Malnutrition is a key factor in metabolic syndrome (MS) and sarcopenia, assessing the nutritional status of these patients is a pressing issue. The purpose of this study was to clarify sarcopenia and sarcopenic obesity in patients with MS based on nutritional status. This was a case–control study between MS/non-MS. Body composition was measured by dual-energy X-ray absorptiometry. Muscle function was assessed by handgrip strength, five times sit-to-stand test, gait speed test and short physical performance battery (SPPB). The Mini Nutritional Assessment (MNA) was performed to assess the nutritional status in the participants in this study. Overall, a total of 56 % and 13 % of participants suffered from possible sarcopenia and sarcopenia, respectively. There was a higher rate of possible sarcopenic obesity in the MS group than in the non-MS group (48·9 % v. 24·7 %, P < 0·01), and all the sarcopenia participants in the MS group had sarcopenic obesity. MNA score was significantly associated with sarcopenia status (P < 0·01). The MNA combined with body fat score showed better acceptable discrimination for detecting sarcopenic obesity and sarcopenia in MS (AUC = 0·70, 95 % CI 0·53, 0·86). In summary, there was a higher prevalence of possible sarcopenic obesity in MS, and all the MS patients with sarcopenia had sarcopenic obesity in the present study. We suggest that the MNA should be combined with body fat percentage to assess the nutritional status of MS participants, and it also serves as a good indicator for sarcopenia and sarcopenic obesity in MS.

Dietary behaviours in early childhood are understudied despite links with later health. Assessing the distribution of key food groups across the day could identify opportunities for improvements. This study aimed to describe the 24-hourly distribution of dietary intakes and frequency of eating occasions for weekdays and weekend days among children aged 18 months and assess associations of eating frequency with vegetable, fruit and discretionary intakes and zBMI. Using two parent-reported 24-h recalls of child dietary intakes from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program, mean frequency of daily eating occasions and hourly intake distributions were calculated for vegetables, fruits, discretionary foods, and total foods and energy-containing beverages on weekdays (n 428) and weekend days (n 376). Multivariable regression analyses assessed associations between frequency of eating occasions, total intake of food groups and zBMI. Overall, children had 7·8 ± 1·8 (mean ± sd) eating occasions/d on weekdays, where 1·5 ± 0·8 contained vegetables, 2·2 ± 1·1 contained fruit and 2·5 ± 1·5 contained discretionary foods. Weekend day intakes were similar. Energy intakes were highest at dinner time. Intakes of total foods, fruits and discretionary foods were spread across the day (06.00–22.00). Vegetable consumption was mainly about 18.00 with minimal intake at other times. Eating frequency was associated with amount of food consumed but not consistently with zBMI. These 18-month-old children ate frequently throughout the day, with little distinction between weekdays and weekend days. Most eating occasions lacked vegetables, and frequency of discretionary foods was higher than of vegetables. Promoting vegetable consumption at occasions other than dinner could improve vegetable intake.

Despite significant economic growth over the past decades, poor nutritional status in India is a serious concern. The social transformation led by growth in income influences both the composition of food and the quality of diet consumed. Against this backdrop of changing lifestyles and the rise in obesity and non-communicable diseases, in this study, we examined changes in diet quality and the critical socio-economic correlates of this quality from 1983 to 2012 using three rounds of nationally representative surveys providing information on food consumption for more than 100 000 households in each round. We constructed diet quality indices at the household level using deficient and excess intake of macro and micronutrients compared with the recommended daily allowances (RDA) for different age-sex groups of the Indian population. We found that in relation to the RDA, fat consumption increased over time while protein and energy consumption decreased. The average diet quality index improved in the rural sector while it deteriorated in the urban sector. Caste and religion are significant correlates of the diet quality index. The deficiency index of nutrients decreased for poor households as they get richer; however, it increased with affluence level for the non-poor. It is suggested that the Indian Government may play a more proactive role in implementing coherent national policies in trade, food and agriculture to protect public health by promoting the demand for a healthy diet.

Folate and vitamin B12 are essential for growth. Our objective was to estimate their long-term effects on linear growth in North Indian children. This is a follow-up study of a factorial designed, double-blind, randomised, placebo-controlled trial in 1000 young children. Starting at 6–30 months of age, we gave folic acid (approximately 2 RDA), vitamin B12 (approximately 2 RDA), both vitamins or a placebo daily for 6 months. Six years after the end of supplementation, we measured height in 791 children. We used the plasma concentrations of cobalamin, folate and total homocysteine to estimate vitamin status. The effect of the interventions, the association between height-for-age z-scores (HAZ) and baseline vitamin status, and the interactions between supplementation and baseline status were estimated in multiple regression models. Mean (sd) age at follow-up was 7·4 (0·7) years (range 6 to 9 years). There was a small, non-significant effect of vitamin B12 on linear growth and no effect of folic acid. We observed a subgroup effect of vitamin B12 supplementation in those with plasma cobalamin concentration < 200 pmol/l (P for interaction = 0·01). The effect of vitamin B12 supplementation in this group was 0·34 HAZ (95 % CI 0·11, 0·58). We found an association between cobalamin status and HAZ in children not given vitamin B12 (P for interaction = 0·001). In this group, each doubling of the cobalamin concentration was associated with 0·26 (95 % CI 0·15, 0·38) higher HAZ. Suboptimal vitamin B12 status in early childhood seemingly limits linear growth in North Indian children.

The association between dairy products consumption in adults and the likelihood of type 2 diabetes mellitus (T2DM) has been described, but more information on the adolescent population is needed. This nationally representative, cross-sectional school-based study aimed to describe the consumption of dairy products and their subtypes and to evaluate their association with prediabetes and T2DM in adolescents. The Study of Cardiovascular Risks in Adolescents (ERICA) includes adolescents aged 12–17 years. Dairy products consumption was evaluated by 24-h food recall. Associations with fasting glucose, glycated hemoglobin (HbA1c) and insulin resistance, as measured by homeostatic model assessment-insulin resistance (HOMA-IR), were evaluated by multivariate linear regression. Poisson regression was also used to assess the association between dairy products consumption and the combined prevalence of prediabetes and T2DM. Models were adjusted for sociodemographic, nutritional, behavioural and anthropometrics. The final sample analysed consisted of 35 614 adolescents. Total intake of dairy products was inversely associated with fasting blood glucose levels after adjusting for all covariates (β = −0·452, 95 % CI −0·899, −0·005). The associations were stronger for overweight and obese adolescents. Findings were similar for full-fat dairy products and yogurt. Higher consumption of low-fat dairy products and cheese were associated with a 46 % (prevalence ratio, PR 1·46, 95 % CI 1·18, 1·80) and 33 % (PR 1·33, 95 % CI 1·14, 1·57) higher combined prevalence of prediabetes and T2DM, respectively. The total consumption of dairy products and full-fat dairy products was associated with a lower combined prevalence of prediabetes and T2DM, while the consumption of cheese and low-fat dairy products was associated with higher combined prevalence of prediabetes and T2DM in Brazilian adolescents.

We evaluated whether early-life protein restriction alters structural parameters that affect β-cell mass on the 15th day and 20th day of gestation in control pregnant (CP), control non-pregnant (CNP), low-protein pregnant (LPP) and low-protein non-pregnant (LPNP) rats from the fetal to the adult life stage as well as in protein-restricted rats that recovered after weaning (recovered pregnant (RP) and recovered non-pregnant). On the 15th day of gestation, the CNP group had a higher proportion of smaller islets, whereas the CP group exhibited a higher proportion of islets larger than the median. The β-cell mass was lower in the low-protein group than that in the recovered and control groups. Gestation increased the β-cell mass, β-cell proliferation frequency and neogenesis frequency independently of the nutritional status. The apoptosis frequency was increased in the recovered groups compared with that in the other groups. On the 20th day of gestation, a higher proportion of islets smaller than the median was observed in the non-pregnant groups, whereas a higher proportion of islets larger than the median was observed in the RP, LPP and CP groups. β-Cell mass was lower in the low-protein group than that in the recovered and control groups, regardless of the physiological status. The β-cell proliferation frequency was lower, whereas the apoptosis rate was higher in recovered rats compared with those in the low-protein and control rats. Thus, protein malnutrition early in life did not alter the mass of β-cells, especially in the first two-thirds of gestation, despite the increase in apoptosis.

Within the USA military, monitoring body composition is an essential component of predicting physical performance and establishing soldier readiness. The purpose of this study was to explore mobile phone three-dimensional optical imaging (3DO), a user-friendly technology capable of rapidly obtaining reliable anthropometric measurements and to determine the validity of the new Army one-site body fat equations using 3DO-derived abdominal circumference. Ninety-six participants (51 F, 45 M; age: 23·7 ± 6·5 years; BMI: 24·7 ± 4·1 kg/m2) were assessed using 3DO, dual-energy X-ray absorptiometry (DXA) and a 4-compartment model (4C). The validity of the Army equations using 3DO abdominal circumference was compared with 4C and DXA estimates. Compared with the 4C model, the Army equation overestimated BF% and fat mass (FM) by 1·3 ± 4·8 % and 0·9 ± 3·4 kg, respectively, while fat-free mass (FFM) was underestimated by 0·9 ± 3·4 kg (P < 0·01 for each). Values from DXA and Army equation were similar for BF%, FM and FFM (constant errors between −0·1 and 0·1 units; P ≥ 0·82 for each). In both comparisons, notable proportional bias was observed with slope coefficients of −0·08 to −0·43. Additionally, limits of agreement were 9·5–10·2 % for BF% and 6·8–7·8 kg for FM and FFM. Overall, while group-level performance of the one-site Army equation was acceptable, it exhibited notable proportional bias when compared with laboratory criterion methods and wide limits of agreement, indicating potential concerns when applied to individuals. 3DO may provide opportunities for the development of more advanced, automated digital anthropometric body fat estimation in military settings.

Adolescents’ snack choices could be altered by increasing the reinforcing value (RV) of healthy snacks compared with unhealthy snacks. This study assessed whether the RV of fruit increased by linking it to a reward and if this increased RV was comparable with the RV of unhealthy snacks alone. Moderation effects of sex, hunger, BMI z-scores and sensitivity to reward were also explored. The RV of snacks was assessed in a sample of 165 adolescents (15·1 (sd 1·5) years, 39·4 % boys and 17·4 % overweight) using a computerised food reinforcement task. Adolescents obtained points for snacks through mouse clicks (responses) following progressive ratio schedules of increasing response requirements. Participants were (computer) randomised to three experimental groups (1:1:1): fruit (n 53), fruit+reward (n 60) or unhealthy snacks (n 69). The RV was evaluated as total number of responses and breakpoint (schedule of terminating food reinforcement task). Multilevel regression analyses (total number of responses) and Cox’s proportional hazard regression models (breakpoint) were used. The total number of responses made were not different between fruit+reward and fruit (b −473; 95 % CI −1152, 205, P=0·17) or unhealthy snacks (b410; 95 % CI −222, 1043, P=0·20). The breakpoint was slightly higher for fruit than fruit+reward (HR 1·34; 95 % CI 1·00, 1·79, P=0·050), whereas no difference between unhealthy snacks and fruit+reward (HR 0·86; 95 % CI 0·62, 1·18, P=0·34) was observed. No indication of moderation was found. Offering rewards slightly increases the RV of fruit and may be a promising strategy to increase healthy food choices. Future studies should however, explore if other rewards, could reach larger effect sizes.

Undernutrition is a major public health problem in developing countries. Around 40·2 % of children are stunted in Pakistan. This longitudinal study aimed to assess the effectiveness of locally produced ready-to-use supplementary foods in the prevention of stunting by detecting change in of children in intervention v. control arm against the 2006 WHO growth reference. A community-based non-randomised cluster-controlled trial was conducted from January 2018 to December 2020 in the district of Kurram, Khyber Pakhtunkhwa, Pakistan. A total of 80 clusters (each cluster comprising ≈ 250–300 households) were defined in the catchment population of twelve health facilities. Children aged 6–18 months were recruited n 1680. The intervention included a daily ration of 50 g – locally produced ready-to-use-supplementary food (Wawa-Mum). The main outcome of this study was a change in length for age z-score (LAZ) v. WHO growth standards. Comparison between the interventions was by t test and ANOVA. Cox proportional hazard models were used to assess the association between stunting occurrence and the utilisation of locally produced supplement. Out of the total 1680, fifty-one out of the total 1680, 51·1 out of the total 1680 and 51·1 % (n 859) were male. Mean age 13·9 months (sd + 859) were male. Mean age 13·9 months (sd + –4·4). At baseline, 36·9 % (n 618) were stunted. In the intervention group, mean LAZ score significantly increased from −1·13(2·2 sd) at baseline to −0·93(1·8 sd) at 6-month follow-up (P value 0·01) compared with the control group. The incidence rate of stunting in the intervention arm was 1·3 v. 3·4 per person year in the control arm. The control group had a significantly increased likelihood of stunting (Hazard Ratio (HR) 1·7, 95 % CI 1·46, 2·05, P value < 0·001) v. the intervention group. Locally produced ready-to-use supplementary food is an effective intervention for reducing stunting in children below 2 years of age. This can be provided as part of a malnutrition prevention package to overcome the alarming rates of stunting in Pakistan.

1. Individual energy intakes and expenditures of seven Tristan men aged between 16 and 57 years, and ten Tristan women aged between 15 and 61 years, were measured daily for 7 consecutive days between May and October 1966.

2. Details of the subjects' main activities together with the energy cost of these activities are given.

3. The mean daily calorie intakes were 2650 kcal for men and 1830 kcal for women; the mean expenditures were 2860 and 2060 kcal per day respectively. Separate values are given for two individuals, a brother and sister, who gave results bearing no resemblance to those of the rest of the subjects.

4. Protein, fat, carbohydrate and alcohol accounted for 12.7, 29.6, 53.7 and 40 % respectively of the men's total calorie intake and 11.9, 27.2, 61.0% and 0% of the women's total calorie intake. The fat content of the diet was low when compared with that of the Islanders' diet while in England, though total calorie intake was greater (Taylor, Hollingsworth & Chambers, 1966). More than half the total calorie intake was provided by processed foodstuffs, but island produce provided a large proportion of the protein in the diet.

5. It is deduced that mean energy requirements of about 2750 kcal per day for men and 1950 kcal per day for women are adequate for the Tristan population and that there are sufficient food supplies available to meet this requirement.

Solving complex problems in large-scale research programmes requires cooperation and division of labour. Simultaneously, large-scale problem solving also gives rise to unintended side effects. Based upon 5 years of researching two large-scale nutrigenomic research programmes, we argue that problems are fragmented in order to be solved. These sub-problems are given priority for practical reasons and in the process of solving them, various changes are introduced in each sub-problem. Combined with additional diversity as a result of interdisciplinarity, this makes reassembling the original and overall goal of the research programme less likely. In the case of nutrigenomics and health, this produces a diversification of health. As a result, the public health goal of contemporary nutrition science is not reached in the large-scale research programmes we studied. Large-scale research programmes are very successful in producing scientific publications and new knowledge; however, in reaching their political goals they often are less successful.

Vitamin and mineral supplements (VMS) are widely available and commonly used. Little is known about patterns of poisoning exposures to VMS in the Australian population. We performed a retrospective study of calls to the New South Wales Poisons Information Centre (NSWPIC), July 2014–June 2019. NSWPIC is Australia’s largest PIC, taking approximately 100 000 calls/year (50 % of Australian poisoning calls) from healthcare professionals and members of the public. We conducted additional analyses on Fe exposures due to their high risk of acute toxicity. There were 10 944 VMS exposures reported to NSWPIC during the study period, increasing 9·6 % per annum over a 5-year period (95 % CI, 7·2, 12·1 %). Toddlers (1–4 years) accounted for 41·5 % (4546) of cases. Agents most commonly involved were multivitamins (n 3610), vitamin D (n 2080), Fe (n 1533) and Mg (n 804). In 17·7 % (1934) of cases, the call originated from hospital or the patient was referred to hospital by NSWPIC. Fe exposures increased by 14·0 % per year (95 % CI, 9·5, 18·5 %), and most were associated with high-strength products (> 45 mg elemental Fe per unit dose, n 1036). Fe exposures were hospitalised in 38 % of cases (n 583). We conclude that VMS exposures are increasing in Australia. Although most exposures can be managed at home, many required hospitalisation. Fe exposures are increasing and had higher rates of hospitalisation than other agents. VMS are often considered safe and without the potential for adverse effects, highlighting the importance of public education into the potential risks of misuse of these products.

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.

Dairy fat is rich in SFA such as palmitic acid (16:0) but low in linoleic acid (18:2n-6). The natural carbon 13 enrichment (δ13C) of 16:0 is higher in dairy fat than in most of the food supply. In adults, serum levels of pentadecanoic acid (15:0) and heptadecanoic acid (17:0) are recognised as biomarkers of dairy intake. In adolescents, no study has evaluated serum fatty acid levels or δ13C in response to chronic dairy consumption. The objectives of this study were to evaluate whether increased dairy product consumption can modulate (1) serum fatty acid levels and (2) 16:0 δ13C in adolescents with overweight/obesity who followed a 12-week weight management programme. This secondary analysis of a randomised control trial included two groups of adolescent females: recommended dairy (RDa; n 23) and low dairy (LDa; n 23). The RDa group was given 4 servings/d of dairy products while the LDa group maintained dairy intakes at ≤ 2 servings/d. Blood was sampled before and after the intervention. Lipids were extracted and separated, and fatty acids were quantified by GC. Isotope ratio MS was used to assess 16:0 δ13C. There were no group differences on serum changes of 15:0 or 17:0. Within TAG, 18:2n-6 was lowered by 7·4 % only in the RDa group (P = 0·040). The difference in delta 16:0 δ13C between the LDa and RDa groups did not reach statistical significance (P = 0·070). Reductions in serum 18:2n-6 by dairy consumption could have positive health implications, but more studies are needed to confirm this assertion.