles identical to that of L. rhamnosus GG (ATCC 53103). All L. rhamnosus isolates showed similar tolerance to acid and were able to bind to human colonic mucus. However, pathogen exclusion by inhibition and competition varied significantly among the different L. rhamnosus isolates and pathogens tested. The results suggest that different sources of the same probiotic may have significantly altered strain properties. This should be considered in in vivo studies on human subjects and also for quality control of probiotic products.

Only one prospective study has analysed the relationship between the inflammatory properties of diet and risk of depression thus far. The aim of this study was to assess the association between the dietary inflammatory index (DII) and the incidence of depression. In a cohort study of 15 093 university graduates, participants completed a validated FFQ at baseline and after 10 years of follow-up. The DII was calculated based on the FFQ. Each of the twenty-eight nutrients or foods received a score based on findings from the peer-reviewed literature reporting on the relationships between diet and inflammatory biomarkers (IL-1β, IL-4, IL-6, IL-10, TNF-α and C-reactive protein). Participants were classified as having depression if they reported a new clinical diagnosis of depression by a physician, antidepressant drugs, or both. Multivariable Cox regression models were used to estimate hazard ratios (HR) of depression according to quintiles of the DII. After a median 8·5 years of follow-up, we observed 1051 incident cases of depression. The HR for participants in the highest quintile of DII (strongly pro-inflammatory) was 1·47 (95 % CI 1·17, 1·85) compared with those in the bottom quintile, with a significant dose–response relationship (Ptrend=0·01). In the subgroup analyses, the association between DII and depression was stronger among participants >55 years and among those with cardiometabolic comorbidities (HR 2·70; 95 % CI 1·22, 5·97 and HR 1·80; 95 % CI 1·27, 2·57, respectively). A pro-inflammatory diet was associated with a significantly higher risk of depression in a Mediterranean population. This association was stronger among older subjects and subjects with cardiometabolic diseases.

Previous national nutrition surveys in Irish adults did not include blood samples; thus, representative serum 25-hydroxyvitamin D (25(OH)D) data are lacking. In the present study, we characterised serum 25(OH)D concentrations in Irish adults from the recent National Adult Nutrition Survey, and determined the impact of vitamin D supplement use and season on serum 25(OH)D concentrations. Of the total representative sample (n 1500, aged 18+ years), blood samples were available for 1132 adults. Serum 25(OH)D was measured via immunoassay. Vitamin D-containing supplement use was assessed by questionnaire and food diary. Concentrations of serum 25(OH)D were compared by season and in supplement users and non-users. Year-round prevalence rates for serum 25(OH)D concentration < 30, < 40, < 50 and < 75 nmol/l were 6·7, 21·9, 40·1 and 75·6 %, respectively (11·1, 31·1, 55·0 and 84·0 % in winter, respectively). Supplement users had significantly higher serum 25(OH)D concentrations compared to non-users. However, 7·5 % of users had winter serum 25(OH)D < 30 nmol/l. Only 1·3 % had serum 25(OH)D concentrations >125 nmol/l. These first nationally representative serum 25(OH)D data for Irish adults show that while only 6·7 % had serum 25(OH)D < 30 nmol/l (vitamin D deficiency) throughout the year, 40·1 % had levels considered by the Institute of Medicine as being inadequate for bone health. These prevalence estimates were much higher during winter time. While vitamin D supplement use has benefits in terms of vitamin D status, at present rates of usage (17·5 % of Irish adults), it will have only very limited impact at a population level. Food-based strategies, including fortified foods, need to be explored.