The objective was to determine the effects of the National Cholesterol Education Program (NCEP) step II diet on LDL and HDL particle size in dyslipidaemic adolescents. Forty-four dyslipidaemic adolescents, aged 10–18 years, participated in this case-control study. The control diet was a diet similar to what most Tehranian adolescents eat. NCEP step II diet was a diet with 30 % of energy as total fat, less than 7 % saturated fat, less than 200 mg cholesterol/d, less than 15 % of energy as MUFA and less than 10 % as PUFA. Lipoprotein particle size was the major outcome variable, which was measured after 3 months of intervention. Comparison was made by the repeated measurement ANOVA. The mean BMI was 26·3 (sd 4·2) kg/m2. There were no significant changes in weight or physical activity in the two groups during the study. The NCEP diet resulted in higher reduction in total cholesterol ( − 13 (sd 4) v. − 2 (sd 0·3) mg/dl, P < 0·001) and LDL ( − 9 (sd 2) v. 3 (sd 0·6) mg/dl, P < 0·01), and higher increase in size of the LDL (1·7 (sd 0·4) v. 0·1 (sd 0·4) nanometer, P < 0·001). HDL particle size did not change significantly. NCEP step II diet had a favourable effect on the LDL particle size. The related mechanism needs to be studied in future experimental designs.

The immunomodulatory properties of lactic acid bacteria (LAB) and foods containing them (e.g., fermented milks) is a topic currently under investigation. Individuals could potentially benefit from the inclusion of LAB in the diet at different times during the life cycle. One of the most accepted specific uses of probiotic bacteria is the prevention of atopic eczema in infants with family history of the disease who receive the probiotic bacteria early, through supplementation of the gestating mother and orally after birth. Immune enhancing effects have also been suggested to be beneficial in diarrhoea treatment, especially in children infected with rotavirus and in malnourished patients, infants and adolescents, whose capacity to produce IFN-γ can be increased after LAB-containing yoghurt intake. Regarding young people and adults, investigations have been conducted exploring the immunomodulation by LAB in subjects under stressful situations, in the prevention of urinary tract infections in fertile women and in the treatment of allergy. However, the beneficial effects of probiotics in these conditions remain controversial and the scientific evidence provided so far is not considered to be conclusive. The elderly population has been the focus of investigations aimed at identifying the capacity of probiotics to counteract the immunosenescence process by increasing phagocytic and natural killer (NK) cell activities and to protect against infection. The mechanisms involved in the different effects attributed to LAB remain to be clarified. Moreover, considering that the immunomodulatory properties are strain-specific, defining the optimal dose of a certain bacteria or combination of bacteria strains and the duration of treatment for a desired effect in a target population group is essential in order to substantiate health claims.

This study evaluated carnitine and lipid status of fifty Korean newborns. Each subject was assigned to two groups: one according to body weight at birth and the other according to gestational age. Serum total, HDL- and LDL-cholesterol were significantly lower and triacylglycerols were significantly higher, by 14 %, in the low birth weight infant (LBWI, 1310–2490 g) group compared with the normal birth weight infant (NBWI, 2570–4420 g) group. Neither birth weight nor gestational age affected serum total carnitine concentrations. However, serum ASAC (acid-soluble acylcarnitine) concentrations were 43 % higher (P < 0·001) in the LBWI group compared with the NBWI group, and approximately twice as high (P < 0·05) in the 28–32 gestational age group compared with the other gestational age groups. NEC (non-esterified acyl carnitine) fractions were significantly higher in the NBWI and 28–32 week groups (P < 0·001 and P < 0·05); consequently serum acyl/NEC carnitine ratios were four times higher in the LBWI group compared with the NBWI group and 2–3 times higher in the 25–32 week age group compared with the more advanced gestational age groups. Urinary carnitine excretion, including the NEC fraction and total carnitine, was significantly higher (P < 0·001) for LBWI than for NBWI. By gestational age, NEC excretion of the 28–32 week group was significantly (P < 0·05) higher than that of the other two groups, but total carnitine excretion was not different among the groups. This study demonstrated that Korean immature and preterm newborns have higher serum triacylglycerol concentrations but lower carnitine status than NBWI. Therefore, the lower carnitine status and moderately higher triacylglycerols may suggest that LBWI in Korea might be at risk for poor carnitine status and decreased capacity to utilise fatty acids for energy.

Children with history of broncho-pulmonary dysplasia (BPD) often suffer from growth failure and lung sequelae. The main objective of this study was to test the role of pulmonary obstruction on resting energy expenditure (REE) and nutritional status in BPD. Seventy-one children with BPD (34 boys and 37 girls) and 30 controls (20 boys and 10 girls) aged 4–8 years were enrolled. Body composition was assessed by bio-impedancemetry measurements; REE was measured by indirect calorimetry. Predicted REE was calculated using the Schofield equation. The population of children with BPD was divided into three groups: children without obstruction of the airways, children with moderate obstruction of the airways, and children with severe obstruction. Children with BPD were significantly smaller and leaner than controls. Altered body composition (reduction of fat mass) was observed in BPD children that suffered from airway obstruction. REE was significantly lower in children with BPD compared to controls, but when adjusted for weight and fat-free mass no significant difference was observed irrespective of pulmonary status. Airway obstruction in children with BPD does not appear to be associated with an increased REE. Moreover altered REE could not explain the altered nutritional status that is still observed in BPD in later childhood. This supports the hypothesis that body composition and pulmonary function in BPD in later childhood are fixed sequelae originating from the neonatal period.

The contribution of dietary Ca and P in renal stone formation is debated. Thus, the main objective was to investigate if there were any differences in the dietary, serum and urine values of Ca and P in stone formers (SF) compared with healthy controls (HC). The secondary aim was to analyse if dietary, serum and urine Ca and P correlated. The study enrolled ten patients with renal stones admitted for stone removal and ten healthy controls. Their dietary macronutrients, Ca and P intakes were calculated from 2-d dietary records. On the second day of dietary record 24-h urine was collected and on the third day morning a 5 ml blood sample was collected. Biochemical analyses were conducted for serum and urine Ca, P and uric acid with qualitative renal stone analysis. All the dietary intakes and urine P were significantly higher (P < 0·05) in SF than in HC. Correlation results showed that in SF dietary Ca correlated to serum and urine Ca. No such correlations were seen for P. Additionally, in SF urine Ca correlated to dietary proteins and fats but not to carbohydrates. None of the biochemical values lay outside the normal range of values. The study suggests urine P rather than urine Ca to be probably at work in the formation of renal stones. Limitation of protein intake with normal Ca intakes could provide a suitable measure to avoid renal stone formation.

The purpose of the present study was to determine whether children experience a higher systemic exposure to isoflavonoids when consuming a body weight-adjusted dose of soya compared with adults. Forty study participants were recruited from a local Waldorf school, including twenty-one children and nineteen adults. Participants collected a baseline urine sample and ate immediately thereafter a body weight-adjusted dose of soya nuts (15 g/54·4 kg equivalent to 0·615 (sd 0·036) mg total isoflavones/kg) followed by a 12 h urine collection. Nineteen children and eighteen adults completed the protocol correctly (fourteen child–parent pairs). Children, compared with adults, showed a statistically significant (P < 0·05 by unpaired t test) higher urinary isoflavone excretion rate for daidzein (+39 %), genistein (+44 %), all non-metabolites (daidzein + genistein + glycitein; +41 %) and total isoflavonoids (+32 %). Isoflavones are more bioavailable in children v. adults. Urine is an excellent medium to determine systemic isoflavone exposure in children due to its non-invasiveness and high compliance, in particular when collected overnight; it also allows evaluation of completeness of specimen collection.

The effect of diet v. statins on LDL particle size as a risk factor for CVD has not been examined. We compared, in the same subjects, the impact of a dietary portfolio of cholesterol-lowering foods and a statin on LDL size electrophoretic characteristics. Thirty-four hyperlipidaemic subjects completed three 1-month treatments as outpatients in random order: a very-low saturated fat diet (control); the same diet with 20 mg lovastatin; a dietary portfolio high in plant sterols (1 g/4200 kJ), soya proteins (21·4 g/4200 kJ), soluble fibres (9·8 g/4200 kJ) and almonds (14 g/4200 kJ). LDL electrophoretic characteristics were measured by non-denaturing polyacrylamide gradient gel electrophoresis of fasting plasma at 0, 2 and 4 weeks of each treatment. The reductions in plasma LDL-cholesterol levels with the dietary portfolio and with statins were comparable and were largely attributable to reductions in the estimated concentration of cholesterol within the smallest subclass of LDL (portfolio − 0·69 (se 0·10) mmol/l, statin − 0·99 (se 0·10) mmol/l). These were significantly greater (P < 0·01) than changes observed after the control diet ( − 0·17 (se 0·08) mmol/l). Finally, baseline C-reactive protein levels were a significant predictor of the LDL size responsiveness to the dietary portfolio but not to the other treatments. The dietary portfolio, like the statin treatment, had only minor effects on several features of the LDL size phenotype, but the pronounced reduction in cholesterol levels within the small LDL fraction may provide additional cardiovascular benefit over the traditional low-fat diet of National Cholesterol Education Program Step II.

Breast milk is the best food for the neonate because it provides a unique combination of proteins, carbohydrates, lipids, minerals and vitamins that ensures the correct growth and development of the infant. In addition, it also contains bioactive compounds responsible for a wide range of beneficial effects such as the promotion of immune system maturation and the protection against infections. Among these bioactive agents, probiotic bacteria have been recently isolated from human milk. The present work reviews the beneficial effects of these bacteria both in animal models and in clinical trials. The promotion of immune system maturation and defence against infections as well as the anti-inflammatory properties are among the main healthy effects of these bacteria. The isolation of probiotic bacteria with beneficial effects for the host provides scientific support for the supplementation of infant formula with these bacteria, in order to advance the pursuit of the main goal of formula: to mimic breast milk and its functional effects as closely as possible.

Lycopene is present mainly as cis-isomers in human serum and tissues whereas all-trans-lycopene predominates in tomato products, suggesting that all-trans-lycopene is isomerised in the body or is less bioavailable. The objectives of the present study were to develop processing conditions for tomatoes to obtain products with different cis-trans-lycopene isomer distribution and to assess their bioavailability. Healthy adult subjects (n 12) were recruited for this randomised cross-over trial. Each intervention was preceded by a 2-week washout period. Two tomato sauces, one rich in all-trans-lycopene (32·5 mg total lycopene/100 g sauce; 5 % cis-isomers), the other high in cis-lycopene (26·4 mg total lycopene/100 g sauce; 45 % cis-isomers), were produced by different heat-processing techniques. Each sauce (150 g) was served in a standardised meal at 08.00 hours after overnight fasting. Plasma TAG-rich lipoprotein fractions over 9.5 h following test-meal consumption as a measure of lycopene absorption were obtained and expressed as baseline-corrected area under the concentration v. time curves (AUC), using HPLC-electrochemical detection. AUC values adjusted for the amount lycopene consumed showed that total, total cis-, and all-trans-lycopene responses were significantly higher from the cis-isomer-rich sauce, compared with the all-trans-rich sauce, being 7·30 (sem 1·45) v. 4·74 (sem 1·08) nmol × h/l (P = 0·002), 3·80 (sem 0·76) v. 1·98 (sem 0·37) nmol × h/l (P = 0·0005) and 3·50 (sem 0·76) v. 2·76 (sem 0·76) nmol × h/l (P = 0·01), respectively. The present study demonstrates significant lycopene bioavailability from cis-lycopene-rich tomato sauce and highlights the importance of considering isomer-distribution for lycopene bioavailability. Furthermore, processing parameters can be controlled to alter isomer patterns of tomato products and influence lycopene bioavailability.

Recent studies have shown a decreased risk of colon cancer with consumption of fish. However, most studies on fish consumption do not distinguish between lean and fatty fish, or between poached and fried fish. The aim of this study was to investigate any association between fish consumption and colon cancer in The Norwegian Women and Cancer (NOWAC) study. We focused mainly on lean fish, which was further divided into poached and fried fish. A total of 63 914 women were included in the analysis, 254 of whom were found to have colon cancer during follow-up. Since fish consumption was one of the main topics of interest in the NOWAC study, there is a predominance of women from northern Norway due to higher fish intake in this area; hence the study is not representative of the whole of Norway. The participants completed a semi-quantitative FFQ between 1996 and 1999, and were followed-up for incidence of colon cancer until 2004. No association between fish consumption and risk of colon cancer was seen, except for the third tertile of poached lean fish consumption (relative risk (RR) 1·46, 95 % CI 1·04, 2·06). This association disappeared when excluding women with less than 1 year of follow-up. In conclusion, the present study does not support the hypothesis of a protective effect of fish against colon cancer risk.

Dietary patterns, which reflect the complexity of food preference, lifestyle and socio-economic status, may play a major role in health and longevity. Understanding dietary patterns and their correlates is important to the research of diet and health relationships. In the Shanghai Men's Health Study (SMHS) a total of 61 582 men aged 40–74 were recruited between 2002 and 2006. Their food intake over the previous year was collected using a validated FFQ. Study participants (75·6 %) reported little or no change in meat and vegetable intake in the 5 years prior to recruitment. Using the baseline data of the SMHS, we assessed dietary patterns, as well as their relationship with socio-demographic and lifestyle factors and with prevalence of some chronic diseases. Three major dietary patterns, fruit-, vegetable- and meat-based diets, were identified in our population. Consumption of the fruit diet appeared to be more common among men who were older and more physically active, had higher income, and lower waist-to-hip ratio (WHR), while this diet was less common among manual labourers. The meat- or vegetable-based diets were less common among elderly men and more common among men with higher WHR. Dietary patterns appeared to be associated with the presence of health conditions. In general, subjects with a chronic disease were more likely to have the vegetable-based diet and less likely to have the fruit- or meat-based diets. Future studies of diet and health in this population will need to carefully take into account these potential confounders.

Certain dietary patterns may be related to the risk of CVD. We hypothesised that a plant-centred dietary pattern would be associated with a reduced risk of first myocardial infarction (MI). A case–control study of Norwegian men and postmenopausal women (age 45–75 years) was performed. A FFQ was administered, generally within 3 d after incident MI (n 106 cases). Controls (n 105) were frequency matched on sex, age and geographic location. On the FFQ, 190 items were categorised into thirty-five food groups and an a priori healthy diet pattern score was created. We estimated OR using logistic regression with adjustment for energy intake, family history of heart disease, marital status, current smoking, education and age. Among food groups, the risk of MI was significantly higher per sd of butter and margarine (OR 1·66 (95 % CI 1·12, 2·46)), and lower per sd of tomatoes (OR 0·53 (95 % CI 0·35, 0·79)), high-fat fish (OR 0·57 (95 % CI 0·38, 0·86)), wine (OR 0·58 (95 % CI 0·41, 0·83)), salad (OR 0·59 (95 % CI 0·40, 0·87)), wholegrain breakfast cereals (OR 0·64 (95 % CI 0·45, 0·90)), cruciferous vegetables (OR 0·66 (95 % CI 0·47, 0·93)) and non-hydrogenated vegetable oil (OR 0·68 (95 % CI 0·49, 0·95)). An abundance of cases were found to have a low a priori healthy diet pattern score. A dietary pattern emphasising nutrient-rich plant foods and high-fat fish and low in trans fatty acids was associated with decreased risk of MI among Norwegians.

Salicylic acid (SA) is a natural phenolic compound known as the active principle of aspirin. Its presence in vegetal sources suggests that fruit and vegetable (FV) consumption could produce measurable SA serum concentrations in human subjects not taking aspirin. The aim of this study was to investigate the relationship between FV intake and circulating SA in healthy subjects. Thirty-eight volunteers (twenty-two males and sixteen females) were recruited from an Italian university campus. They recorded their food intake for 7 d to evaluate dietary consumption and, in particular, FV intake; fasting blood samples were taken on the morning of the eighth day to measure SA serum concentration, using a sensitive stable isotope dilution and GC–MS method. Median SA serum concentration was 0·124 μmol/l (range 0·028–0·295). Circulating SA was significantly related to FV consumption, both to the mean daily intake (r2 0·13, P = 0·03) and to the last day intake (r2 0·16, P = 0·01). The subjects in the highest FV intake quartile in the preceding day (>4·75 servings) had significantly higher SA concentrations than in the lowest quartile ( < 2·3 servings) (median concentrations 0·188 and 0·112 μmol/l, respectively; P = 0·04). This study proved that, after overnight fast, human subjects not taking aspirin display circulating SA in amounts related to the FV consumption. It is therefore possible that the beneficial effects of regular FV consumption in man could also depend on low chronic SA exposure.

There is currently an increased global interest in the published glycaemic index (GI) values of foods. The aim of the present work was to supplement a previous study on the glycaemic response of 140 foods available in the UK by studying a further forty-four foods. One hundred and twenty-two healthy subjects, with a mean age of 32·4 (sd 11·4) years and a mean BMI of 23·6 (sd 3·6) kg/m2, were recruited to the study. Subjects were served equivalent available carbohydrate amounts (50 or 30 g) of test foods (cereal products and weight-management meals) and a standard food (glucose) on separate occasions. Capillary blood glucose was measured from finger-prick samples in fasted subjects (0 min) and at 15, 30, 45, 60, 90 and 120 min after starting to eat each test food. For each test food, the GI value was determined, and the glycaemic load was calculated as the product of the GI and the amount of available carbohydrate in a reference serving size. The GI values of the foods tested ranged from 23 to 83. Of the forty-four foods tested, thirty-three were classified as low-GI, eight as medium-GI and three as high-GI foods. Most GI values of the foods tested compared well with previously published values for similar foods. In summary, this study provides reliable GI and glycaemic load values for a range of foods, further advancing our understanding of the glycaemic response of different foods. The data reported here make an important addition to published GI values.

The objective of the present study is to explore the association between lower urinary tract symptoms (LUTS) and dietary isoflavone in elderly men. In a large prospective cohort of 2000 Chinese men, the association between dietary isoflavone and LUTS were studied using standardized structured questionnaires. Dietary intake was assessed by a modified version of the Block FFQ. LUTS were assessed by the Chinese version of the International Prostatic Symptoms Score. Demographic, lifestyle and other medical information were also collected and were adjusted for in the analysis. After excluding 299 men with history of bladder surgery, bladder or prostate cancer or who were current users of medication for urinary problems, the association between LUTS and dietary isoflavone was explored. A total of 96·2 % of subjects reported some consumption of genistein, glycitein or daidzein. In ordinal multinominal logistic regression, subjects with dietary total isoflavone of more than 5·1 mg were significantly less likely to suffer from more severe LUTS (dietary intake from 5·1 to 9·5 mg: OR 0·59; 95 % CI 0·44, 0·80; from 9·6 to 14·3 mg: OR 0·81; 95 % CI 0·61, 1·09; from 14·4 to 21·7 mg: OR 0·68; 95 % CI 0·51, 0·92; 21·8 mg and above: OR 0·73; 95 % CI 0·54, 0·98) after adjustment for covariates. In this cross-sectional study, we showed a strong inverse association between dietary intake of isoflavone and the risk of LUTS.

This trial was designed to assess the effect of live probiotic consumption on leucine assimilation from fresh and pasteurised yoghurt in volunteers with different lactose digestibility. Thirty-three volunteers (mean age 32, s.d. 7 years) participated in this parallel single-blind study (16 of them with moderate lactose intolerance). Breath samples were taken before and at 15 min intervals over 3-h after the ingestion of fresh and pasteurised yoghurt extrinsically labelled with (1-13C)leucine. The 13C enrichment in breath was measured by isotopic rate mass spectrometry and mathematically converted to a percentage of assimilated leucine (100-%13C-dose in breath) and the assimilation kinetic constant (min− 1). The 13C-leucine assimilation was statistically higher after the fresh yoghurt intake than after the pasteurised product intake (P = 0·032) while the kinetic constant of assimilation was slower in intolerance status (P = 0·014) although a product-related effect (P = 0·445) was not found. In conclusion, fresh yoghurt intake resulted in higher short-term leucine assimilation, while lactose intolerance appears to negatively affect the assimilation rate of leucine from dairy products. These findings offer new insight on acute in vivo amino acid assimilation in the presence of probiotics and moderate lactose intolerance.

A population-based case–control study of diet, inherited susceptibility and prostate cancer was undertaken in the lowlands and central belt of Scotland to investigate the effect of phyto-oestrogen intake and serum concentrations on prostate cancer risk. A total of 433 cases and 483 controls aged 50–74 years were asked to complete a validated FFQ and provide a non-fasting blood sample. Multivariate logistic regression analysis found significant inverse associations with increased serum concentrations of enterolactone (adjusted OR 0·40, 95 % CI 0·22, 0·71] and with the consumption of soy foods (adjusted OR 0·52, 95 % CI 0·30, 0·91). However, no significant associations were observed for isoflavone intake or serum genistein, daidzein and equol. This study supports the hypotheses that soy foods and enterolactone metabolised from dietary lignans protect against prostate cancer in older Scottish men.

The identification of the target foods that most affect the fat content of a diet, independently whether or not they contain fat, can be a useful tool in the process of drawing up more effective dietary guidelines with nutritional education strategies more directed at the needs of each population. With this purpose, the contribution analysis designed by Block and colleagues and multiple linear regression models were applied to a representative sample of Catalonia. Olive oil was the food that provided the highest absolute and relative percentage of fat-derived energy intake and cheese the food that provided the highest percentage of saturated fat-derived energy intake. According to the results of the present work, during the last 10 years the consumption of fruits and vegetables in Catalonia has increased, more in women than men. The intake of white fish is significantly higher than the intake of blue fish, which should be increased in both men and women, and red meat is still the first meat source in this population. Special attention should be paid to the increasing sweet cereal consumption, which is a source of invisible fat to the diet.

Postmenopausal women with the metabolic syndrome are at high risk of oxidative stress. Several studies have suggested possible antioxidant properties of soya, but little evidence is available regarding the effect of soya on oxidative stress in postmenopausal women with the metabolic syndrome. The objective of the present study was to determine the effects of soya consumption on plasma total antioxidant capacity (TAC) and malondialdehyde (MDA) level in postmenopausal women with the metabolic syndrome. A randomised cross-over trial was undertaken on forty-two postmenopausal women with the metabolic syndrome. Participants were randomly assigned to consume a control (Dietary Approaches to Stop Hypertension; DASH) diet, a soya protein diet, or a soya nut diet, each for 8 weeks. Red meat in the DASH diet (one serving per d) was replaced by soya protein in the soya protein period and by soya nuts in the soya nut period. Significant differences between the end values of the control diet, soya protein diet and soya nut diet were seen for MDA (0·70, 0·64 and 0·63 μmol/l; global P < 0·01). The results also showed a significant difference between the end values for TAC (1950, 2030 and 2110 μmol/l, respectively; P < 0·01). The difference from control for TAC was +4·5 % (P < 0·01) in the soya nut period and +5·8 % (P < 0·01) in the soya protein regimen. Both soya nuts and soya protein decreased MDA significantly compared with the control diet (difference from control was − 7·9 % (P < 0·01) in the soya nut period and − 9·4 % (P < 0·01) in the soya protein diet). We conclude that soya consumption reduces plasma MDA and increases plasma TAC levels in postmenopausal women with the metabolic syndrome.

Folate is required for 1-carbon metabolism and deficiency in folate leads to megaloblastic anemia. Low levels of folate have been associated with increased risk of vascular disease. To investigate whether RDA of folate are met, habitual folate intake needs to be assessed reliably. We developed a FFQ to specifically measure folate intake over the previous 3 months in elderly people in the Netherlands. Major sources of folate intake, i.e. foods contributing to at least 80 % of the average folate intake, were identified through an analysis of the second Dutch Food Consumption Survey for the sub-population of men and women aged 50–70. In 2000 and 2001, folate intake was estimated with this questionnaire in 1286 individuals aged 50–75 years. Concentrations of serum and erythrocyte folate served as biomarkers with which relative validity of the questionnaire was assessed. The same FFQ was repeated after 3 years in 803 subjects in order to assess long-term reproducibility. Mean folate intake was estimated to be 196 (sd 69) μg/d. Spearman correlation coefficients between folate intake and serum and erythrocyte concentrations were 0·14 (P < 0·01) and 0·05 (P = 0·06) respectively. Spearman correlations between folate intakes measured at baseline and after 3 years were 0·58 (P < 0·01). 47 % of the participants were classified in the same quartiles on the two occasions. Our FFQ showed a weak correlation between folate intake and blood folate concentrations and reproducibility was acceptable. This FFQ is able to rank subjects according to their folate intake.