It has been estimated that up to one-third of patients with diabetes mellitus use some form of complementary and alternative medicine. Momordica charantia (bitter melon) is a popular fruit used for the treatment of diabetes and related conditions amongst the indigenous populations of Asia, South America, India and East Africa. Abundant pre-clinical studies have documented the anti-diabetic and hypoglycaemic effects of M. charantia through various postulated mechanisms. However, clinical trial data with human subjects are limited and flawed by poor study design and low statistical power. The present article reviews the clinical data regarding the anti-diabetic potentials of M. charantia and calls for better-designed clinical trials to further elucidate its possible therapeutic effects.

Meta-analysis was applied to quantify the effect of replacement of fish meal by soyabean products in diets on fish growth. Measurement of growth in different units among studies required the use of a standardised effect size (Hedges' d). From a total of ninety-nine studies concentrating on fish meal replacement by defatted soyabean meal, 53 % were eliminated due to, among others, absence of a fish meal control diet (n 18), or no statistical differences or measurement of dispersion (n 6) indicated. Replacement of 4 to 40 % fish meal by soyabean meal (inclusion levels of 71–366 g/kg) resulted in a mean effect size of − 0·1142 (95 % CI − 0·4665, 0·2382) obtained in forty-eight comparisons evaluated with seventeen different fish species. However, at higher fish meal replacement levels the 95 % CI calculated for combined effect sizes did not overlap with zero. With soya protein concentrate replacing 25 to 100 % of fish meal in diets for seven fish species, methionine supplementation (mean − 2·4373 (95 % CI − 3·9004, − 0·9742); n 10) did not have a substantial influence on the magnitude of cumulative effect sizes relative to no supplementation (mean − 2·7306 (95 % CI − 3·7991, − 1·6620); n 16). Information on other soyabean products (full-fat soyabeans, soya flour) used as protein sources in fish diets was found as too limited for analysis and definite conclusions. The present study contributes by putting a numerical value to the magnitude of growth differences in fish when replacing dietary fish meal by soyabean products.

The diet consumed by urban residents in modern China has become rich in saturated fats and cholesterol. In addition, the diet is high in carbohydrates from white rice and processed wheat starch. The aim of the present study was to determine the effects of replacing white rice and processed wheat starch with wild rice (WR) as the chief source of dietary carbohydrates. Rats fed with the diet patterned after the diet consumed by city residents of modern China showed elevated serum lipid levels comparable with rats consuming a high fat/cholesterol diet known to induce hyperlipidaemia in this species. Meanwhile, rats consuming the city diet with WR as the carbohydrate source suppressed the increase in serum TAG and total cholesterol, and the decrease in HDL cholesterol level. In addition, the rats fed the WR diet suppressed the build-up of oxidative stress by improving antioxidant capacity, increasing superoxide dismutase activity and reducing malondialdehyde concentration, both in the serum and liver. These findings illustrate that WR is effective in suppressing hyperlipidaemia and oxidative stress in rats even when the diet consumed is high in fat and cholesterol.

High postprandial lipaemia increases cardiovascular risk. Algae consumption may affect postprandial lipoproteinaemia. The effects of dietary alga and cholesterol supplementation on postprandial lipaemia and lipoproteinaemia and arylesterase (AE) activity in growing male Wistar rats were tested in the present study. Six groups of ten rats were fed a casein-based diet for 3 weeks. Three of the diets contained 2·4 % cholesterol-raising agent (Chol), while the other three did not (NChol). Seven percentage of the control diets (NChol-C and Chol-C) consisted of a cellulose–wheat starch mix (35:65), while the Nori alga diets (NChol-N and Chol-N) and Konbu diets (NChol-K and Chol-K) contained 7 % of each respective freeze-dried alga. Postprandial plasma was obtained after a 3 h diet withdrawal. Supplementary cholesterol and alga type significantly affected (at least P < 0·05) the cholesterol, TAG, phospholipid and protein contents of the various lipoprotein fractions. AE enzyme activity increased (P < 0·05) in NChol rats given Nori and Konbu diets. NChol-K, but not NChol-N, rats displayed higher (P < 0·05) plasma cholesterol, TAG and phospholipid levels than NChol-C animals. NChol-K rats presented higher TAG, phospholipid, protein and lipoprotein mass values than their NChol-C counterparts. Inclusion of algae in Chol diets decreased (P < 0·001) the postprandial hypertriacylglycerolaemia. The Chol-N diet affected most lipoprotein fraction contents. Chol-N rats had lower postprandial cholesterolaemia and a better lipoprotein profile (fewer LDL and a tendency toward more HDL and fewer cholesterol-enriched VLDL) than Chol-K rats, suggesting that Nori is the alga of choice in dietary treatment of hypercholesterolaemia.

Rapeseed oil (RSO) is a novel source of plant sterols, containing the unique brassicasterol in concentrations higher than allowed for plant sterol blends in food products in the European Union. Effects of RSO sterols and stanols on aortic atherosclerosis were studied in cholesterol-fed heterozygous Watanabe heritable hyperlipidaemic (Hh-WHHL) rabbits. Four groups (n 18 per group) received a cholesterol-added (2 g/kg) standard chow or this diet with added RSO stanol esters (17 g/kg), RSO stanol esters (34 g/kg) or RSO sterol esters (34 g/kg) for 18 weeks. Feeding RSO stanol esters increased plasma campestanol (P < 0·001) and sitostanol (P < 0·001) and aortic campestanol (P < 0·05) compared with controls. Feeding RSO sterol esters increased concentrations of plasma campesterol (P < 0·001), sitosterol (P < 0·001) and brassicasterol (P < 0·001) and aortic campesterol (P < 0·01). Significantly lower plasma cholesterol (P < 0·001) was recorded in the treated groups after 3 weeks and throughout the study. LDL-cholesterol was reduced 50 % in the high-dose RSO sterol ester (P < 0·01) and high-dose RSO stanol ester (P < 0·001) groups compared with controls. Atherosclerotic lesions were found in three rabbits in each of the RSO stanol ester groups and in one in the RSO sterol ester group. Aortic cholesterol was decreased in the treated groups (P < 0·001) in response to lowering of plasma cholesterol induced by RSO sterol and stanol esters. In conclusion, RSO stanol and sterol esters with a high concentration of brassicasterol were well tolerated. They were hypocholesterolaemic and inhibited experimental atherosclerosis in cholesterol-fed Hh-WHHL rabbits. A significant uptake of plant sterols into the blood and incorporation of campesterol and campestanol into aortic tissue was recorded.

The suitability of the pig as an animal model for predicting protein digestibility in man was evaluated. Healthy adult human subjects (mean body weight 67 kg; n 11) and growing pigs (mean body weight 40 kg; n 15) were fed semi-synthetic mixed meals containing, as a sole source of N, casein (C), hydrolysed casein (HC) or rapeseed isolate (R). There was no prior adaptation to the test meal. Ileal digesta were sampled through a naso-ileal tube (human subjects) or a post-valve T-caecum cannula (pigs) after ingestion of a bolus meal. The protein sources were 15N-labelled. Amino acid (AA) digestibilities were not determined for R. Ileal apparent N digestibility was markedly lower (14–16 %; P < 0·001) in human subjects than in pigs (C, HC, R). Similarly, most apparent ileal AA digestibilities were lower (8 % on average; P < 0·05) in human subjects (C, HC). Ileal true N digestibility was slightly lower (3–5 %; P < 0·001) in human subjects than in pigs (C, HC, R) and most true ileal AA digestibilities were similar (P>0·05) between the species (C, HC). Exceptions were for phenylalanine, tyrosine, lysine, histidine and aspartic acid for which digestibilities were lower (3 % on average; P < 0·001) in human subjects. A similar ranking of the diets was observed for true ileal N digestibility between species. The inter-species correlation for true ileal digestibility was high for N (r 0·98 over 3 × 2 data; P = 0·11) and AA (r 0·87 over 26 × 2 data; P < 0·0001). Overall, this supports the use of the pig as a model for predicting differences among dietary protein digestibility, especially regarding true ileal N digestibility, in man.

The effects of dietary capsanthin, the main carotenoid in paprika (Capsicum annuum), on lipid metabolism were examined. Young male Wistar rats were fed diets containing paprika powder, paprika organic solvent extract, residue of paprika extract, and purified capsanthin. Administration of purified capsanthin for 2 weeks resulted in a significant increase in plasma HDL-cholesterol (P < 0·05) without detectable differences in plasma total cholesterol and TAG concentrations. A statistically significant correlation (r 0·567; P < 0·001) was found between dietary capsanthin concentrations and plasma HDL-cholesterol concentrations. Animals receiving diets containing two different capsanthin concentrations exhibited dose-dependent increases in plasma HDL-cholesterol (r 0·597; P < 0·005). While capsanthin was absent in the liver of animals fed the basal diet, it increased markedly in capsanthin-fed animals (P < 0·001). Quantitative analyses of hepatic mRNA levels revealed that capsanthin administration resulted in up-regulation of mRNA for apoA5 and lecithin cholesterol acyltransferase (LCAT), without significant differences in other mRNA levels related to HDL-cholesterol metabolism. These results suggest that capsanthin had an HDL-cholesterol-raising effect on plasma, and the potential to increase cholesterol efflux to HDL particles by increasing apoA5 levels and/or enhancement of LCAT activity.

The present study was planned to investigate the protective effect of 10 % and 20 % apricot-containing feed on carbon tetrachloride (CCl4)-induced hepatic steatosis and damage. Adult male Wistar rats (n 42) were divided into six groups of seven each, as follows: control group; CCl4 group; CCl4+10 % apricot group; CCl4+20 % apricot group; 10 % apricot group; 20 % apricot group. All apricot groups were fed with 10 % or 20 % apricot-containing feed for 5 months. CCl4 injections were applied to the CCl4 groups at the dose of 1 mg/kg for 3 d at the end of 5 months. In the CCl4 group, vacuolated hepatocytes and hepatic necrosis were seen, especially in the centrilobular area. Hepatocytes showed an oedematous cytoplasmic matrix, large lipid globules and degenerated organelles. The area of liver injury was found significantly decreased with apricot feeding. Malondialdehyde and total glutathione levels and catalase, superoxide dismutase and glutathione peroxidase activities were significantly changed in the CCl4 group and indicated increased oxidative stress. Apricot feeding decreased this oxidative stress and ameliorated histological damage. We concluded that apricot feeding had beneficial effects on CCl4-induced liver steatosis and damage probably due to its antioxidant nutrient (β-carotene and vitamin) contents and high radical-scavenging capacity. Dietary intake of apricot can reduce the risk of liver steatosis and damage caused by free radicals.

Gambian infants show growth faltering, but the underlying body composition is unknown. The present study aimed to compare body composition in Gambian and UK infants using 2H dilution; and to evaluate accuracy of bioelectrical impedance analysis (BIA) and creatinine excretion for estimating lean mass (LM), using 2H as the reference. Body composition was measured in thirty Gambian infants, aged 3–18 months, using (1) anthropometry, (2) 2H, (3) BIA (equation of Fjeld et al.Pediatr Res (1990), 27, 98–102) and (4) 5 h urinary creatinine excretion. Compared with UK reference data, Gambian infants were light, short and had reduced BMI and skinfolds. The subscapular skinfold standard deviation score (SDS) was greater than the triceps SDS (P < 0·01), indicating central fat preservation. Both LM and fat mass were reduced in Gambian infants, with or without adjustment for length. However, whereas the Gambia–UK difference in LM increased with age, that in fat mass decreased. Average creatinine excretion was similar to that expected (95·5 (sd 23·2) % recovery), but LM estimates showed unacceptable error in individuals. BIA using Fjeld's equation overestimated total body water and LM (P < 0·001), hence a new equation was developed, with standard error of 0·47 kg LM. In conclusion, Gambian infants characterised by growth faltering had LM deficits that increased with age. However, adiposity increased with age, and showed indications of a more central distribution than in the reference infants. A new BIA equation for LM prediction is presented; however, creatinine excretion is not recommended for LM estimation in this population.

Homocysteine has been related to increased risk of CVD. Matrix degradation and inflammation may be involved in this link between hyperhomocysteinaemia and CVD. Recent studies suggest that cystatin C can modulate matrix degradation and inflammation. The present study measured cystatin C at protein (plasma) and mRNA levels (peripheral blood mononuclear cells (PBMC)) in hyperhomocysteinaemic individuals (n 37, female seven and male thirty, aged 20–70 years) before and after B-vitamin supplementation for 3 months in a randomised, placebo-controlled double-blind trial. In a cross-sectional study, seventeen of the hyperhomocysteinaemic subjects were age- and sex-matched to healthy controls (n 17). Our main findings were: (i) as compared with controls, hyperhomocysteinaemic subjects tended to have higher plasma concentrations of cystatin C and lower mRNA levels of cystatin C in PBMC; (ii) compared with placebo, treatment of hyperhomocysteinaemic individuals with B-vitamins significantly increased plasma levels of cystatin C and mRNA levels of cystatin C in PBMC; (iii) while plasma levels of cystatin C were positively correlated with plasma levels of TNF receptor-1, mRNA levels of cystatin C in PBMC were inversely correlated with this TNF parameter. Taken together, our findings suggest that disturbed cystatin C levels may be a characteristic of hyperhomocysteinaemic individuals, potentially related to low-grade systemic inflammation in hyperhomocysteinaemic subjects, and that B-vitamins may modulate cystatin C levels in these individuals.

The health benefits of green tea (Camellia sinensis) catechins are becoming increasingly recognised. Amongst the proposed benefits are the maintenance of endothelial function and vascular homeostasis and an associated reduction in atherogenesis and CVD risk. The mounting evidence for the influential effect of green tea catechins on vascular function from epidemiological, human intervention and animal studies is subject to review together with exploration of the potential mechanistic pathways involved. Epigallocatechin-3-gallate, one of the most abundant and widely studied catechin found in green tea, will be prominent in the present review. Since there is a substantial inconsistency in the published data with regards to the impact of green tea catechins on vascular function, evaluation and interpretation of the inter- and intra-study variability is included. In conclusion, a positive effect of green tea catechins on vascular function is becoming apparent. Further studies in animal and cell models using physiological concentrations of catechins and their metabolites are warranted in order to gain some insight into the physiology and molecular basis of the observed beneficial effects.

The amount and the type of dietary protein could play a role in determining the quantity of skeletal muscle mass. The aim was to examine the relationship between the type of protein intake and the level of muscle mass in healthy omnivorous and vegetarian Caucasian women. The design of the present study was an observational and cross-sectional study. Twenty-one omnivores (Om) and nineteen vegetarians (Ve) were recruited. Muscle mass index (urinary creatinine), dietary intake (5 d dietary records) and biochemical analyses (hormone, phyto-oestrogen and lipid profiles) were obtained. We found differences between groups for muscle mass (Ve: 18 kg v. Om: 23 kg; P = 0·010), muscle mass index (Ve: 6·7 kg/m2v. Om: 8·3 kg/m2; P = 0·002), animal protein intake in g/d (P = 0·001) and in g/kg body weight per d (P = 0·003), plant protein intake in g/d (P = 0·015) and in g/kg body weight per d (P = 0·007), the animal:plant protein intake ratio (P = 0·001) and sex hormone-binding globulin (SHBG) (P = 0·001). Muscle mass index still correlated with animal protein intake in g/d (P = 0·001) and in g/kg body weight per d (P = 0·008), and the animal:plant protein intake ratio (P = 0·007) even after controlling for SHBG and plant protein intake. Finally, animal protein intake (g/d) was the independent predictor of muscle mass index (adjusted r2 0·42). Thus, a vegetarian diet is associated with a lower muscle mass index than is an omnivorous diet at the same protein intake. A good indicator of muscle mass index in women seems to be animal protein intake.

n-3 PUFA have well-recognised cardio-beneficial effects. In contrast, premature coronary deaths are associated with consumption of high levels of trans-fatty acids (TFA). The present study determined the effects of n-3 PUFA and TFA on sudden cardiac death and vascular inflammation. A rat coronary ligation model was used to study the effect of fatty acids on sudden cardiac death, whereas a mouse femoral artery ligation model was used to study compensatory vascular remodelling. Human aortic endothelial cells (HAEC) were utilised for the in vitro studies to investigate expression of inflammatory molecules. Feeding animals an n-3 PUFA-enriched diet caused a sevenfold increase in plasma n-3 PUFA compared with that of the TFA-fed group, whereas a TFA-enriched diet caused a 2·5-fold increase in plasma TFA compared with the n-3 PUFA group. Animals on a TFA diet had a lower survival rate due to sudden cardiac death and exhibited variable degrees of aortic atherosclerotic lesions. Animals on a TFA diet had diminished hindlimb collateral growth, whereas animals on the n-3 PUFA diet exhibited extensive collateral growth about ligated regions. HAEC treated with TFA (trans-18 : 2) showed significantly increased expression of intracellular adhesion molecule-1 and nitrosylation of cellular proteins than those treated with DHA (n-3 PUFA, 22 : 6). The in vivo study demonstrates that, in contrast to TFA, n-3 PUFA improve animal survival after myocardial infarction, prevent development of atherosclerotic lesions and stimulate compensatory vascular remodelling. The in vitro study demonstrates that TFA induce, while n-3 PUFA prevent, vascular inflammation.

The present study aimed at comparing the anthropometric profile of Asian Indian adolescents from Guadeloupe with that of their island counterparts. A total of 720 voluntary 11- to 17-year-old students participated: 180 Asian Indians and 540 age- and sex-matched students of other origin. Weight and height were measured to calculate the BMI. Waist and hip circumferences and bicipital, tricipital, subscapular and supra-iliac skinfold thicknesses were assessed. The percentage of body fat was estimated by bioelectrical impedance analysis. Obesity was defined from BMI according to the International Obesity Task Force recommendations. Asian Indians were smaller and lighter than their counterparts. They had a higher body fat percentage even after adjustment on BMI but the prevalence of obesity did not differ, with an overall prevalence of 5·69 (95 % CI 5·67, 5·71) %. No principal effects of ethnicity on waist and hip circumferences or the waist:hip ratio were evidenced. The sum of the four skinfold thicknesses was the strongest predictor of body fat percentage, and the adjustment of overall body fat on subcutaneous fat cancelled the effect of ethnicity on this dependent variable. The present study found that Asian Indian adolescents from Guadeloupe had the same tendency toward higher body fat and body fat-for-BMI as previously documented in Asian Indian adults. It raises the hypothesis of a higher cardiovascular risk in this ethnic group from adolescence and questions the validity of using common BMI references for screening obesity in multiethnic communities.

Excessive gestational weight gain and postpartum weight retention are risk factors for female obesity. The present study was to examine dietary intakes and weight history from a prospective follow-up study from early pregnancy to 1 year postpartum. A total of 151 pregnant women within 20 weeks of pregnancy in Taipei, Taiwan were interviewed periodically to collect dietary and lifestyle information. The participants had an average age of 30 years and the average gestational weight gain was 14 kg, with an average daily intake of 7830 kJ (1870 kcal) in the 1 year following parturition. By bivariate analyses, maternal age, pre-pregnancy BMI and breast-feeding were not related to postpartum weight retention, but gestational weight gain had significant positive correlations (r 0·54 at 6 months, r 0·44 at 1 year; P < 0·05). The generalised estimating equations showed that the average weight before pregnancy, at 6 months and 1 year postpartum was 53·35 kg, 55·75 kg (weight retention 2·36 kg; P < 0·01) and 54·75 kg (weight retention 1·48 kg; P < 0·01), respectively. After controlling for age, pre-pregnancy BMI, gestational weight gain and parity, we found at 6 months that the adjusted weight retention at postpartum was 0·79 kg (P < 0·01), but at 1 year it was − 0·08 kg (P>0·05). From multivariate analyses, dietary energy intake and energy intake per kg body weight as a long-term physical activity index could explain 24 % of the variation at 6 months and 27 % of the variation at 1 year in postpartum weight retention. These results suggest that pregnant women should be advised to control gestational weight gain, decrease energy intakes after child-bearing and maintain regular exercise in order to prevent postpartum obesity.

Under-reporting of energy intake (EI) is a well-known problem when measuring dietary intake in free-living populations. The present study aimed at quantifying misreporting by comparing EI estimated from the Danish pre-coded food diary against energy expenditure (EE) measured with a validated position-and-motion instrument (ActiReg®). Further, the influence of recording length on EI:BMR, percentage consumers, the number of meal occasions and recorded food items per meal was examined. A total of 138 Danish volunteers aged 20–59 years wore the ActiReg® and recorded their food intake for 7 consecutive days. Data for 2504 participants from the National Dietary Survey 2000–2 were used for comparison of characteristics and recording length. The results showed that EI was underestimated by 12 % on average compared with EE measured by ActiReg® (PreMed AS, Oslo, Norway). The 95 % limits of agreement for EI and EE were − 6·29 and 3·09 MJ/d. Of the participants, 73 % were classified as acceptable reporters, 26 % as under-reporters and 1 % as over-reporters. EI:BMR was significantly lower on 1–3 consecutive recording days compared with 4–7 recording days (P < 0·03). Percentage consumers of selected food items increased with number of recording days. When recording length was 7 d, the number of reported food items per meal differed between acceptable reporters and under-reporters. EI:BMR was the same on 4 and 7 consecutive recording days. This was, however, a result of under-reporting in the beginning and the end of the 7 d reporting. Together, the results indicate that EI was underestimated at group level and that a 7 d recording is preferable to a 4 d recording period.

To evaluate the efficacy of adding cognitive behavioural treatment (CBT) to either a low-carbohydrate (LC) diet or a low-fat (LF) diet in the treatment of weight loss of obese women, a randomised clinical intervention study was performed. A total of 105 healthy non-pregnant obese women (average age and BMI of 45·4 (sd 10·4) years and 36 (sd 4·3) kg/m2) were randomly allocated to the CBT or control (C) groups; within each group, women were randomly selected to receive either the LC or LF diet during 6 months. The pre-planned primary trial end-point was the weight loss. Differences between the groups were assessed using one-way ANOVA. There were three women (2·8 %) who dropped out, all of them in the CBT group. No differences in the anthropometric and laboratory characteristics at baseline were noted between women in the CBT (n 52) and control groups (n 50). Intention-to-treat analysis showed that weight loss in the CBT-LC (90 (sd 12·3) to 82·1 (sd 12·1) kg) and C-LC (89·4 (sd 10·0) to 85·8 (sd 9·8) kg) groups reached 8·7 and 4·0 %, respectively (P < 0·0001), and in the CBT-LF (87·9 (sd 11·4) to 79·4 (sd 11·8) kg) and C-LF (88·8 (sd 14·5) to 85·3 (sd 14·3) kg) groups it was 9·7 and 3·9 %, respectively (P < 0·05). Weight loss was higher in the CBT-LF group than in the CBT-LC groups (P = 0·049). The present results showed that adding CBT to either the LF or LC diet produced significantly greater short-term weight loss in obese women compared with diet alone. These finding support the efficacy of CBT in breaking previous dietary patterns and in developing healthier attitudes that reinforce a healthier lifestyle.

Environmental conditions influence meal size in adults and children. Intake of sweet drinks could contribute significantly to energy intake and potentially affect body weight, particularly in young individuals. The objectives of the present study were to measure the lunch intake of food and drinks under controlled laboratory settings in teenagers and to compare the influence of different meal conditions. Normal-weight adolescents (fourteen males and fifteen females) participated in four standardised lunches, scheduled 1 week apart. The same popular items (meat dish, dessert, water, juice, soda) were served at all meals. Ad libitum intake was measured under four conditions: subjects ate alone; in groups; alone while viewing television; alone while listening to music. Visual analogue scales were used to assess pre- and post-meal hunger and thirst and meal palatability. Energy, solid food and fluid intake was different (significantly lower) only in the ‘eating in group’ condition, in spite of identical intensity of pre-meal hunger. More soda was consumed when participants were watching television, and more water was consumed while listening to music. Across all conditions, more soda than water was consumed. Post-meal ratings of hunger, thirst and palatability did not differ between conditions. We concluded that, in teenagers, a ‘social inhibition’ effect appears rather than the ‘social facilitation’ previously reported in adults. Although teenagers do not respond to the presence of television or another ‘distractor’ such as music by eating more, they do ingest more soda when the television is on. The social significance of meals, conditioned responses and habituation to ‘distractors’ may be different between adolescents and adults.