A randomized controlled intervention study was undertaken to increase egg and protein intake in community-dwelling adults over 55 years old. During a 12 week intervention, recipes for protein-rich egg-based meals and single-use herbs/spice packets were provided to 53 individuals in the intervention group to promote the addition of flavour and variety to the diet. Egg intakes increased by 20%, and this increase was sustained up to 12 weeks after the end of the intervention. Exploratory analyses however revealed some individual differences within the intervention group, where some participants increased their egg intake and others did not.

We compared the participants who increased their egg intake to those who did not on several demographic characteristics and baseline outcomes, and explored the qualitative feedback related to recipe use collected after the intervention.

Results show that the participants who increased their egg intake during the intervention (n = 27) had a significantly higher BMI (U = 402, p = .035), a lower health-related quality of life (U = 198, p = .047), and take external reports and recommendations about eggs and health from media and health professionals more seriously (U = 399, p = .038) than those who did not increase egg intake. Those who increased their egg intake during the 12 week follow up period (n = 19) reported a lower availability of eggs during their upbringing (U = 371, p = .041), with no other differences between the groups.

Feedback from the whole group showed that reasons for choosing to use or not use the recipes were based on preferences, culinary skills, time/effort to prepare the meal, having ingredients already in the cupboard, the importance of variety, habits and familiarity, and the portion sizes, which were generally considered too large. The recipes used most often included ingredients that are more traditionally combined with eggs in the English diet (e.g. cheese/ham), while the recipes used least often were more unfamiliar (e.g. Turkish eggs with yoghurt).

Our study used recipes that specifically focus on eggs, but our findings suggest that recipe based interventions in this age group may be particularly beneficial for those with a higher BMI, those who may feel their health could be improved, those who are more likely to respect external advice, and those who have less early experience with the included foods. Greater future benefit may also be obtained from recipes that are for smaller dishes, using familiar ingredients, and that cater to a range of culinary skills and preferences.

There is convincing evidence that sugar-sweetened beverages increase the risk of body weight (BW) gain and higher body mass index. In contrast, observational studies on regular consumption of 100% fruit juice provide conflicting results, with most indicating a neutral impact on BW and body mass index, while others suggest positive or even inverse associations. The lack of agreement may be due to confounding factors, or studies incorrectly grouping sugar-sweetened juice drinks with 100% fruit juice, which by law does not contain added sugars.

Intervention studies provide an opportunity to investigate the short-to-medium term impact of daily 100% orange juice (OJ) on BW. From 17 available studies (none of which individually reported statistically significant BW gain following OJ consumption), 6 randomised controlled trials in adults (n = 236) were selected for a meta-analysis. Inclusion criteria were an OJ intervention group and a non-OJ control group. Comparison with a control group was essential as some were weight loss studies with additional BW loss components, and for consistency this comparison between groups was used for all studies.

The meta-analysis focussed on the differences in BW change between OJ and control arms of each study. Where the standard deviation (SD) or standard error (SE) of the change was not reported and could not be obtained from the authors, it was imputed by using the mean SD from studies where it was available. The combined effect estimate was obtained from a random effects model using the DerSimonian-Laird estimator. Cochran's Q statistic was used to test for study heterogeneity.

The resulting forest plot revealed no statistically significant change in BW following OJ intakes of 250–500 ml per day for 4 to 12 weeks (which would theoretically provide 102–205 kcal on average). The Q statistic was 10.6 (I2 = 53%, p = 0.059) while the combined effect estimate was -0.34 kg (95% CI -1.11, 0.43). Interestingly, a similar finding was noted in a meta-analysis (Onakpoya et al. 2017) investigating BW change and daily grapefruit juice consumption from 3 intervention studies (n = 233); mean difference -0.45 kg [95% CI:-1.06 to 0.16; I2 = 53%].

In conclusion, daily consumption of OJ does not appear to have an adverse impact on BW. This may be due to dietary energy compensation (conscious or unconscious) or a satiety effect linked with the low glycemic index of OJ (GI = 50).

Onakpoya I et al. (2017) Crit Rev Food Sci Nutr 57: 602–612.

A survey made worldwide (including South Africa) revealed that most teenagers are overweight and obese and that they eat little nutritious food. Obesity and overweight are public health problems and need to be addressed from a community perspective. The reason for exploring this problem in this study was that South Africa has one of the highest rates of overweight and obesity in the world among urban and rural black women. The objective was to investigate the eating and lifestyle habits of overweight and obese female teenagers in Thulamela Local Municipality, Limpopo province, South Africa. This was an exploratory, descriptive study conducted amongst 125 female teenagers aged 13 to 18 years from rural schools in Thulamela Local Municipality. Eating and lifestyle habits, physical activity, meaning of healthy and unhealthy dietary habits, weight, height and body mass index were measured. A hundred and twenty-five questionnaires were completed and data were gathered on the demographics, anthropometry, social and lifestyle habits, nutrition-related problems, dietary patterns and dietary history of the participants. The BMI revealed that 34.4% were of normal weight, 39.2% overweight and 26.4 obese. Seventy percent of the respondents actively consumed meals in a day, 83% consumed starchy snacks, whilst 72% of the respondents carried lunchboxes to school. Regarding lifestyle habits, 88% of the respondents slept more hours than recommended (8 hours) while 88% performed sedentary activities and 66% did physical activities such as walking. The results pointed out unhealthy eating and lifestyle habits influencing teenagers’ weight and provided information on which of these must be considered in order to develop tailored nutrition interventions, improving teenagers’ consciousness about s adopting a healthy lifestyle.

The World Health Organisation (WHO) strongly recommends reducing free sugar intake to < 10% energy, and suggests a further conditional reduction to < 5% energy. This study aims to assess how achievable these free sugar intake recommendations are in healthy diets of 1–5 year olds in Ireland and to identify the main food contributors.

Using minimal added sugar, fat and no added salt, four-day food intake patterns were developed for 1–5 year old children (n30 girls; n30 boys) representing different percentile levels on the WHO growth charts. These food intake patterns were based on foods commonly consumed in the Irish National Pre-school Nutrition Survey and adjusted to meet energy, macronutrient and micronutrient requirements. The free sugar content of each food used was identified according to the WHO definition and estimated using food composition tables. Free sugar content of the four-day patterns was assessed against the two WHO recommendations. Subjects were compared depending on recommendations achieved. Where necessary, nutrients were estimated per 500kcal to control for energy.

Food intake patterns of all subjects (n60) achieved the WHO recommendation of < 10% energy, with 50% (n30) meeting the further recommendation of < 5% energy. Subjects with free sugar intakes < 5% energy compared with those not meeting this recommendation, were younger (2 years vs. 3.5 years, p < 0.001), had lower energy intakes (946kcal vs. 1263.8kcal, p < 0.001), higher fat intakes (37% vs. 29%, p < 0.001), higher saturated fat intakes (18% vs. 13%, p < 0.001) and lower carbohydrate intakes (46% vs. 53%, p < 0.001). When estimated per 500kcal they had lower intakes of fibre (5.0 g vs. 6.2 g, p < 0.001) and vitamin D (5.9μg vs. 6.3μg, p < 0.001) and higher intakes of vitamin A (177.3μg vs. 108.5μg, p < 0.001) and DHA and EPA (0.3 g vs. 0.2 g, p < 0.001). The main foods contributing to free sugar intakes in these subjects were cereals (29% of free sugar intake), yoghurts (27%), breads (5%) and ice cream (4%). By comparison the main foods contributing to free sugar in subjects whose intakes exceeded 5% energy included yoghurts (22%), stewed apples (9%) and puddings (6%).

This analysis demonstrates the WHO strong recommendation of < 10% energy for free sugar was easily achievable, but the further conditional recommendation (< 5%) was more difficult. This was only achieved at younger ages and was associated with increased intakes of fat and saturated fat and lower intakes of fibre and vitamin D. The main food contributors to free sugar in healthy diets for 1–5 year olds are important sources of nutrients.

From an early age nutrition is part of everyday life, but the motives of eating change over the life span. The nutrition depends on many factors and is always embedded in an individual and social dimension. Especially life-phase-specific framework conditions and factors play an important role in the daily nutrition. The aim of this project was to find out how different factors affect nutritional behaviour in different age groups.

The study was part of the research project “enable - healthy food choices in all stages of life”. In order to examine the factors influencing the nutritional behaviour, focus groups with young women and men, middle-agers and elderly had been implemented. In addition biographical interviews were conducted to gain a deeper insight into the reasons for changing the nutritional behaviour. Thus influencing factors and their weighting could be identified and their mode of action could be linked.

For example, changes in the nutritional habits of adolescents could be figured out more accurately. Essential for young adults is the replacement of the parents, which is obtained by moving out of the parental home. An own lifestyle and nutritional style has to be developed and there are many changes and new freedoms and opportunities to try out. The consumption of fast food, for example, is particularly attractive to adolescents, as it is a distinction from the adult culture and rules of eating, like eating with cutlery. Another example is the nutritional situation of elderly, which is often characterized by malnutrition or disease-related dietary requirements. However, many elderly do not eat as recommended, even if they have the skills to implement it. In everyday life, deviations from the nutritional recommendations are often legitimized by the age itself “now I can indulge myself a bit”. Other legitimization factors include the death of the partner “I have been cooking my whole life, now I can just eat a sandwich”.

The majority of people do not eat according to nutritional recommendations, too much sugar and salt and little fruits and vegetables characterize the nutrition. The consequences do not only concern health aspects such as nutritional diseases, but also ecological aspects. Despite knowing about the consequences of unhealthy food, many do not realize their knowledge about healthy eating in everyday life. If the nutritional situation should be improved sustainably, it is therefore necessary to include the individual factors and changes in the life span in considerations and concepts of nutritional programs.

The ketogenic diet has been shown to be very effective in managing drug-resistant epilepsy, treatment of obesity, improving symptoms of diabetes and reducing cardiovascular risk. Growing evidence supports the use of the ketogenic diet as an alternative or additional therapy in many types of cancer, polycystic ovary syndrome, acne, and neurological diseases. The rationale for the use of the ketogenic diet in brain diseases is based on its neuroprotective properties. But mechanisms responsible for these effects are only partially explained. It is possible that stimulation of macroautophagy (hereafter termed autophagy) may be one of the mediators of the neuroprotection afforded by the ketogenic diet. Autophagy is a key mechanism for maintaining cell homeostasis and therefore its proper function is necessary for preventing accelerated brain aging and neurodegeneration. Autophagy has become a subject of intensive research as a promising target for neuroprotective strategies, which are urgently needed in our aging population, in which the burden of age-related diseases is constantly increasing. The ketogenic diet may induce autophagy in brain cells through at least a couple of mechanisms: downregulation of mTORC1, activation of AMP-activated kinase, elevation of free fatty acids, activation of Sirtuin 1 and an increase of HIF1α expression. The aim of this study was to verify the hypothesis that the ketogenic diet affects the level of autophagy in the mouse brain. Thirty 9-weeks-old male mice were divided into three groups and fed with one of two differently composed ketogenic chows (KA, KB) or with standard rodent chow (SD) for 4 subsequent weeks. Western blotting (LC3, p62) and confocal microscopy (LC3 puncta) were employed to monitor autophagy in hippocampal and cerebrocortical samples. The Western blot results revealed an increased level of LC3 II protein - a marker of autophagosomes, in the hippocampus and frontal cortex of mice treated with ketogenic diet. The size of this effect was dependent on the composition of the diet. This observation was confirmed by the evaluation of the number of LC3 puncta with immunofluorescence microscopy. This study reports for the first time the upregulation of autophagosome synthesis in the brain of animals fed with the ketogenic diet. Our results make a significant contribution to the understanding of the mechanisms of ketogenic diet action. This research is supported by the National Science Center grant no 2017/01/X/NZ3/00984.

Folic acid (FA) and iron absorption is performed by transporters encoded by the Slc46a1 and Slc11a2 genes, respectively. The aim of this study was to determine how FA and iron deficiency in rats, and subsequent supplementation of the animals’ diet with these nutrients, affects Slc11a2 and Slc46a1 gene expression and the metabolic biomarkers of FA and iron status.

150 female Wistar rats were assigned to a group fed a diet deficient in iron and FA (D, n = 120) or to a group fed a control diet (C, n = 30, AIN-93M) for 28 days. After this period, the rats were randomized to a group fed for 2, 10, or 21 days with a diet deficient in FA and supplemented with iron (DFE), a diet deficient in iron and supplemented with FA (DFOL), a diet supplemented with iron and FA (FEFOL), or a diet deficient in iron and folic (D).

Transcript and protein levels were determined in the duodenum using the real-time PCR and western blot methods, respectively. FA concentrations in serum were assessed using the electrochemiluminescence method, and homocysteine concentrations were determined with an enzymatic assay. Iron metabolism was evaluated by measuring the total and unsaturated iron-binding capacity (TIBC and UIBC) in serum, and iron concentrations were determined using a photometric method. Hepcidin concentrations were measured in plasma with an immunoenzymatic method. Morphological parameters of the blood were determined with a Sysmex XT-4000 analyzer.

The D group had higher Slc11a2 transcript levels than the DFE group at every time-point (p < 0.01). There were higher Slc46a1 mRNA levels in the DFE group than in the FEFOL group at the third time-point (p < 0.05). We did not observe any differences in PCFT or DMT1 protein abundance. The DFOL, FEFOL, and C groups had higher serum FA concentrations at the second and third time-points (p < 0.001), as well as the lowest homocysteine concentrations (p < 0.001). TIBC concentrations were lowest in the DFE and the FEFOL groups at the final time-point (p < 0.001). We did not observe any differences in hepcidin concentrations. Simultaneous supplementation with FA and iron resulted in significantly higher hemoglobin concentrations at the third time-point (p < 0.01).

This study shows that dietary FA and iron deficiency, and subsequent supplementation with moderate amounts of these nutrients, may affect the transcription but not the protein abundance of FA and iron transporters in the rat duodenum.

Nut consumers have lower body weight and are at lower cardiovascular disease risk than non-consumers. Interestingly, minority adults, who have the highest prevalence of obesity and are at disproportionate risk of cardiovascular disease, have low nut intakes. The goal of this study was to test whether consumption of almonds, compared to low-fat/high-carbohydrate cereal bars (LF-HC), as a supplement for 24 wk, would improve appetite regulation and body composition in Blacks and Hispanics. Twenty-nine adults, BMI > 25 kg/m2, age 30–65 y, were recruited and randomized to consume either almonds or LF-HC providing 17.5% of their estimated energy requirements as part of their regular diet. A total of 17 adults completed the study, 9 men and 8 women; 7 of whom were randomized to almond consumption (4 men, 3 women), and 10 to LF-HC consumption (5 men, 5 women). Outcome variables included appetite-regulating hormones and inflammatory markers, which were measured from fasting blood samples taken at baseline, week 12, and endpoint. Body composition was measured by magnetic resonance imaging at baseline and endpoint. Data were analyzed using linear mixed model with treatment, time, and their interaction as predictor variables; age, race, sex, and baseline BMI as covariates; and participant ID as a random effect variable. Peptide YY concentrations were higher in the almond group compared to LF-HC (time x treatment interaction at 12 wk, P < 0.001; 24 wk, P = 0.13). Glucagon-like peptide 1 concentrations were higher in the almond group compared to LF-HC (time x treatment interaction at 12 wk, P = 0.10; 24 wk, P = 0.015). Ghrelin levels decreased in LF-HC compared to the almond group at 12 wk but not 24 wk (time x treatment interaction at 12 wk, P = 0.017; 24 wk, P = 0.23). There was a slight trend for a time x treatment interaction on body weight (P = 0.14; change in almond = 0.6 ± 1.8 kg; LF-HC = 1.9 ± 2.7 kg). There was a time x treatment interaction on intermuscular adipose tissue (P = 0.013; change in almond = -0.10 ± 0.14 cm3; LF-HC = 0.04 ± 0.07 cm3). None of the measured inflammatory markers (C reactive protein, interleukin-6, and tumor necrosis factor) were affected by the dietary interventions. Despite the lack of profound body composition changes, daily almond intake for 24 wk, within the usual diet, ameliorated satiety and ectopic fat deposition, suggesting a potential role of nut consumption in the context of a weight reduction program in minority adults. Our data support further exploration of the health effects of nut consumption in this population.

Blueberries (Vaccinium corymbosum, L.) are a valuable source of health-promoting bioactive compounds, particularly polyphenols. The beneficial effects of polyphenols on health depend not only on food sources but also on their stability, which can vary depending on the post-harvest processing methods, the matrix in which they are incorporated, and endogenous factors such as microbiota and digestive enzymes. The aim of this study was to investigate the influence of high-intensity ultrasound treatment on in vitro gastrointestinal stability of the total polyphenol content and antioxidant capacity of blueberries. Blueberry puree was treated with high-intensity ultrasound using different amplitudes (30, 45 and 60μm) and treatment times (3, 6 and 9 min), and a part of sample was used as a control (untreated sample). Total phenolic content (TPC) and antioxidant capacity (by DPPH and FRAP methods) were determined prior to and after two-phase in vitro digestion process (gastric and duodenal) using human gastrointestinal enzymes. The results showed a high stability of total blueberry polyphenols and antioxidant activity during simulated gastric digestion step, both in untreated and ultrasound treated samples. The use of high-intensity ultrasound had a significant effect on the stability of polyphenols and their antioxidant activity after simulated digestion in duodenum. Significant increase in polyphenol content after duodenal digestion step was determined in three ultrasound treated samples with longer treatment time (6 and 9 minutes), and only sample with significant reduction of TPC was untreated sample. Modification of the food matrix as a result of cavitation from ultrasound treatment may be the reason for higher stability of polyphenol during in vitro digestion. After in vitro digestion blueberry polyphenols still possessed antioxidant activity that may be directly related to their beneficial effects on health. The highest antioxidant activity measured with DPPH and FRAP method was determined for sample treated with maximum amplitude (60μm) and longest time (9 minutes). Determination of the stability of phenolic compounds is important as it affects their bioavailability for uptake as well as their possible beneficial effects on intestinal epithelial tissue such as reduction of oxidative stress and cancer prevention. Our results showed that ultrasound treatment can preserve the blueberry phenolics and their antioxidant characteristics after in vitro digestion.

Current evidence has shown that orange juice flavonoids have antihypertensive, lipid lowering, insulin sensitizing, antioxidant and antinflammatory properties, which are correlated with antiatherogenic activity. The objective of this study was to verify whether regular administration of 100% pure orange juice (OJ), as a source of antioxidant and bioactive compounds, associated with a healthy dietary pattern improves endothelial and vascular function and reduces Global Risk of Coronary Heart Disease (Global Risk of CHD). Obese volunteers (n = 68) with metabolic syndrome were randomly assigned to the control (n = 34) or OJ (n = 34) groups, and all of them were counseled and followed up to maintain a healthy-eating pattern for 12 weeks. In addition, OJ group participants drank 500 ml of 100% orange juice daily in two servings of 250 mL each between meals. After the intervention, a significant reduction of 2% in anthropometric measurements (body weight and fat) was observed in both groups, with no change in lean mass. In the OJ group, a significant reduction of total cholesterol (-9.4%) was detected, whereas the controls reduced only HDL-C (-9%). In both groups there was a significant reduction in systolic and diastolic blood pressure (-8% and -9%, respectively) and an increase in antioxidant capacity (1%). Only the OJ group reduced vascular markers ICAM (-14%) and VCAM (-15%) and inflammatory markers TNF-alpha (-20%) and hsPCR (-22%) (p < 0.05). Both groups reduced IL-6 (-45%), improved brachial artery flow-mediated dilatation (BA-FMD), and reduced carotid artery intima-media thickness (CA-IMT) by 10% (p < 0.05). Daily consumption of orange juice, along with a healthy-eating pattern, was able to reduce cardiovascular risk factors related to systemic inflammation and endothelial function in individuals with metabolic syndrome. A significant reduction in the prevalence of the high-risk of CHD was observed in 47% of subjects who consumed a healthy diet, while 70% of patients who had a healthy eating pattern along with orange juice reverted to low CHD risk, showing the additional benefit of regular intake of 100% orange juice. This was probably due to the action of antioxidant compounds present in high concentrations in orange juice, such as vitamin C and citrus flavonoids

Food matrix is known to interact with some dietary constituents and microconstituents during digestion. These interactions may potentially affect the metabolism and bioavailability of some compounds, and as a consequence modulate their biological effects. In this context, the aim of this study was to determine the effect of apple food matrix on the bioavailability of flavan-3-ols and on the ability of these compounds to modulate the nutrigenomic response to a high fat challenge in minipigs.

Adult male Yucatan minipigs (n = 5) were assigned to a random treatment sequence of high-fat meals non supplemented or supplemented with 250 g of raw apple, 250 g of apple puree or 1.4 g of apple polyphenols extract, with a 7-days washout period between each treatment. Each supplementation provided 155 mg flavan-3-ol monomers. At each treatment period, fasting- and 1h-, 2h-, 3h-postprandial blood samples were collected, and the concentration in flavan-3-ol monomers was measured on hydrolyzed serum, using UPLC-Q-TOF MS. The ability of apple-derived products to modulate the postprandial gene expression profile was assessed and compared in circulating PBMCs collected at 3 h after consumption of the four tested meals using a microarray analysis.

Results show that the apple matrix did not affect the kinetic of the postprandial absorption of flavan-3-ol monomers. The total flavan-3-ols concentrations measured at peak were significantly higher in the extract (x1.75), suggesting an impact of the apple matrix on flavan-3-ols absorption. However, no significant difference in total flavanols was observed between raw apple and apple puree.

Principal Component Analysis of the microarray data from PBMCs identified three distinct clusters of gene expression patterns: one corresponding to gene expression profiles after the high-fat meal, one for meal supplemented with raw apples or apple puree, and a third cluster for meal supplemented with polyphenol extract. A set of 309 genes was identified as differentially expressed by apple-derived products compared to high-fat meal alone, including 93 modulated with the three apple products. The variations in gene expression were similar for only 75% of the 93 genes, suggesting that the apple matrix affects the nutrigenomic response to flavan-3-ols. A bioinformatics analysis revealed that genes affected by apple-derived products are involved in inflammation and leukocyte transendothelial migration, suggesting a beneficial impact of apple-derived products.

In conclusion, these results raise awareness for considering the impact of food matrix on the biological responsiveness of polyphenols in future nutritional studies.