The xanthophylls lutein and zeaxanthin probably play a role in visual function and may participate in the prevention of age-related eye diseases. Although a minimum amount of TAG is required for an optimal bioavailability of these carotenoids, the effect of the type of TAG fatty acids (FA) is less clear. The aim was to assess the effect of the type of TAG FA on bioavailability of these xanthophylls. A total of three complementary models were used: an in vitro digestion model to study bioaccessibility, Caco-2 cells to study uptake efficiency and orally administered rats to study in vivo bioavailability. Results showed that lutein and zeaxanthin bioaccessibility was greater (about 20–30 %, P< 0·05) with butter and palm oil than with olive and fish oils. Mixed micelle size, which was significantly lower (about 8 %, P< 0·05) with SFA than with unsaturated FA, was inversely related to lutein and zeaxanthin bioaccessibility. There was no significant effect of the type of TAG FA on xanthophyll uptake by Caco-2 cells, but some compounds present in natural oils significantly affected xanthophyll uptake. Oral administration of rats with spinach and butter over 3 d led to a higher fasting plasma lutein concentration than oral administration with olive or fish oils. In conclusion, dietary fats rich in SFA lead to a higher bioavailability of lutein and zeaxanthin, as compared with fats rich in MUFA and PUFA. This is due partly to the higher bioaccessibility of these xanthophylls in the smaller mixed micelles produced when SFA are incorporated into mixed micelles.

We have previously shown nutritional intervention with fish oil (n-3 PUFA) to reduce numerous complications associated with the metabolic syndrome (MetS) in the JCR:LA-corpulent (cp) rat. In the present study, we sought to explore the potential role of fish oil to prevent glomerulosclerosis in JCR:LA-cp rats via renal eicosanoid metabolism and lipidomic analysis. Male lean and MetS JCR:LA-cp rats were fed a lipid-balanced diet supplemented with fish oil (5 or 10 % of total fat). After 16 weeks of feeding, albuminuria was significantly reduced in MetS rats supplemented with 5 or 10 % fish oil ( − 53 and − 70 %, respectively, compared with the untreated MetS rats). The 5 % fish oil diet resulted in markedly lower glomerulosclerosis ( − 43 %) in MetS rats and to a lesser extent in those supplemented with 10 % fish oil. Interestingly, untreated MetS rats had higher levels of 11- and 12-hydroxyeicosatetraenoic acids (HETE) v. lean rats. Dietary fish oil reduced these levels, as well as other (5-, 9- and 15-) HETE. Whilst genotype did not alter prostanoid levels, fish oil reduced endogenous renal levels of 6-keto PGF1α (PGI2 metabolite), thromboxane B2 (TxB2), PGF2α and PGD2 by approximately 60 % in rats fed 10 % fish oil, and TxB2 ( − 50 %) and PGF2α ( − 41 %) in rats fed 5 % fish oil. In conclusion, dietary fish oil prevented glomerular damage in MetS rats and mitigated the elevation in renal HETE levels. These results suggest a potential role for dietary fish oil to improve dysfunctional renal eicosanoid metabolism associated with kidney damage during conditions of the MetS.

One of the many functions of taurine is to protect cells against oxidation, by protecting mitochondrial integrity and respiration. Taurine metabolism has attracted much attention in fish nutrition due to the fact that as plant ingredients replace fishmeal, dietary taurine has declined. As the endogenous synthesis of taurine might be too low to protect cells against oxidative stress and apoptosis, the present study aimed to test whether taurine may protect liver cells from apoptosis. Liver cells isolated from Atlantic salmon (Salmo salar) were grown in media supplemented with a physiological concentration of taurine (25 (se 0·5) mm) or without any taurine supplementation (14 (se 3) μm) for 3 d. To increase oxidation in the mitochondria and maximise any cellular response of taurine supplementation, 100 μm-CdCl2 was added or not added to the cells at day 3. At day 4, cells were harvested and assessed for viability. As expected, the addition of CdCl2 decreased cell viability without showing any interaction with taurine supplementation. Cells grown in the taurine-supplemented media had lower protein abundance of active caspase-3. In addition, the protein abundance of phosphorylated mitogen-activating phosphokinase (P-p63, P-p42/44 and P-p38) as well as cytochrome P450 were reduced when taurine was added to the media. Cells grown without taurine supplementation had a more condensed chromatin and more smeared DNA, also pointing to a higher apoptosis in these cells. In conclusion, taurine attenuated apoptosis in primary liver cells isolated from Atlantic salmon, and as such, taurine may be conditionally indispensable in Atlantic salmon.

A 9-week feeding trial was conducted to evaluate the effects of dietary cholesterol supplementation at different levels (0, 0·3, 0·6, 0·9, 1·2 and 1·5 %) on growth and cholesterol metabolism of rainbow trout (Oncorhynchus mykiss) fed soyabean meal (SBM)-based diets. Daily growth coefficient (DGC) steadily increased when the supplemental cholesterol was increased by up to 1·2 %, but declined upon further addition. The total cholesterol (TC), HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) levels in plasma generally increased when the supplemental cholesterol was increased by up to 1·2 %. Thereafter, the TC level reached a plateau, the LDL-C level showed a marked decline, whereas the HDL-C level continued to increase. Dietary cholesterol supplementation generally increased the total lipid and cholesterol levels in liver; the total lipid and TAG levels in muscle; the TC, free cholesterol, cholesteryl ester and total bile acid levels in intestinal contents; and the triiodothyronine and Ca levels in plasma. However, significant differences were mainly observed with high levels of supplemental cholesterol (0·9–1·5 %). Low levels of supplemental cholesterol (0·3–0·9 %) decreased hepatic 3-hydroxy-3-methyl-glutaryl-CoA reductase and cholesterol 7α-hydroxylase activities, but high levels of supplemental cholesterol (1·5 %) increased hepatic acyl-CoA:cholesterol acyl transferase and cholesterol 7α-hydroxylase activities. These results suggest that rainbow trout fed SBM-based diets have a certain ‘cholesterol-buffering capacity’, which in turn suggests the possibility of the inhibition of exogenous cholesterol absorption and/or inadequate endogenous production of cholesterol in trout fed SBM-based diets. DGC increased steadily with increasing supplemental cholesterol level up to 1·2 %, and the growth-promoting effects might be related to the alleviation of the negative effects caused by a soyabean diet and/or make up for the deficiency of endogenous cholesterol in rainbow trout.

Cognitive dysfunction syndrome is a major disease affecting old cats and is the consequence of severe and irreversible loss of brain cells and brain atrophy. The present study focused on the hypothesis that the optimal strategy for promoting successful brain ageing is to target risk factors associated with brain ageing and dementia. We used a nutritional strategy involving supplementation with a blend of nutrients (antioxidants, arginine, B vitamins and fish oil) to test this hypothesis. Middle-aged and old cats between 5·5 and 8·7 years of age were assigned to cognitively equivalent control or treatment groups based on prior cognitive experience and performance on baseline cognitive tests. The cats in the treatment group were maintained on a diet supplemented with the nutrient blend and the cats in the control group were maintained on the identical base diet without the additional supplementation. After an initial wash-in period, all cats were tested on a battery of cognitive test protocols. The cats fed the test diet showed significantly better performance on three of four test protocols: a protocol assessing egocentric learning, a protocol assessing discrimination and reversal learning and a protocol focused on acquisition of a spatial memory task. The results support the hypothesis that brain function of middle-aged and old cats can be improved by the nutrient blend that was selected to minimise or eliminate the risk factors associated with brain ageing and dementia.

Vitamin D status, as measured by serum 25-hydroxy vitamin D (s-25OHD), is important to human health. Dermal 25OHD production depends on UVB light that is influenced by latitude. We aimed to identify factors important to the production of s-25OHD in Arctic people and investigated subjects living in the town of Ilulissat and the settlement of Saqqaq in North Greenland (70°N) during the four seasons. Participants were enrolled with a balanced representation of non-Inuit and Inuit in Ilulissat and Inuit in Saqqaq, men and women, aged 30–39 and 40–49 years. Supplement use, hours spent outdoors and other lifestyle factors were determined by questionnaires. Scores of traditional Inuit food intake were computed from a FFQ at inclusion, and frequencies of intake were recorded at each visit. s-25OHD concentration was measured. There were sixty-four Inuit and thirty-three non-Inuit participants. Inuit food score < 40 % was found in 87, 64 and 48 % of non-Inuit, Inuit in Ilulissat and Inuit in Saqqaq participants, respectively (P= 0·009). Inuit diet associated positively with s-25OHD (P< 0·001). s-25OHD concentration was lower in non-Inuit than in Inuit participants (spring/summer/autumn/winter/average: 30·3 v. 36·8/43·2 v. 44·7/43·6 v. 48·6/32·8 v. 43·5/39·0 v. 44·6 nmol/l, P= 0·002/0·62/0·19/ < 0·001/0·011, respectively). s-25OHD levels differed with season (Inuit, P< 0·001; non-Inuit, P< 0·001) as did diet (Inuit, P< 0·001; non-Inuit, P< 0·001) and hours spent outdoors (Inuit, P< 0·001; non-Inuit, P= 0·012). s-25OHD level was influenced by diet (P< 0·001), season (P< 0·001), origin (P= 0·001), residence (P= 0·013) and sex (P= 0·026). We conclude that the season influenced vitamin D status in Arctic populations beyond diet, ethnicity and vitamin intake. This suggests dermal 25OHD production at a high latitude of 70°N.

Whey proteins (WP) exert anti-inflammatory and antioxidant effects. Hyperbaric pressurisation of whey increases its digestibility and changes the spectrum of peptides released during digestion. We have shown that dietary supplementation with pressurised whey improves nutritional status and systemic inflammation in patients with cystic fibrosis (CF). Both clinical indices are largely affected by airway processes, to which respiratory epithelial cells actively contribute. Here, we tested whether peptides released from the digestion of pressurised whey can attenuate the inflammatory responses of CF respiratory epithelial cells. Hydrolysates of pressurised WP (pWP) and native WP (nWP, control) were generated in vitro and tested for anti-inflammatory properties judged by the suppression of IL-8 production in CF and non-CF respiratory epithelial cell lines (CFTE29o- and 1HAEo-, respectively). We observed that, in both cell lines, pWP hydrolysate suppressed IL-8 production stimulated by lipopolysaccharide (LPS) to a greater magnitude compared with nWP hydrolysate. Neither hydrolysate suppressed IL-8 production induced by TNF-α or IL-1β, suggesting an effect on the Toll-like receptor (TLR) 4 pathway, the cellular sensor for LPS. Further, neither hydrolysate affected TLR4 expression or neutralised LPS. Both pWP and nWP hydrolysates similarly reduced LPS binding to surface TLR4, while pWP tended to more potently increase extracellular antioxidant capacity. In conclusion: (1) anti-inflammatory properties of whey are enhanced by pressurisation; (2) suppression of IL-8 production may contribute to the clinical effects of pressurised whey supplementation on CF; (3) this effect may be partly explained by a combination of reduced LPS binding to TLR4 and enhanced extracellular antioxidant capacity.

Curcumin has been used in Asian traditional medicine for its medicinal properties. Recent studies have demonstrated that curcumin has antioxidant, anti-tumour and anti-inflammatory activities. The aim of the present study is to investigate the effects of curcumin on established lupus nephritis (LN) in New Zealand Black/White (NZB/W) F1 female mice, in particular, its interaction with regulatory T (Treg) cells. Starting at 18 weeks of age, mice were fed a standard diet or a diet containing 1 % curcumin until the end of the study. The proteinuria level and the serum levels of IgG1, IgG2a and anti-double-stranded DNA (dsDNA) IgG antibodies were measured. Additionally, IgG immune complex deposition in the glomeruli and renal inflammation were compared between curcumin-treated mice and control mice. Curcumin decreased the proteinuria level and serum levels of IgG1, IgG2a and anti-dsDNA IgG antibodies in NZB/W F1 female mice. IgG immune complex deposition in the glomeruli was reduced in curcumin-treated mice. Furthermore, renal inflammation was also decreased after curcumin treatment. Interestingly, these therapeutic effects of curcumin disappeared after Treg depletion by anti-CD25 antibody injection. Curcumin exerted a protective effect against LN in NZB/W F1 mice. We speculate that the protective effects of curcumin in LN may involve, at least in part, its interaction with Treg cells.

A high-fat diet disturbs the composition and function of the gut microbiota and generates local gut-associated and also systemic responses. Intestinal mast cells, for their part, secrete mediators which play a role in the orchestration of physiological and immunological functions of the intestine. Probiotic bacteria, again, help to maintain the homeostasis of the gut microbiota by protecting the gut epithelium and regulating the local immune system. In the present study, we explored the effects of two probiotic bacteria, Lactobacillus rhamnosus GG (GG) and Propionibacterium freudenreichii spp. shermanii JS (PJS), on high fat-fed ApoE*3Leiden mice by estimating the mast cell numbers and the immunoreactivity of TNF-α and IL-10 in the intestine, as well as plasma levels of several markers of inflammation and parameters of lipid metabolism. We found that mice that received GG and PJS exhibited significantly lower numbers of intestinal mast cells compared with control mice. PJS lowered intestinal immunoreactivity of TNF-α, while GG increased intestinal IL-10. PJS was also observed to lower the plasma levels of markers of inflammation including vascular cell adhesion molecule 1, and also the amount of gonadal adipose tissue. GG lowered alanine aminotransferase, a marker of hepatocellular activation. Collectively, these data demonstrate that probiotic GG and PJS tend to down-regulate both intestinal and systemic pro-inflammatory changes induced by a high-fat diet in this humanised mouse model.

Fruits rich in phytochemicals have been shown to improve memory by protecting or enhancing neuronal functions mediated by neurotrophic factors, such as nerve growth factor (NGF), in the hippocampus. Mori Fructus (Morus alba L., Moraceae), also called mulberry, is used as a food, dietary supplement and an anti-ageing agent in traditional Oriental medicine. It is also known to contain abundant flavonoid compounds and to exhibit various pharmacological effects. The present study was performed to evaluate the memory-enhancing effect of Mori Fructus extract (ME) in mice, with a focus on NGF regulation. ME (20, 100 and 500 mg/kg per d for 7 d, per os) dose-dependently promoted NGF release in the mouse hippocampus, leading to phosphorylation of extracellular signal-regulated kinases and cyclic AMP response element-binding protein. ME significantly increased pre- and post-synapse formation, acetylcholine synthesisation, neuronal cell differentiation, neurite outgrowth and neuronal cell proliferation in the mouse hippocampus. Furthermore, ME significantly increased latency time in the passive avoidance task (P< 0·001) and recognition time of novel objects in the object recognition test (P< 0·05), indicating improvements in learning and memory. Taken together, these data suggest that ME exhibits a memory-enhancing effect via up-regulation of NGF.

The study was undertaken to explore the amelioration of chronic fluoride (F) toxicity (with low and normal Ca) in rats. The study was conducted in two phases. In phase I (6 months), seventy-six Wistar, weanling male rats were assigned to four treatment groups: normal-Ca (0·5 %) diet (NCD), Ca+F − ; low-Ca (0·25 %) diet (LCD), Ca − F − ; NCD +100 parts per million (ppm) F water, Ca+F+; LCD +100 ppm F water, Ca − F+. In phase II (reversal experiment, 3 months), LCD was replaced with the NCD. Treatment groups Ca+F+ and Ca − F+ were divided into two subgroups to compare the effect of continuation v. discontinuation along with Ca supplementation on reversal of chronic F toxicity. In phase I, significantly reduced food efficiency ratio (FER), body weight gain (BWG), faecal F excretion, serum Ca and increased bone F deposition were observed in the treatment group Ca − F+. Reduced serum 25-hydroxy-vitamin D3, increased 1,25-dihydroxy-vitamin D3 and up-regulation of Ca-sensing receptor, vitamin D receptor and S100 Ca-binding protein G (S100G) were observed in treatment groups Ca − F −  and Ca − F+. In phase II (reversal phase), FER, BWG and serum Ca in treatment groups Ca − F+/Ca+F −  and Ca − F+/Ca+F+ were still lower, as compared with other groups. However, other variables were comparable. Down-regulation of S100G was observed in F-fed groups (Ca+F+/Ca+F+ and Ca − F+/Ca+F+) in phase II. It is concluded that low Ca aggravates F toxicity, which can be ameliorated after providing adequate Ca and F-free water. However, chronic F toxicity can interfere with Ca absorption by down-regulating S100G expression irrespective of Ca nutrition.

Human milk proteins provide term and preterm infants with both nutrition and protection. The objective of the present study was to examine longitudinal changes in the protein composition of term and preterm milk during the first 2 months of lactation, focusing on protein phosphorylation and glycosylation. Using gel electrophoresis, the relative concentration and glycosylation status of lactoferrin, secretory Ig A, β-casein, α-lactalbumin, serum albumin, bile salt-stimulated lipase, xanthine oxidoreductase, tenascin and macrophage mannose receptor 1 were measured in milk collected on days 7, 10, 14, 18, 21, 28 and 60 postpartum from preterm mothers (28–32 weeks gestation, n 17). The phosphorylation status of β-casein was also investigated. To determine if these variables differ in term and preterm milk, samples from term mothers (38–41 weeks gestation, n 8) collected on days 7, 14 and 30 of lactation were also analysed. The concentration of the abundant milk proteins decreased during lactation in term and preterm milk (P <0·05). No difference in protein glycosylation was observed, except for the glycoproteins serum albumin and tenascin. The phosphorylation of β-casein varied significantly between term and preterm milk. Further investigation is required to determine whether these modifications affect protein function and are clinically important to preterm infants.

The gut microbiome interacts with the host in the metabolic response to diet, and early microbial aberrancies may be linked to the development of obesity and metabolic disorders later in life. Probiotics have been proposed to affect metabolic programming and blood lipid levels, although studies are lacking in infants. Here, we report on the lipid profile and global metabolic response following daily feeding of probiotics during weaning. A total of 179 healthy, term infants were randomised to daily intake of cereals with (n 89) or without (n 90) the addition of Lactobacillus paracasei ssp. paracasei F19 (LF19) 108 colony-forming units per serving from 4 to 13 months of age. Weight, length and skinfold thickness were monitored. Venous blood was drawn at 5·5 and 13 months of age for analysis of the serum lipid profile. In a subsample, randomly selected from each group, GC-time-of-flight/MS was used to metabolically characterise plasma samples from thirty-seven infants. A combination of multi- and univariate analysis was applied to reveal differences related to LF19 treatment based on 228 putative metabolites, of which ninety-nine were identified or classified. We observed no effects of probiotic feeding on anthropometrics or the serum lipid profile. However, we detected significantly lower levels of palmitoleic acid (16 : 1) (P< 0·05) and significantly higher levels of putrescine (P< 0·01) in LF19-treated infants. Palmitoleic acid is a major MUFA strongly linked to visceral obesity, while putrescine is a polyamine with importance for gut integrity. Whether the observed differences will have long-term health consequences are being followed.

We compared changes in the dietary patterns of morbidly obese patients undergoing either laparoscopic gastric bypass surgery or a comprehensive lifestyle intervention programme. The present 1-year non-randomised controlled trial included fifty-four patients in the lifestyle group and seventy-two in the surgery group. Dietary intake was assessed by a validated FFQ. ANCOVA was used to adjust for between-group differences in sex, age, baseline BMI and baseline values of the dependent variables. Intakes of food groups and nutrients did not differ significantly between the intervention groups at baseline. At 1-year follow-up, the lifestyle group had a significantly higher daily intake of fruits and vegetables (561 (sd 198) v. 441 (sd 213) g, P= 0·002), whole grains (63 (sd 24) v. 49 (sd 16) g, P< 0·001) and fibre (28 (sd 6) v. 22 (sd 6) g, P< 0·001) than the surgery group and a lower percentage of total energy intake of saturated fat (12 (sd 3) v. 14 (sd 3) %, P< 0·001). The intake of red meat declined significantly within both groups, vegetables and fish intake were reduced significantly in the surgery group and added sugar was reduced significantly in the lifestyle group. The lifestyle patients improved their dietary patterns significantly (compared with the surgery group), increasing their intake of vegetables, whole grains and fibre and reducing their percentage intake of saturated fat (ANCOVA, all P< 0·001). In conclusion, lifestyle intervention was associated with more favourable dietary 1-year changes than gastric bypass surgery in morbidly obese patients, as measured by intake of vegetables, whole grains, fibre and saturated fat.

Infant and childhood nutrition influences short- and long-term health. The objective of the present paper has been to explore dietary patterns and their associations with child and parent characteristics at two time points. Parents of Norwegian 2-year-olds were, in 1999 (n 3000) and in 2007 (n 2984), invited to participate in a national dietary survey. At both time points, diet was assessed by a semi-quantitative FFQ that also provided information on several child and parent characteristics. A total of 1373 participants in the 1999 sample and 1472 participants in the 2007 sample were included in the analyses. Dietary patterns were identified by principal components analysis and related to child and parent characteristics using the general linear model. Four dietary patterns were identified at each time point. The ‘unhealthy’ and ‘healthy’ patterns in 1999 and 2007 showed similarities with regard to loadings of food groups. Both the ‘bread and spread-based’ pattern in 1999 and the ‘traditional’ pattern in 2007 had high positive loadings for bread and spreads; however, the ‘traditional’ pattern did also include positive associations with a warm meal. The last patterns identified in 1999 and in 2007 were not comparable with regard to loadings of food groups. All dietary patterns were significantly associated with one or several child and parent characteristics. In conclusion, the ‘unhealthy’ patterns in 1999 and in 2007 showed similarities with regard to loadings of food groups and were, at both time points, associated with sex, breastfeeding at 12 months of age, parity, maternal age and maternal work situation.

Dietary pattern changes may be one of the key factors associated with increasing asthma prevalence. Observational studies have found negative associations between fruit, vegetable and fish consumption and risk of asthma. Experimental studies have also shown that probiotics can modulate the immune system. However, each dietary component exhibits a modest effect. The objective of the present study was to investigate the joint effect of multiple beneficial dietary components on asthma. We designed a 16-week school-based double-blind placebo-controlled randomised trial. The supplement group received fruit plus vegetable concentrate, fish oil and probiotics (FVFP supplement), while the control group received placebos. A total of 192 asthmatic children aged 10–12 years were recruited from elementary schools in metropolitan Taipei. Pulmonary function, medication usage, Paediatric Asthma Quality of Life Questionnaire (PAQLQ) score and the Childhood Asthma Control Test score were evaluated at baseline, and at weeks 8 and 16. Compared with the placebo group, the supplement group showed significant improvement in pulmonary function parameters (91 v. 178 ml for forced vital capacity (FVC), 40 v. 107 ml for forced expiratory volume in 1 s (FEV1) and 1·6 v. 4·8 % for FEV1:FVC ratio; all P values < 0·01) and had a significantly reduced proportion of those using short-acting inhaled bronchodilators and inhaled corticosteroids. However, the PAQLQ score and the Childhood Asthma Control Test score were not significantly different between the two groups, possibly because the majority of the children were treated routinely. FVFP supplements reduced medication use and improved pulmonary function in asthmatic children. The present study supports an adjuvant intervention with a combination of fruit, vegetable, fish and probiotic foods.

Little is known about vitamin D status in preterm infants and their response to supplementation. To investigate this, we assessed serum 25-hydroxyvitamin D (25OHD) levels using RIA in a consecutive sample of stable preterm very low birth weight (VLBW) infants (born ≤ 32 weeks gestation or birth weight ≤ 1·5 kg), and we explored associated factors. Serum 25OHD level was first assessed once infants were tolerating feeds (n 274). If this first 25OHD level was below 50 nmol/l (20 ng/ml), which is the level associated with covering requirements in terms of skeletal health in the majority, then we recommended prolonged augmented vitamin D intake ( ≥ 10 μg (400 IU) daily) from a combination of fortified feeds and vitamin supplements and follow-up re-assessment at approximately 6 weeks corrected age (n 148). The first assessment, conducted at a median for chronological age of 18 (interquartile range (IQR) 11–28) d, found that 78 % had serum 25OHD levels below 50 nmol/l. Multivariable analysis demonstrated that the determinants of serum 25OHD levels were duration of vitamin D supplementation and gestational age at birth (r2 0·215; P< 0·001). At follow-up, after a median of 104 (IQR 78–127) d, 87 % achieved levels ≥ 50 nmol/l and 8 % had levels >125 nmol/l, a level associated with potential risk of harm. We conclude that low 25OHD levels are an issue for preterm VLBW infants, warranting early nutritional intervention. In infants with serum 25OHD levels < 50 nmol/l, a vitamin D intake of ≥ 10 μg (400 IU) daily achieves target levels in the majority; however, further work is needed to determine the exact dose to safely meet target levels without overcorrection.

The main objective of the present study was to determine the potential of n-3 and n-6 fatty acids or coenzyme Q10 (CoQ10) to alter serum prostate-specific antigen (PSA) levels in normal healthy men. A total of 504 healthy men with serum PSA level ≤ 2·5 ng/ml were recruited into the study. Serum PSA values were not segregated by decade of age. Participants were randomly assigned to a daily dietary supplement containing n-3 fatty acids (1·12 g of EPA and 0·72 g of DHA per capsule) (group 1, n 126), n-6 fatty acid (600 mg γ-linolenic acid (GLA) each capsule) (group 2, n 126), CoQ10 (100 mg per capsule) (group 3, n 126) or a similar regimen of placebo (group 4, n 126) for 12 weeks. Study medication was administered as two capsules to be taken twice daily. Serum levels of PSA, EPA, DHA, GLA, lipid profile and reproductive hormones were also measured. EPA treatment significantly reduced serum PSA level by 30·0 (95 % CI 25, 36) % (P= 0·004) from baseline. In contrast, GLA therapy significantly increased serum PSA concentration by 15·0 (95 % CI 11, 20) % (P= 0·02). CoQ10 therapy also significantly reduced serum PSA level by 33·0 (95 % CI 27, 40) % (P= 0·002). In multivariable analysis, serum values of PSA were strongly correlated with duration of EPA (r − 0·62; 95 % CI − 0·42, − 0·77; P= 0·003), n-6 (r 0·42; 95 % CI 0·31, 0·58; P= 0·02) and CoQ10 use (r − 0·77; 95 % CI − 0·56, − 0·87; P= 0·001). There were also significant correlations between serum values of DHA, EPA, GLA and CoQ10 and serum PSA levels. The present study demonstrates that dietary supplements containing EPA, GLA or CoQ10 may significantly affect serum PSA levels.

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (n 4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as ‘sometimes’ or ‘often’ not having enough food to eat. Analyses were adjusted for sex, race, age, smoking, education, income, BMI, other co-morbid conditions and complex survey design. Prevalence of frailty was highest among people who were obese (20·8 %), followed by overweight (18·4 %), normal weight (16·1 %) and lowest among people who were underweight (13·8 %). Independent of BMI, daily energy intake was lowest in people who were frail, followed by pre-frail and highest in people who were not frail (6648 (se 130), 6966 (se 79) and 7280 (se 84) kJ, respectively, P< 0·01). Energy-adjusted macronutrient intakes were similar in people with and without frailty. Frail (adjusted OR (AOR) 4·7; 95 % CI 1·7, 12·7) and pre-frail (AOR 2·1; 95 % CI 0·8, 5·8) people were more likely to report being food insufficient than not frail people. Serum albumin, carotenoids and Se levels were lower in frail adults than not frail adults. Research is needed on targeted interventions to improve nutritional status and food insufficiency among frail older adults, while not necessarily increasing BMI.

Although diet is thought to affect the natural history of heart failure (HF), nutrient intake in HF patients has not been well studied. Based on prior research linking high intake of Ca, Mg and K to improved cardiovascular health, we hypothesised that these nutrients would be inversely associated with mortality in people with HF. Of the 161 808 participants in the Women's Health Initiative (WHI), we studied 3340 who experienced a HF hospitalisation. These participants were followed for post-hospitalisation all-cause mortality. Intake was assessed using questionnaires on food and supplement intake. Hazard ratios (HR) and 95 % CI were calculated using Cox proportional hazards models adjusted for demographics, physical function, co-morbidities and dietary covariates. Over a median of 4·6 years of follow-up, 1433 (42·9 %) of the women died. HR across quartiles of dietary Ca intake were 1·00 (referent), 0·86 (95 % CI 0·73, 1·00), 0·88 (95 % CI 0·75, 1·04) and 0·92 (95 % CI 0·76, 1·11) (P for trend = 0·63). Corresponding HR were 1·00 (referent), 0·86 (95 % CI 0·71, 1·04), 0·88 (95 % CI 0·69, 1·11) and 0·84 (95 % CI 0·63, 1·12) (P for trend = 0·29), across quartiles of dietary Mg intake, and 1·00 (referent), 1·20 (95 % CI 1·01, 1·43), 1·06 (95 % CI 0·86, 1·32) and 1·16 (95 % CI 0·90, 1·51) (P for trend = 0·35), across quartiles of dietary K intake. Results were similar when total (dietary plus supplemental) nutrient intakes were examined. In summary, among WHI participants with incident HF hospitalisation, intakes of Ca, Mg and K were not significantly associated with subsequent mortality.