Findings on dietary glycaemic index (GI) and glycaemic load (GL) as risk factors for type 2 diabetes have been controversial. We examined the associations of dietary GI and GL and the associations of substitution of lower-GI carbohydrates for higher-GI carbohydrates with diabetes risk in a cohort of Finnish men. The cohort consisted of 25 943 male smokers aged 50–69 years. Diet was assessed, at baseline, using a validated diet history questionnaire. During a 12-year follow-up, 1098 incident diabetes cases were identified from a national register. Cox proportional hazard modelling was used to estimate the risk of diabetes, and multivariate nutrient density models were used to examine the effects of substitution of different carbohydrates. Dietary GI and GL were not associated with diabetes risk; multivariate relative risk (RR) for highest v. lowest quintile for GI was 0·87 (95 % CI 0·71, 1·07) and for GL 0·88 (95 % CI 0·65, 1·17). Substitution of medium-GI carbohydrates for high-GI carbohydrates was inversely associated with diabetes risk (multivariate RR for highest v. lowest quintile 0·75, 95 % CI 0·59, 0·96), but substitution of low-GI carbohydrates for medium- or high-GI carbohydrates was not associated with the risk. In conclusion, dietary GI and GL were not associated with diabetes risk, and substitutions of lower-GI carbohydrates for higher-GI carbohydrates were not consistently associated with a lower diabetes risk. The associations of dietary GI and GL with diabetes risk should be interpreted by considering nutritional correlates, as foods may have different properties that affect risk.

The use of skinfold thickness measurements to evaluate the distribution of subcutaneous adipose tissue and to predict body fat has recognised advantages. However, the different types of skinfold calliper available present limitations that make them unattractive and perhaps less used in daily practice. The purpose of the present study was to evaluate the accuracy and functionality of a new digital skinfold system, the Liposoft 2008+Adipsmeter V0 (LA), for measuring skinfold thickness and determining body fat proportion (%BF). Skinfold thickness measurements made by the LA were compared with those obtained with a Harpenden (H) calliper from two samples of adults (n 45) and older adults (n 56) in a university-based cross-sectional study. A comparison was also conducted between estimated %BF from skinfolds and dual-energy X-ray absorptiometry. Bland and Altman plots show that skinfolds measured by the LA and H calliper are in high agreement, with a mean difference of 0·3 (95 % CI − 3·1, 3·4) mm. In regard to the %BF estimated from LA and H skinfolds measurement, the LA produced a similar approximation to dual-energy X-ray absorptiometry %BF, with a mean difference of 0·2 (95 % CI − 0·8, 1·2) %, compared with %BF obtained with the H calliper. The LA system is an accurate instrumentation and represents an innovation in the evaluation of skinfold thickness and body composition based on anthropometric measurement.

The objective of the present study was to determine total Cr and Fe content and the corresponding mineral dialysable fraction in a total of sixty-three duplicate meals. Samples of breakfast, lunch and dinner were taken over twenty-one consecutive days at a female university residence in Granada (Spain). Cr content in the duplicate daily meals ranged from 98·50 to 120·80 μg, with a mean of 110·00 μg, and Fe levels ranged from 9·50 to 40·00 mg, with a mean content of 18·50 mg. The mean Cr and Fe dialysable fractions ranged from 0·50 to 1·50 % and from 7·75 to 11·80 %, respectively. Possible correlations with energy and other nutrient intakes were also evaluated. Adherence of the meals to the Mediterranean dietary patterns was tested, and these findings reveal that a balanced and varied diet based on a Mediterranean-style diet plan provides adequate levels and bioaccessibility of Cr and Fe for young women, which is especially important to avoid mineral deficiencies.

Children's diets contain too few fruits and vegetables and too many foods high in saturated fat. Food intake is affected by multiple individual and family factors, which may differ for core foods (that are important to a healthy diet) and non-core foods (that are eaten more for pleasure than health). Data came from a sample of twins aged 11 years (n 342) and their parents from the Twins Early Development Study. Foods were categorised into two types: core (e.g. cereals, vegetables and dairy) and non-core (e.g. fats, crisps and biscuits). Parents' and children's intake was assessed by an FFQ. Mothers' and children's preference ratings and home availability were assessed for each food type. Parental feeding practices were assessed with the child feeding questionnaire and child television (TV) watching was maternally reported. Physical activity was measured using accelerometers. Correlates of the child's consumption of each food type were examined using a complex samples general linear model adjusted for potential confounders. Children's non-core food intake was associated with more TV watching, higher availability and greater maternal intake of non-core foods. Children's core food intake was associated with higher preferences for core foods and greater maternal intake of core foods. These results suggest that maternal intake influences both food types, while preferences affect intake of core foods but not of non-core foods, and availability and TV exposure were only important for non-core food intake. Cross-sectional studies cannot determine causality, but the present results suggest that different approaches may be needed to change the balance of core and non-core foods in children's diets.

There is a new merging of health economics and nutrition disciplines to assess the impact of diet on health and disease prevention and to characterise the health and economic aspects of specific changes in nutritional behaviour and nutrition recommendations. A rationale exists for developing the field of nutrition economics which could offer a better understanding of both nutrition, in the context of having a significant influence on health outcomes, and economics, in order to estimate the absolute and relative monetary impact of health measures. For this purpose, an expert meeting assessed questions aimed at clarifying the scope and identifying the key issues that should be taken into consideration in developing nutrition economics as a discipline that could potentially address important questions. We propose a first multidisciplinary outline for understanding the principles and particular characteristics of this emerging field. We summarise here the concepts and the observations of workshop participants and propose a basic setting for nutrition economics and health outcomes research as a novel discipline to support nutrition, health economics and health policy development in an evidence and health-benefit-based manner.

Adults with intellectual disabilities experience high rates of obesity. Despite this higher risk, there is little evidence on the effectiveness of weight-loss interventions for adults with intellectual disabilities and obesity. The present study examined the effectiveness of the TAKE 5 multi-component weight-loss intervention. Adults with obesity were invited using specialist intellectual disability services to participate in the study. Obesity was defined as a BMI of 30 kg/m2 or greater. TAKE 5 included a daily energy-deficit diet of 2510 kJ (600 kcal), achieved via a personalised dietary prescription. Participants' body weight, BMI, waist circumference and levels of physical activity and sedentary behaviour were measured before and after the intervention. A total of fifty-four individuals consented to participate, of which forty-seven (87 %) completed the intervention in the study period. There was a significant decrease in body weight (mean difference − 4·47 (95 % CI − 5·91, − 3·03) kg; P < 0·0001), BMI ( − 1·82 (95 % CI − 2·36, − 1·29) kg/m2; P < 0·0001), waist circumference ( − 6·29 (95 % CI − 7·85, − 4·73) cm; P < 0·0001) and daily sedentary behaviour of participants ( − 41·40 (95 % CI − 62·45, − 20·35) min; P = 0·00 034). Of the participants who completed the intervention, seventeen (36·2 %) lost 5 % or more of their initial body weight. Findings from the study suggest that TAKE 5 is an effective weight-loss intervention for adults with intellectual disabilities and obesity. The effectiveness of TAKE 5 should be examined further in a controlled study.

The brain response to a retro-nasally sensed food odour signals the perception of food and it is suggested to be related to satiation. It is hypothesised that consuming food either in multiple small bite sizes or with a longer durations of oral processing may evoke substantial oral processing per gram consumed and an increase in transit time in the oral cavity. This is expected to result in a higher cumulative retro-nasal aroma stimulation, which in turn may lead to increased feelings of satiation and decreased food intake. Using real-time atmospheric pressure chemical ionisation-MS, in vivo retro-nasal aroma release was assessed for twenty-one young, healthy and normal-weight subjects consuming dark chocolate-flavoured custard. Subjects were exposed to both free or fixed bite size (5 and 15 g) and durations of oral processing before swallowing (3 and 9 s) in a cross-over design. For a fixed amount of dark chocolate-flavoured custard, consumption in multiple small bite sizes resulted in a significantly higher cumulative extent of retro-nasal aroma release per gram consumed compared with a smaller amount of large bite sizes. In addition, a longer duration of oral processing tended to result in a higher cumulative extent of retro-nasal aroma release per gram consumed compared with a short duration of oral processing. An interaction effect of bite size and duration of oral processing was not observed. In conclusion, decreasing bite size or increasing duration of oral processing led to a higher cumulative retro-nasal aroma stimulation per gram consumed. Hence, adapting bite size or duration of oral processing indicates that meal termination can be accelerated by increasing the extent of retro-nasal aroma release and, subsequently, the satiation.

The relative contributions of fat-free mass (FFM) and fat mass (FM) to body weight are key indicators for several major public health issues. Predictive models could offer new insights into body composition analysis. A non-parametric equation derived from a probabilistic Bayesian network (BN) was established by including sex, age, body weight and height. We hypothesised that it would be possible to assess the body composition of any subject from easily accessible covariables by selecting an adjusted FFM value within a reference dual-energy X-ray absorptiometry (DXA) measurement database (1999–2004 National Health and Nutrition Examination Survey (NHANES), n 10 402). FM was directly calculated as body weight minus FFM. A French DXA database (n 1140) was used (1) to adjust the model parameters (n 380) and (2) to cross-validate the model responses (n 760). French subjects were significantly different from American NHANES subjects with respect to age, weight and FM. Despite this different population context, BN prediction was highly reliable. Correlations between BN predictions and DXA measurements were significant for FFM (R2 0·94, P < 0·001, standard error of prediction (SEP) 2·82 kg) and the percentage of FM (FM%) (R2 0·81, P < 0·001, SEP 3·73 %). Two previously published linear models were applied to the subjects of the French database and compared with BN predictions. BN predictions were more accurate for both FFM and FM than those obtained from linear models. In addition, BN prediction generated stochastic variability in the FM% expressed in terms of BMI. The use of such predictions in large populations could be of interest for many public health issues.

The objective of the present study was to assess the intake of naturally occurring plant sterols and β-carotene via the overall diet of Belgian pre-school children and adults. Two different Belgian food consumption databases were used: (1) one with consumption data of pre-school children (2·5–6·5 years old) and (2) one with consumption data of adults ( ≥ 15 years old). These consumption data were combined with a newly developed database containing the plant sterol and β-carotene content in all relevant food items based on international food composition databases and scientific literature. The results show that Flemish pre-school children have a median plant sterol intake of 172 (interquartile range (IQR) = 47) and 184 (IQR = 52) mg/d for girls and boys, respectively. Their median β-carotene intake was 1857 (IQR = 1250) μg/d, without significant difference between girls and boys. Belgian women and men have a median plant sterol intake of 218 (IQR = 113) and 280 (IQR = 158) mg/d, respectively, and a median β-carotene intake of 2086 (IQR = 1254) μg/d (not significantly different between the sexes). The main food source of naturally occurring plant sterols was bread and other cereal products. For β-carotene, the main food source was vegetables.

Intestinal bacterial colonisation in pre-term infants is delayed compared with full-term infants, leading to an increased risk of gastrointestinal disease. Modulation of colonisation through dietary supplementation with probiotics or prebiotics could decrease such a risk. The present study evaluated clinical tolerance, the effects on gut microbiota, and inflammatory and immunological mucosal responses to an infant formula adapted for pre-term infants that included in its manufacturing process a fermentation step with two probiotic strains, Bifidobacterium breve C50 and Streptococcus thermophilus 065, inactivated by heat at the end of the process. A total of fifty-eight infants (gestational age: 30–35 weeks), fed either the fermented pre-term formula or a standard pre-term formula, were followed up during their hospital stay. Clinical tolerance, faecal microbiota using a culture and a culture-independent method (temporal temperature gel electrophoresis), faecal calprotectin and secretory IgA were analysed weekly. No difference was observed regarding anthropometric data and digestive tolerance, except for abdominal distension, the incidence of which was lower in infants fed the fermented formula for 2 weeks. Bacterial colonisation was not modified by the type of feeding, particularly for bifidobacteria. Faecal calprotectin was significantly lower in infants fed the fermented formula for 2 weeks, and secretory IgA increased with both mother's milk and the fermented formula. The fermented formula was well tolerated and did not significantly modulate the bacterial colonisation but had benefits on inflammatory and immune markers, which might be related to some features of gastrointestinal tolerance.

Particle passage from the reticulorumen (RR) depends on particle density and size. Forage particle density and size are related and change over time in the RR. Particle density mainly influences sorting in the reticulum, whereas particle size influences particle retention in the fibre mat of stratified rumen contents (‘filter-bed’ effect). We investigated these effects independently, by inserting plastic particles of different sizes (1, 10 and 20 mm) and densities (1·03, 1·20 and 1·44 mg/ml) in the RR of cattle (Bos primigenius f. taurus) as a pilot study, and of muskoxen (Ovibos moschatus; n 4) and moose (Alces alces; n 2) both fed two diets (browse and grass). Faeces were analysed for plastic residues for 13 d after dosing to calculate mean retention times (MRT). The results confirmed previous findings of differences in absolute MRT between species. Comparing muskoxen with moose, there was no difference in the effect of particle density on the MRT between species but particle size had a more pronounced effect on the MRT in muskoxen than in moose. This indicated a stronger ‘filter-bed effect’ in muskoxen, in accord with the reports of stratified RR contents in this species v. the absence of RR content stratification in moose. Low-density particles were retained longer in both species fed on grass diets, indicating a contribution of forage type to the ‘filter-bed effect’. The results indicate that retention based on particle size may differ between ruminant species, depending on the presence of a fibre mat in the RR, whereas the density-dependent mechanism of sedimentation in the RR is rather constant across species.

The model developed by Forbes (1987) of how body fat mass (FM) and fat-free mass (FFM) change during periods of weight loss or gain (Δ body weight (BW)) assumed that they change in relationship to a constant C = 10·4, where ΔFFM/ΔBW = 10·4/(10·4+FM). Forbes derived C based on aggregated, cross-sectional data from a small sample of women. The objective of the present study was to reanalyse the relationship described by Forbes and to explore whether this relationship is consistent across ethnicity and sex groups using cross-sectional data from a large sample of white and African-American men and women. Baseline data from white and African-American men and women aged 18–60 years, who participated in a clinical study at the Pennington Biomedical Research Center since 2001 and who underwent dual-energy X-ray absorptiometry scans, were available for analysis. To overcome differences in BMI distributions among the ethnicity-by-sex groups, a stratified random sample of participants was selected within each group such that numbers in each BMI category ( < 25, 25–29·9, 30–34·9, 35–39·9, 40+ kg/m2) were proportional to those within the group with the smallest sample size, yielding a sample of 1953 individuals. Linear regression models assessed the FM–FFM relationship across the four ethnicity-by-sex groups. The FM–FFM relationship varied little by ethnicity (P = 0·57) or by sex (P = 0·26). The constant describing the FM–FFM relationship was estimated to be 9·7 (95 % CI 9·0, 10·3). In conclusion, results from our large, biethnic sample of men and women found a FM–FFM relationship very close to that originally described by Forbes, absent of significant variability by ethnicity or sex.

Studies show an inverse relationship between breakfast frequency and weight gain. This may reflect poor eating habits generally and associated low physical activity (PA) or direct impacts of breakfast on mechanisms leading to lethargy and reduced PA. The relationship between breakfast frequency and PA is inconclusive. We aimed to determine whether breakfast frequency is associated with PA levels in British adolescents independent of body composition and socio-economic status (SES). Habitual breakfast frequency (self-report questionnaire) was assessed in 877 adolescents (43 % male, age 14·5 (sd 0·5) years old). PA was measured over 5 d (accelerometry, average counts/min; cpm). Associations between daily PA and breakfast frequency were assessed using linear regression adjusted for body fat percentage and SES. Effect modification by sex and associations with PA during the morning (06.00–12.00 hours) were explored. For boys, there were no significant associations between breakfast frequency and PA. For girls, less frequent breakfast consumption was significantly associated with lower PA (cpm) during the morning (occasional v. frequent β − 6·1 (95 % CI − 11·1, − 1·1), P = 0·017) when adjusted for body fat percentage and SES. There were no associations between PA and breakfast consumption over the whole day; however, for girls, less frequent breakfast consumption may be associated with lower PA levels during the morning, suggesting that breakfast consumption should perhaps be taken into consideration when aiming to promote PA in adolescent girls.