Although hepcidin synthesis is stimulated by inflammation and inhibited by Fe deficiency, the strength of their opposing effects on serum hepcidin (SHep) in humans remains unclear. It was recently shown that an inflammatory stimulus in anaemic women did not increase SHep or decrease Fe absorption. The enhancing effect of ascorbic acid on Fe absorption may not be effective during inflammation because of increased SHep. Our study aim was to test whether reducing inflammation in Fe-depleted overweight (OW) women with low-grade inflammation would lower SHep and improve Fe absorption with and without ascorbic acid, compared with normal-weight (NW) women without inflammation. Before and after 14 d of anti-inflammatory treatment (3 × 600 mg ibuprofen daily) in OW and NW women (n 36; 19–46 years of age), we measured SHep and fractional Fe absorption (FIA) (erythrocyte Fe incorporation) from 57Fe- and 58Fe-labelled test meals with and without ascorbic acid. There were significant group effects on IL-6, C-reactive protein, serum ferritin and SHep (for all, P < 0·05). There was a significant treatment effect on SHep (P < 0·05): in OW women, treatment decreased IL-6 by approximately 30 % and SHep by approximately 45 %. However, there were no significant treatment or group effects on FIA. Body Fe stores (BIS) were a significant positive predictor of SHep before and after treatment (P < 0·001), but IL-6 was not. Reducing chronic inflammation in OW women halved SHep but did not affect Fe absorption with or without ascorbic acid, and the main predictor of Fe absorption was BIS.

During lactation, areal (a) and volumetric (v) bone mineral density (BMD) are known to temporarily decrease. Factors that affect skeletal changes postpartum are not fully elucidated. The aim was to study determinants of the previously observed changes in aBMD at lumbar spine, and cortical vBMD, microstructure and dimensions at ultra-distal tibia postpartum. Women (25–40 years) were studied longitudinally at 2 weeks (baseline) and 4 months (n 81), 12 months (n 79) and 18 months (n 58) postpartum. At each visit, blood samples were collected, body weight and height were measured and information about lactation habits, oestrogen contraceptives and physical activity was obtained. Ca intake was measured using 4-d food diaries at 4 months postpartum. Serum 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography-tandem MS. Skeletal changes were assessed with dual-energy X-ray absorptiometry and high-resolution peripheral quantitative computed tomography. Mean baseline BMI was 24·8 (sd 3·1) kg/m2. Median (quartiles 1–3) duration of total lactation was 8·1 (6·8–10·4) months. Longer duration of full lactation was associated with larger decreases of lumbar spine aBMD and tibia vBMD and microstructure. Higher baseline body weight was associated with smaller decreases in tibia vBMD and microstructure. Higher Ca intake was associated with smaller decreases in tibia cortical vBMD and thickness. Higher baseline 25OHD was only associated with larger decreases in lumbar spine aBMD. In conclusion, lactation and body weight were the main determinants of skeletal changes during the first 18 months postpartum. Ca intake and serum concentrations of 25OHD appear to have different associations with cortical and trabecular bone.

‘Dietary variety’ has been identified as a factor associated with food intake. Whilst this relationship may have longer-term benefits for body weight management when eating low-energy, nutrient-dense foods, it may increase the risk of overconsumption (and body adiposity) when foods are high energy density. This study sought to further explore pathways underpinning the relationship between dietary variety and body weight, by considering energy density as a moderating factor and portion size as a mediating factor in this relationship. Using prospective data from the UK Biobank, dietary variety scores (DVS), cumulative portion size and energy density were derived from 24-h dietary recall questionnaires at baseline and follow-up. BMI, whole-body fat percentage and fat-free mass were included as outcomes. Contrary to predictions, linear multiple regression models found some evidence of a negative, direct association between DVS and body weight outcomes at baseline (b = –0·13). Though dietary variety was significantly associated with larger portions across time points (b = 41·86–82·64), a moderated mediation effect was not supported at baseline or follow-up (Index ≤ 0·035). Taken together, these findings provide population-level evidence to support a positive association between variety and food intake, which in turn has potential implications for body weight management, both in terms of moderating food intake and benefitting diet quality.

1. Food intake and energy expenditure were determined on 500 soldiers drawn from infantry, artillery and engineer units of the Indian army, for 3 months during winter..

2. The units were located in two different regions of India at altitudes varying from sea level to 2300 m..

3. The energy requirements were assessed from the actual food intake as well as from energy expenditure and from the changes in body-weight and skinfold thickness..

4. The nutritional adequacy of the diet was assessed from clinical examination and changes in blood haemoglobin concentration..

5. The mean energy expenditure was found to be 15.39 MJ (3679 kcal) and on this basis the energy requirement was 16.61 MJ (3970 kcal); energy intake was found to be 16.47 MJ (3936 kcal)..

6. The energy contributed by protein, fat and carbohydrate was 0.115, 0.240 and 0.645 of the total intake respectively..

7. There was no significant change in body-weight, blood haemoglobin level and skinfold thickness on this mean daily intake.

This study aimed to investigate the association between hyperemesis gravidarum (HG) severity and early enteral tube feeding on cardiometabolic markers in offspring cord blood. We included women admitted for HG, who participated in the MOTHER randomised controlled trial (RCT) and observational cohort. The MOTHER RCT showed that early enteral tube feeding in addition to standard care did not affect symptoms/birth outcomes. Among RCT and cohort participants, we assessed how HG severity affected lipid, c-peptide, glucose and free thyroxine cord blood levels. HG severity measures were severity of vomiting at inclusion and 3 weeks after inclusion, pregnancy weight gain and 24-h energy intake at inclusion, readmissions and duration of hospital admissions. Cord blood measures were also compared between RCT participants allocated to enteral tube feeding and those receiving standard care. Between 2013-2016, 215 women were included: 115 RCT and 100 cohort participants. Eighty-one cord blood samples were available. Univariable not multivariable regression analysis showed that lower maternal weight gain was associated with higher cord blood glucose levels (β: –0·08, 95% CI –0·16, –0·00). Lower maternal weight gain was associated with higher Apo-B cord blood levels in multivariable regression analysis (β: –0·01, 95% CI –0·02, –0·01). No associations were found between other HG severity measures or allocation to enteral tube feeding and cord blood cardiometabolic markers. In conclusion, while lower maternal weight gain was associated with higher Apo-B cord blood levels, no other HG severity measures were linked with cord blood cardiometabolic markers, nor were these markers affected by enteral tube feeding.

This study assessed postprandial plasma aminoacidemia, glycemia, insulinemia and appetite responses to ingestion of a novel salmon-derived protein peptide (Salmon PP) compared with milk protein isolate (Milk PI). In a randomised, participant-blind crossover design, eleven healthy adults (M = 5, F = 6; mean ± sd age: 22 ± 3 years; BMI: 24 ± 3 kg/m2) ingested 0·3 g/kg/body mass of Salmon PP or Milk PI. Arterialised blood samples were collected whilst fasted and over a 240-min postprandial period. Appetite sensations were measured via visual analogue scales. An ad libitum buffet-style test meal was administered after each trial. The incremental AUC (iAUC) plasma essential amino acid (EAA) response was similar between Salmon PP and Milk PI. The iAUC plasma leucine response was significantly greater following Milk PI ingestion (P < 0·001), whereas temporal and iAUC plasma total amino acid (P = 0·001), non-essential amino acid (P = 0·002), glycine (P = 0·0025) and hydroxyproline (P < 0·001) responses were greater following Salmon PP ingestion. Plasma insulin increased similarly above post-absorptive values following Salmon PP and Milk PI ingestion, whilst plasma glucose was largely unaltered. Indices of appetite were similarly altered following Salmon PP and Milk PI ingestion, and total energy and macronutrient intake during the ad libitum meal was similar between Salmon PP and Milk PI. The postprandial plasma EAA, glycine, proline and hydroxyproline response to Salmon PP ingestion suggest this novel protein source could support muscle and possibly connective tissue adaptive remodelling, which warrants further investigation, particularly as the plasma leucine response to Salmon PP ingestion was inferior to Milk PI.

While there is growing interest in the link between diet and psychological health, there is a surprising lack of studies investigating the precise associations between nutrient-rich foods (such as fruit and vegetables) v. nutrient-poor foods (such as energy-dense savoury and sweet snacks), and psychological health. Similarly, the psychological processes underpinning the relationship between dietary intake and psychological health remain unclear. Hence, the present study aimed to explore the relationship between dietary consumption and psychological health, with cognitive processes as a theoretical mediator. This cross-sectional online study included 428 healthy adults (53 % female; mean age = 39·7 years, sd = 13·0), with participants completing a range of validated questionnaires measuring dietary habits and psychological health. Stepwise multiple regression revealed that more frequent consumption of fruit was associated with reduced symptoms of depression (β = –0·109, P = 0·025) and greater positive psychological wellbeing (β = 0·187, P < 0·001). Conversely, more frequent savoury snacking was associated with increased anxiety (β = 0·127, P = 0·005). Further, mediation analyses revealed that more frequent consumption of savoury snacks was associated with increased symptoms of depression, stress, anxiety and reduced psychological wellbeing, via an increase in cognitive failures (ps < 0·001). These results provide new insights on the independent associations between certain types of food and psychological health, and the psychological mechanisms that may mediate these. Further work is now required to establish causality and determine whether these may represent modifiable dietary targets that can directly (and indirectly) influence our psychological health.

We aimed to assess the individual and joint association of serum vitamin D and cardiorespiratory fitness (CRF) with obesity and metabolic syndrome (MetSyn). In this cross-sectional study 270 adults with an age range of 18 years and older were recruited from health centers from five districts in Tehran, Iran. CRF was assessed with Bruce protocol. MetSyn was defined based on International Diabetes Federation 2009. The odds ratio (OR) and 95 % confidence interval (CI) of obesity and MetSyn across tertiles of serum vitamin D and CRF were estimated with control for confounders. The results indicated that neither 25(OH)D nor 1,25(OH)D was associated with obesity and MetSyn. There was a strong inverse association between CRF and general (P -trend < 0.001) and abdominal adiposity (P -trend: 0.001). The joint association of vitamin D and CRF indicated that the inverse association of CRF with obesity was stronger in those with high serum vitamin D than those with low serum vitamin D and this joint association remained after considering age and diet quality. There was a significant inverse association for those with low serum 25(OH)D and high CRF (OR: 0.12, 95 % CI: 0.04–0.81; P = 0.02) compared to those with low serum 25(OH)D and low CRF in the crude model. Also, the OR of general obesity was 0.17 (95 % CI: 0.02–0.79; P = 0.03) for those with high CRF and low serum 1,25(OH)D compare with the reference group. Our findings indicated a strong inverse association between CRF and obesity, especially in those with high serum vitamin D.

Multiple micronutrient deficiencies are widespread in Ethiopia. However, the distribution of Se and Zn deficiency risks has previously shown evidence of spatially dependent variability, warranting the need to explore this aspect for wider micronutrients. Here, blood serum concentrations for Ca, Mg, Co, Cu and Mo were measured (n 3102) on samples from the Ethiopian National Micronutrient Survey. Geostatistical modelling was used to test spatial variation of these micronutrients for women of reproductive age, who represent the largest demographic group surveyed (n 1290). Median serum concentrations were 8·6 mg dl−1 for Ca, 1·9 mg dl−1 for Mg, 0·4 µg l−1 for Co, 98·8 µg dl−1 for Cu and 0·2 µg dl−1 for Mo. The prevalence of Ca, Mg and Co deficiency was 41·6 %, 29·2 % and 15·9 %, respectively; Cu and Mo deficiency prevalence was 7·6 % and 0·3 %, respectively. A higher prevalence of Ca, Cu and Mo deficiency was observed in north western, Co deficiency in central and Mg deficiency in north eastern parts of Ethiopia. Serum Ca, Mg and Mo concentrations show spatial dependencies up to 140–500 km; however, there was no evidence of spatial correlations for serum Co and Cu concentrations. These new data indicate the scale of multiple mineral micronutrient deficiency in Ethiopia and the geographical differences in the prevalence of deficiencies suggesting the need to consider targeted responses during the planning of nutrition intervention programmes.

This systematic review aimed to provide a synthesis of the evidence relating to how the provision of vitamin D supplements influences oral health status. An electronic database search was performed across six databases using a standardised search strategy. The PICO framework (Population, Intervention, Comparison, Outcome) was used to define the review question. The screening and selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses process (PRISMA). The quality of reporting was assessed using Consolidated Standards of Reporting Trials (CONSORT) guidelines, and the bias was assessed using the revised Cochrane tool RoB2. A total of 1812 studies were retrieved. 1427 studies were excluded due to unmet inclusion criteria. Full texts of seventy-five potential studies were retrieved and ultimately six studies met the inclusion criteria. There were limitations in the quality of reporting of studies (between 49 % and 73 %). 70 % of the risk of bias items were in the low risks category. Vitamin D interventions varied with respect to dosage and duration. Qualitative syntheses identified significantly better oral health outcomes. Heterogeneity of study design, intervention and outcomes precluded quantitative synthesis. Few clinical trials investigated the effect of vitamin D supplementation on oral health. There is considerable heterogeneity among studies interventions and oral health outcomes. Quality of reporting of studies has limitations and there is evidence of study biases. Nonetheless, qualitative synthesis of the evidence suggests that vitamin D supplements improve oral health outcomes, particularly periodontal health. Calcium may also play a significant role. Further high-quality trials are required of comparable vitamin D supplements with similar oral health outcomes focused to inform quantitative synthesis of the evidence.