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

Hypertension or high blood pressure is a significant health problem worldwide. Bioactive peptides that inhibit angiotensin I converting enzyme (ACE) in the cardiovascular system can contribute to the prevention and treatment of hypertension. These ACE inhibitory peptides are derived from many food proteins, especially milk proteins. An ACE inhibitory activity in vitro does not always imply an antihypertensive effect in vivo. Even if it does, it is very difficult to establish a direct relationship between in vitro and in vivo activity. This is mainly due to the bioavailability of the ACE inhibitory peptides after oral administration and the fact that peptides may influence blood pressure by mechanisms other than ACE inhibition. To exert an antihypertensive effect after oral ingestion, ACE inhibitory peptides have to reach the cardiovascular system in an active form. Therefore, they need to remain active during digestion by human proteases and be transported through the intestinal wall into the blood. The bioavailability of some ACE inhibitory peptides has been studied. It is also known that (hydroxy)proline-containing peptides are generally resistant to degradation by digestive enzymes. Peptides can be absorbed intact through the intestine by paracellular and transcellular routes, but the potency of the bioactivity after absorption is inversely correlated to chain length. In addition, some strategies are proposed to increase the bioavailability of ACE inhibitory peptides. Further research into the bioavailability of ACE inhibitory peptides will lead to the development of more effective ACE inhibitory peptides and foods.

ApoA-IV is a protein constituent of HDL particles; the gene coding for it is a member of the ApoA-I–ApoC-III–ApoA-IV cluster. To investigate the effects of the quantity and the degree of saturation of dietary lipid on the long-term response of this Apo, and on the hypothetical coordinated regulation of the cluster in vivo, pigs were fed isoenergetic, cholesterol-free, low-lipid or lipid-enriched diets (containing either extra olive oil (rich in MUFA) or sunflower oil (rich in n−6 PUFA)) for 42 d. In animals fed on the control diet, ApoA-IV was mainly associated with plasma lipoproteins. An increase in plasma ApoA-IV concentration, mainly in the lipoprotein-free fraction, was induced by the lipid-enriched diets, independent of the degree of saturation of the fatty acids involved. The latter diets also led to increases in hepatic ApoA-I, ApoA-IV and ApoC-III mRNA levels, more so with the sunflower oil-rich diet. The present results show that porcine plasma ApoA-IV levels and their association with lipoproteins are very sensitive to increases in dietary lipids, independent of the degree of fatty acid saturation. Furthermore, hepatic expression of RNA appears to be coordinated along with that of the other members of the gene cluster.

Dieting Makes You Fat, the title of a 1980s book on weight control, is a popularised paradox, conveying a conclusion that is consistent with personal experience and the reported failure of most dietary approaches in the treatment of obesity. Few studies have been designed specifically to test this association. Yet there are prospective data showing that baseline dieting or dietary restraint increases the risk of weight gain, especially in women. Metabolic adaptations and the disinhibited eating of restrained eaters have been the most commonly cited explanations for such weight gain. Dietary restraint has also been implicated in the development and persistence of binge eating. The present paper critically evaluates the evidence supporting this paradox and reaches a rather different conclusion.

The effects of Lactobacillus gasseri JCM 1131T on isoflavonoid levels within the caecum and plasma were assessed in adult mice. Male 5-week-old mice were fed an AIN 93M diet for 30 d. Two groups of mice were administered either L. gasseri JCM 1131T (the LGI group) or physiological saline solution (the control (CI) group) daily for 5 d before dissection. The plasma daidzein concentration was significantly higher in the LGI group, however, their plasma equol concentration was significantly less than in the CI group. The total amount of equol present as aglycone in the caecum was significantly greater in the CI group, but there was no significant difference in the total daidzein present as caecal aglycone. In an in vitro incubation of daidzin with the faecal flora of mice, the equol concentration was significantly higher in the CI group. The numbers of lactobacilli present were significantly higher in the LGI group. The present data suggest that the administration of L. gasseri is likely to influence the effect of isoflavonoids on the host via changes in the gastrointestinal environment.

Dieting has developed a negative reputation among many researchers and health care professionals. However, ‘dieting’ can refer to a variety of behavioural patterns that are associated with different effects on eating and body weight. The wisdom of dieting depends on what kind of dieting is involved, who is doing it, and why. Thus, depending on what one means by the term, dieting can be quite harmful, merely ineffective or actually beneficial. The present paper considers examples of all three. In particular, we argue that judgements about the desirability of dieting should consider the likely consequences to particular individuals of engaging in, or not engaging in, dieting behaviour.

The objective of this project was to collect and evaluate data on nutrient intake and status across Europe and to ascertain whether any trends could be identified. Surveys of dietary intake and status were collected from across Europe by literature search and personal contact with country experts. Surveys that satisfied a defined set of criteria – published, based on individual intakes, post-1987, adequate information provided to enable its quality to be assessed, small age bands, data for sexes separated above 12 years, sample size over 25 and subjects representative of the population – were selected for further analysis. In a small number of cases, where no other data for a country were available or where status data were given, exceptions were made. Seventy-nine surveys from 23 countries were included, and from them data on energy, protein, fats, carbohydrates, alcohol, vitamins, minerals and trace elements were collected and tabulated. Data on energy, protein, total fat and carbohydrate were given in a large number of surveys, but information was very limited for some micronutrients. No surveys gave information on fluid intake and insufficient gave data on food patterns to be of value to this project. A variety of collection methods were used, there was no consistency in the ages of children surveyed or the age cut-off points, but most surveys gave data for males and females separately at all ages. Just under half of the surveys were nationally representative and most of the remainder were regional. Only a small number of local surveys could be included. Apart from anthropometric measurements, status data were collected in only seven countries. Males had higher energy intakes than females, energy intake increased with age but levelled off in adolescent girls. Intakes of other nutrients generally related to energy intakes. Some north–south geographical trends were noted in fat and carbohydrate intakes, but these were not apparent for other nutrients. Some other trends between countries were noted, but there were also wide variations within countries. A number of validation studies have shown that misreporting is a major problem in dietary surveys of children and adolescents and so all the dietary data collected for this project should be interpreted and evaluated with caution In addition, dietary studies rely on food composition tables for the conversion of food intake data to estimated nutrient intakes and each country uses a different set of food composition data which differ in definitions, analytical methods, units and modes of expression. This can make comparisons between countries difficult and inaccurate. Methods of measuring food intake are not standardised across Europe and intake data are generally poor, so there are uncertainties over the true nutrient intakes of children and adolescents across Europe. There are insufficient data on status to be able to be able to draw any conclusions about the nutritional quality of the diets of European children and adolescents.

The high stability of sesame oil against oxidative deterioration is attributed to lignans in its non-glycerol fraction. The present study evaluates the effects of feeding sesame lignans (sesamin and sesamolin) on Fe2+-induced oxidative stress in rats. Three groups, each of sixteen male weanling WNIN rats, were fed diets containing 200 g casein/kg and 100 g oil/kg (group 1, groundnut oil; group 2, sesame oil; group 3, sesame oil+sesamin (0·4 g/kg). After 45 d of feeding, eight rats from each group were injected with saline (9 g Na Cl/l, controls) intraperitoneally while the remaining eight rats were injected with 30 mg Fe2+/kg body weight as ferrous sulfate in normal saline. The animals were killed after 90 min to evaluate hepatic function and antioxidant status. Compared with those fed groundnut oil (group 1), sesame oil-fed rats (groups 2 and 3) had lower levels of hepatic thiobarbituric acid-reactive substances, serum glutamate:oxaloacetate transaminase activities and serum glutamate pyruvate transaminase activities, indicating protection against Fe-induced oxidative stress. Despite similar tocopherol levels in the three diets, hepatic α-tocopherol levels were higher in rats fed the sesame-oil diets (groups 2 and 3) compared with controls (group 1). However, activities of hepatic antioxidant enzymes (superoxide dismutase and glutathione peroxidase) were significantly (P<0·05) increased only in rats fed higher levels of lignans (group 3). These observations suggest that sesame lignans may have sparing effects on tocopherols. The increased bioavailability of tocopherols in the presence of dietary lignans might be due to the regeneration of oxidized tocopherols. The synergistic effects of lignans with tocols has nutritional and therapeutic implications.

The objective of the present study was to determine if any associations between reproductive experience and anthropometric or sub-clinical metabolic alterations of glucose metabolism exist. Sixty-seven women were recruited from the University of Brasilia Hospital and were evaluated at 12–18 months postpartum. Demographic, socio-economic, physical activity, anthropometric and health history (biochemical, reproductive) data were obtained. After a 12h overnight fast, a 2h oral glucose tolerance test was performed. Blood samples were collected at several points: at baseline, after intake of d-glucose solution (750g/l; 100ml) and every 30min thereafter. Blood glucose and lipids were measured by enzymic assays. Blood insulin was measured by RIA. In multiple regression analysis four dependent logarithmically transformed (logt) variables (increased area under the glucose curve (IAUGC), increased area under the insulin curve (IAUIC), insulin peak (IP), homeostasis model of assessment (HOMA)) were adjusted for parity, age, lactation index, BMI, percentage body fat (PBF), waist circumference, superior skinfold thickness sum:inferior skinfold thickness sum ratio and oral contraceptive use. PBF was positively associated with logt-IAUIC (P=0·004) and IP (P=0·006). However, the lactation index was negatively associated with logt-IAUIC (P=0·02) IAUGC and HOMA did not present significant associations. We conclude that during the postnatal period, independent of parity, body adiposity accumulation is associated with initial alterations in insulin secretion. Furthermore, independent of body adiposity, breast-feeding has a long-lasting protective effect on insulin response.

Diabetes mellitus and CVD are some of the leading causes of mortality and morbidity. Accumulating data indicate that a diet characterised by low-glycaemic index (GI) foods may improve the management of diabetes or lipid profiles. The objective of the present meta-analysis was to critically analyse the scientific evidence that low-GI diets have beneficial effects on carbohydrate and lipid metabolism compared with high-GI diets. We searched for randomised controlled trials with a crossover or parallel design published in English between 1981 and 2003, investigating the effect of low-GI v. high-GI diets on markers for carbohydrate and lipid metabolism. Unstandardised differences in mean values were examined using the random effects model. The main outcomes were fructosamine, glycated Hb (HbA1c), HDL-cholesterol, LDL-cholesterol, total cholesterol and triacylglycerol. Literature searches identified sixteen studies that met the strict inclusion criteria. Low-GI diets significantly reduced fructosamine by –0·1 (95 % CI –0·20, 0·00) mmol/l (P=0·05), HbA1c by 0·27 (95 % CI –0·5, –0·03) % (P=0·03), total cholesterol by –0·33 (95 % CI –0·47, –0·18) mmol/l (P>0·0001) and tended to reduce LDL-cholesterol in type 2 diabetic subjects by –0·15 (95 % CI –0·31, –0·00) mmol/l (P=0·06) compared with high-GI diets. No changes were observed in HDL-cholesterol and triacylglycerol concentrations. No substantial heterogeneity was detected, suggesting that the effects of low-GI diets in these studies were uniform. Results of the present meta-analysis support the use of the GI as a scientifically based tool to enable selection of carbohydrate-containing foods to reduce total cholesterol and to improve overall metabolic control of diabetes.

The aim of the present prospective study was to detect lactose malabsorption in subjects in northern India infected with Entamoeba histolytica and passing cysts. The study group included forty-one patients with E. histolytica cysts in at least one of three consecutive faecal samples. Lactose malabsorption was detected by a lactose H2 breath test. The results were compared with those of forty controls subjects. Thirty-two of forty-one (78·0%) subjects passing E. histolytica cysts had lactose malabsorbtion compared with seventeen of forty (42·5%) control subjects (P>0·01). In conclusion, the present study shows that lactose malabsorption is significantly more common in individuals infected with E. histolytica and passing cysts compared with control subjects.

Hg and Pb are of public health concern due to their toxic effects on vulnerable fetuses, persistence in pregnant and breast-feeding mothers, and widespread occurrence in the environment. To diminish maternal and infant exposure to Hg and Pb, it is necessary to establish guidelines based on an understanding of the environmental occurrence of these metals and the manner in which they reach the developing human organism. In the present review, environmental exposure, acquisition and storage of these metals via maternal–infant interaction are systematically presented. Though Hg and Pb are dispersed throughout the environment, the risk of exposure to infants is primarily influenced by maternal dietary habits, metal speciation and interaction with nutritional status. Hg and Pb possess similar adverse effects on the central nervous system, but they have environmental and metabolic differences that modulate their toxicity and neurobehavioural outcome in infant exposure during fetal development. Hg is mainly found in protein matrices of animal flesh (especially fish and shellfish), whereas Pb is mainly found in osseous structures. The potential of maternal acquisition is higher and lasts longer for Pb than for Hg. Pb stored in bone has a longer half-life than monomethyl-mercury acquired from fish. Both metals appear in breast milk as a fraction of the levels found in maternal blood supplied to the fetus during gestation. Habitual diets consumed by lactating mothers pose no health hazard to breast-fed infants. Instead, cows' milk-based formulas pose a greater risk of infant exposure to neurotoxic substances.

The intestinal Na-dependent D-glucose co-transporter (SGLT)-1 in sheep is under dietary regulation by luminal substrates. The aim of the present study was to find out whether the SGLT-1 in the forestomach of sheep is also regulated by sugars. Furthermore, the location of a possible glucosensor (luminal v. intracellular v. basolateral) was to be elucidated. Ruminal epithelia of sheep (Ovis aries, Merino breed) were pre-incubated in Ussing chambers with various substrates on the mucosal (i.e. luminal) or serosal (i.e. blood) side. This pre-incubation period was followed by a second pre-incubation period without the tested substrates (washout period). Thereafter, apical D-glucose uptake by ruminal epithelial cells was determined with 200 μmol D-[14C]glucose/l in the absence or co-presence of the SGLT-1 inhibitor, phlorizin. Pre-incubation with D-glucose on the mucosal side had no significant effect on apical D-glucose uptake (P>0.05). In contrast, pre-incubation with D-glucose, D-mannose, 3-O-methyl-D-glucose or sucrose on the serosal side significantly increased D-glucose uptake compared with mannitol-treated controls (P<0.05). Serosal pre-incubation with cellobiose or D-xylose had no effect. The stimulation of D-glucose uptake by serosal D-glucose pre-incubation was concentration dependent, with maximal stimulation at about 10 mmol/l. We conclude that the ruminal SGLT-1 can be up-regulated in a concentration-dependent manner by blood-borne D-glucose via an extracellular sugar-sensing mechanism.

The present study compared leucine kinetics and acute-phase-protein concentrations in three groups of marasmic, acutely infected Malawian children fed one of three isoenergetic diets. These were: an enhanced-protein-quality diet (egg-white+tryptophan, providing 1.2 g protein/kg per d; n 14); an increased-protein-content diet (egg-white+tryptophan, providing 1·8 g protein/kg per d; n 14); a standard-protein diet (1·2 g milk protein/kg per d; n 25). The hypotheses tested were that children receiving a diet with more protein would have greater rates of non-oxidative leucine disposal and that children receiving an isonitrogenous diet with a higher protein quality would have lower rates of leucine oxidation. The children were studied after 24 h of therapy using standard [13C]leucine stable-isotope tracer techniques. The children receiving the higher-protein-content diet had greater leucine kinetic rates than those receiving the standard-protein-content diet; non-oxidative leucine disposal was 170 (SD 52) v. 122 (SD 30) μmol leucine/kg per h (P<0·01). Leucine oxidation was less in the children receiving the enhanced-protein-quality diet than in those receiving the standard-protein-quality diet; 34 (SD 12) v. 45 (SD 13) μmol leucine/kg per h (P<0·05). The children receiving the high-protein-content diet increased their serum concentration for five of six acute-phase proteins 24 h after starting therapy, while those receiving the standard-protein-content diet did not. These data suggest that there was greater whole-body protein synthesis, and a more vigorous acute-phase response associated with the higher-protein-content diet. The clinical benefits associated with a higher protein intake in marasmic, acutely infected children need further study.

Conjugated linoleic acid (CLA) refers to the positional and geometric dienoic isomers of linoleic acid. The dietary intake of CLA has been associated with changes in lipid metabolism. The aim of the present work was to assess the effects of the two main isomers of CLA on sterol regulatory element binding protein (SREBP)-1a and SREBP-1c mRNA levels, as well as on mRNA levels and the activities of several lipogenic enzymes in liver. For this purpose hamsters were fed an atherogenic diet supplemented with 5 g linoleic acid, cis-9,trans-11 or trans-10,cis-12 CLA/kg diet for 6 weeks. The trans-10,cis-12 isomer intake produced significantly greater liver weight, but also significantly decreased liver fat accumulation. No changes in mRNA levels of SREBP-1a, SREBP-1c and lipogenic enzymes, or in the activities of these enzymes, were observed. There was no effect of feeding cis-9,trans-11 CLA. These results suggest that increased fat accumulation in liver does not occur on the basis of liver enlargement produced by feeding the trans-10,cis-12 isomer of CLA in hamsters. The reduction in hepatic triacylglycerol content induced by this isomer was not attributable to changes in lipogenesis.

Studies of food habits and dietary intakes face a number of unique respondent and observer considerations at different stages from early childhood to late adolescence. Despite this, intakes have often been reported as if valid, and the interpretation of links between intake and health has been based, often erroneously, on the assumption of validity. However, validation studies of energy intake data have led to the widespread recognition that much of the dietary data on children and adolescents is prone to reporting error, mostly through under-reporting. Reporting error is influenced by body weight status and does not occur systematically across different age groups or different dietary survey techniques. It appears that the available methods for assessing the dietary intakes of children are, at best, able to provide unbiased estimates of energy intake only at the group level, while the food intake data of most adolescents are particularly prone to reporting error at both the group and the individual level. Moreover, evidence for the existence of subject-specific responding in dietary assessments challenges the assumption that repeated measurements of dietary intake will eventually obtain valid data. Only limited progress has been made in understanding the variables associated with misreporting in these age groups, the associated biases in estimating nutrient intakes and the most appropriate way to interpret unrepresentative dietary data. Until these issues are better understood, researchers should exercise considerable caution when evaluating all such data.

The present review summarises the effects of different carbohydrate and fat structures on food intake and appetite and the differences in response at various levels of processing of macronutrients. Several physico-chemical properties of carbohydrate and fat molecules appear to influence the short-term satiating properties. However, long-term substantiation of these findings expressed in terms of food intake or body weight is not currently available. Such studies will be required to make clear recommendations regarding dietary composition to aid satiety.

Linseed (LO) and soyabean (SO) oils were evaluated as fish-oil (FO) substitutes in the diets of marketable-sized gilthead sea bream (Sparus aurata). Practical diets were designed factorially with the lipid added as follows (%): FO 100, LO 60+FO 40, LO 80+FO 20, SO 60+FO 40, SO 80+FO 20. The effects of experimental diets on growth, fatty acids patterns in liver and muscle, flesh quality variables and activities of selected enzymes involved in lipid synthesis and catabolism were determined at the end of a 7-month trial. Fatty acid composition of liver and muscle generally reflected the fatty acid composition of the diets. The n−3 PUFA levels were significantly reduced by the inclusion of vegetable oils. This tendency was more pronounced for EPA than for docosahexaenoic acid. The n−3:n−6 fatty acid ratio reached the lowest values in fish fed the SO diets; this was associated with a higher liver lipid deposition. No differences were found in fillet texture and pH. However, under conditions of forced peroxidation, muscles from fish fed the SO diets had lower peroxidation levels. Vegetable oil substitution decreased lipogenesis in liver and this effect was greatest at the highest substitution level. In contrast, muscle β-oxidation enzymes had increased activities with vegetable oil substitution. Thus, the lower hepatic lipogenesis was correlated with an increased lipid utilisation in muscle. It is concluded that growth and lipid metabolism were affected by experimental diets.

A characteristic dietary feature at weaning is a switch from a milk-based to plant-based diet, i.e. from a non-fibrous to a fibrous diet. The present study aimed to evaluate the effects of such an abrupt dietary switch on gastric emptying rate in pigs maintained on a milk substitute after weaning. Eighteen piglets were kept on a milk substitute for 5 weeks after weaning and were then switched to wheat-based or barley-based diets or kept on the milk substitute (six piglets per group). All piglets were fasted for 1d before the switch and daily food intake was then increased linearly to reach initial values within 3d. The gastric emptying rate was measured by γ-scintigraphy before and after the switch. Corpo-antral peristalsis was also evaluated by the use of high-frequency scintigraphic frames. The gastric emptying rate of the wheat-based diet was accelerated on days 1 to 3 after the switch, but was similar to that in the milk-substitute group thereafter. This acceleration was concomitant with an enhanced frequency of corpo-antral waves on days 2 and 3. Conversely, the gastric emptying rate of the barley-based diet tended to be enhanced on day 2, but was delayed on days 4 and 5, without any change in frequency of corpo-antral waves. We conclude that a switch from a non-fibrous to a fibrous diet alters the gastric emptying rate differently depending on the type of dietary fibre.

The purpose of the present study was to evaluate the effects of β-carotene on the cell viability and antioxidant status of hepatocytes from chronically ethanol-fed rats. Rats in the ethanol group were given an ethanol-containing liquid diet that provided 36% of total energy as ethanol, while rats in the control group were fed an isoenergetic diet without ethanol. After 4 weeks, hepatocytes were taken out and cultured for 24 h. Hepatocytes from the rats in the control and ethanol groups were cultured in medium without (HC, HE) or with β-carotene (HC+B, HE+B). The results showed that lactate dehydrogenase leakage was significantly increased in the HE compared with that in the HC group. However, lactate dehydrogenase leakage of the HE+B group was similar to that of the HC group. When compared with the HC group, activities of glutathione peroxidase and catalase in the HE group were significantly decreased by 54 and 31%, respectively. Catalase activity in the HE+B group was significantly increased by 61% compared with that in the HE group. However, activities of glutathione reductase and superoxide dismutase showed no difference among the groups. The level of glutathione in the HC+B and HE+B groups was significantly increased to 155 and 143% compared with those in the HC and HE groups, respectively. The concentration of lipid peroxides showed no difference among the groups. The present results demonstrate that β-carotene improved the cell viability of hepatocytes, and increased catalase activities and glutathione levels in hepatocytes from chronically ethanol-fed rats.