In the last 10 years nutritional research on diabetes has improved dramatically in terms of both number of studies produced and quality of methodologies employed. Therefore, it is now possible to attempt to provide the evidence on which nutritional recommendations for the prevention of type 2 diabetes could be based. We therefore performed a literature search and, among the papers published in indexed journals, we selected relevant epidemiological (mostly prospective) and controlled intervention studies. Lifestyle factors that have, so far, been consistently associated with increased risk of type 2 diabetes are overweight and physical inactivity. However, recent evidence from epidemiological studies has shown that the risk of type 2 diabetes is also associated with diet composition, particularly with: (1) low fibre intake; (2) a high trans fatty acid intake and a low unsaturated:saturated fat intake ratio; (3) absence of or excess alcohol consumption. All these factors are extremely common in Western populations and therefore the potential impact of any intervention on them is large: indeed, >90% of the general population has one or more of these risk factors. The ability to correct these behaviours in the population is estimated to reduce the incidence of diabetes by as much as 87%. Recent intervention studies have shown that type 2 diabetes can be prevented by lifestyle changes aimed at body-weight reduction, increased physical activity and multiple changes in the composition of the diet. Within this context, the average amount of weight loss needed is not large, about 5% initial weight, which is much less than the weight loss traditionally considered to be clinically significant for prevention of type 2 diabetes. In conclusion, new emphasis on prevention by multiple lifestyle modifications, including moderate changes in the composition of the habitual diet, might limit the dramatic increase in incidence of type 2 diabetes envisaged worldwide.

Hg and Pb are of public health concern due to their toxic effects on vulnerable fetuses, persistence in pregnant and breast-feeding mothers, and widespread occurrence in the environment. To diminish maternal and infant exposure to Hg and Pb, it is necessary to establish guidelines based on an understanding of the environmental occurrence of these metals and the manner in which they reach the developing human organism. In the present review, environmental exposure, acquisition and storage of these metals via maternal–infant interaction are systematically presented. Though Hg and Pb are dispersed throughout the environment, the risk of exposure to infants is primarily influenced by maternal dietary habits, metal speciation and interaction with nutritional status. Hg and Pb possess similar adverse effects on the central nervous system, but they have environmental and metabolic differences that modulate their toxicity and neurobehavioural outcome in infant exposure during fetal development. Hg is mainly found in protein matrices of animal flesh (especially fish and shellfish), whereas Pb is mainly found in osseous structures. The potential of maternal acquisition is higher and lasts longer for Pb than for Hg. Pb stored in bone has a longer half-life than monomethyl-mercury acquired from fish. Both metals appear in breast milk as a fraction of the levels found in maternal blood supplied to the fetus during gestation. Habitual diets consumed by lactating mothers pose no health hazard to breast-fed infants. Instead, cows' milk-based formulas pose a greater risk of infant exposure to neurotoxic substances.

Linseed (LO) and soyabean (SO) oils were evaluated as fish-oil (FO) substitutes in the diets of marketable-sized gilthead sea bream (Sparus aurata). Practical diets were designed factorially with the lipid added as follows (%): FO 100, LO 60+FO 40, LO 80+FO 20, SO 60+FO 40, SO 80+FO 20. The effects of experimental diets on growth, fatty acids patterns in liver and muscle, flesh quality variables and activities of selected enzymes involved in lipid synthesis and catabolism were determined at the end of a 7-month trial. Fatty acid composition of liver and muscle generally reflected the fatty acid composition of the diets. The n−3 PUFA levels were significantly reduced by the inclusion of vegetable oils. This tendency was more pronounced for EPA than for docosahexaenoic acid. The n−3:n−6 fatty acid ratio reached the lowest values in fish fed the SO diets; this was associated with a higher liver lipid deposition. No differences were found in fillet texture and pH. However, under conditions of forced peroxidation, muscles from fish fed the SO diets had lower peroxidation levels. Vegetable oil substitution decreased lipogenesis in liver and this effect was greatest at the highest substitution level. In contrast, muscle β-oxidation enzymes had increased activities with vegetable oil substitution. Thus, the lower hepatic lipogenesis was correlated with an increased lipid utilisation in muscle. It is concluded that growth and lipid metabolism were affected by experimental diets.

Three xylanase products, xylanase A derived from Thermomyces lanuginosus, xylanase B from Humicola insolens and xylanase C from Aspergillus aculeatus, were examined for their effects on the nutritive value of wheat. The study investigated the effects of enzyme addition to broiler diets based on a low-metabolisable-energy (ME) wheat and a normal-ME wheat, with the emphasis on changes in composition of the NSP along the digestive tract in broiler chickens. There were significant (P>0·01) enzyme and wheat effects on the apparent ME, but there was no wheat×enzyme interaction on apparent ME. Weight gain and feed conversion efficiency (except xylanase C for normal wheat) were also significantly (P>0·01) increased by the xylanases. The enzymes differed in their effect on a number of important nutritional parameters. Xylanase A reduced (P>0·05) the excreta moisture level from 77·1% in birds fed the normal-ME wheat control to 73·4% and from 77·4% in those fed the low-ME wheat to 73·0%. The other two enzymes did not affect excreta moisture levels. The digesta viscosity in the duodenum, jejunum and ileum of birds fed both types of wheat was reduced (P>0·01) by xylanases A and C, but was increased (P>0·01) in the jejunum and ileum by xylanase B. The digestibility of the soluble NSP was mostly negative in the small intestine. The digestibility of the insoluble NSP differed (P>0·01) between the two wheats, with those in the low-ME wheat being more digestible (14 v. 28%). When supplemented with xylanase A, the ileal digestibility of the insoluble NSP in the normal- and low-ME wheats was increased by 28 and 42?%, respectively. Xylanases B and C did not affect the digestibility of the insoluble NSP regardless of wheat type. It may be concluded that wheats with low or normal ME values vary in their responses to xylanase supplementation. Apart from having an elevated level of soluble NSP, low-ME wheat may also contain insoluble NSP, which in the present study appeared to be more easily degradable in the gut of the chicken.

Laboratory opossums (Monodelphis domestica) show extreme genetic variability in their responsiveness to dietary lipids; a great proportion of the genetic variability in responsiveness is due to a single major gene. To determine whether the major gene for dietary response detected by genetic analysis in opossums is responsive to dietary cholesterol or dietary saturated fat, or a combination of both, we used males and females of susceptible and resistant lines of laboratory opossums that were 5 to 7 months old. The animals were challenged with three different experimental diets (high-cholesterol diets with or without high saturated fat from lard or coconut oil) and plasma lipoproteins were measured. Plasma and VLDL+LDL-cholesterol concentrations increased several-fold when the animals were fed the diet containing elevated cholesterol (P>0·001) or elevated cholesterol and fat (P>0·001) and differed between the two lines when they were fed high-cholesterol diets with or without fat (P>0·001). Plasma HDL-cholesterol concentrations were higher (P>0·05) in animals of the resistant line than in the susceptible line when they were fed the basal diet (550 (sem 30) v. 440 (sem 20) mg/l) and when they were fed the low-cholesterol and high-fat diet (600 (sem 30) v. 490 (sem 30) mg/l). Dietary coconut oil and lard had similar effects on plasma lipoprotein cholesterol concentrations in the susceptible line of opossums. A reduction in dietary cholesterol by 50% with either the lard or coconut oil blunted the plasma cholesterol response. The results from the present studies suggest that the major gene for dietary response previously detected by genetic analysis in laboratory opossums affects the response to dietary cholesterol but not to saturated fat.

The high dietary protein requirements of salmonid fish are met with fishmeal-based feed in commercial aquaculture. The sustainability of this practice is questionable and, therefore, the feasibility of substituting fishmeal with plant-based products needs to be investigated. We investigated growth and metabolism in rainbow trout (Oncorhynchus mykiss) fed a diet composed of a mixture of plant proteins compared with those fed a fishmeal-based diet. Using two-dimensional gel electrophoresis of liver protein extracts, we showed that the liver protein profile changed in response to the alteration in the diet. A number of metabolic pathways were identified as sensitive to the protein source substitution. These included pathways involved in primary energy generation, maintenance of reducing potential, bile acid synthesis, and transport and cellular protein degradation. Interestingly, the pathways shown to be affected in the present study were somewhat different from those identified in our previous work with soyabean-based-protein replacement of fishmeal, with the effects on the abundance of several stress response proteins notably absent. We conclude, therefore, that the metabolic effects of plant protein replacement in aquaculture feed varies with plant-protein source.

The effect of yoghurt and soya yoghurt containing Bifidobacterium lactis Bb-12 or B. longum Bb-46 on Ehrlich ascites tumour cell proliferation was investigated in vitro and in vivo. Tumour cells were incubated with B. lactis Bb-12 or B. longum Bb-46 cultivated in de Mann Rogosa Sharpe (MRS) broth medium, or with their centrifuged supernatant fractions or sediments, for 2 h at 37°C. Treatment resulted in the inhibition of tumour cell proliferation by 85·42 (sd 0·78) and 85·10 (sd 1·28) % by intact micro-organisms, 77·61 (sd 0·29) and 71·43 (sd 1·75) % by their supernatant fractions, but only 4·00 (sd 0·19) and 9·09 (sd 1·24) % by the two sedimented bacteria, respectively. The incubation of tumour cells with yoghurt and soya yoghurt containing Bb-12 for 2 h resulted in 83·01 (sd 0·11) and 88·23 (sd 0·06) % inhibition, respectively, while it was 83·82 (sd 0·24) and 86·36 (sd 0·06) %, respectively for the same products containing Bb-46. Corresponding values for plain yoghurt and soya milk (without bifidobacteria) were 32·81 (sd 0·14) and 5·55 (sd 0·12) %, respectively. The differences between yoghurt or soya yoghurt containing Bb-12 or Bb-46 and plain yoghurt, soya milk or control treatments were statistically significant (n 3; P>0·05). Female Swiss albino mice were injected intraperitoneally with the same tumour cells. The lifespan of mice fed diets supplemented with yoghurt or soya yoghurt containing Bb-12 or Bb-46 was prolonged by 16, 23, 34 and 39%, respectively compared with that of the positive control group (n 6; P>0·05). The lifespan of groups fed plain yoghurt or soya milk was prolonged by 15 and 8%, respectively. Prolongation of lifespan was positively correlated with faeces bifidobacterial count in the groups fed yoghurt or soya yoghurt containing bifidobacteria (r 0·917; P>0·05).

Nutrient utilisation and growth performance responses of White Pekin ducks (Anas platyrinchos domesticus) offered diets containing low- or high-viscosity wheat supplemented with xylanase were investigated in two studies. In Expt 1, six diets consisting of low-viscosity wheat or high-viscosity wheat supplemented with 0·0, 1·5 or 3·0 g xylanase (2590 units/g)/kg diet were used in a true metabolisable energy (TME) bioassay with eight 8-week-old ducks per diet group. In Expt 2, eight pens of ten 3-d-old ducks per pen for each of six wheat-based diets arranged in a 2×3 factorial of low-viscosity or high-viscosity wheat and 0·0, 1·5 or 3·0 g xylanase/kg were used in a 42 d growth study. High-viscosity wheat depressed (P>0·001) TME and xylanase supplementation improved (P>0·001) TME, more so for high-viscosity than low-viscosity wheat. Xylanase supplementation of the high-viscosity wheat-based diet improved (P>0·05) weight gain and gain:feed ratio by 13 and 12% respectively. There was no weight gain or gain:feed ratio response to xylanase supplementation of the low-viscosity wheat-based diet. Xylanase supplementation reduced (P>0·001) the viscosity of duodenal and ileal digesta for high-viscosity but not low-viscosity wheat-based diets. Ileal digestibilities of nutrients and energy were higher (P>0·001) for low-viscosity than high-viscosity wheat-based diets; xylanase supplementation improved (P>0·05) energy, fat, N and starch digestibilities. Given that xylanase supplementation of high-viscosity wheat assuaged its anti-nutritional effect, it is surmised that digesta viscosity plays a role in anti-nutritional effects in wheat-based diets for ducks.

Caecal microbial activity, digestion and gut health were analysed in the young rabbit, in response to fibre substitution by starch, in diets with high proportions of rapidly fermentable polysaccharides (pectins+hemicelluloses:acid-detergent fibre (ADF) ratio of 1·7). A range of five diets corresponding to a 60% linear reduction of the ADF level (230 to 92 g ADF/kg) without changes in the fibre quality, and to a corresponding linear increase in dietary starch, was given ad libitum to young rabbits from 18 d until 70 d of age. A one half reduction of the ADF level resulted in a sharp increase in energy digestibility (+25 units), associated with a lower feed intake (−35%) and to an increase of the mean retention time (+6 h) in the whole digestive tract. Despite large variations in the fibre intake (20 to 59 g ADF/d), the fibre digestive efficiency remained similar among the five diets. Starch ileal concentrations were low after 4 weeks of age (>5%), and variations with age were significant when the dietary starch level was over 19%. A 65% lower biomass production was measured when the ADF level progressed from 230 to 165 g/kg, and no precise relationship was found with fermentative activity. Reducing the fibre intake led to a linear decrease of caecal volatile fatty acids concentrations, and to higher pH and NH3 levels. An increased occurrence of mortality by diarrhoea was registered with the lowest fibre intake. It can be concluded that a sufficient supply of fibre, with high proportions in rapidly fermentable polysaccharides, stimulates the maturation of microbial activity and reduces the occurrence of diarrhoea.

The aim of the present prospective study was to determine if malnutrition, measured using a simple validated score, is an independent risk factor for nosocomial infections (NI) in non-selected hospital in-patients. Between 29 and 31 May 2001, a survey on the prevalence of NI was conducted on all 1637 in-patients (61 (sd 25) years old) in a French university hospital as part of a national survey. Actual and usual body weights were recorded in all in-patients, and serum albumin levels were measured on all blood samples taken during the week before the study. Nutritional status was evaluated by using the nutritional risk index (NRI). Albumin values were obtained in 1084 patients, and complete weight information was obtained in 911. Therefore, NRI was calculated in 630 patients (61 (sd 20) years old): 427 (67·8%) were malnourished. NI prevalence was 8·7%: 4·4% in non-malnourished patients, 7·6% in moderately malnourished patients and 14·6% in severely malnourished patients. In univariate analysis, the odds ratios for NI were 1·46 (95% CI 1·2, 2·1) in moderately malnourished patients and 4·8 (95% CI 4·6, 6·4) in severely malnourished patients. In multivariate analysis, age, immunodeficiency and NRI class influenced NI risk. Vascular and urinary catheters, and surgical intervention, were the extrinsic factors associated with NI, with odds ratios ranging from 2·0 (95% CI 1·8, 2·6) for vascular catheters to 10·8 (95% CI 8·8, 12·6) for association of the three factors. In conclusion, in non-selected hospitalized patients, malnutrition assessed with a simple and objective marker is an independent risk factor for NI. An early screening for malnutrition may therefore be helpful to reduce the high prevalence of NI.

A high plasma carotenoid concentration could improve the immune response and result in decreased risk of infectious diseases. However, data on the relationship of plasma carotenoid concentration with acute respiratory infections, which occur frequently in elderly people, are scarce. We investigated, therefore, the relationship of plasma concentrations of six major carotenoids (β-carotene, α-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin) with the incidence and severity of acute respiratory infections. Baseline data from an intervention trial were used. Participants were 652 non-institutionalized elderly people (≥60 years old) enrolled via two community-based sampling strategies in the Wageningen area of The Netherlands in 1998–99. Plasma carotenoid concentrations were divided into quartiles, the lowest being the reference. Frequency and severity of episodes during the previous 1 year, i.e. staying in bed, medical consultation and episode-related medication, were self-reported by means of a questionnaire. On average 1·6 episodes per person were recorded. The incidence rate ratio of acute respiratory infections at high β-carotene status was 0·71 (95% CI 0·54–0·92) as compared with the low β-carotene concentration group. No association was observed between β-carotene and illness severity. α-Carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin were not related to incidence or severity of the infections. We conclude that elderly people with a high plasma β-carotene concentration may have a lower occurrence of acute respiratory infections.

The present study was designed to evaluate the effect of olive oil and its main polyphenol (oleuropein) in ovariectomised rats with or without inflammation. Rats (6 months old) were ovariectomised or sham-operated as control. Ovariectomised rats were separated into three groups receiving different diets for 3 months: a control diet with 25 g peanut oil and 25 g rapeseed oil/kg (OVX), the control diet with 50 g olive oil/kg or the control diet with 0·15 g oleuropein/kg. The sham-operated group was given the same control diet as OVX. Inflammation was induced 3 weeks before the end of the experiment by subcutaneous injections of talc (magnesium silicate) in one-half of each group. The sucess of ovariectomy was verified at necropsy by the atrophy of uterine horns. Inflammation, oleuropein or olive oil intakes did not have any uterotrophic activity, as they had had no effect on uterus weight. The plasma concentration of α-1-acid glycoprotein (an indicator of inflammation) was increased in OVX rats with inflammation. With regard to bone variables, osteopenia in OVX was exacerbated by inflammation, as shown by a decrease in metaphyseal and total femoral mineral density. Both oleuropein and olive oil prevented this bone loss in OVX rats with inflammation. At necropsy, oleuropein and olive oil consumption had had no effect on plasma osteocalcin concentrations (marker of bone formation) or on urinary deoxypyridinoline excretion (marker of bone resorption). In conclusion, oleuropein and olive-oil feeding can prevent inflammation-induced osteopenia in OVX rats.

Thiamin deficiency remains an important public health problem in some populations. The aim of the present investigation was to study thiamin status during the third trimester of pregnancy and its influence on the concentration of this vitamin in transition (days 13–14 of lactation) and mature breast milk (day 40 of lactation) in a group of Spanish women. The pregnancies and lactation periods of fifty-one healthy women 18–35 (mean 26·7 (sd 3·7)) years old were monitored. Vitamin intake during the third trimester was determined by recording the consumption of foods over 5 d and of the quantities provided by dietary supplements. Thiamin status during this stage of pregnancy was determined by measuring the activation coefficient of erythrocyte transketolase (α-ETK). Milk thiamin content was estimated (in 41% of the subjects) by oxidizing thiamin to thiocrome and measuring fluorescence. Subjects with thiamin intakes above that recommended (group H) had more satisfactory serum α-ETK coefficients (1·01 (sd 0·19)) than did those with lower intakes (group L) (1·21 (sd 0·30); P>0·05). Mature milk thiamin concentrations were significantly higher in group H subjects (0·59 (sd 0·44) μmol/l) than group L subjects (0·25 (sd 0·07) μmol/l). Subjects with α-ETK coefficients >1·25 in the third trimester had significantly lower mature milk thiamin concentration (0·31 (sd 0·10) μmol/l) than did subjects with more satisfactory α-ETK levels at this time (0·55 (sd 0·42) μmol/l; P>0·05). The thiamin status of women can be improved since 25·5% of subjects took less than that recommended and 13·7% showed signs of severe deficiency (α-ETK >1·25). The influence of maternal thiamin intake on α-ETK coefficients and on mature breast milk thiamin concentration is confirmed.

Relationships between vitamin E status (α and γ-tocopherol and their ratio in plasma), anthropometric and biochemical indices, and food and nutrient intakes, were studied in four British National Diet and Nutrition Surveys: children aged 1·5–4·5 years, young people aged 4·0–18·0 years, adults 19·0–64·0 years and adults aged ≥65·0 years. γ-Tocopherol:α-tocopherol ratio declined with age. In older women γ-tocopherol and γ-tocopherol:α-tocopherol ratios were directly related to indices of obesity. In young men α- and γ-tocopherols were directly correlated with obesity, but γ-tocopherol:α-tocopherol ratio was not. For young people and toddlers, fewer obesity indices were available and relationships were weaker. Other fat- and water-soluble vitamin indices correlated directly with α-tocopherol and inversely with γ-tocopherol and γ-tocopherol:α-tocopherol ratio. Whereas α-tocopherol correlated directly with ‘healthy’ nutrient choices (such as intrinsic sugars, dietary fibre, vitamins and potassium) and inversely with ‘unhealthy’ choices (extrinsic sugars and monounsaturated fats, i.e. avoidance of polyunsaturated fat), γ-tocopherol and the γ-tocopherol:α-tocopherol ratio related inversely with ‘healthy’ choices. Food groups had analogous relationships; thus, α-tocopherol related directly to use of polyunsaturated fats, fresh fruits and fruit juices, and inversely to non-polyunsaturated fats and extrinsic sugar. The reverse was true for γ-tocopherol and γ-tocopherol:α-tocopherol ratio. Although the mechanisms underlying these relationships are obscure, the γ-tocopherol:α-tocopherol ratio may reveal poor dietary choices, status predictors and a propensity for obesity in later life, especially in women.

Dietary vitamin K1 (phylloquinone) levels that are sufficient to maintain normal blood coagulation may be sub-optimal for bone, and habitual low dietary intakes of vitamin K may have an adverse effect on bone health. The objective of the present study was to measure the intake and adequacy of phylloquinone intake and the contribution of foods to phylloquinone intake in a nationally representative sample of Irish adults. The North/South Ireland Food Consumption Survey database was used, which contains data collected using a 7 d food diary in a randomly selected sample of Irish adults aged 18–64 years (n 1379; 662 men and 717 women). Phylloquinone intakes were estimated using recently compiled food composition data for phylloquinone. The mean daily intake of phylloquinone from food sources was 79 (sd 44) μg. Intakes were significantly higher (P>0·001) in men than in women at levels of 84 and 75quest;μgsol;d. The main contributors to phylloquinone intakes were vegetables (48%), particularly green vegetables (26%). Potatoes (including chipped and fried potatoes), dairy products and fat spreads contributed 10% each and meat contributed 8%. In men, social class and smoking status influenced phylloquinone intakes. Of the population, 52% had phylloquinone intakes below 1 μg/kg body weight and only 17% of men and 27% of women met the US adequate intakes of 120 and 90 μg/d, respectively. The present study shows that habitual phylloquinone intakes in Irish adults are low, which may have implications for bone health.

A 2-year milk intervention trial was carried out with 757 girls, aged 10 years, from nine primary schools in Beijing (April 1999 – March 2001). Schools were randomised into three groups: group 1, 238 girls consumed a carton of 330 ml milk fortified with Ca on school days over the study period; group 2, 260 girls received the same quantity of milk additionally fortified with 5 or 8 μg cholecalciferol; group 3, 259 control girls. Anthropometric and bone mineralisation measurements, as well as dietary, health and physical-activity data, were collected at baseline and after 12 and 24 months of the trial. Over the 2-year period the consumption of this milk, with or without added cholecalciferol, led to significant increases in the changes in height (≥0·6%), sitting height (≥0·8%), body weight (≥2·9%), and (size-adjusted) total-body bone mineral content (≥1·2%) and bone mineral density (≥3·2%). Those subjects receiving additional cholecalciferol compared with those receiving the milk without added 25-hydoxycholecalciferol had significantly greater increases in the change in (size-adjusted) total-body bone mineral content (2·4 v. 1·2%) and bone mineral density (5·5 v. 3·2%). The milk fortified with cholecalciferol significantly improved vitamin D status at the end of the trial compared with the milk alone or control groups. It is concluded that an increase in milk consumption, e.g. by means of school milk programmes, would improve bone growth during adolescence, particularly when Ca intake and vitamin D status are low.

Secoisolariciresinol diglucoside (SDG) is an important dietary lignan that is found at very high levels in flaxseed (1–4%, w/w). Flaxseed lignans have received much research interest in recent years because of reported phyto-oestrogenic, anticarcinogenic, and anti-atherogenic effects. Previously, flaxseed feeding has been shown to decrease vitamin E concentrations in rats despite the antioxidant potential of SDG in vitro. Sesamin, a sesame lignan, on the other hand has been shown to increase vitamin E concentrations in rats. The aim of the present study was to investigate the effect of dietary SDG and its oligomers on vitamin E and cholesterol concentrations in rats. SDG was extracted from defatted flaxseed flour with a dioxane–ethanol mixture and purified by silica column chromatography. The major oligomers with 3-hydroxy-3-methyl glutaric acid, containing a high ratio of SDG to p−coumaric and ferulic acid glucosides, were purified from the extracts by reversed-phase liquid chromatography. When fed to rats at 0·1% in the diet for 27%, both SDG and its oligomers had no effect on animal performance but caused an increase in liver cholesterol and a 2-fold reduction in the levels of α- and γ-tocopherols in rat plasma and liver. It is notable that a phenolic antioxidant, such as SDG, causes a vitamin E-lowering effect in rats. This cannot be explained at present, but warrants further investigations with respect to the magnitude, mechanism, and significance of the observed effect for human nutrition.

We have carried out a randomised trial comparing brief behavioural counselling with nutritional education counselling to increase fruit and vegetable consumption and associated biomarkers in adults from a low-income neighbourhood. The objective of the present analysis was to assess the impact of interventions on quality of life and health status, and associations between changes in fruit and vegetable consumption, plasma vitamins C and E, and quality of life. Behavioural counselling and nutritional education counselling were carried out in 271 adults in two 15 min sessions in a primary-care setting. Physical and mental health status (medical outcome study short form 36) and self-rated health were assessed at baseline, 8 weeks and 12 months, and analysed on an intention-to-treat basis. Both groups reported increased fruit and vegetable consumption; plasma vitamin E and β-carotene also increased, with significantly greater changes in consumption and plasma β-carotene in the behavioural counselling condition. Physical and mental health status, and the proportion of participants in good self-rated health, increased in both groups to a similar extent. Individual differences in improvements in physical health status and self-rated health were correlated with increases in fruit and vegetable intake and in plasma vitamins C and E, independently of age, gender, ethnicity, financial status, smoking, BMI and use of vitamin supplements. We conclude that participation in the present study was associated with improved health-related quality of life. Increases in fruit and vegetable intake and plasma vitamin levels may stimulate beneficial changes in physical health status in socio-economically deprived adults.