BACKGROUND\nIncreased physical activity is related to reduced risk of cardiovascular disease, possibly because it leads to improvement in the lipoprotein profile. However, the amount of exercise training required for optimal benefit is unknown. In a prospective, randomized study, we investigated the effects of the amount and intensity of exercise on lipoproteins.\n\n\nMETHODS\nA total of 111 sedentary, overweight men and women with mild-to-moderate dyslipidemia were randomly assigned to participate for six months in a control group or for approximately eight months in one of three exercise groups: high-amount-high-intensity exercise, the caloric equivalent of jogging 20 mi (32.0 km) per week at 65 to 80 percent of peak oxygen consumption; low-amount-high-intensity exercise, the equivalent of jogging 12 mi (19.2 km) per week at 65 to 80 percent of peak oxygen consumption; or low-amount-moderate-intensity exercise, the equivalent of walking 12 mi per week at 40 to 55 percent of peak oxygen consumption. Subjects were encouraged to maintain their base-line body weight. The 84 subjects who complied with these guidelines served as the basis for the main analysis. Detailed lipoprotein profiling was performed by nuclear magnetic resonance spectroscopy with verification by measurement of cholesterol in lipoprotein subfractions.\n\n\nRESULTS\nThere was a beneficial effect of exercise on a variety of lipid and lipoprotein variables, seen most clearly with the high amount of high-intensity exercise. The high amount of exercise resulted in greater improvements than did the lower amounts of exercise (in 10 of 11 lipoprotein variables) and was always superior to the control condition (11 of 11 variables). Both lower-amount exercise groups always had better responses than the control group (22 of 22 comparisons).\n\n\nCONCLUSIONS\nThe highest amount of weekly exercise, with minimal weight change, had widespread beneficial effects on the lipoprotein profile. The improvements were related to the amount of activity and not to the intensity of exercise or improvement in fitness.

Effects of the amount and intensity of exercise on plasma lipoproteins: Editor's comments

https://www.sinpe.org/documenti/protein_intake_espen.pdf

Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group

Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies

The Biomarkers of Nutrition for Development (BOND) project is designed to provide evidence-based advice to anyone with an interest in the role of nutrition in health. Specifically, the BOND program provides state-of-the-art information and service with regard to selection, use, and interpretation of biomarkers of nutrient exposure, status, function, and effect. To accomplish this objective, expert panels are recruited to evaluate the literature and to draft comprehensive reports on the current state of the art with regard to specific nutrient biology and available biomarkers for assessing nutrients in body tissues at the individual and population level. Phase I of the BOND project includes the evaluation of biomarkers for 6 nutrients: iodine, iron, zinc, folate, vitamin A, and vitamin B-12. This review represents the second in the series of reviews and covers all relevant aspects of folate biology and biomarkers. The article is organized to provide the reader with a full appreciation of folate's history as a public health issue, its biology, and an overview of available biomarkers (serum folate, RBC folate, and plasma homocysteine concentrations) and their interpretation across a range of clinical and population-based uses. The article also includes a list of priority research needs for advancing the area of folate biomarkers related to nutritional health status and development.

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Biomarkers of Nutrition for Development (BOND)-Iron Review.

ESPEN guideline on clinical nutrition and hydration in geriatrics

The 4th edition of the Nordic Nutrition Recommendations, NNR 2004, gives the proportions between energy yielding nutrients, recommended daily intakes (RI) of certain vitamins and minerals, and reference values for energy intakes in different age and sex groups. Recommendations are also given for dietary fibre, salt and alcohol. Recommendations on daily physical activity are now included and interaction with physical activity has been taken into account for the individual nutrient recommendations wherever appropriate. For adults 30minutes of daily physical activity of at least moderate intensity is recommended. More physical activity (about60 minutes daily) with a moderate and/or vigorous intensity may be needed for prevention of weight gain. For children a minimum of 60 minutes of physical activity every day is recommended. As in the 3rd edition, the recommendation is to limit of the intake of saturated plus trans fatty acids to about 10% of the total energy intake (E%) and of the total fat intake to 30 E%. The intake of carbohydrate and dietary fibres should increase, while the intake of refined sugars should not exceed 10 E%. The RI for vitamin A (women) has been lowered, while it has been increased for vitamin D (children and adults up to 60 y), vitamin C (adults) and folate (women of reproductive age; pregnant and lactating women).NNR is to be used for planning and evaluation of diets, and as a basis for food and nutrition policy, teaching and dietary information. Keywords: nutrition recommendations; physical activity; vitamins; minerals; Nordic countries

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Nordic Nutrition Recommendations 2004 – integrating nutrition and physical activity

Nordic nutrition recommendations

The relation between added sugars and density of dietary fibre and micronutrients was examined by analysing diets from 983 Danish girls and boys aged 4-14 years. The average intake of added sugars was 13.7 E% ranging from 3.4 to 38 E%. One fourth of the diets were below the recommended maximum level of 10 E%. No differences between sex and age groups were found. The diets were ranked and divided into quintiles (fifths) according to percentage of energy from added sugars. A strongly significant decline in nutrient density for all nutrients, except vitamin C, was observed as sugar concentration rose across quintiles. Nutrient densities expressed relative to recommended values varied from 30% to 300% illustrating that the nutritional significance of the dilution effect of added sugars differs from one nutrient to another. The results support the concept of "empty calories" and restriction of added sugars should still be recommended. Key words: Added sugars, children, empty calories, micronutrients, nutrient density

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Added sugars and nutrient density in the diet of Danish children

/pdf/en-faglig-vurdering-af-den-omvendte-kostpyramide-201g6857gd.pdf

En faglig vurdering af den »omvendte« kostpyramide

Dear Editor, Infectious keratitis can cause visual impairment and permanent loss of vision. Accordingly, the correct diagnosis of the infectious agent is imperative to optimize treatment. We suspected that our current diagnostic approach, using a broth culture technique, could potentially miss certain infectious agents, especially filamentous fungi. Nextgeneration sequencing (NGS) is a newer method using a massive parallel sequencing platform, that can be utilized to investigate the microbiome of the ocular surface by targeting ribosomal RNA from bacteria (16S), fungi and parasites (18S) at a relatively low cost (<70 €) (Ma et al., 2019). The advantage of this approach is that the NGS method covers all prokaryotes (bacteria) and almost all eukaryotic microorganisms (fungi and parasites) as opposed to specific PCRs, which only covers a single species or a small group of species. We performed a prospective observational quality control study, which aimed to compare our broth culture technique to NGS (16S/18S microbiome sequencing) in patients with infectious keratitis at our university hospital clinic. We included all patients with infectious keratitis, from which a corneal scraping was obtained at the Department of Ophthalmology, Odense University Hospital, over a 1year period (from January 2021 to January 2022). The corneal samples were inoculated into broth medium and transferred to the Department of Clinical Microbiology, where it was incubated for 24 h and subcultured in accordance with Schønheyder et al. (1997) for 5 days. This was supplemented with Sabouraud agar for culturing of fungi, which were incubated for 10 days. In addition to that, broth medium samples were forwarded to Statens Serum Institut in Copenhagen for 16S/18S microbiome sequencing (Holmgaard et al., 2021). The study included 62 eyes from 62 patients. NGS was not performed in five cases because broth material was not available, and these patients were excluded from further evaluation. Thus, the study group comprised of a total of 57 patients. The median age of the patients was 48 years (range 22– 90) with most being female (54%). A total of 49% were contact lens users, 30% had received topical antibiotic treatment (chloramphenicol) prior to the investigation and 4% had received prior topical steroids. An outline of the relationship between the two methods is shown in Table 1. In one of the cases in which there was discrepancy between the two methods, culture was negative and Streptococcus pseudopneumoniae was detected with NGS. However, the patient had presumably received effective topical antibiotic treatment prior to the corneal scraping being obtained. In another divergent case, culture was negative but Fusarium oxysporum (filamentous fungi) was identified with NGS. However, the finding was likely clinically insignificant, as the patient responded to antibacterial treatment. The microorganism was interpreted as a contaminant. In one case Staphylococcus aureus was cultured, but NGS was negative. There is no reasonable explanation for this as staphylococci were detected by NGS in 14 other samples of 20 NGS positive samples. Studies using NGS for the detection of bacteria, parasites and fungi in corneal scrapings are very limited. Holmgaard et al. (2021) investigated the applicability of NGS compared with specific realtime PCR for the detection of Acanthamoeba in corneal scrapings and found NGS to be slightly less sensitive than realtime PCR. The advantage of NGS compared to culture is that it can detect fastidious and dead microorganisms. We detected Streptococcus pseudopneumoniae with NGS but not culture. Presumably, the bacteria were dead because of prior treatment. Although treatment was already effective, it is reassuring for the patient and the treating physician to obtain a diagnosis and confirm that the treatment is correct. In conclusion, our NGS method might be considered in cases with negative culture from corneal scrapings, where nonviral causes of infectious keratitis are suspected. However, the number of eyes included was too small to make any reliable conclusions and further studies are needed to determine the sensitivity of this method. Received: 22 June 2022 | Accepted: 29 October 2022

Niels Lyhne

Papers

Nordic Nutrition Recommendations 2004 – integrating nutrition and physical activity

Nordic nutrition recommendations

Added sugars and nutrient density in the diet of Danish children

En faglig vurdering af den »omvendte« kostpyramide

Identification of microorganisms in patients with keratitis by next‐generation sequencing