In Europe, the label information on food is regulated by the Reg. (EU) n.1169/2011 but many other regulated declarations (e.g. nutrition or heath claims (NHC), presence of gluten) can be provided on the pack. All this information could influence the perception of food quality and thus the consumers’ intention-to-buy. However, whether the nutritional quality of food products is comparable among products with different characteristics (e.g. presence/absence of NHC, gluten free (GF) declaration, brand) has been barely studied.

Based on these premises, the Food Labelling of Italian Products (FLIP) Study aims to systematically investigate the overall nutritional quality of the main food categories sold on the Italian market. The present work focused on sweet cereal-based products (biscuits, breakfast cereals, and sweet snacks).

Products were selected from the website of thirteen retailers present on the Italian market and data were collected from the complete images of all the sides of the pack. Then, biscuits, breakfast cereals, and sweet snacks were further sub-grouped for specific comparisons considering i) descriptive name reported, ii) presence/absence of GF declaration, iii) presence/absence of NHC declaration, iv) brand/own label. Data of energy, nutrient and salt contents per 100 grams of product for each product category were considered and comparisons among the sub-groups were performed (Mann Whitney test or Kruskal Wallis one-way ANOVA based on two or multiple independent samples, respectively) (ver. 25.0, SPSS Inc., Chicago, IL, USA). In addition, a Principal Component Analysis was performed for all products and for each product sub-category by considering energy and nutrient contents per 100 grams of product to better describe the inter-product nutritional variability.

A total of 814 biscuits, 371 breakfast cereals and 476 sweet snacks were included. Limited differences were found between branded and own label products and between GF and gluten-containing products. Conversely, interesting differences were observed between products with and without NHC. For instance, biscuits with nutrition claims resulted with an overall lower content of total energy, total fats and sugars compared to product without these claims, in agreement with previous investigations. Finally, a high inter-product variability was observed among the different sub-categories for the three product categories.

Future researches performed within the FLIP study will allow to have a clearer picture about the nutritional quality of food products sold in Italy and to understand if specific food characteristics might be considered as a “marker” of the overall quality of food products

Reducing saturated fat (SFA) intake can lower low-density lipoprotein (LDL)-cholesterol and thereby cardiovascular disease (CVD) but there are no brief interventions sufficiently scalable to achieve this. The Primary Care Shopping Intervention for Cardiovascular Disease Prevention (PC-SHOP) study developed and tested a behavioural intervention to provide health professional (HP) advice alone or in combination with personalised feedback on food shopping, which was delivered using a bespoke tool that created a nutritional profile of the grocery shopping based on loyalty card data from the UK largest supermarket.

Participants with raised LDL-cholesterol were randomly allocated to one of three groups: ‘No Intervention’ (n = 17), ‘Brief Support’ (BS, n = 48), ‘Brief Support plus Shopping Feedback’ (BSSF, n = 48). BS consisted of a 10-minute consultation with a nurse to inform and motivate participants to reduce their SFA intake. The BSSF group received brief support as well as personalised feedback on the SFA content of their grocery shopping including lower SFA swaps. The primary outcome was the between-group difference in the change between baseline and 3 months in SFA intake (% total energy intake) adjusted for baseline SFA intake and GP practice. The trial was powered to detect a reduction in SFA of 3% (SD3).

There was no evidence of a difference between the groups. Changes in SFA intake from baseline to follow-up were: -0.7% (SD3.5) in BS, -0.9% (SD3.6) in BSSF and -0.1% (SD3.3) with no intervention. Compared to no intervention, the adjusted difference in SFA intake was -0.33%; 95%CI -2.11, 1.44 with BS and -0.11%; 95%CI -1.92, 1.69 with BSSF. There was no significant difference in total energy intake (BS: -152kcal; 95%CI -513, 209; BSSF: -152kcal; 95%CI -516, 211); body weight (BS: -1.0 kg; 95%CI -2.5, 0.5; BSSF: -0.6 kg 95%CI -2.1, 1.0); or LDL-cholesterol (BS: -0.15mmol/L; 95%CI -0.47, 0.16; BSSF: -0.04mmol/L; 95%CI -0.28, 0.36) compared to no intervention.

This trial shows that it is feasible to deliver brief advice in primary care to encourage reductions in SFA intake and we have developed a system to provide personalised advice to encourage healthier choices using supermarket loyalty data. This small trial showed no evidence of large benefits but we are unable to exclude more modest benefits. Even a reduction of 1% in SFA intake when replaced by polyunsaturated fat may reduce CVD incidence by 8%, suggesting that a larger trial to assess whether benefits of this size may occur is now warranted.

Takeaway shops are more clustered around secondary than primary schools and UK planning policies to limit takeaways show poor implementation against international examples and good practice statements. A major concern is that, worldwide, there are no standardised measures used to measure the food environment around homes, schools, work or any other facilities. This study aims to examine the differences in using different methods to evaluate the food environment particularly around secondary schools in the Avon region in the UK. Geographical Information System (GIS) was used to locate all schools and takeaways in the region and to measure the density and proximity scores, applying both road network and straight-line methods. In addition, the Hansen Index was used to measure the accessibility score of each schools to all takeaways in the region (not just the nearest). All of the nonparametric statistical analysis tests including Wilcoxon test, agreement (Kappa statistic) test and correlation test were carried out using Stata software version 15.0. It was observed that more than 50% of the schools had no takeaway shops within 200, 400, and 600 metres when the road network buffer was used. Statistical differences were observed between the road network and the straight-line methods. For example, the median of the difference between the straight-line and road network density within 1000 metres was 4.1 (CI 2.6, 5.9; P < 0.001). The median of the difference between the road network and straight-line proximity was 203.2 (CI 144.6, 261.9; P < 0.001). Also, the agreement between straight-line and road network densities within 800 (Kappa = 0.38) and 1000 (Kappa = 0.47) metres were fair and moderate, respectively. The agreement between both methods to measure the proximity was fair to moderate (Kappa = 0.40). In addition, the correlation results showed that both the straight-line and road network proximity were negatively correlated to the accessibility score measured. Our findings suggest that the 800 and 1000 metres road network density and proximity may be more appropriate to explore the real relationships between fast food accessibility and diet or health relationships. In addition, the Hansen index is another metric that may be used if the aim of the study is to consider multiple locations when calculating the accessibility score. The availability of best-practice methods would help to explore the food environment in a consistent way and therefore lead to the implementation of effective actions and policies targeting the food environments, particularly around secondary schools.

Pistachios (Pistacia Vera) are nutrient-dense foods with a healthy nutritional profile that contains fiber, unsaturated fatty acids, essential nutrients, phytochemicals and protein. However, the nutritional quality of the protein has not been characterized to date. Therefore, the objective of this study was to determine the Protein Digestibility Corrected Amino Acid Score (PDCAAS) and Digestible Indispensable Amino Acid Score (DIAAS) for raw and roasted American pistachio nuts in growing pigs. The values for apparent ileal digestibility (AID) of crude protein (CP) and the standard ileal digestibility (SID) where calculated for these proteins. The CP content was greater for raw pistachios (27.1%) compared with roasted pistachios (25.1%). The amino acid (AA) in greatest concentrations for both types of pistachio were arginine followed by leucine. The AA in the lowest concentration were tryptophan followed by methionine. The AID of CP was greater (P < 0.05) for raw pistachios than for roasted pistachios, and the AID of most indispensable AA (IAA), except arginine, isoleucine, and phenylalanine, was greater (P < 0.05) for raw pistachios. The SID of CP was greater (P < 0.05) for raw than for roasted pistachios, and the SID of all IAA, except phenylalanine, was greater (P < 0.05) for raw than for roasted pistachios. The PDCAAS value calculated for both types of pistachios was based on the requirement for children from 2 to 5 years old (FAO, 1991), whereas the DIAAS value was calculated based on the requirement for children 3 years and older, adolescents, and adults (FAO, 2013). Both raw and roasted pistachios had a PDCAAS value of 75. In contrast, the DIAAS was numerically greater for raw pistachios than for roasted pistachios with values of 86 and 83, respectively. For PDCAAS, the first limiting AA in both raw and roasted pistachios when compared with the AA requirements for children 2 to 5 years was threonine. For DIAAS, lysine was the first limiting AA in both raw and roasted pistachios when compared with the AA requirements for children 3 years and older, adolescents, and adults. Based on the DIAAS cut-off values describing protein quality (FAO, 2013), raw pistachios and roasted pistachios can both be considered a ‘Good’ quality protein if consumed by children older than 3 year, adolescents, and adults.

The use of nutrition and health claims on food is legislated for in Commission Regulation 1924/2006 and SI No. 11 of 2014. This legislation ensures that any claim made on a food label is clear, accurate and substantiated, enabling consumers to make informed choices. A study undertaken by the Food Safety Authority of Ireland (FSAI) in 2009 found that yoghurts were the food category with the highest use of nutrition and health claims on the Irish market.

In 2018, the FSAI undertook a nutrition label verification study to verify the accuracy of declared nutrition information on yoghurts. The aims of this study were to measure the use of nutrition and health claims on a sample of yoghurts available on the Irish market in 2018 and assess their compliance with Regulation 1924/2006 Nutrition and Health Claims made on Food.

Yoghurts identified in a 2016 market scan (n578) were weighted based on categorisation of manufacturer type (branded, own brand), product category (natural, flavoured and luxury) and declared nutrition content. Samples (n200) were randomly selected from these weighted groups for the 2018 nutrition label verification study. A subsample (n100) was randomly sampled and checked for presence of nutrition and health claims. Presence of nutrition and health claims was recorded in Microsoft Excel and checked for compliance with Regulation 1924/2006.

Of the yoghurts reviewed, 67% (n67) made at least one nutrition claim and 34% (n34) made at least one health claim. Of these, 29% (n29) made a nutrition and a health claim. Branded yoghurts were more likely to make nutrition and health claims than own brand yoghurts (78% (n49) vs. 48% (n18)). Of yoghurts with a health claim, 88% (n30) were branded and 12% (n4) were own brand. Of yoghurts with a nutrition claim, 1.5% (n1) made a nutrition claim which was potentially non-compliant with Regulation 1924/2006. Of yoghurts with a health claim, 74% (n23) made a health claim which was potentially non-compliant with Regulation 1924/2006. The majority of potentially non-compliant health claims were in relation to probiotic strains and ‘live cultures’.

In conclusion, yoghurts continue to be a food category which often uses nutrition and health claims. Nutrition and health claims are more frequently used by branded than own brand products. Potentially non-compliant health claims are an issue amongst this food category which will be further investigated and followed up.

The aim of the study was to identify the effect of marinating meat on selected quality determinants. Fifty-four pork samples were prepared from longissimus dorsi muscles, each 2.5-cm-thick; they were subsequently marinated for 24 hours (n = 12) and control samples were also prepared (n = 6). The following marinades were used: base marinade (M) whose ingredients included a mixture of herbs and condiments (salt, pepper, juniper berries, rosemary, bay, pimento, garlic) and 3 liquid marinades obtained by adding to the base marinade of apple cider vinegar (MV), light beer (MB) and buttermilk (MM). In the samples pH, marinade absorption, drip loss, cooking loss, WBSF and tenderness by sensory assessment were measured(1,2).

The pH value of the material used for the study was 5.8 ± 0.02. The use of the base marinade increased the pH to 6.37 ± 0.03, whereas the liquids used in the marinades decreased the pH to 5.5 ± 0.05. Marination resulted in an increase in the material weight by 2.87 ± 0.05% (MB), 4.45 ± 0.07% (MM), 0.87 ± 0.03% (M). The addition of vinegar resulted in exuding meat juice and a decrease in the material weight by 2.53 ± 0.06% (MV). Using the base marinade reduced drip loss (0.53 ± 0.01%) compared with the control (1.37 ± 0.03%). Sour marinade (MV) increased cooking loss by 18% compared to the control, the MB and MM marinades did not affect this parameter significantly, and the base marinade had a significant effect on reducing cooking loss by 24%. Each of the marinades used had a significant effect on reducing the maximum shear strength by 31% (liquid marinades) and by as much as 46% – base marinade. This relationship was confirmed in a sensory assessment, where higher notes for tenderness were given when base marinade (9.2 ± 0.3pts), marinade with buttermilk (8.1 ± 0.2pts), and marinades with vinegar and beer (7.3 ± 0.3pts) was used compared with control samples (5.7 ± 0.4pts).

This study has shown a beneficial effect of the marinades on the tenderness of the products. The most beneficial effect on the quality determinants under study was exerted by the base marinade, which consisted of herbs and condiments only.

Growing urbanization and rapid changes in dietary patterns and lifestyle led to a nutrition transition in several Arabic countries, including Egypt. While Egyptian women have one of the highest mean body mass index worldwide, they also suffer from several micronutrient deficiencies, more particularly iron and vitamin D. The objective of this study was to identify changes needed in dietary practices and product offer, which could help to rebalance energy and nutrient intakes for women living in urban Egypt. Food intakes were obtained from a 4-days dietary record in 130 women aged 19–30 years from urban Egypt. Food prices were collected in modern and traditional trades typical from middle socio-economic classes in Cairo to calculate diet cost. Modeling analyses (with Optifood software) were used to identify problem nutrients and design affordable food-based recommendations (FBRs). The study assessed whether the most consumed foods (i.e. consumed by > 5% of women) could theoretically ensure nutrient adequacy under the mean diet cost, without exceeding recommendations in energy, SFAs, sugars and sodium. The potential of fortified foods to improve intakes of the most problematic micronutrient to cover was tested in additional modeling analyses. Preliminary results from modeling analyses indicate that iron appeared as the most limiting nutrient with locally consumed foods. Daily consumption of fruits, vegetables, milk or yoghurt, and tahini (sesame paste) associated with specific food choices in the meat-fish-eggs category would result in a low percentage of women at risk of inadequate intakes for 11 out of 12 modeled micronutrients. Among the fortified foods tested, iron fortified bread, rice, milk or yoghurt are the most promising vectors. Local and consumed foods allow to meet nutrient adequacy for most nutrients except iron, for which fortified products would be required. Tailored strategies are needed to promote acceptable FBRs (and fortified products) and secure that nutrient requirements are met by most Egyptian women.

Antimicrobial and antioxidant activities of nine species of microalgae have been determined to study its potential as healthy ingredients for functional foods. In order to determine the antioxidant capacity, two different techniques have been used. Firstly, a colorimetric test was carried out in order to detect the presence of lipophilic and hydrophilic antioxidant compounds, this method is based on the detection of the radical ABTS + , which is produced by the oxidation of ABTS in the presence of potassium persulfate, detection of the radical ABTS + decreases in the presence of antioxidant compounds. Also the ORAC test was also applied for this purpose. Results with both methods showed very promising results for Rhodomonas lens. Thus this species was chosen to develop a functional cheese and study the healthy properties that the microalgae confer on it.

To determine the antimicrobial activity five food food-borne pathogenic strains were used: Escherichia coli CECT 516, Enterococcus faecalis CECT 481, Listeria monocytogenes CECT 935, Salmonella enterica CECT 4594 and S. aureus CECT 435. First, extracts of different polarity were obtained from microalgae. From each species, 4 extracts were obtained using different solvents of higher to less polarity (MilliQ Water, ethanol, ethyl acetate and hexane). The use of these solvents is common in the preparation of plant extracts, since they ensure the solubility of most of the compounds of interest and do not show toxicity after evaporation to determine the antimicrobial activity. The agar diffusion technique was used and the plates were kept refrigerated at 4 ° C for 1 h to allow the extracts to diffuse through the agar and subsequently incubated at 37 ° C for 24 h to allow microbial growth. After that time the presence of inhibition halos was observed around the perforations of the plates. Results showed that the ethanolic extract presented more antimicrobial activity than the extracts using MilliQ Water, ethyl acetate or hexane. Salmonella was not inhibited by any of the extracts studied.

Marine shellfish is considered high-protein, low-fat and low-saturated-fat food, yet providing significant amounts of essential lipids such as polyunsaturated fatty acids (PUFA), phospholipids, fat-soluble vitamins (A, D3 and E) and carotenoids. These nutrients exhibit a variety of beneficial effects on human health, therefore the increased intake of marine shellfish could contribute significantly to a diverse and nutritious diet. One of the most consumed Black Sea shellfish species in Bulgaria is the black mussel (Mytilus galloprovincialis). The aim of the present study was to assess health-beneficial properties of Black Sea mussels based on their nutritional lipid composition.

Total lipids (TL) were extracted according to Bligh & Dyer. Lipid classes were separated by column and thin layer chromatography. Fatty acid composition was determined by GC/MS system and sterol – by GC/FID. Fat-soluble vitamins and carotenoids were analyzed simultaneously using RP-HPLC system.

Mytilus galloprovincialis were characterized by low lipid content: 1.8 ± 0.08 g.100g-1 ww, more than 50% representing polar lipids. Sterols were minor components (6.2% of TL fraction). Fatty acid (FA) composition showed similar distribution: polyunsaturated > monounsaturated > saturated FA in TL, neutral lipids (NL) and polar lipids (PL) classes. Sum of omega-3 (n-3) PUFA was from 47.1% in TL, 49.2% in NL and 62.5% in PL. Ratio n-6/n-3 was 0.2. Analyzed mussels contained EPA + DHA 0.360 g.100g-1 ww. Sterol fraction consisted mainly of cholesterol (36.3%) and brassicasterol (22.9%). Fat-soluble vitamins contents were: 50.1 ± 2.01μg.100g-1 ww (vitamin A), 7.3 ± 0.2μg.100g-1 ww (vitamin D3) and 4500 ± 140μg.100g-1 ww (vitamin E); and carotenoids: 40.1 ± 1.9μg.100g-1 ww (astaxanthin), 490 ± 5.2μg.100g-1 ww (β-carotene).

Strong correlation between seafood consumption and various obesity-related disorders can suggest the unique potential of seafood, such as shellfish for supplementation nutrients deficiencies. Recent studies suggest that seafood consumption in Bulgaria is low, increasing the concern of nutrient deficiency, especially PUFA, phospholipids and vitamin D3. This study presented that although Black Sea shellfish is low in TL content, it is a very good source of PL bonded n-3 PUFA (> 140% of RDI), vitamin D3 (> 50% of RDI) and other essential lipid antioxidants (astaxanthin). The PUFA/SFA (1.4) and n-6/n-3 (0.2) showed the good nutritional quality of Black Sea Mytilus galloprovincialis tissue. Black Sea shellfish lipids are rich in molecules with health-beneficial properties and high potential for developing functional foods and dietary supplements. Increased intake of shellfish should be encouraged to provide essential nutrients to avoid nutritional deficiencies in Bulgarian population.

The Health Canada Surveillance Tool (HCST), a Canadian nutrient profile (NP) model, assesses products’ adherence to the 2007 Canada's Food Guide (CFG), using thresholds for total fat, saturated fat, sugars and sodium. In 2019, new dietary guidelines were published (i.e., CFG 2019); however; the HCST has not been updated to reflect changes implemented in this new guide. Given suggestions to adapt previously validated NP models rather than create new models, this research aimed to assess whether the HCST could be a useful tool to assess alignment with updated dietary guidance. Specifically, the objective of this study was to test the agreement between products’ alignment with the CFG 2007 (as per the HCST) and products’ alignment with the recently released CFG 2019 guidelines. This study analyzed data from the University of Toronto Food Label Information Program (FLIP) 2017 database. FLIP contains label and nutrition information for prepackaged food products from top Canadian grocery retailers. Products were categorized into Tiers based on HCST thresholds: Tiers 1 and 2 were considered “in line” with dietary guidance, while Tiers 3, 4 and “Other” (i.e. foods not addressed by CFG) were considered “not in line”. Two raters independently classified foods according to their alignment to CFG 2019. Proportions of products that were considered “in line” with CFG 2007 and 2019 were calculated. Overall agreement between alignment with CFG 2007 and 2019 was determined by cross-classifications of the proportion of products considered “in line” or “not in line” with both CFG versions. Cohen's Kappa (κ) statistic tested the level of agreement (Interpretation of κ: 0.01–0.20, “slight”; 0.21–0.40, “fair”; 0.41–0.60, “moderate”; 0.61–0.80, “substantial”; and 0.81–0.99, “almost perfect”). Analyses were conducted overall and by Health Canada's Table of Reference Amounts for Food category. In total, n = 16,973 products were analyzed, with 98% inter-rater reliability for CFG 2019 alignment. Overall, 30.2% and 28.2% of products were “in line” with CFG 2007 and 2019, respectively, with 80.4% overall agreement and “moderate” kappa agreement (κ [95% CI]: 0.49 [0.46, 0.49]). Overall agreement in individual food categories ranged from 100% (Dessert Toppings, Sauces, Sugars and Sweets; κ: N/A) to 54.8% (Eggs, κ: 0.21 [-0.01, 0.4]). From these results, the HCST appears to be an effective NP model for assessing alignment with CFG 2019. Further analysis could elucidate specific areas for adaptation of the HCST to optimize its functionality in this context.

Gluten-free claims (GFC) on food labels are becoming popular despite the fact that 1% and 6% of the population have celiac disorder or gluten sensitivity, respectively. A previous Canadian study found that GFC were displayed on 8% of food labels; however, certain food categories (e.g., snacks, meat products) were among the ones carrying most GFC. This study aimed to assess trends in the use of GFC on Canadian food labels in top food categories carrying GFC from 2013 to 2017 and to determine the nutritional quality between products with and without GFC.

This study was a repeated cross-sectional analysis of the University of Toronto Food Label Information Program 2013–2017. GFC were identified by systematically reviewing the photographs of food labels (n = 9,179) in seven food categories previously identified as carrying larger proportions of GFC: 1) desserts; 2) desserts toppings and fillings; 3) meat products; 4) nuts and seeds; 5) sauces and dips; 6) snacks; and 7) soups. GFC were coded as present, if a gluten-free declaration or symbol was made on package, otherwise products were coded as claim absent. Proportions of products displaying GFC were calculated overall and by food category. Mean contents of saturated fat (g per 100g/ml), sodium (mg per 100g/ml) and sugar (g per 100g/ml) were calculated for products with and without GFC. Chi-square and Mann-Whitney-Wilcoxon tested differences in proportions and mean contents of those nutrients between years.

Results showed that among these categories, GFC have significantly increased from 11% in 2013 to 23% in 2017 (p < 0.001). At a category level, snacks had the greatest increase of GFC as their prevalence doubled (15% to 33%, p < 0.001), followed by nuts and seeds (12% to 27%, p < 0.001) and meat products (15% to 28%, p < 0.001), respectively for 2013 and 2017. The proportion of GFC in dessert toppings and fillings remained constant (16% in 2013 and 14% in 2017, p = 0.74). When the nutritional composition was examined, results were mixed: in dessert toppings and filling, meat products and, nuts and seeds, products with GFC had higher contents of saturated fat, sodium and sugar in comparison to their counterpart without claims, whereas the opposite was true for foods within desserts, sauces and dips, snacks, and soups categories (p < 0.001 for all nutrients, except for saturated fat in nuts and seeds). In conclusion, prevalence of GFC has doubled in the Canadian food supply; such claims are not indicative of better nutritional composition.

A positive association has been reported between vitamin D status, muscle strength and physical function in older Caucasian women. However, little is known about this relationship in UK South Asian older women. This cross-sectional study aimed to explore the association between vitamin D status, muscle strength and physical function in UK South Asian (Pakistani and Indian) older women.

One hundred and twenty community-dwelling women were recruited via visiting community centres, mosques, Indian temples (Gurdwara) and by word of mouth (between January to May 2018). Inclusion criteria were: community-dwelling, South Asian women, age 60 years and above, able to communicate effectively and able to give written or verbal consent. A general interview (demographic, anthropometric, self-reported exhaustion, health history, supplementation use/duration/dose), handgrip strength (kg), short physical performance battery (single chair stand, repeated chair stands, balance, timed up-and-go test), and blood 25 hydroxyvitamin D (25(OH)D, nmol/l) concentration were performed. Dietary intake and self-reported physical activity was also assessed using multiple-pass 24-hour diet recall method and International Physical Activity Questionnaire (IPAQ) short form respectively.

Overall, 47% of participants had insufficient blood 25(OH)D concentration (< 50nmol/L) and 53% had sufficient blood 25(OH)D (≥ 50nmol/L) using the IOM classification. As expected 86% of current vitamin D supplement users had adequate vitamin D status and only 14% of women who reported current vitamin D supplement use had insufficient vitamin D status. Amongst supplement non-users 68% had insufficient vitamin D status and only 32% had adequate levels. An inverse correlation (Spearman's analysis) was found between vitamin D status and single chair stand test (sec) (r = -0.25, p = 0.006); repeated chair stand test (sec) (r = -0.29, p = 0.002) and timed up-and-go test (sec) (r = -0.20, p = 0.02). No correlation was observed between vitamin D status and handgrip strength (r = 0.09, p = 0.30).

The prevalence of vitamin D insufficiency is high in post-menopausal South Asian women not taking vitamin D supplements. Significant association was observed between vitamin D status and some aspects of muscle strength and physical function. We are now conducting a randomized control trial to investigate whether vitamin D supplementation may restore muscle strength and function in this population.

Wholegrain consumption is linked to a lower risk of cardiovascular disease. Evidence from randomized controlled trials have established that the consumption of wholegrain oats lowers blood cholesterol, via a mechanism partly mediated by β-glucan soluble fiber. However, oats contain an array of phenolic acids, including ferulic acid and also structurally related avenanthramides, which may also contribute to the cardiovascular health benefits of oat intake. We investigated whether 4 weeks, daily consumption of oat phenolics leads to improvement in markers of CVD risk men and women.In a 3 arm crossover single-blind, placebo-controlled trial, 28 volunteers consumed either: 1) oatmeal/oatcake intervention (-containing 48.9 mg of phenolic acids and 19.2 mg of avenanthramides); 2) oatbran concentrate + rice porridge/wheat cracker intervention (-containing 38.4 mg of phenolic acids and 0.5 mg of avenanthramides) or 3) rice porridge/wheat cracker intervention (containing 13.8 mg of phenolic acids). All treatments were matched in soluble fiber (4.8g) and energy (500kcal). The primary endpoint was FMD and other cardiovascular endpoints were blood pressure, LDI, LDL/HDL cholesterol, platelets and endothelial cell-derived extracellular vesicles (EVs). All measures were taken at baseline and after three, 4 week long intervention periods and two washout periods.Our data indicates an increase by 1.09 % ± 0.41 %(Mean ± SEM) in FMD response following high phenolic oat intake with a significant difference (P = 0.007) between baseline and post-intervention. Consumption of high phenolic oats also led to a significant improvement in 24-hour SBP, day time SBP and night time SBP (P < 0.01, P < 0.01 and P < 0.05) and day time and night time DBP (p < 0.05). There was also a significant decrease with total and LDL cholesterol after the consumption of moderate and high phenolic oat interventions (P < 0.05) and a small improvement in LDI (both Ach and SNP) but not significant. The number of resting endothelial EVs were also found to be increasing after the consumption of high phenolic oats.The findings of this study may provide evidence about the role of oat phenolic acids and avenanthramides in cardiovascular health and contribute to more effective public health advice about the consumption of oats and healthy cardiovascular aging.

The common C677T polymorphism in the MTHFR gene encoding the folate-metabolising enzyme methylenetetrahydrofolate reductase is implicated in hypertension and hypertension in pregnancy. Hypertension affects up to 15% of all pregnancies and has been identified as a leading cause of maternal and neonatal morbidity and mortality worldwide. We previously reported higher systolic and diastolic blood pressure (BP) in non-pregnant women with the variant MTHFR 677TT genotype compared to CT/CC genotypes. In addition, randomised controlled trials (RCTs) in non-pregnant hypertensive adults from our Centre demonstrated that supplemental riboflavin (co-factor for MTHFR) lowers BP specifically in those with the TT genotype. However, the role of this common folate polymorphism and its interaction with riboflavin during pregnancy remains unclear. The aim of this study was to investigate the impact of MTHFR genotype and riboflavin status on BP in pregnancy. Data were generated from the ongoing Optimal Nutrition for the Prevention of Hypertension (OptiPREG) project. Pregnant women were recruited at the end of the first trimester from antenatal clinics in Northern Ireland and in the Republic of Ireland. Participants were screened for MTHFR genotype and BP was measured according to current clinical guidelines. Biomarker status of riboflavin was determined using the erythrocyte glutathione reductase activation coefficient (EGRac), a functional assay with higher EGRac values representing a lower status. Overall, 117 (11.6%) participants were identified with the variant MTHFR 677TT genotype. Both systolic and diastolic BP decreased from 8th to 16th gestational week (GW), however, this typical BP pattern was not observed in the TT genotype group. After adjusting for maternal age, GW and body mass index, women with the TT genotype at 12th GW had higher mean systolic (P 0.035) and diastolic (P 0.034) BP. When the results at the 12th GW were stratified by riboflavin status, the BP phenotype owing to this polymorphism was evident only among women with lower status (i.e. EGRac > 1.30), with mean (SEM) systolic BP of 120.4 (3.1) mmHg compared to 112.6 (2.5) mmHg in those with higher status (EGRac ≤ 1.30) within the TT genotype group; in contrast, low versus high riboflavin status had no impact on BP in CT/CC genotype groups. These results suggest that MTHFR genotype influences BP during pregnancy and that riboflavin can exert an important modulating effect on BP in women with TT genotype. An RCT is required to fully investigate the role of MTHFR genotype and its interactive effect with riboflavin in BP during pregnancy.

Maternal BMI has been shown to be inversely correlated with vitamin D status (25-hydroxyvitamin D (25(OH)D) concentrations) during pregnancy. Pregnant women with obesity and with vitamin D deficiency are at risk of many adverse health outcomes in pregnancy.

The aim of this study was to examine differences in maternal vitamin D status across normal weight, overweight and obese pregnant women in early pregnancy.

Data collected at baseline from a double-blind randomised vitamin D intervention study (MO-VITD) were used. Pregnant women without pregnancy complications, aged > 18 years and having a singleton pregnancy were recruited between January 2016 and August 2017 at antenatal clinics in the Western Health and Social Care Trust, Northern Ireland. Non-fasting blood samples were collected at 12 weeks gestation and analysed for total serum 25(OH)D, using liquid chromatography tandem mass spectrometry. Data from 239 pregnant women (80 normal weight, 79 overweight, 80 obese) were included in the current analysis.

The mean ± SD 25(OH)D concentration of all pregnant women at 12 weeks gestation was 52.0 ± 21.6 nmol/L. Women classed as obese or overweight had significantly lower 25(OH)D concentrations compared to women of normal weight (48.8 ± 20.3 vs 49.8 ± 20.4 vs. 57.5 ± 23.1 nmol/L, P = 0.019; obese, overweight, normal weight respectively). A total of 45% of all pregnant women were found to be either vitamin D deficient (25(OH)D < 25nmol/L; 13%) or insufficient (25–50 nmol/L; 32%) in early pregnancy. BMI was significantly negatively correlated with 25(OH)D concentrations (r = -0.168; P = 0.009). Regression analyses showed that BMI (β = -0.165; P = 0.006), season (β = 0.220; P = < 0.0001), supplement use (β = -0.268; P < 0.0001) and a sun holiday within the previous 6 months (β = -0.180; P = 0.010) were significant predictors of 25(OH)D concentrations. In early pregnancy, 62% of pregnant women reported using a supplement containing vitamin D and 38% reported no supplement use. Supplement users had a significantly higher vitamin D status than non-supplement users in all BMI categories but overall, 37% of supplement users were still classified as vitamin D insufficient. Vitamin D status was significantly lower in winter months compared to summer months. In early pregnancy, especially during winter months, pregnant women with obesity, particularly non-supplement users, are at higher risk of low vitamin D status. Based on the lower vitamin D status observed in early pregnancy in obese women, the effect of BMI on vitamin D supplementation throughout pregnancy needs to be examined.

Vitamin B12 deficiency is common among older adults, even with dietary intakes well in excess of current recommendations. Severe clinical B12 deficiency (i.e. pernicious anaemia) leads to irreversible neurological damage, but once diagnosed, can be treated effectively with B12 injections. A much more common cause of low vitamin B12 status in older adults is food-bound malabsorption owing to atrophic gastritis. This in turn leads to reduced gastric acid secretion, thus limiting B12 absorption from food (given the essential role of gastric acid in releasing B12 from food proteins). Proton pump inhibitor (PPI) drugs reduce gastric acid secretion, similar to atrophic gastritis, thus there is a concern that these medications may lead to vitamin B12 malabsorption. Therefore, the aim of this study was to investigate biomarker status of vitamin B12 in relation to atrophic gastritis and PPI usage. Data were accessed from The Trinity Ulster Department of Agriculture (TUDA) Ageing Cohort Study, a cross-sectional study of community-dwelling adults (n 5186, ≥ 60 years) recruited across Northern Ireland and the Republic of Ireland (2008–2012). TUDA participants were classified into 3 groups; ‘healthy’ controls, atrophic gastritis and PPI users. Vitamin B12 status was assessed using a total of four biomarkers: serum total B12; serum holotranscobalamin, holoTC; plasma methylmalonic acid, MMA; plasma homocysteine. Atrophic gastritis was identified using pepsinogen analysis (via ELISA), with a pepsinogen I : II ratio of < 3 considered indicative of atrophic gastritis. Based on results from all four biomarkers, participants with atrophic gastritis were found to have significantly lower B12 status compared to healthy controls: e.g. mean (95% CI) serum total vitamin B12, 188 (156, 218) pmol/L vs. 262 (252, 272) pmol/L P < 0.001; holoTC, 46.0 (38.1, 53.8) pmol/L vs. 60.3 (57.8, 62.8) pmol/L P < 0.001; plasma MMA, 0.65 (0.52, 0.78) μmol/L vs. 0.37 (0.32, 0.42) μmol/L P = 0.001. No differences in B12 biomarker concentrations were observed between PPI users and healthy controls. Regular consumption of fortified foods (i.e. ≥ 5 portions per week) compared to non-regular consumption (i.e. 0–4 portions per week) impacted positively on B12 biomarker status in all participants. This effect however appeared insufficient to restore normal vitamin B12 status in those with atrophic gastritis. These results show that older adults with atrophic gastritis have significantly lower vitamin B12 biomarker status, particularly in those who did not regularly consume fortified foods. Further investigations of the effect of atrophic gastritis and PPI usage on B12 status are warranted.

Age-related bone loss leads to a significant decline in bone formation and an increase in bone resorption resulting in a marked negative effect on bone mineral density (BMD). This bone turnover cycle can be further disrupted by estrogen deficiency during menopause which can lead to a great net loss of bone in post-menopausal women. Evidence suggests that n-3 polyunsaturated fatty acids (PUFA) may have a beneficial effect on the inflammatory regulation of bone remodelling and thus reducing bone loss. This study investigated the relationship between PUFA status, total body bone mineral density (BMD) and bone turnover markers in a cohort of post-menopausal women in Northern Ireland. Total body T-score and BMD were measured using dual energy x-ray absorptiometry (DEXA) in 300 non-osteoporotic post-menopausal women (45–75 years). The bone turnover markers serum osteocalcin, alkaline phosphatase, C-terminal telopeptides of type 1 collagen (CTX) and urinary deoxypyridinoline (DPD) were quantified. Total n6 PUFA (LA + AA) and n3 PUFA (ALA + EPA + DPA + DHA) were measured in serum using gas chromatography mass spectrometry. Total n3:n6 ratio was calculated. Dietary intake and lifestyle factors were determined by 4 day food diary and questionnaire, respectively. Spearman rank correlation analysis were conducted to investigate the relationship between PUFA and total body BMD. Secondary analysis investigated the relationship between PUFA and the bone turnover markers. Median (IQR) age was 61 (10) years, body mass index 27 (6) kg/m2, total body BMD, 1.3 (0.11) g/cm2 and age at menopause was 50 (6) years. Total median (IQR) serum n-3 PUFA status was 0.231 (0.128) mg/mL, total n6 PUFA was 1.248 (0.477) mg/mL and the n6:n3 PUFA ratio was 5.82 (2.63). Median (IQR) daily fish consumption was 25 (46) grams, calcium 702 (364) mg and vitamin D 2.21 (2.3) μg. There was no significant correlation between markers of total n3, n6, n6:n3 ratio and total body T-score, BMD or bone mineral content. PUFA was not significantly associated with total body BMD. There was a significant negative correlation between the urinary bone resorption marker DPD and total n3 PUFA (r = -0.137, P = 0018); EPA (r = -0.150, P = 0.009), and DPA (r = -0.118, P = 0.042). A significant negative correlation was observed between urinary CTX and the n-6 PUFA AA (r = -0.121, P = 0.036), the n3 PUFA ALA (r = -0.123, P = 0.033). PUFA were associated with less bone resorption therefore it is plausible that PUFA have a positive anti-inflammatory effect on bone resorption and warrants further investigation.