Globally, severe acute malnutrition (SAM) accounts for >1/3–0⋅5 of deaths in children <5 years, and approximately 54 % deaths in developing countries. The minimum international standard set for the management of SAM is a cure rate of at least 75 % and death rate <10 %. The present study was conducted to determine treatment outcome and associated factors among children 1–5 years hospitalised with SAM in Lacor and Gulu Regional Referral Hospital (GRRH) in 2017. A retrospective observational method supplemented with a qualitative inquiry was done. A total of 317 patients’ records were reviewed in either hospital; checklist data were analysed using SPSS version 16 with P-values <0⋅05 considered for statistical significance. The case fatality rate (CFR) was 12⋅6 % (GRRH) and 9⋅5 % (Lacor). The average length of stay (LOS) was 14⋅69 d (GRRH) and 14⋅10 d (Lacor). There was statistical significance between Human Immunodeficiency Virus (HIV) status, blood transfusion, type of SAM, treatment provision at admission, antibiotics, mid-upper arm circumference (MUAC), hospital category and treatment outcome. In total, ten key informants were interviewed and they reported the presence of co-infections and severity of SAM complications as having an important bearing on treatment outcome. A significant proportion of patients were discharged not cured 19⋅9 % (Lacor) v. 16⋅4 % (GRRH). The CFR in GRRH was higher than the WHO recommendation. The LOS in both hospitals was within recommended. These results provide a generalisable problem in most African hospitals and could explain the persistently high rates of SAM in Africa.

More knowledge about improving dietary intake in secondary preventive actions against childhood overweight and obesity is needed. The objective was to evaluate the impact of a 2-year intervention on energy, macronutrient and food intake of overweight and obese children participating in a randomised controlled trial. Children (8–12 years old) living in Sweden were recruited to participate for 2 years between 2006 and 2009. The children were randomised into either an intervention group (n 58), participating in an intervention concerning food habits, physical activity and behavioural change, or a control group (n 47). Dietary intake at baseline and the 2-year measurement were assessed with a diet history interview covering 14 d. Energy intake (EI) of the intervention and control groups was underestimated by 28 and 21 %, respectively, after 2 years, but with no difference between the groups (P = 0·51). After 2 years of intervention, the intervention group, compared with the control group, had a lower intake of sugar-sweetened beverages (P = 0·015) as well as a higher intake of foods high in fibre, low in saturated fat, sugar and salt (P = 0·031). Further, a lower EI in relation to BMR, lower total fat, MUFA and cholesterol was seen in the intervention group compared with the control group. In conclusion, the food and nutrient intake of overweight and obese children was improved after participating in a 2-year intervention programme. Dietary counselling should be included in secondary preventive actions against childhood overweight and obesity to promote healthy food habits.

The cashew apple is an unvalued by-product from the cashew nut industry, of which millions of tonnes are simply discarded globally. Interestingly, however, cashew apple nutrients may have beneficial effects for health even if these are still poorly described. The present study was designed to evaluate the effect of a hydro-alcoholic extract of cashew apple (cashew apple extract; CAE; Cashewin™) on obesity and diabetes, in two experimental designs using the diet-induced obesity (DIO) mouse model. First, in the preventive design, mice were treated orally with the CAE at the dose of 200 mg/kg body weight from the first day under a high-fat diet (HFD) and during 8 weeks thereafter. Second, in the curative design, the animals were first maintained under the HFD for 4 weeks and then treated with the CAE for a further 4 weeks under the same regimen. For both experimental designs, body weight, peri-epididymal adipose tissue, liver weight, food consumption, glycaemia, insulinaemia and insulin resistance were assessed. In both designs, the CAE significantly reduced body-weight gain and fat storage in both the peri-epididymal adipose tissue and the liver for mice under the HFD. This was achieved without modifying their energy consumption. Furthermore, glycaemia, insulinaemia and insulin resistance (homeostasis model assessment-insulin resistance) of the DIO mice were significantly lowered compared with the control group. Thus, a well-designed hydro-alcoholic extract of cashew apple could provide an attractive nutritional food ingredient to help support the management of body weight and associated metabolic parameters such as blood glucose and insulin levels.

The present study aimed to assess the longitudinal associations of coffee and tea consumption with metabolic syndrome and its component conditions in a group of Australian older adults who participated in the Blue Mountains Eye Study (n 2554, mean age: 64 years, 43 % female). Participants’ coffee and tea intake were measured using a validated food frequency questionnaire. Hazard ratios (HRs) over a 10-year period were estimated using Cox hazard regression models adjusting for lifestyle factors. Results showed that coffee consumption was not associated with the incidence of metabolic syndrome, high fasting glucose, high triglycerides, central obesity, high blood pressure and low HDL-cholesterol (HDL-C). Tea consumption was not associated with incidence of metabolic syndrome and the component conditions except for the risk of having low HDL-C, in which a nominally inverse association was observed (multivariate-adjusted HR at 2–3 cups/d: 0⋅48, 95 % CI 0⋅26, 0⋅87, P = 0⋅016; 4 cups/d or more: 0⋅50, 95 % CI 0⋅27, 0⋅93, P = 0⋅029). After stratifying for fruit consumption (Pinteraction between tea and fruit = 0⋅007), consuming four cups of tea per day was nominally associated with lower incidence of metabolic syndrome among those with high fruit consumption (multivariable-adjusted HR: 0⋅44, 95 % CI 0⋅20, 0⋅93, P = 0⋅033). Our results did not support a significant association between tea and coffee consumption and metabolic syndrome. Tea consumption may be associated with a lower risk of having low HDL-C, while high tea and fruit consumption together may be associated with a lower risk of developing metabolic syndrome.

Montmorency tart cherries (MC) have been found to modulate indices of vascular function with interventions of varying duration. The objective of this preliminary study was to identify the chronic effects of MC supplementation on vascular function and the potential for urinary metabolomics to provide mechanistic evidence. We performed a placebo-controlled, double-blind, randomised study on 23 healthy individuals (18M, 7F) that consumed 30 ml MC or a placebo twice daily for 28 days. Whole body measures of vascular function and spot urine collections were taken at baseline and after supplementation. There were no significant changes to vascular function including blood pressure and arterial stiffness. Urinary metabolite profiling highlighted significant changes (P < 0⋅001) with putative discriminatory metabolites related to tryptophan and histidine metabolism. Overall, MC supplementation for 28 days does not improve indices of vascular function but changes to the urinary metabolome could be suggestive of potential mechanisms.

College students constitute a significant proportion of the young adult population in Norway. They are in their reproductive years, which is of interest regarding diet and preconception health. Our objective was to assess young college students’ diet and nutrient intake in relation to national dietary recommendations and assess the probability of inadequate micronutrient intake for both genders using the Nordic Nutrition Recommendations, and also to evaluate its consequences on preconception health and create a groundwork for future interventions on this group. At the University of Agder (UiA), we enrolled 622 students aged 18–40 years for a cross-sectional study of student's diet, StudentKost. The students completed a food frequency questionnaire, including questions of supplement use, over the past 4 weeks. Intake of fruits, vegetables, oily fish, and whole grain was lower than recommended, as were mean intake of folate, iron, and iodine. Our main findings are that students have a somewhat suboptimal diet compared to the Norwegian dietary guidelines. Male students had generally lower diet quality than females. Compared to the Nordic Nutrition Recommendations (NNR), we also saw a relatively high probability of inadequate intake of several micronutrients and a very high probability for some micronutrients in a significant portion of the sample. Public health effort should be directed towards improving students and young adults’ diet in general, and interventions towards improving preconception health should be explored. The low participation rate limits the generalizability of our findings. Our findings encourage further investigation into young adults’ diet.

Cardiovascular diseases are among the main causes of death in Brazil and worldwide. The literature indicates the hypertriglyceridemic waist phenotype (HTWP) as an accessible alternative for the identification of cardiovascular and metabolic risk. The present study aimed to identify the prevalence and factors associated with HTWP in individuals diagnosed with arterial hypertension (AH) and/or diabetes mellitus type 2 (DM2). A cross-sectional study was conducted with individuals diagnosed with AH and/or DM2. The study data were collected through semi-structured interviews containing socio-demographic information, lifestyle, health care, in addition to anthropometric assessment, blood pressure measurement and biochemical blood tests. The prevalence of HTWP was estimated and bivariate and multivariate logistic regression was used to assess the factors associated with HTWP. Of the 788 individuals analysed, 21⋅5 % had the HTWP. In the adjusted model, the following variables remained associated with a greater chance of presenting HTWP: sex, age, body mass index (BMI) and very-low-density lipoprotein (VLDL). Being female increased the chance of HTWP by 7⋅7 times (OR 7⋅7; 95 % CI 3⋅9, 15⋅2). The one-year increase in age increased the chance of HTWP by 4 % (OR 1⋅04; 95 % CI 1⋅02, 1⋅06). The addition of 1 mg/dl of VLDL-c increased the chance of HTWP by 15 % (odds ratio (OR) 1⋅15; 95 % confidence interval (CI) 1⋅12, 1⋅18), as well as the increase of 1 kg/m2 in the BMI increased the chance of this condition by 20 % (OR 1⋅20; 95 % CI 1⋅15, 1⋅27). The prevalence of HTWP was associated with females, older age, higher BMI, higher VLDL-c and risk waist/height ratio.

All dietary assessment methods inevitably introduce measurement errors, which should ideally be considered during data analysis and interpretation. Methodological studies should be conducted to address how well a given assessment method captures dietary intake and to highlight the extent and direction of the measurement error. Within a subgroup of the Hordaland Health Study (HUSK3), we examined the relative validity of a web-based food frequency questionnaire (WebFFQ) by comparing its estimates of mean daily intake of nutrients and foods with estimated mean daily intakes from repeated administrations of 24-hour dietary recall interviews (24-HDRs). Men and women born between 1950 and 1951 were recruited from HUSK3. The participants (n = 67) completed a WebFFQ and three non-consecutive 24-HDRs over the course of a year. Relative validity was assessed using Spearman's rank correlation, crosstab analysis and Bland–Altman plots. Linear regression models were used to compute the calibration coefficients. The estimated correlation coefficients were acceptable or strong for all nutrients and foods except iodine (rs = 0⋅19). The highest correlation coefficient was found for juice (rs = 0⋅71), whereas the lowest correlation coefficient was found for iodine (rs = 0⋅19). Cross-classification by quartiles categorised more than 72 % of the participants into the same or adjacent quartiles using the two methods. Few data points fell outside the limits of agreement in the Bland–Altman plots. Calibration coefficients ranged from 0⋅10 (wholegrain) to 0⋅81 (alcohol). Our findings suggest that the WebFFQ has reasonable ranking abilities for all the included nutrients and foods, except for iodine.

The present study aimed to investigate the interaction of Apo A-II polymorphism and dietary total antioxidant capacity (DTAC) with lipid profile and anthropometric markers in patients with type 2 diabetes (T2DM) that are at risk for atherosclerosis. This cross-sectional study was conducted on 778 patients with T2DM (35–65 years). Dietary intakes were assessed by a 147-item food frequency questionnaire. DTAC was computed using international databases. Participants were categorised into two groups based on rs5082 genotypes. The gene–diet interaction was analysed by an ANCOVA multivariate interaction model. Total cholesterol, TC; triacylglycerol, TG; high- and low-density lipoprotein, HDL and LDL; TC–HDL ratio; waist circumference, WC and body mass index, BMI were obtained according to standard protocols. Overall, the frequency of CC homozygous was 12⋅1 % among study participants. We found that a significant interaction between rs5082 variants and DTAC on mean WC (PTEAC = 0⋅044), TC concentration (PFRAP = 0⋅049 and PTEAC = 0⋅031) and TC/HDL (PFRAP = 0⋅031 and PTRAP = 0⋅040). Among patients whose DTAC was higher than the median intake, the mean of weight, WC and TC/HDL were significantly higher only in individuals with CC genotype. Also, the high DTAC was associated with a lower TC concentration only in T-allele carriers (PFRAP = 0⋅042). We found that adherence to a diet with high total antioxidant capacity can improve the complications of diabetes and atherosclerosis in the T carrier genotype more effectively than the CC genotype. These results could indicate the anti-atherogenic properties of Apo A-II. However, further studies are needed to shed light on this issue.

Children's vitamin D intake and status can be optimised to meet recommendations. We investigated if nutritionally balanced school meals with weekly fish servings affected serum 25-hydroxyvitamin D (25(OH)D) and markers related to bone in 8- to 11-year-old Danish children. We conducted an explorative secondary outcome analysis on data from 784 children from the OPUS School Meal Study, a cluster-randomised cross-over trial where children received school meals for 3 months and habitual lunch for 3 months. At baseline, and at the end of each dietary period, 25(OH)D, parathyroid hormone (PTH), osteocalcin (OC), insulin-like growth factor-1 (IGF-1), bone mineral content (BMC), bone area (BA), bone mineral density (BMD), dietary intake and physical activity were assessed. School meals increased vitamin D intake by 0·9 (95 % CI 0·7, 1·1) μg/d. No consistent effects were found on 25(OH)D, BMC, BA, BMD, IGF-1 or OC. However, season-modified effects were observed with 25(OH)D, i.e. children completing the school meal period in January/February had higher 25(OH)D status (5·5 (95 % CI 1·8, 9·2) nmol/l; P = 0·004) than children completing the control period in these months. A similar tendency was indicated in November/December (4·1 (95 % CI –0·12, 8·3) nmol/l; P = 0·057). However, the effect was opposite in March/April (–4·0 (95 % CI –7·0, –0·9) nmol/l; P = 0·010), and no difference was found in May/June (P = 0·214). Unexpectedly, the school meals slightly increased PTH (0·18 (95 % CI 0·07, 0·29) pmol/l) compared with habitual lunch. Small increases in dietary vitamin D might hold potential to mitigate the winter nadir in Danish children's 25(OH)D status while higher increases appear necessary to affect status throughout the year. More trials on effects of vitamin D intake from natural foods are needed.

Activity monitors are increasingly being used to quantify the activity of pet dogs. The aim of the present study was to investigate associations between signalment and activity of free-living pet dogs. Healthy pet dogs were recruited to wear an Actical activity monitor on their collars continuously for 2 weeks in their home environment. At least fifteen dogs were enrolled in each of the following weight ranges: <10, 10–20, 21–30, 31–40, >40 kg and their age, sex and reproductive status recorded. Each dog's intensity of activity for each minute of recording was classified using the total counts for that minute and our pre-established cut-points. The percentage of time dogs spent in sedentary, light or moderate/vigorous activity each day was calculated. Median total daily activity counts and median percentages of time dogs spent in activities of differing intensity were used for the analysis. Associations between signalment characteristics and activity parameters were evaluated with the Mann–Whitney test, the Kruskal–Wallis test and Spearman rank correlations. Ninety-eight dogs were enrolled with ≥17 dogs in each weight category. Time that dogs were sedentary correlated positively with age (r 0·50, uncorrected P < 0·001), while the median total daily activity count (r −0·47, uncorrected P < 0·001), time spent in light (r −0·46, uncorrected P < 0·001) and more vigorous activity (r −0·50, uncorrected P < 0·001) were negatively associated with age. No other significant associations between signalment and activity parameters were found. The lack of differences in activity across weight categories may reflect the impact of lifestyle negating any potential behavioural differences across breeds.

The ongoing nutrition transition in lower- and middle-income countries (LMIC) in South East Asia may have a positive impact on protein nutrition. This study assessed the diversity of plant and animal protein food sources in relation to essential amino acid (EAA) adequacy in a population-based sample (N 1665) in Indonesia. Dietary intakes from in-person 24 h recalls provided data on energy and protein intakes (in g/d) from plants (grains, legumes), meat, poultry and fish, and eggs and dairy. Protein diversity scores were based on the number of protein food sources over 24 h. EAA scores were the ratio of amino acid intakes to recommended values. Protein diversity and EAA scores were then compared across multiple socio-demographic indices. Analysis of variance and χ2 tests were used to test for differences among groups. Energy intakes were 1678 kcal/d for men and 1435 kcal/d for women. Average protein intakes (and prevalence of inadequacy) were 59⋅4 g/d (41⋅7 %) for men and 51⋅5 g/d (51⋅1 %) for women. In regression analyses, higher protein diversity scores were associated with higher protein intakes, more animal protein and less plant protein and with higher EAA scores. Lower protein diversity scores were associated with lower intakes of lysine, leucine and valine relative to requirements, as well as with lower EAA, rural settings, less wealth and less modernisation. Greater diversity of animal protein food sources, observed among groups of higher socio-economic status, was linked to better amino acid adequacy and protein nutrition.

The present study aimed to (a) establish the frequency of consumption of red meat and eggs; (b) determine serum ferritin levels (μg/l); and (c) establish the relationship between serum ferritin and the consumption of red meat and eggs. In Colombia during 2014–2018, an analytical study was conducted in 13 243 Colombian children between the ages of 5 and 17 years, based on cross-sectional data compiled by ENSIN-2015 (Encuesta Nacional de la Situación Nutricional en Colombia-2015) on serum ferritin levels and dietary consumption based on a questionnaire of the frequency of consumption. Using simple and multiple linear regression, with the serum ferritin level as the dependent variable and the frequency of consumption as the main explanatory variable, the crude and adjusted partial regression coefficients (β) between serum ferritin levels and consumption were calculated. The frequency of habitual consumption of red meat was 0⋅49 (95 % CI 0⋅47, 0⋅51) times/d. The frequency of habitual egg consumption was 0⋅76 (95 % CI 0⋅74, 0⋅78) times per d. The mean serum ferritin level in men was 41⋅9 (95 % CI 40⋅6, 43⋅1) μg/l and in women, 35⋅7 (95 % CI 34⋅3, 37⋅7) μg/l (P < 0⋅0001). The adjusted β between the consumption of red meat and eggs and serum ferritin levels were β = 3⋅0 (95 % CI 1⋅2, 4⋅7) and β = 2⋅5 (95 % CI 1⋅0, 3⋅9) for red meat and eggs, respectively. In conclusion, red meat and eggs are determinants of serum ferritin levels in Colombia and, therefore, could be considered public policy options to reduce anaemia and Fe deficiency.

Substantial evidence suggests that regular tree nut consumption does not lead to changes in body weight (BW). However, these studies used a variety of dietary substitution instructions which may confound the interpretation of prior BW outcomes. The purpose of the present study was to examine the impact of daily pecan consumption, with or without isocaloric substitution instructions, on BW and composition. This was an 8-week randomised, controlled trial with three treatments: a nut-free control group (n 32) and two pecan groups. ADD (n 30) consumed pecans (68 g/d) as part of a free-living diet, and SUB (n 31) substituted the pecans (68 g/d) for isocaloric foods from their habitual diet. BW and total body fat percentage (BF) were measured, and theoretical changes in these outcomes if pecans were consumed without compensation were determined. BW increased in all groups across the intervention, and there was a trend (P = 0⋅09) for an increase in ADD (1⋅1 ± 0⋅2 kg) and SUB (0⋅9 ± 0⋅3 kg) compared to control (0⋅3 ± 0⋅2 kg). In addition, there was increased BF in SUB (1⋅0 ± 0⋅3 %; P = 0⋅005) but not ADD (0⋅1 ± 0⋅2 %) or control (−0⋅2 ± 0⋅3 %) There was a large difference in the actual v. theoretical change in BW regardless of pecan treatment (actual: 1⋅1 ± 0⋅2 and 0⋅9 ± 0⋅3 v. theoretical: 3⋅3 ± 0⋅0 and 3⋅2 ± 0⋅0 kg in ADD and SUB, respectively; P < 0⋅001). Furthermore, there was a difference in actual v. theoretical change in BF in ADD (0⋅1 ± 0⋅2 v. 1⋅2 ± 0⋅1 %; P = 0⋅002) but not SUB or control. In conclusion, daily pecan consumption for 8 weeks did not result in significant weight gain, regardless of dietary substitution instructions.

Telomeres are nucleoprotein complexes that form the ends of eukaryotic chromosomes where they protect DNA from genomic instability, prevent end-to-end fusion and limit cellular replicative capabilities. Increased telomere attrition rates, and relatively shorter telomere length, is associated with genomic instability and has been linked with several chronic diseases, malignancies and reduced longevity. Telomeric DNA is highly susceptible to oxidative damage and dietary habits may make an impact on telomere attrition rates through the mediation of oxidative stress and chronic inflammation. The aim of this study was to examine the association between leucocyte telomere length (LTL) with both the Dietary Inflammatory Index® 2014 (DII®) and the Alternative Healthy Eating Index 2010 (AHEI-2010). This is a cross-sectional analysis using baseline data from 263 postmenopausal women from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial, in Calgary and Edmonton, Alberta, Canada. No statistically significant association was detected between LTL z-score and the AHEI-2010 (P = 0·20) or DII® (P = 0·91) in multivariable adjusted models. An exploratory analysis of AHEI-2010 and DII® parameters and LTL revealed anthocyanidin intake was associated with LTL (P < 0·01); however, this association was non-significant after a Bonferroni correction was applied (P = 0·27). No effect modification by age, smoking history, or recreational physical activity was detected for either relationship. Increased dietary antioxidant and decreased oxidant intake were not associated with LTL in this analysis.

The recommendations for the Ca supply for maintenance of dogs have been reduced by about 75 % in the last decades. An important factor for Ca requirements is faecal Ca losses. In previous studies with experimental diets faecal Ca losses depended on Ca intake and on faecal DM excretion. A predictive equation for faecal Ca losses in mg/kg body weight (BW) developed in a fibre model is: faecal losses = −33·8 + (13·6 faecal DM excretion (g/kg BW)) + (0·78 Ca intake (mg/kg BW)). The present study aimed at testing this equation in pet food with material from trials carried out for other purposes. Digestion trials with twenty-five dry and fifteen moist foods (326 observations in total) were evaluated retrospectively. Faecal DM excretion and faecal Ca losses were significantly correlated (r2 0·86; P < 0·001). There was a highly significant correlation (r2 0·87; P < 0·001) between the experimentally determined faecal Ca excretion and the faecal Ca excretion predicted by the equation of Kienzle et al. The data from the previous fibre model study could be transferred to prepared moist and dry dog food. Faecal DM excretion has a considerable impact on faecal Ca losses in a practical feeding situation. In conclusion, Ca requirements for maintenance may vary with food DM intake and digestibility.

Dietary diversity is one of the eight core indicators of infant and young child feeding (IYCF) practices. It is also a proxy for nutrient adequacy of the diet of individuals. There are minimal studies showing the level of dietary practice in urban and rural settings comparably. Hence, the present study intended to assess and compare differences in the level of dietary diversity and its contributing factors in urban and rural settings of the West Shoa zone of Oromia, Ethiopia. A community-based comparative cross-sectional study was conducted among 674 pairs of mothers/caregivers and children aged 6–23 months using a multistage sampling technique. Data were analysed and descriptive summaries were presented with tables, charts and graphs. A linear regression analysis was used to identify factors that were associated with the level of dietary diversity. The dietary diversity score (DDS) was 26⋅1 % (95 % CI 22⋅8, 29⋅5) both in urban and rural (P < 0⋅001), and also the minimum meal frequency was 56⋅5 % (95 % CI 52⋅7, 60⋅2) (P < 0⋅038). Child from merchant mother, own production of foods at the household level and frequent advice of IYCF practices during Post natal care (PNC) visit in urban residents, maternal secondary educational level, living with caregiver only, having a merchant father, advice of IYCF practice during PNC visit and utilisation of horse as a means of transportation in rural were positively associated with the level of dietary diversity. Generally, infant and young children who received the recommended dietary diversity and the minimum meal frequency were low in the study area both in the urban and rural settings.

In 2021, the Lancet Commission on adolescent nutrition highlighted the need to prioritise the elimination of adolescent malnutrition to tap the human capital potential and break the intergenerational malnutrition trap. The nutritional requirement during adolescence reaches its peak. The present study aims to appraise the prevalence of undernutrition (stunting and thinness) and anaemia among adolescents (10–19 years) in India and the role of socioeconomic, individual-level hygiene behaviour and dietary diversity in nutritional outcomes. We have used the nationally representative Comprehensive National Nutrition Survey (CNNS-2016–18) that covers children and adolescents (0–19 years) in India. The prevalence of stunting, anaemia and thinness among adolescents was 27⋅2, 28⋅5 and 24⋅1 %, respectively. Bivariate and multivariable logistic regression models were applied to estimate the likelihood of undernutrition. The likelihood of stunting was higher for late adolescence (OR 1⋅21, 95 % CI 1⋅15, 1⋅27), low dietary diversity (OR 1⋅37, 95 % CI 1⋅26, 1⋅49) and low hygiene behaviour compliance (OR 1⋅53, 95 % CI 1⋅42, 1⋅64). Adolescents from the poorest quintile were more likely to be stunted (OR 3⋅20, 95 % CI 2⋅94, 3⋅48), anaemic (OR 1⋅66, 95 % CI 1⋅47, 1⋅87) and thin (OR 1⋅68, 95 % CI 1⋅54, 1⋅82). We found that lower hygienic compliance was significantly associated with undernutrition and anaemia. Therefore, promoting hygienic practices should be emphasised to tackle undernutrition and anaemia. Furthermore, dietary diversity and poverty were strong predictors of stunting and thinness, therefore targeting the poor and focusing on improving dietary diversity should be the priority.

High flavonoid consumption can improve vascular health. Exploring flavonoid–metabolome relationships in population-based settings is challenging, as: (i) there are numerous confounders of the flavonoid–metabolome relationship; and (ii) the set of dependent metabolite variables are inter-related, highly variable and multidimensional. The Metabolite Fingerprint Score has been developed as a means of approaching such data. This study aims to compare its performance with that of more traditional methods, in identifying the metabolomic fingerprint of high and low flavonoid consumers. This study did not aim to identify biomarkers of intake, but rather to explore how systemic metabolism differs in high and low flavonoid consumers. Using liquid chromatography–tandem MS, 174 circulating plasma metabolites were profiled in 584 men and women who had complete flavonoid intake assessment. Participants were randomised to one of two datasets: (a) training dataset, to determine the models for the discrimination variables (n 399); and (b) validation dataset, to test the capacity of the variables to differentiate higher from lower total flavonoid consumers (n 185). The stepwise and full canonical variables did not discriminate in the validation dataset. The Metabolite Fingerprint Score successfully identified a unique pattern of metabolites that discriminated high from low flavonoid consumers in the validation dataset in a multivariate-adjusted setting, and provides insight into the relationship of flavonoids with systemic lipid metabolism. Given increasing use of metabolomics data in dietary association studies, and the difficulty in validating findings using untargeted metabolomics, this paper is of timely importance to the field of nutrition. However, further validation studies are required.

Vitamin D insufficiency is associated with various disease processes. We determined whether consumption of a diet supplemented with HyD®, a 25-hydroxycholecalciferol (25(OH)D3) source, would safely increase plasma 25(OH)D3 concentrations in Golden Retrievers with low vitamin D status. We hypothesised that dietary supplementation with HyD® would rapidly increase and sustain plasma 25(OH)D3 levels in healthy Golden Retrievers with low vitamin D status compared with supplementation with vitamin D3. Of fifty-seven privately owned dogs recruited with written owner consent, eighteen dogs with low vitamin D status were identified and sorted between two groups to have similar initial plasma 25(OH)D3 concentrations, sex distributions, ages and body weights. Dogs of each group were fed a dry dog food supplemented with either 16 μg/kg of 25(OH)D3 as HyD® (n 10) or 81 μg/kg of cholecalciferol (D3) (n 8) for 4 months. Plasma 25(OH)D3 concentrations were determined monthly. A significant time effect (P < 0⋅001) and time by group interaction (P = 0⋅0045) were found for monthly determined plasma 25(OH)D3 concentrations. Dogs fed the HyD®-supplemented diet experienced a 40⋅5 % rise in plasma 25(OH)D3 values after 1 month (P < 0⋅001) and no change thereafter. Plasma 25(OH)D3 values of dogs supplemented with vitamin D3 did not increase (P > 0⋅05) and were less than values of dogs supplemented with HyD® (P = 0⋅044). With few exceptions, average haematologic, biochemical and urinalyses results remained within the reference range for both groups. Dietary supplementation with HyD® is sufficient to safely increase and sustain plasma 25(OH)D3 levels in healthy dogs.