Showing papers in "European Journal of Clinical Nutrition in 1996"

Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements

Abstract: Objectives To describe average levels of free-living energy expenditure in people from affluent societies and to determine the influence of body weight, height, age and sex. Design Analysis of 574 measurements of total energy expenditure (TEE, assessed by the doubly-labelled water method); basal metabolic rate (BMR, directly measured or derived from similar directly measured proxy measures such as during sleep); activity energy expenditure (AEE, derived as TEE-BMR); and physical activity level (PAL, derived as TEE/BMR) from people aged 2-95 years. The dataset was extracted from 1614 published and unpublished measurements in 1156 subjects after exclusion of repeat estimates and subjects in special physiological or behavioural states (eg pregnancy, athletic or military training etc). Results A separate analysis of data from non-ambulant subjects, and from elite endurance athletes (all excluded from the main dataset) established the limits of human daily energy expenditure at around 1.2 x BMR and 4.5 x BMR. In the main analysis, the validity of PAL as an index of TEE adjusted for BMR was tested and confirmed. Regression equations were then derived to describe TEE, BMR, AEE and PAL in terms of body weight, height, age and sex. As anticipated, TEE, BMR and AEE were all positively related to weight and height, while age was a negative predictor, especially of activity. The influence of weight disappeared when TEE was expressed as PAL, but height and age remained as highly significant predictors. For all three components, females expended 11% less energy on average than males after adjustment for weight, height and age. Average levels of energy expenditure in different age and sex groups are tabulated. Conclusions There now exists a large and robust database of energy expenditure measurements obtained by the doubly-labelled water method. Analysis of the data from affluent societies shows that, in general, levels of energy expenditure are similar to the recommendations for energy requirements adopted by FAO/WHO/UNU (1985) and UK Department of Health (1991). PAL values for active subjects tend to be higher than is currently assumed. The current analysis provides a substantial body of normal data against which other estimates can be compared.

In vivo antioxidant effect of green and black tea in man.

Abstract: OBJECTIVE Evaluation of the vitro antioxidant activity of green and black tea, their in vivo effect on plasma antioxidant potential in man and the effect of milk addition. DESIGN The antioxidant activity of the tea, with and without milk, was tested in vitro by measuring the length of the peroxyl radical induced lag-phase. The in vivo activity was tested on two groups of five healthy adults. Each group ingested 300 ml of either black or green tea, after overnight fast. The experiment was repeated on a separate day, adding 100 ml whole milk to the tea (ratio 1:4 ). Five subjects acted as controls. The human plasma antioxidant capacity (TRAP) was measured before and 30, 50 and 80 min from the ingestion of tea. RESULTS Both teas inhibited the in vitro peroxidation in a dose-dependent manner. Green tea was sixfold more potent than black tea. The addition of milk to either tea did not appreciably modify their in vitro antioxidant potential. In vivo, the ingestion of tea produced a significant increase of TRAP (P <0.05), similar in both teas, which peaked at 30-50 min. When tea was consumed with milk, their in vivo activity was totally inhibited. CONCLUSIONS The paper shows that tea possesses a strong antioxidant activity in vitro which is believed to be exerted by its polyphenols moiety. It also provides compelling evidence that tea has also a potent in vivo activity in man. The promptness of the in vivo response suggests that the absorption of the bioactive components of tea takes place in the upper part of the gastrointestinal system. The inhibition of this effect by milk is thought to be due to the complexation of tea polyphenols by milk proteins. These findings might help to clarify the putative role of dietary poly- phenols in modulating oxidative stress in vivo.

Effect of maternal docosahexaenoic acid (DHA) supplementation on breast milk composition

Abstract: OBJECTIVE To assess the effect of varying maternal intake of docosahexaenoic acid (DHA, 22 : 6n-3), in the absence of other dietary polyunsaturates, on breast milk fatty acids. DESIGN AND INTERVENTION Lactating mothers were randomised on day 5 post-partum to groups consuming equal numbers of capsules but containing either placebo or an oil containing DHA (43%) as its only polyunsaturate to receive 0, 0.2, 0.4, 0.9, 1.3 g DHA/day. Breast milk fatty acids as well as maternal plasma and erythrocyte phospholipids were assessed at 12 weeks post partum by capillary gas chromatography. RESULTS Breast milk DHA levels ranged from 0.2 to 1.7% of total fatty acids and increased in a dose dependent manner (r2 = 0.89, P < 0.01). Maternal plasma (r2 = 0.71, P < 0.01) and erythrocyte (r2 = 0.77, P < 0.01) phospholipid DHA levels increased and were also strongly associated with dietary dose of DHA. Increasing maternal dietary doses of DHA did not affect breast milk arachidonic acid (AA, 20 : 4n-6) levels or antioxidant status as measured by plasma vitamin A or E levels. CONCLUSIONS Our results have demonstrated that DHA in the diet has a strong, specific and dose-dependent effect on breast milk DHA.

Breakfasts high in protein, fat or carbohydrate: effect on within-day appetite and energy balance

Abstract: OBJECTIVE To compare the effect of isoenergetically-dense, high-protein (HP), high-fat (HF) or high-carbohydrate (HC) breakfasts (at 08.30) on subjective hunger, fullness and appetite (measured hourly on a 100 mm visual analogue scale), macronutrient balance and ad libitum energy intake (EI), at a test meal (13.30) and throughout the rest of the day (until 23.00). DESIGN Six men each spent 24 h in a whole-body indirect calorimeter on three separate occasions during which they received breakfasts designed to match 75% of BMR and that comprised, on average 3.1 MJ of protein (HP), carbohydrate (HC) or fat (HF), respectively, the remainder being split between the other two macronutrients. Every item of the ad libitum diet comprised 13% protein, 40% fat and 47% carbohydrate by energy, with an energy density of 550 kJ/100 g. RESULTS Subjectively-rated pleasantness did not differ between the breakfasts, or any of the subsequent ad libitum meals. Subjective hunger was significantly greater during the hours between breakfast and lunch after the HF (26) treatment relative to the HP (18) or HC (18 mm) meals (P < 0.001), although the HP treatment suppressed hunger to a greater extent than the other two treatments over 24 h. However, mean ad libitum lunch intakes were similar at 5.38, 5.30 and 5.18 MJ (NS) on the HP, HC and HF treatments, respectively. After-lunch intakes were also very similar at 6.14, 6.18 and 5.83 MJ (NS). Mean 24-h energy expenditure amounted to 11.12, 11.14 and 10.93 MJ, respectively, producing energy balances of 5.71, 5.83 and 5.04 MJ (NS), respectively. The HP, HF and HC breakfasts led to enhanced P, F and C oxidation, respectively (P < 0.003). CONCLUSIONS Large HP, HC or HF breakfasts led to detectable changes in hunger that were not of sufficient magnitude to influence lunch-time intake 5 h later, or EI for the rest of the day. A single positive balance of each macronutrient can be buffered by oxidation and storage capacity, without leading to changes in meal-to-meal EI, when subjects feed ad libitum on unfamiliar diets of fixed composition.

Energy expenditure in overweight and obese adults in affluent societies: an analysis of 319 doubly-labelled water measurements.

Abstract: OBJECTIVES: To describe the relationship between graded levels of obesity and free-living energy expenditure in men and women in affluent societies DESIGN: Analysis of 319 measurements of energy expenditure in adults aged 18-64 years The variables analysed were: total energy expenditure (TEE, assessed by the doubly-labelled water method); measured basal metabolic rate (BMR); activity energy expenditure (AEE, derived as TEE-BMR); and physical activity level (PAL, derived as TEE/BMR) Results were analysed according to four categories of body mass index (BMI): 350 kg/m2 RESULTS: TEE increased steadily with increasing BMI (95 to 135 MJ/d in women, 129 to 175 MJ/d in men, ANOVA, P < 00001 for both sexes) BMR also increased (57 to 82 MJ/d in women, 72 to 116 MJ/d in men, P < 00001 for both) AEE increased steadily in women (38 to 53 MJ/d, P < 00003), but in men increased up to the third BMI category (57 to 75 MJ/d, ns) and then declined in the most obese group (59 MJ/d, ns) The increases in energy expenditure were not in direct proportion to body weight since, when expressed per kg, both TEE and AEE declined significantly with increasing BMI PAL remained quite constant across the three lowest BMI groups, indicating similar levels of physical activity There was a non-significant decrease in PAL in the most obese men and women CONCLUSIONS: This analysis confirms that habitual energy expenditure is substantially and progressively raised in obesity It contradicts the claim, based on self-reported food intake, that obesity develops and is maintained in spite of very low levels of energy intake The analysis suggests that, except in massive obesity, patterns of physical activity are quite similar at different levels of BMI This does not exclude the possibility that an inactive lifestyle may be an important general risk factor for the development of obesity

Relationship between feeding pattern and body mass index in 220 free-living people in four age groups.

Abstract: OBJECTIVE To assess the relationship between feeding pattern and body mass index in free-living humans. DESIGN AND SUBJECTS Feeding pattern was assessed from 220 7-day weighed dietary records. 187 records were obtained from three separate existing studies, and reanalysed. These studies contained data on three age groups in the British population; Elderly group (n = 88), Middle-aged group (n = 40), Working age group (n = 59). A separate study of 13-14 year olds living in Croydon was conducted from which 33 usable diet records were collected to produce a fourth, Adolescent group. RESULTS 'Nibbling' and greater energy intakes at breakfast were associated with a lower body mass index (BMI) in the Adolescent group. In the Middle-aged group, greater energy intakes at breakfast and lower energy intakes during the evening were associated with a lower BMI. However, when diet records which produced unreasonably low energy intakes were removed from the analysis, these relationships disappeared except for energy intakes at breakfast and BMI in the Adolescent group. CONCLUSION It is suggested that the relationship between feeding pattern and BMI observed in the Adolescent and Middle-aged groups was caused by underestimation of 'habitual' energy intake from snacks and the omission of breakfast by females and those who were overweight. The lack of relationship in the Working age group was attributed to the fact that more individuals in this group appeared to report valid diet records. Reported energy intake was directly related to BMI in the Working age group, but was not related to BMI in the other three age groups. It is concluded that feeding pattern is not a major factor in determining BMI in humans. Also, since snacks have a relatively high sugar and low fat composition compared with meals, it is suggested that biased under-reporting of snacks by the obese could produce spurious results from free-living studies which show that obesity is related to the proportion of energy from fat in the diet.

Energy requirements of infants.

Abstract: ObjectiveTo estimate the energy requirements of infants from total energy expenditure and energy deposition during growthDesignEnergy requirements during infancy were estimated from total energy expenditure measured by the doubly labelled water method and energy deposition based on measured protein and fat gainsSettingDatabase on the total energy expenditure and energy deposition of infants was compiled from available studies conducted in China, Chile, Gambia, Mexico, Netherlands, UK, and USASubjectsHealthy, term infantsResultsTotal energy requirements (kJ day−1) increased with age and were higher in boys than girls due to differences in weight Energy requirements decreased from 473 kJ kg−1 per day for boys and 447 kJ kg−1 per day for girls at 1 month of age to 337 kJ kg−1 per day for boys and 341 kJ kg−1 per day for girls at 6 months of age, and thereafter tended to plateau Energy deposition as a percentage of total energy requirements decreased from 40% at 1 month to 3% at 12 months of age These estimates are 10–32% lower than the 1985 FAO/WHO/UNU recommendations which were based on observed energy intakes of infantsConclusionsRecommendations for the energy intake of infants should be revised based on new estimates of total energy expenditure and energy deposition

Modern and healthy : Socioeconomic differences in the quality of diet

Abstract: OBJECTIVE: The purpose of this study was to describe how nutrient intake and food consumption varied according to education and household income in men and women. The second aim was to find out to what extent the goals of the national dietary guidelines were met in different socioeconomic groups. DESIGN: A random dietary survey using a 3 d estimated food record and a self-administered questionnaire. SETTING: Individuals from four different regions in Finland in spring 1992. SUBJECTS: 870 men and 991 women aged 25-64 y. MAIN OUTCOME MEASURES: Food group and nutrient consumption, two saturated fat indices, educational level and household income. MAIN RESULTS: Men with a higher educational level had a lower energy intake and women with a higher income a lower intake of carbohydrates. The intake of vitamin C and carotenoids increased with increasing socioeconomic status. Otherwise, no socioeconomic differences in energy intake, densities of fat and saturated fat, macronutrient or fibre were found. Higher socioeconomic groups consumed more cheese, vegetables, fruit and berries and candies and less milk, butter and bread. CONCLUSIONS: Higher socioeconomic groups did not follow current national dietary guidelines better than lower socioeconomic groups. Higher socioeconomic groups consumed more of the modern recommended foods, such as vegetables and fruit and berries, but less traditional recommended foods, such as bread and potatoes.

Dietary carotenoids and their role in combating vitamin A deficiency: a review of the literature.

Abstract: OBJECTIVE: To evaluate the evidence that carotene-rich fruits and vegetables can overcome vitamin A deficiency. DESIGN: Results of studies on the relationship between dietary carotenoids and vitamin A deficiency were evaluated critically. RESULTS: Increased intake of fruits and vegetables has been shown to be related to improved vitamin A status in many cross-sectional, case-control and community-based studies, but this does not prove causality of the relationship. Many experimental studies indicating a positive effect of fruits and vegetables can be criticized for their poor experimental design while recent experimental studies have found no effect of vegetables on vitamin A status. Thus, it is too early to draw firm conclusions about the role of carotene-rich fruits and vegetables in overcoming vitamin A deficiency. Bioavailability of dietary carotenoids and their conversion to retinol are influenced by the following factors: Species of carotene; molecular Linkage; Amount of carotene in a meal; Matrix in which the carotenoid is incorporated; Absorption modifiers; Nutrient status of the host; Genetic factors; Host-related factors and Interactions (SLAMANGHI). Studies are required to quantify the impact of these factors, especially of the matrix, host-related factors and absorption modifiers. CONCLUSIONS: The effectiveness of carotene-rich foods in improving vitamin A status and ways of improving carotene bioavailability need further investigation.

A critique of the effects of snacking on body weight status.

Abstract: Increasingly Western populations appear to be moving away from the 'gorging' to the 'nibbling' pattern of eating, probably as a direct result of the increased availability of snack foods and snacks There have been many individual suggestions for the definition of a 'snack', each one based on different parameters of measurement (Rotenburg, 1981; Bernstein et al, 1981; De Castro, 1993) However, no one definition has been universally accepted in the scientific literature due to the problems inherent in individual perception of what constitutes a 'snack' as opposed to a 'meal' For the purposes of this review, however, a snack is defined as 'any food taken outwith a regular mealtime (namely breakfast, lunch and dinner) or snack item taken in place of such meal' Snacking is commonly regarded by the general public as predisposing to overweight and obesity, believing that it is more beneficial to adhere to an eating pattern of three meals a day Thus, in this context, many weight reduction programmes include avoidance of snacks, reducing the frequency of eating occasions to two to three times a day Indeed one hypothesis, the Booth hypothesis (Booth, 1988), suggests that this growing trend for snacking is a major factor in the aetiology of obesity However, there is evidence to suggest that snacking, per se, may not necessarily predispose to overweight and that those individuals who snack throughout the day may have positive advantages, in terms of body weight control, over those conforming to a rigid pattern of three meals a day This paper reviews the literature in the area of eating frequency with respect to energy balance and body weight control and suggests some directions for further research

Serum calcium, magnesium, copper and zinc and risk of cardiovascular death

Abstract: Objective To study the association of serum calcium, magnesium, copper and zinc concentrations with cardiovascular mortality. Design A nested case-control study within a prospective population study. Subjects and methods 230 men dying from cardiovascular diseases and 298 controls matched for age, place of residence, smoking and follow-up time. Mean follow-up time was 10 years. Serum calcium, magnesium, copper and zinc concentrations were determined from samples kept frozen at -20 degrees C. Results High serum copper and low serum zinc concentrations were significantly associated with an increased mortality from all cardiovascular diseases and from coronary heart disease in particular. The relative risk of coronary heart disease mortality between the highest and lowest tertiles of serum copper and zinc were 2.86 (P = 0.03) and 0.69 (P = 0.04), respectively. Adjustment for social class, serum cholesterol, body mass index, hypertension and known heart disease at baseline examination did not materially alter the results. No significant differences were observed in concentrations of serum calcium and magnesium between cases and controls. Conclusions High serum copper and low serum zinc are associated with increased cardiovascular mortality whereas no association was found with serum calcium and magnesium and mortality risk.

Fish diet, fish oil and docosahexaenoic acid rich oil lower fasting and postprandial plasma lipid levels

Abstract: OBJECTIVE The present study was carried out to clarify the effects of fish diet, fish oil and docosahexaenoic acid (DHA) rich oil on fasting and postprandial lipid levels in healthy male students. DESIGN The study was a randomized single-blind study with a control and three study groups. SETTING The study was carried out in the Departments of Physiology and Clinical Nutrition of University of Kuopio. SUBJECTS Healthy male volunteers were recruited for the study from the university student population. Fifty-nine subjects entered and 55 completed the study. INTERVENTIONS For 15 weeks the subjects in the fish diet group ate 4.3 +/- 0.5 fish containing meals per week and those in the fish oil and DHA-oil groups ate 4 g oil per day. Fish diet provided 0.38 +/- 0.04 g eicosapentaenoic acid (EPA) and 0.67 +/- 0.09 g DHA, fish oil 1.33 g EPA and 0.95 g DHA and DHA-oil (EPA-free) 1.68 g DHA per day. RESULTS Fasting plasma triglyceride levels decreased in all test groups in 14 weeks when compared to the control group (P < 0.05). Total plasma cholesterol levels did not change but the HDL2/HDL3-cholesterol ratio increased in all test groups by over 50% (P < 0.05). The postprandial total and chylomicron triglyceride responses, measured as areas under the response curve, were lowered in 15 weeks by the fish diet and fish oil (P < 0.05), the same tendency (P < 0.1) being seen in DHA-oil group. CONCLUSIONS These results show that both fasting and postprandial triglyceride concentrations can be decreased with moderate intakes of long-chain n-3 fatty acids either from a fish diet or fish oil and that also pure DHA has a hypotriglyceridemic effect.

Evaluation of multiple frequency bioelectrical impedance and Cole-Cole analysis for the assessment of body water volumes in healthy humans

Abstract: OBJECTIVE: To assess the application of a Cole-Cole analysis of multiple frequency bioelectrical impedance analysis (MFBIA) measurements to predict total body water (TBW) and extracellular water (ECW) in humans. This technique has previously been shown to produce accurate and reliable estimates in both normal and abnormal animals. DESIGN: The whole body impedance of 60 healthy humans was measured at 496 frequencies (ranging from 4 kHz to 1 MHz) and the impedance at zero frequency, Ro, and at the characteristic frequency, Zc, were determined from the impedance spectrum, (Cole-Cole plot). TBW and ECW were independently determined using deuterium and bromide tracer dilution techniques. SETTING: At the Dunn Clinical Nutrition Centre and The Department of Biochemistry, University of Queensland. SUBJECTS: 60 healthy adult volunteers (27 men and 33 women, aged 18-45 years). RESULTS: The results presented suggest that the swept frequency bioimpedance technique estimates total body water, (SEE = 5.2%), and extracellular water, (SEE = 10%), only slightly better in normal, healthy subjects than a method based on single frequency bioimpedance or anthropometric estimates based on weight, height and gender. CONCLUSIONS: This study has undertaken the most extensive analysis to date of relationships between TBW (and ECW) and individual impedances obtained at different frequencies ( > 400 frequencies), and has shown marginal advantages of using one frequency over another, even if values predicted from theoretical bioimpedance models are used in the estimations. However in situations where there are disturbances of fluid distribution, values predicted from the Cole-Cole analysis of swept frequency bioimpedance measurements could prove to be more useful.

Vitamin D deficiency in veiled Kuwaiti women.

Abstract: OBJECTIVE To study vitamin D deficiency in veiled Kuwaiti women. DESIGN Prospective on cases and volunteers. SETTING The medical department in a general hospital in Kuwait serving about 300000 persons (Adan Hospital). SUBJECTS The authors saw four cases of unexplained vitamin D deficiency osteomalacia in otherwise healthy veiled Kuwaiti women. This stimulated us to study 50 veiled volunteer Kuwaiti women aged between 14 and 45 years old who had three children or less, and 22 unveiled volunteer Kuwaiti women with matched age and number of children as control. INTERVENTIONS Blood samples were taken to check levels of 25-hydroxy cholecalciferol, calcium, phosphorus and alkaline phosphatase. Blood urea, serum creatinine, serum bilirubin, serum alanine transaminase, serum aspartate transaminase, serum lactic dehydroginase, prothrombin time, urine for proteins and pH were checked to exclude renal and hepatic disease. RESULTS showed subclinical vitamin D deficiency among veiled women and two cases of clinically overt osteomalacia were discovered among the veiled volunteers suggesting a high prevalence of the disease among veiled Kuwaiti women.

The relationship between arm-span measurement and height with special reference to gender and ethnicity.

Abstract: OBJECTIVE The relationship between height and arm-span measurement in both sexes and different ethnic groups was studied in order to assess the use of the arm-span measurement as a suitable proxy indicator for height. SETTING School of Biological and Molecular Sciences, Oxford Brookes University. SUBJECTS Five hundred and fifty-three subjects (272 male and 281 female) aged 23.3 years (s.d. 5.5). RESULTS Correlation coefficients (r = 0.73-0.89) indicated a clear association between arm-span measurements and height in all groups. However, arm-span was found to be significantly different (P < 0.01) from height in two ethnic groups, the Afro-Caribbean's of both sexes and Asian males. This suggests that arm-span measurements may be an inappropriate proxy for height in certain populations. CONCLUSION The arm-span measurement and height relationship is significantly different in Afro-Caribbean and Asian males. This suggests that any future studies attempting to use arm-span measurement as a proxy for height must consider these ethnic differences.

Effects of short-term exercise on appetite responses in unrestrained females.

Abstract: OBJECTIVE To examine the short-term effects of exercise and diet composition on appetite in unrestrained females. DESIGN A 2 x 2 repeated measures design study was conducted, with exercise and lunch type as the repeated factors. SETTING The Human Appetite Research Unit at Leeds University Psychology department. SUBJECTS 13 unrestrained, normal weight females were recruited from the student and staff population of Leeds University. INTERVENTIONS Subjects were assigned to four experimental treatments in a counterbalanced order. These were a control (no-exercise) session and an intense (70% VO2 max) exercise session followed by a free-selection test lunch consisting of high-fat/low-carbohydrate or low-fat/high-carbohydrate foods. The effects of exercise and lunch type were measured by monitoring energy intake and macronutrient intake during the test lunches only. Visual analogue scales were used to monitor profiles of motivation to eat during the treatments. RESULTS Subjects did not experience the marked suppression of hunger induced by exercise, which is a striking and robust finding in men. Moreover, unlike men, females rated a range of foods to be more palatable after exercise (F(1,12) = 8.0, P < 0.05). Similar to male subjects, exercise in females had no significant short-term effect on energy or macronutrient intake. Energy intake was significantly influenced by the fat:carbohydrate composition of the foods available (F(1,12) = 64.7, P < 0.001), and the short-term energy deficit induced by exercise when followed by low-fat lunch was completely wiped out when exercise was followed by a high-fat lunch (F(1,12) = 66.2, P < 0.001). CONCLUSIONS These results show that there are similarities and differences between males and females in the appetite response to foods varying in macronutrient composition following vigorous exercise. The differences may help to explain why exercise so often produces a disappointing effect on weight control in females.

Effects of Bifidobacterium sp fermented milk ingested with or without inulin on colonic bifidobacteria and enzymatic activities in healthy humans.

Abstract: OBJECTIVE To assess in healthy humans the effects of prolonged ingestion of Bifidobacterium sp fermented milk (BFM) with or without inulin on fecal bifidobacteria and some bacterial enzymatic activities. DESIGN Twelve volunteers randomly divided into two groups were studied for three consecutive periods. During the ingestion period, they received BFM in association with ether 18g/d inulin or placebo in three oral doses for 12 days. Stools were regularly collected for bacteriological analysis. SETTING Clinical Nutrition Unit, Hopital Saint-Lazare, Paris. RESULTS The administration of BFM with placebo led to an increase in total bifidobacteria (indigenous and exogenous) (P < 0.01) and exogenous bifidobacteria (P < 0.01) and a decrease in beta-glucuronidase activity (P < 0.01). Simultaneous administration of BFM and inulin led to an increase in total bifidobacteria (P < 0.01) and exogenous bifidobacteria (P < 0.01), but had no effect on beta-glucuronidase activity. No differences were found for fecal concentrations reached by exogenous and indigenous bifidobacteria between the two groups. Administrated alone or with inulin, BFM did not change fecal total anaerobe counts, pH, nitrate reductase, nitroreductase and azoreductase activities. CONCLUSIONS Administration of BFM substantially increases the proportion of bifidobacteria in the colonic flora, but the concurrent administration of inulin does not enhance this effect.

Effects of moderate consumption of red wine on platelet aggregation and haemostatic variables in healthy volunteers.

Abstract: Objective To evaluate the effect of moderate consumption of red wine on platelet aggregation and haemostatic variables, discriminating the effect of alcohol from that of non-alcoholic components. Design A randomised crossover study. Setting The Department of Food Science and Technology, University of Milan. Subjects Eleven healthy male volunteers who were moderate drinkers. Interventions For three periods of four weeks, subjects drank three different beverages [320 ml of red wine (providing 30 g/day of alcohol), 30 g/day of alcohol diluted in 320 ml of clear fruit juice or 320 ml of dealcoholised red wine] during the two main meals. Each treatment was preceded by a period of four weeks of complete withdrawal from any alcoholic beverage. At the end of each period platelet aggregation after collagen and ADP stimulus, and levels of fibrinogen, plasminogen, tissue-type plasminogen activator (t-PA) antigen and von Willebrand factor (vWF) were determined. Results Consumption for a period of four weeks of 30 g/day of alcohol either from red wine or alcohol resulted in similar decreases of collagen-induced platelet aggregation and fibrinogen levels. ADP-induced platelet aggregation, t-PA antigen, vWF and plasminogen levels were not affected by any treatment. No differences were detected when we compared platelet function and the other haemostatic variables at the end of red wine and dealcoholised treatments with findings at the end of alcohol treatment and abstinence. Conclusions The well known positive effect of moderate consumption of red wine on haemostasis seems due to alcohol and not to the non-alcoholic fraction present in red wine.

Evaluation of a food frequency questionnaire used to assess nutrient intakes in pregnant women.

Abstract: Objective To compare nutrient intakes assessed by food frequency questionnaire (FFQ) with those determined from food diaries. Design A 100-item FFQ was administered to women at 15 weeks of pregnancy. Food diaries were kept for a 4-day period at 16 weeks of pregnancy. Setting Community-based study of a general population sample of pregnant women booked for delivery at the Princess Anne Maternity Hospital, Southampton, UK. Subjects 603 women were recruited. Complete dietary data were provided by 569 women. Results Nutrient intakes determined by FFQ were greater than those from food diaries. Spearman rank correlation coefficients for macronutrients ranged from 0.27 (protein and starch) to 0.37 (fat). Stronger correlations for energy, fat and carbohydrate were seen in women who did not experience nausea, suggesting that the level of agreement observed between the FFQ and food diary in the whole group may be an underestimate of the true agreement. The percentage of individuals classified to the same quarter of the distribution of nutrient intake by the FFQ and diaries ranged from 30% (starch) to 41% (calcium), with between 4% (riboflavin) and 8% (energy, protein and vitamin E) classified to the opposite quarters. Using serum vitamin C as an independent biomarker of intake, the percentage of individuals classified to the correct quarter of intake was similar for the FFQ and diary (34% and 37%), with 8% (FFQ) and 6% (diary) misclassified to the opposite quarter. Conclusion The FFQ appears to give meaningful estimates of nutrient intake in early pregnancy which can be used to rank individuals within the distribution.

Interrelationships among postprandial satiety, glucose and insulin responses and changes in subsequent food intake.

Abstract: Objective The aim of this study was to investigate whether postprandial glucose and insulin responses were related to concurrent changes in satiety. Design Thirty-eight common foods, grouped into six food categories, were tested in total. Each food category was fed to a separate group of subjects. A within-subjects repeated-measures design was used such that within each food category each subject consumed all of the test foods in random order. Setting The study was conducted at the Human Nutrition Research Unit, Sydney University. Subjects Separate groups of 11-13 healthy young subjects, who were unrestrained eaters, were recruited for each of the six food categories. Interventions Isoenergetic 1000 kJ (240 kcal) portions of the test foods were fed to fasting subjects. Fingerprick blood samples and satiety ratings were obtained every 15 min over 120 min after which a standard meal was presented and ad libitum food intake was recorded. A glycaemic score, insulin index and satiety index score was calculated for each food by dividing the area under the 120 min response curve (AUC) for the test food by the AUC for white bread and multiplying by 100. Expressing the results of the test foods relative to those for white bread minimised the confounding influence of inherent differences between the subjects. Results Among the 38 test foods, there were no significant relationships between satiety and plasma glucose or insulin responses. However, a negative correlation was found between insulin AUC responses and ad libitum food intake at 120 min which suggests that test foods producing a higher insulin response within 120 min were associated with less food intake and thus indirectly greater satiety. This result is consistent with previous findings that carbohydrate-rich foods are more satiating than fat-rich foods. Thus, total carbohydrate content appears to have been a stronger determinant of short-term satiety, in conjunction with the foods structural characteristics, than the foods glycaemic impact. Conclusions The total amount of carbohydrate consumed at a meal and subsequent insulinaemia may partly determine the degree of hunger arising within the next 2 h.

High and low fat consumers, their macronutrient intake and body mass index: further analysis of the National Diet and Nutrition Survey of British Adults.

Abstract: OBJECTIVES To explore the different characteristics of high and low fat consumers, in particular their macronutrient intake and body mass index DESIGN Reanalysis of data from the Dietary and Nutritional Survey of British Adults Comparisons were made between groups defined as high and low fat consumers on the basis of 7-day weighed food records considered to be valid for energy intake Individuals were classified in two ways according to the percentage energy from fat (FAT%) and the absolute amount of fat consumed (FATg) The criteria for classification of the high FAT% being > 45% (high fat) and 138 g/day (men) and > 102 g/day (women), and for the low fat group < 85 g/day (men) and < 70 g/day (women) SETTING Dietary data was collected from private households in Great Britain between 1986 and 1987 SUBJECTS From the total population of 2197, individuals who were slimming, ill or had an EI: BMR of < 12 were excluded in order to use data which was most likely to represent habitual energy intakes From the remaining 1240 subjects, 108% of this sample (61% of the total population) were classified as low fat consumers (76 men and 58 women) and 154% high fat (87% of the total population, 93 men and 98 women) MAIN OUTCOME MEASURES Macronutrient consumption and body mass index (BMI) RESULTS 30% of the subjects changed fat group classification when the criteria of defining high and low fat groups altered from FAT% to FATg Nutrient intakes differed according to definition of the groups The high fat FATg group ate significantly more of all nutrients than the low fat FATg group However, this was not seen for the FAT% analysis, with the high fat group eating more fat and less carbohydrate The average BMI tended to be higher in the high fat than the low fat groups, particularly in the FATg analysis However, the high fat group contained a wide range of BMIs Further exploration of BMI in the high fat groups, showed that age (an 11-year difference) was the only variable to distinguish individuals in the top and bottom quartiles of BMI CONCLUSIONS High and low fat consumers differ according to a number of variables, and this is affected by how these groups are defined (FAT% or FATg) High fat consumers tend to have a higher BMI than low fat consumers, but not all high fat consumers are overweight or obese

The Malmö Food Study: the relative validity of a modified diet history method and an extensive food frequency questionnaire for measuring food intake.

Abstract: Objective: To assess the relative validity of two diet assessment methods, an extensive quantitative food frequency questionnaire (method A) and a novel shorter quantitative food frequency questionnaire with a 14 day food record (method B). Design: A randomized prospective cohort study. Setting: General community. Subjects: 206 residents of the town of Malmo, aged between 50-69 years, 101 men and 105 women who completed the methods during one year. Methods: Both diet methods were designed to cover the whole diet and portion sizes were estimated using a booklet with 120 photographs; method A comprised 250 items and method B combined a two-week food record measuring lunch and dinner meals and a shorter 130 item quantitative food frequency questionnaire for average consumption of foods, snacks and beverages during the past year. An 18 day dietary record comprising six 3-day weighed records evenly distributed over one year served as a reference method. Results: Pearson's correlation coefficients varied from 0.25 for fat intake to 0.84 for milk products for method A and from 0.32 for fish to 0.88 for meat for method B. Correlations for most food groups ranged between 0.50-0.80, and were higher for method B. Only small changes were noted after adjustment for energy intake. On average for most food groups categorization of subjects into quartiles, 55% of subjects belonging to the lowest quartile, and 57-59% of those belonging to the highest quartile for method A and B were correctly classified. Conclusion: A combined food record with a quantitative food frequency questionnaire is a better tool for food assessment than an extensive food frequency questionnaire. Sponsorship: This study was supported by the Swedish Medical Research Council (K84-19X-7010-01) and the International Agency for Research on Cancer (Collaborative Research Agreement DEB/85/43). (Less)

Twenty-four-hour energy expenditure and urinary catecholamines of humans consuming low-to-moderate amounts of medium-chain triglycerides: a dose-response study in a human respiratory chamber

Abstract: OBJECTIVE To determine whether medium-chain triglycerides, in low-to-moderate amounts consumed with meals (at breakfast, lunch and dinner), can increase daily energy expenditure (EE) and 24-h urinary excretion of catecholamines in humans. DESIGN Dose-response study conducted under double-blind randomised design. SETTING Respiratory chamber at the Faculty of Medicine, University of Geneva. SUBJECTS Eight healthy young men were recruited from the student population by advertisement in our Faculty. METHODS 24-h EE and urinary catecholamines were measured in each subject during stay in a respiratory chamber on four separate occasions. These were randomised between four different combinations of medium-chain triglycerides (MCT) and long-chain triglycerides (LCT), a total 30g/day, which was consumed with their habitual diet in three equal parts (10g each) at breakfast, lunch, and dinner in the following ratio of MCT: LCT (g/g) 0:30, 5:25, 15:15 and 30:0. RESULTS 24-h EE increased significantly with increasing MCT:LCT ratio (ANOVA, P < 0.001), with the diet providing a total of 15-30 g MCT per day stimulating 24-h EE by 5%: this corresponds to a mean absolute increase in daily EE of approximately 500kJ, with individual values varying between 268 kJ and 756 kJ. No significant differences were observed in respiratory quotient nor in urinary nitrogen losses across diets, but 24-h urinary noradrenaline was significantly increased (ANOVA, P < 0.025), whereas adrenaline and dopamine were unaltered. CONCLUSIONS This study suggests that relatively low-to-moderate intake of MCT (15-30 g per day) as part of habitual diet may play a role in the control of human body composition by enhancing daily EE, and that this effect is mediated at least in part through activation of the sympathetic nervous system.

Long-term (6 months) effect of a new fermented milk product on the level of plasma lipoproteins--a placebo-controlled and double blind study.

Abstract: OBJECTIVE We have recently demonstrated a short-term hypocholesterolemic effect (reduction of 8-10%) of a new fermented milk product taken for 6 weeks (Agerbaek et al, 1995; Richelsen et al, 1993). The present study was undertaken to investigate the more long-term (6 months) effect of this fermented product on the level of lipoproteins. DESIGN The study was randomized, double-blind, and placebo-controlled, and performed for a period of six months. SUBJECTS Eighty-seven non-obese and normocholesterolemic females and males, aged 50-70 y old, were included in the study. INTERVENTION 200 ml of either the fermented milk product or placebo (chemically fermented) were given daily. The test product was fermented with a bacteria culture containing Enterococcus faecium and two strains of Streptococcus termophilus. RESULTS After one month the total- and LDL-cholesterol were significantly reduced in the fermented milk group as compared to placebo, LDL was reduced by 0.21 mmol/l vs 0.0 mmol/1 (P < 0.02). The maximal reduction of LDL-cholesterol was reached after 3 months in the test group with a reduction of 0.32 mmol/1 of initial values (P < 0.001). In the placebo group a gradual fall of total- and LDL-cholesterol was observed from 1-6 months of the study. Thus, after six months the reduction of LDL-cholesterol was similar in the two groups (P = 0.95) even though the reduction was significant in both groups in relation to initial values (P < 0.05). No changes in HDL-cholesterol or triglyceride were observed during the study. There were no differences in the response between women and men. CONCLUSION The fermented milk product resulted in a rapid reduction of LDL-cholesterol observed after one month but during long-term intake (6 months) the reduction of LDL-cholesterol was similar to the placebo product, indicating that low-fat milk or fermented milk products may have some hypocholesterolemic effects but the present tested product does not seem to be superior in that respect to the placebo milk product used in the present study.