Type 2 Diabetes Mellitus is a chronic diseases with very high morbidity and mortality worldwide; associated with obesity and hypertension and representing at least 90% of all cases of diabetes. It is characterized by insulin resistance in peripheral tissues and a deterioration in its secretion by the pancreatic β-cell. The control and treatment of these patients is a low-carbohydrate diet, for which non-nutritive sweeteners such as sucralose and stevia are being used, maintaining the sweet taste. It is known that these sweeteners are harmless, but the results so far are still controversial. To identify alterations in the secretion of cytokines and adipokines in db/db mice with consumption of sweeteners. We conducted a randomized, controlled study, with 24 eight week-old male db/db mice. They were divided into 4 groups: a) Control (CL), b) Sucrose (SUC), c) Sucralose (SUCL) and c) Stevia (ST). The animals were fed a normal diet and water ad libitum. The sweeteners were administered for 8 weeks diluted in purified water at 41.66 mg/mL of Sucrose and 4.16 mg/mL of Sucralose or Stevia. Blood glucose was quantified daily; water consumption with and without sweetener, food, and BMI, were quantified weekly. The concentration of IL-4, IL-5, IL-6, IL-10, IL-12, IL-17, INF-γ, TGF-β and TNF-α, insulin, adiponectin, resistin and peptide-C in plasma were determined by luminometry. Glucose was found increased at the end of 8 weeks in the SUC group, compared to CL. They consumed more food, water with and without sweetener in the SUC group (p < 0.001), compared with the controls. BMI was higher in the SUC group, compared with the ST group (p < 0.019). ST decreased the secretion of IL-4, IL-5, IL-6, IL-10, IL-12, IL-17, INF-γ and TNF-α, adiponectin and insulin (p < 0.001), but it increased TGF-β, without modifications in resistin (p < 0.051). On the other hand, SUC decreased the secretion of IL-4, IL-5, IL-10, IL-12, INF-γ, TNF-α, adiponectin, insulin and C-peptide (p < 0.028), but increased IL-6, IL-17 and resistin (p < 0.001), without modifications in TGF-β. Sucralose is a non-nutritive sweetener that caused an increase in the BMI of db/db mice, this because it increased the consumption of food. It also modified the secretion of adipokines; while Stevia decreased the secretion of pro-inflammatory cytokines such as IL-4, IL-5, IL-6, IL-10, IL-12, IL-17, INF-γ and TNF-α. Our results suggest that sweetener consumption may alter the inflammatory profile and the production of adipokines in subjects with type 2 diabetes mellitus.

Coffee is an important source of bioactive compounds, including caffeine, trigonelline, and phenolic compounds. Several studies have highlighted the preventive effects of coffee consumption on major cardiometabolic diseases, but the impact of coffee dosage on markers of cardiometabolic risk is not well understood. Moreover, the pool of coffee-derived circulating metabolites in real-life settings is unknown. This study evaluated the bioavailability and effects on recognised cardiometabolic markers of coffee bioactives, considering different levels of consumption. An innovative experimental design, including both a chronic and an acute sub-study, and a comprehensive analytical approach were used.

A 3-arm, randomised, crossover trial was conducted in 21 healthy volunteers (age, 23 ± 2 y; BMI, 22.3 ± 2.5 kg/m2) (Mena et al., Trials 2017, 18, 527). Volunteers were assigned to consume 3 treatments for 4 weeks, including 1 cup of espresso coffee/day, 3 cups of espresso coffee/day, and 1 cup of espresso coffee plus 2 cocoa-based confectionary products containing-coffee twice per day. The last day of each treatment, blood and urine samples were collected at specific time points for 24 hours. Dietary intake, body weight, BMI, waist circumference, blood pressure, fasting glucose, insulin, LDL- and HDL-cholesterol, triglycerides, nitric oxide, inflammatory markers (IL-8, TNFα, VEGF), trimethylamine-N-oxide (TMAO), DNA damage, DNA catabolites, and eicosanoids were assessed. The pool of coffee-derived circulating metabolites was also assessed in acute conditions. Untargeted metabolomics was performed.

Energy intake did not change among treatments after 4 weeks, while significant differences were observed in the intake of saturated fatty acids and carbohydrates. The effect of different coffee dosages on the set of cardiometabolic markers assessed was negligible. Plasma and urinary pharmacokinetic profiles were evaluated for 6 caffeine metabolites, 3 trigonelline derivatives, and up to 40 phenolic metabolites. Pharmacokinetics highlighted the different “waves” of circulating metabolites occurring upon repeated coffee consumption. Differences in several pharmacokinetic parameters were observed among treatments, which may support the long-term cardiometabolic benefits of certain patterns of coffee consumption. Multivariate analyses clearly differentiated treatments on the basis of the urinary metabolome.

This work provided a comprehensive picture of the impact of different coffee dosages on the pool of coffee-derived circulating metabolites, the urinary metabolome, and a wide number of cardiometabolic markers. Multivariate analyses focused on inter-individual differences are ongoing to better understand the effect of coffee on cardiometabolic health.

Food cues modulate hunger and dictate nutritional choices. The omnipresent stimulus of palatable food promotes the epidemics of obesity and metabolic diseases. The aim of our study was to investigate the impact of visual stimulation with food pictures on appetite-related hormones as well as the functionality of the secreted hormones and its impact on macronutrient uptake and deposition in healthy subjects. Additionally, we sought to identify differences in response to visual food cues of total and active ghrelin to and to a meal followed by the stimulation.

Healthy, non-obese participants were recruited for two two-day studies. During the first study, the subjects were shown random non-food pictures on the first day and pictures of appetizing foods on the second day of the study. The second study followed the same schedule and additionally, following the picture session, the participants were asked to drink a milkshake. The subjects reported subjective hunger. Levels of glucose, triglycerides and hunger-related hormones were measured in blood. In addition, an animal study was performed, during which 4 hours fasted mice were submitted to visual and olfactory stimulation using chow, while not being able to access the food. Following the stimulation, oral glucose tolerance test was performed, gene expression and blood total, as well as acylated ghrelin, were measured.

Exposure to food pictures affected participant's blood glucose and incretin levels. Concentrations of several hormones in the blood were interdependent and in case of ghrelin and GIP as well as ghrelin and GLP-1 this co-occurrence relied on the visual cues. Changes of total ghrelin concentration following food stimulation was highly individual and participants could be grouped as ghrelin responders or non-responders. The responders showed upregulated total ghrelin and their total ghrelin levels correlated with food picture score revealing that in ghrelin non-responders reaction to food pictures was diminished. The concentration of active ghrelin decreased following a meal but was not affected by exposure to the pictures of food. Protein content and color intensity of food pictures correlated reversely with participants’ rating of the pictures. Sensory stimulation of mice resulted in increased blood glucose levels.

We conclude that observation of food pictures significantly influences blood glucose levels and concentration of several appetite-related hormones. The protein content of the observed foods and green color intensity in pictures may serve as a predictor of subjective attractiveness of the presented meal.

Breakfast cereals are widely consumed in Ireland with over 80% of adults choosing ready-to-eat cereals or porridge. In terms of healthy eating, breakfast cereals are considered a nutritious choice and are not expected to contribute significantly to daily salt intakes. Since 2003, the Food Safety Authority of Ireland has coordinated a salt reduction programme to achieve voluntary reduction by the food industry in the salt content of processed foods available in Ireland. This study aims to examine whether salt levels of breakfast cereals are decreasing due to reformulation practices.

A random selection of breakfast cereals on the Irish market were sampled using the following categories: rice-based, bran-based, cornflake-type, biscuit-based, multigrain, muesli and no added salt/low salt varieties in 2003, 2007, 2011 and 2015 (muesli and no added salt/low salt varieties were not sampled again in 2015) (n687). Samples were analysed for sodium content using atomic emission spectrophotometry and converted to salt (g) per 100 g of the food product by multiplying by 2.54. Results were analysed using IBM SPSS (version 25). As data was not normally distributed, median values (minimum and maximum) were investigated across breakfast cereal categories at the different time-points. Differences between the time-points were assessed using Krusal-Wallis test and Mann-Whitney U tests.

In 2003, salt levels were found to be highest in cornflake-type cereals and lowest in no added salt/low salt cereals (2.02 g (0.20–2.31) and 0.01 g (0.0–0.03) per 100 g respectively). The salt content of rice-based, bran-based, cornflake-type, biscuit-based and multigrain varieties significantly decreased (up to 65% in cornflake-type cereals) until 2011. No further reduction was achieved for rice-based, bran-based and cornflake-type varieties in 2015 and a significant increase in salt was observed for biscuit-based (p = 0.001) and multigrain products (p = 0.007). Between 2003 and 2011, no reduction in salt levels was observed for muesli or no added salt/low salt products.

This study revealed there has been a significant reduction in the salt content of breakfast cereals since 2003 – an important finding considering breakfast cereals are recommended for healthy eating. However, this work also shows that continuous salt monitoring is necessary to ensure this reduction in breakfast cereals is maintained. Future FSAI reformulation work will examine a range of nutrients in food products as the food industry have committed to achieve a gradual reduction in fat, saturated fat and sugar, as well as salt, as part of the National Obesity Policy and Action Plan.

The 2017 implementation in France of the front-of-package nutrition label known as Nutri-Score is a major public health strategy to help individuals make healthier food choices at the point of purchase and thus help reduce chronic disease risk on the population level. The algorithm behind the Nutri-Score is intended to reflect the overall nutritional quality of food and is based on the one developed by the British Food Standards Agency Nutrient Profiling System, following a slight modification (FSAm-NPS) in accordance with French dietary guidelines. Prior research has focused on its association with various physical health outcomes (weight gain, metabolic syndrome, cancer incidence, etc.), yet no studies have explored the link with oral health indicators. We analyzed the cross-sectional association of the FSAm-NPS with oral health in a population-based sample of 33,231 men and women enrolled in the NutriNet-Santé cohort. Oral health (main dependent variable) was assessed in 2016 with the General Oral Health Assessment Index (GOHAI). It consists of 12 items scored on a 5-point Likert scale (maximum score = 60) with lower scores corresponding to poorer oral health with a detrimental impact on quality of life. FSAm-NPS (main independent variable) was calculated on the basis of 3 non-consecutive 24-h dietary records, following established methodology (score range: -15 to + 40, with lower scores corresponding to higher nutritional quality). Age-specific associations (cutoff = 60 y) were explored via multivariable linear regression models. Mean GOHAI score in the sample was 53.8 ± 5.5 (range: 19 to 60) and mean FSAm-NPS was 6.0 ± 2.2 (range: -6.7 to + 15.5). The unadjusted and the age- and sex-adjusted models were significant only in the younger age group (18–59 y). The fully-adjusted model showed modest yet significant associations between overall nutritional quality and oral health in younger and older participants, with the strength of the model being more pronounced in the former compared with the latter age group (F value: 28.5 vs. 6.3, both p < 0.0001). Overall, consuming food with a higher FSAm-NPS score (corresponding to lower nutritional quality) was associated with higher risk of oral health problems. Future longitudinal studies are needed to confirm the observed associations. On the public health policy level, the findings support implementation of the Nutri-Score on pre-packaged food in order to steer consumer choice toward nutritional profiles that are favorable not only for chronic disease prevention but also for oral health.

Frequent consumption of sugar-sweetened beverages (SSBs) has been linked to a greater risk of obesity, type 2 diabetes mellitus, dental caries and coronary heart disease. SSBs are an ideal target for public health intervention to help control the type 2 diabetes mellitus epidemics since they have absolutely no nutritional value, and do not protect against disease. However, successful implementation of policies to reduce consumption of SSBs depends on public acceptability and support. Therefore, determining the public acceptability of government interventions to reduce sugar-sweetened beverages is critical for effectiveness as well as implementation. The aim of the present study was to conduct an empirical investigation of how different policy-related factors (namely perceived policy effectiveness, perceived policy fairness, policy trust and political ideology) link to public support. Policy options included low, medium and high intensity versions of: imposing a tax (10%, 20% and 30%); adding a warning label (with and without graphic warning label); reducing number of SSB retail outlets (schools only and all public institutions); and regulating SSB advertising (ban advertising aimed at children and ban all SSB advertising). Data were collected from a representative sample of 948 consumers (age range from 18 to 69) through an online survey, which was carried out in February 2019. Sample quotas were set for age, gender and income. The partial least squares approach of the structural equation modelling (PLS-SEM) is employed to investigate direct effects of the proposed factors on public acceptance. Importantly, the results indicate that perceived fairness and perceived effectiveness of the political interventions had a significantly positive correlation with public acceptance (β = 0.518, p-value < 0.001 and β = 0.299, p-value < 0.001, respectively). Meanwhile, those who have a greater trust in government are more likely to support (β = 0.049, p-value < 0.05). Also, public acceptance is positively associated with liberal policy strains. This is in line with social cognitive motives such as openness to new experiences and desire for equality in society. Moreover, higher trust in government is positively associated with perceived fairness as well as perceived effectiveness. These findings reflect that those who trust government believe that the government policy is fair in terms of the policy itself, how it is established as well as its specific distributive effects. Therefore, participatory policymaking that involves the public in the decision-making process can enhance citizens’ trust and overall acceptance in policy interventions with regard to SSBs.

In 2017, 11 million deaths related to non-communicable diseases (NCDs) were attributable to dietary risk factors (GBD, 2019). Helping consumers make healthier food choices hence appears as one key strategy to prevent NCDs-related mortality. To this end, political authorities are considering implementing a simple label to reflect the nutritional quality of food products. The five-colour Nutri-Score label, derived from the Nutrient Profiling System of the British Food Standards Agency (FSAm-NPS), has been chosen by several countries in Europe (France, Belgium, Spain). Yet, its implementation is still voluntary per EU labelling regulation. Scientific evidence is therefore needed regarding the relevance of the FSAm-NPS at the European level. Following on our results showing an increased risk of cancer related to the consumption of foods with a high FSAm-NPS score in the EPIC cohort, our objective is now to focus on NCDs-related mortality. Our prospective analyses included 501,594 adults from the EPIC cohort (1992–2015, median follow-up: 17.2 years). Mortality events occurring < 2 years after recruitment were excluded, leaving 50,743 death events (main causes: cancer, n = 21,971; cerebro/cardiovascular diseases, n = 12,407; respiratory diseases, n = 2,796). Usual food intakes were assessed with standardized country-specific diet assessment methods. The FSAm-NPS was calculated for each food/beverage using their 100-g content in energy, sugar, saturated fatty acid, sodium, fibres, proteins, and fruits/vegetables/legumes/nuts. The individual FSAm-NPS Dietary Index (DI) is obtained as an energy-weighted mean of the FSAm-NPS scores of all food items usually consumed by a participant. Cox proportional hazards models adjusted for confounding factors, including personal history of cancer, cardiovascular diseases and diabetes were computed. Fine and Gray models were also tested to take into account competing events for cause-specific mortality analyses. A higher FSAm-NPS DI score, reflecting a lower nutritional quality of the diet, was associated with a higher mortality risk overall (HRQ5vs.Q1 = 1.06 [95%CI: 1.02–1.09], P-trend < 0.001) and by cancer (HRQ5vs.Q1 = 1.06 [1.01–1.11], P-trend = 0.003) and respiratory diseases (HRQ5vs.Q1 = 1.33 [1.16–1.52], P-trend < 0.001), with similar results in competing events analyses. Associations with cerebro-/cardiovascular diseases mortality were weaker (HRQ5vs.Q1 = 1.05 [0.98,1.11], P-trend = 0.04) and no longer statistically significant in competing events analyses. In this large multinational European cohort, the consumption of food products with a higher FSAm-NPS score (lower nutritional quality of the foods consumed) was associated with a higher mortality risk, supporting the relevance of the FSAm-NPS to grade the nutritional quality of food products for public health applications (e.g, Nutri-Score) aiming to guide the consumers towards healthier food choices.

Canada's food supply is abundant in energy-dense products containing excess amounts of sodium, saturated fat and free sugars, increasing Canadians' risk of developing obesity and non-communicable diseases. Food companies shape the food supply through their control over the formulation of their products; however, no studies have examined the healthfulness of products offered by different companies in Canada. This study aimed to assess and compare the nutritional quality of the product portfolios of major packaged food and beverage companies in Canada. Twenty-two top food companies were selected for study, representing a combined 50% and 73% of Canadian packaged food and beverage sales in 2018, respectively. This included 18 multinational companies, 2 Canadian manufacturers and 2 retailers with private-label brands. Nutritional information for products was sourced from the University of Toronto Food Label Information Program 2017 database. The nutritional quality of all products offered by the sampled companies that were included in the database (n = 8,211) were evaluated using the Health Star Rating (HSR) system, with HSRs ranging from 0.5 (less healthy) to 5 (healthier). Descriptive analyses and analysis of variance with post-hoc tests examined the HSRs of each company's products overall and by food category (n = 24). Mean HSRs of companies’ overall product portfolios ranged from 1.8 to 3.7 (μx̅ = 2.7, σx̅ = 0.5) and differed significantly between companies (p < 0.001). Mean HSRs differed between companies for all food categories except eggs (p = 0.5), seafood (p = 0.2), legumes (p = 0.1), nuts and seeds (p = 0.4), and vegetables (p = 0.08). Variation in mean HSRs of products offered by different companies was greatest for beverages (range = 1.3–5.0, μx̅ = 2.0, σx̅ = 1.0), fats/oils (range = 0.7–4.4, μx̅ = 3.6, σx̅ = 1.6), fruit/fruit juices (range = 0.8–4.0, μx̅ = 2.6, σx̅ = 0.9), and sauces/dips/gravies/condiments (range = 0.5–3.4, μx̅ = 2.3, σx̅ = 1.0). These findings demonstrate that the nutritional quality of products offered by leading food manufacturers in Canada varies significantly overall and by food category, with many of these products considered less healthy according to the HSR system. Differences between companies may reflect the nature of their products; for example, products offered by dairy companies were healthier than those of confectionary and soft drink manufacturers, on average. Variation in nutritional quality within food categories illustrates the need and potential for many companies to improve the healthfulness of their products. By identifying companies that offer less healthy products compared with others in Canada, this study may prompt reformulation.

Obesity is characterized by chronic low-grade inflammation. Visceral adipose tissue (VAT) is heavily infiltrated by macrophages producing pro-inflammatory cytokines (IL-6), therefore VAT predicts greater systemic inflammation compared to peripheral fat. Thus, central adiposity may cause increased serum hepcidin (SHep) and may affect iron metabolism more than peripheral adiposity. Although increased total body fat (BF) is linked to disordered iron homeostasis, the potential effects of body fat distribution on iron metabolism have not been studied. Therefore, the aim of this study was to assess the effect of BF distribution on iron and inflammation parameters, SHep and iron metabolism.

We enrolled 37 normal-weight women and 81 overweight/obese women in this cross-sectional study. Body composition was assessed using DXA and iron- and inflammation parameters and SHep were measured. The overweight/obese women were assigned to a peripheral (n = 54) and a central (n = 27) fat deposit group, according to their android fat percentage. All women received 100 mg oral iron as ferrous citrate and the change in serum iron was assessed after 2 h to determine iron absorption.

The three groups differed significantly in body weight, BMI, waist circumference, android fat, gynoid fat, total fat, android/gynoid ratio and VAT (for all p < 0.001). Hemoglobin, serum ferritin, body iron stores (BIS), serum iron and transferrin saturation (TSAT) were lowest and transferrin receptor was highest in central obesity. CRP was higher in central obesity compared to both, peripheral obesity (p < 0.05) and normal-weight (p < 0.001). SHep was higher in central and peripheral obesity compared to normal-weight (both p < 0.01), with no difference between the two overweight/obese groups. Δserum iron was ≈30% and ≈20% lower in central obesity compared to normal-weight and peripheral obesity. We performed linear regression analysis on SHep, CRP, TSAT and Δserum iron: Android fat and BIS were positive predictors of SHep (p < 0.05, p < 0.001), android fat was a positive predictor of CRP (p < 0.001), BIS was a positive, android fat was a negative predictor of TSAT (p < 0.001, p < 0.05) and TSAT and android fat were both negative predictors of Δserum iron (p < 0.001, p < 0.05).

Controlling for iron status, inflammation and SHep are increased in women with central obesity and predict lower iron absorption and hypoferremia compared to women with more peripheral fat distribution. Thus, women with central fat distribution may be at increased risk for iron deficiency and anemia.