Since national figures on the occurrence of metabolic syndrome among Chinese adolescents are lacking, this study aims to estimate its prevalence and distribution among Chinese youngsters. The 2002 China National Nutrition and Health Survey is a nationally representative cross-sectional study. Applying the criteria for US adolescents, we estimated the prevalence of metabolic syndrome among 2761 adolescents aged 15 to 19 years. The prevalence of metabolic syndrome among Chinese adolescents overall was 3·7 % (10 % in US adolescents). It was 35·2 %, 23·4 % and 2·3 % among adolescents who were overweight (BMI ≥ 95th percentile), at risk of overweight (BMI between 85th and 95th percentile) and normal weight (BMI below the 85th percentile), respectively. Urban boys had the highest rate (5·8 %) compared with girls and rural youngsters. Among adolescents who had a BMI ≥ 85th percentile and one or two parent(s) with metabolic syndrome, the prevalence was 46·4 %. A total of 96 % of overweight adolescents had at least one and 74·1 % overweight adolescents had at least two abnormalities of metabolic syndrome. Based on these figures, it is estimated that more than three million Chinese adolescents have metabolic syndrome. Both overweight and metabolic syndrome prevalence among adolescents are still relatively low in China, but the prevalence of metabolic syndrome among Chinese overweight adolescents is similar to those living in the USA.

The iodine intake level in a population is determined in cross-sectional studies. Urinary iodine varies considerably and the reliability of studies of iodine nutrition and the number of samples needed is unsettled. We performed a longitudinal study of sixteen healthy men living in an area of mild to moderate iodine deficiency. Iodine and creatinine concentrations were measured in spot urine samples collected monthly for 13 months. From these data we calculated the number of urine samples needed to determine the iodine excretion level for crude urinary iodine and for 24 h iodine excretion estimated from age- and gender-specific creatinine excretions. We found that mean urinary iodine excretion varied from 30 to 87 μg/l (31 to 91 μg/24 h). Sample iodine varied from 10 to 260 μg/l (20 to 161 μg/24 h). Crude urinary iodine varied more than estimated 24 h iodine excretion (population standard deviation 32 v. 26; individual standard deviation 29 v. 21; Bartlett's test, P < 0·01 for both). The number of spot urine samples needed to estimate the iodine level in a population with 95 % confidence within a precision range of ± 10 % was about 125 (100 when using estimated 24 h iodine excretions), and within a precision range of ± 5 % was about 500 (400). A precision range of ± 20 % in an individual required twelve urine samples or more (seven when using estimated 24 h iodine excretions). In conclusion, estimating population iodine excretion requires 100–500 spot urine samples for each group or subgroup. Less than ten urine samples in an individual may be misleading.

Self-report recall questionnaires used to measure physical activity and dietary intake in children can be labour intensive and monotonous and tend to focus on either dietary intake or physical activity. The web-based software, Synchronised Nutrition and Activity ProgramTM (SNAPTM), was developed to produce a novel, simple, quick and engaging method of assessing energy balance-related behaviours at a population level, combining principles from new and existing 24 h recall methodologies, set within a user-friendly interface. Dietary intake was measured using counts for twenty-one food groups and physical activity levels were measured in min of moderate to vigorous physical activity (MVPA). A combination of the mean difference between methods, type II regression and non-parametric limits of agreement techniques were used to examine the accuracy and precision of SNAPTM. Method comparison analyses demonstrated a good agreement for both dietary intake and physical activity behaviours. For dietary variables, accuracy of SNAPTM (mean difference) was within ± 1 count for the majority of food groups. The proportion of the sample with between-method agreement within ± 1 count ranged from 0·40 to 0·99. For min of MVPA, there was no substantial fixed or proportional bias, and a mean difference between methods (SNAPTM – accelerometry) of − 9 min. SNAPTM provides a quick, accurate, low-burden, cost-effective and engaging method of assessing energy balance behaviours at a population level. Tools such as SNAPTM, which exploit the popularity, privacy and engagement of the computer interface, and linkages with other datasets, could make a substantial contribution to future public health monitoring and research.

Iodine intake is important for thyroid function. Iodine content of natural waters is high in some areas and occurs bound in humic substances. Tap water is a major dietary source but bioavailability of organically bound iodine may be impaired. The objective was to assess if naturally occurring iodine bound in humic substances is bioavailable. Tap water was collected at Randers and Skagen waterworks and spot urine samples were collected from 430 long-term Randers and Skagen dwellers, who filled in a questionnaire. Tap water contained 2 μg/l elemental iodine in Randers and 140 μg/l iodine bound in humic substances in Skagen. Median (25; 75 percentile) urinary iodine excretion among Randers and Skagen dwellers not using iodine-containing supplements was 50 (37; 83) μg/24 h and 177 (137; 219) μg/24 h respectively (P < 0·001). The fraction of samples with iodine below 100 μg/24 h was 85·0 % in Randers and 6·5 % in Skagen (P < 0·001). Use of iodine-containing supplements increased urinary iodine by 60 μg/24 h (P < 0·001). This decreased the number of samples with iodine below 100 μg/24 h to 67·3 % and 5·0 % respectively, but increased the number of samples with iodine above 300 μg/24 h to 2·4 % and 16·1 %. Bioavailability of iodine in humic substances in Skagen tap water was about 85 %. Iodine in natural waters may be elemental or found in humic substances. The fraction available suggests an importance of drinking water supply for population iodine intake, although this may not be adequate to estimate population iodine intake.

Lactic acid bacteria have traditionally been thought to have immunomodulating effects. To verify this property, Lactobacillus plantarum was orally administered to mice (5 × 107 colony forming units (c.f.u.)), prior to infection with Listeria monocytogenes in order to evaluate the host resistance against an infectious micro-organism and to better define the influence of L. plantarum on such responses. Balb/c mice were treated daily with L. plantarum or received PBS (sham-treated mice as controls) for 4 weeks. Subsequently, mice were intravenously infected with a clinical isolate of L. monocytogenes. Our study revealed that the administration of L. plantarum did not significantly increase the survival (P = 0·13) of mice (fifteen in each group) after L. monocytogenes infection (106 c.f.u./ml), whereas a sub-lethal dose of L. monocytogenes (105 c.f.u./ml) was eliminated from liver and spleen 5 d after the challenge in both L. plantarum- and sham-treated mice (n 5). Nevertheless, the levels of IL-1β and IL-6 from sera of orally administered L. plantarum were drastically reduced at 0, 4 (P < 0·01) and 6 d after L. monocytogenes infection, whereas TNF-α production was unaltered. In conclusion, administration of L. plantarum reduced pro-inflammatory IL production after challenge with L. monocytogenes, although it did not significantly impact the survival of mice. We speculate that L. plantarum could exert anti-inflammatory effects, which may represent an important model to reduce inflammatory disorders. Therefore, further studies in human subjects should determine the role of L. plantarum as an immunomodulatory micro-organism and its relationship in the host protection to pathogens.

Leucine has been suggested to have the potential to modulate muscle protein metabolism by increasing muscle protein synthesis. The objective of this study was to investigate the surplus value of the co-ingestion of free leucine with protein hydrolysate and carbohydrate following physical activity in elderly men. Eight elderly men (mean age 73 ± 1 years) were randomly assigned to two cross-over treatments consuming either carbohydrate and protein hydrolysate (CHO+PRO) or carbohydrate, protein hydrolysate with additional leucine (CHO+PRO+leu) after performing 30 min of standardized physical activity. Primed, continuous infusions with l-[ring-13C6]phenylalanine and l-[ring-2H2]tyrosine were applied, and blood and muscle samples were collected to assess whole-body protein turnover as well as protein fractional synthetic rate in the vastus lateralis muscle over a 6 h period. Whole-body protein breakdown and synthesis rates were not different between treatments. Phenylalanine oxidation rates were significantly lower in the CHO+PRO+leu v. CHO+PRO treatment. As a result, whole-body protein balance was significantly greater in the CHO+PRO+leu compared to the CHO+PRO treatment (23·8 (sem 0·3) v. 23·2 (sem 0·3) μmol/kg per h, respectively; P < 0·05). Mixed muscle fractional synthetic rate averaged 0·081 (sem 0·003) and 0·082 (sem 0·006) %/h in the CHO+PRO+leu and CHO+PRO treatment, respectively (NS). Co-ingestion of leucine with carbohydrate and protein following physical activity does not further elevate muscle protein fractional synthetic rate in elderly men when ample protein is ingested.

Taste acuity declines with age and may be dependent upon Zn status. The aim of the present double-blind, randomised controlled intervention trial has been to determine taste acuity in response to Zn supplementation (placebo, or 15 or 30 mg Zn/d). Healthy older European adults aged 70–87 years were recruited within Italy (Rome) (n 108) and France (Grenoble) (n 91) to the European Commission-funded Zenith project. A signal detection theory approach was adopted for taste assessment. The data were converted to R indices and analysed by repeated-measures ANOVA controlling for baseline taste acuity as well as serum and erythrocyte Zn. Serum Zn increased post-intervention, indicating compliance with the intervention. Results differed across geographical region. Salt taste acuity was greater in response to Zn (30 mg) than placebo post-intervention among those recruited in Grenoble. There was no apparent change in acuity for sweet, sour or bitter taste in response to Zn. Supplemented Zn may have potential to enhance salt taste acuity in those over the age of 70 years. Further research is required to determine if enhanced salt taste acuity is reflected in the eating experiences of older individuals.

The objective of the present study was to investigate the bioavailability and the configurational isomer distribution of the carotenoid astaxanthin (AST) in human plasma after ingestion of wild (Oncorhynchus spp.) and aquacultured (Salmo salar) salmon. In a randomised and double-blind trial, twenty-eight healthy men consumed 250 g wild or aquacultured salmon daily for 4 weeks which provided 5 μg AST/g salmon flesh. The plasma AST concentrations as well as the isomer distribution were measured by HPLC using a reversed and a chiral stationary phase. After 6 d of intervention with salmon, plasma AST concentrations reached a plateau of 39 nmol/l after consumption of wild salmon and of 52 nmol/l after administration of aquacultured salmon. At days 3, 6, 10 and 14 – but not at day 28 – the AST concentrations in human plasma were significantly greater after ingestion of aquacultured salmon. After administration of wild salmon, the (3S,3′S) isomer predominated in plasma (80 %), whereas after intake of aquacultured salmon the meso form (3R,3′S) prevailed (48 %). Therefore, the AST isomer pattern in human plasma resembles that of the ingested salmon. However, after consumption of both wild and aquacultured salmon for 28 d the relative proportion of the (3S,3′S) isomer was slightly higher and the (3R,3′R) form lower in human plasma compared with the isomer distribution in salmon flesh. A selective process of isomer absorption could be responsible for the observed differences in the relative proportions of the (3S,3′S) and (3R,3′R) isomers in human plasma compared with salmon flesh.

Adolescents aged 11–14 years (n 326), belonging to organized sports federations in the Federal District, Brazil were interviewed. Subjects (n 107) provided four non-consecutive days of food consumption and 219 subjects provided two non-consecutive days of intake. The objective was to assess their nutrient and water intake according to dietary reference intake values and their energy and macronutrient intake by sex and sports groups they were engaged in: endurance, strength-skill or mixed, according to the guidelines established by the American College of Sport Medicine (ACSM). Dietary data were corrected for intra-individual variation. Total energy expenditure was higher among endurance athletes (P < 0·001) following their higher training time (P < 0·001) when compared to adolescents engaged in strength-skill or mixed sports. Total energy intake was only significantly higher among endurance-engaged females (P = 0·05). Protein intake of males was above the guidelines established by the ACSM for all sports groups. All male sport groups fulfilled the intake levels of carbohydrate per kg body weight but only females engaged in endurance sports fulfilled carbohydrate guidelines. Intakes of micronutrients with low prevalence of adequate intake were: vitamins B1, E and folate, magnesium and phosphorus. Few adolescents ( < 5 %) presented adequate intake for calcium, fibre, drinking water and beverages. For micronutrients, prevalence of adequacies were lower for females than males, except for liquids and water. Nutrition guidance is needed to help adolescents fulfil specific guidelines of macronutrient intake for their sports and to improve their intake of micronutrients and water. Special attention should be given to female adolescent athletes.

Both cigarette smoking and high fat meals induce oxidative stress, which is associated with the pathogenesis of numerous diseases. We compared blood antioxidant status, oxidative stress biomarkers and TAG in twenty smokers and twenty non-smokers, matched for age and physical activity, in response to a high fat test meal standardized to body mass. Blood samples were collected before feeding (resting and fasted) and at 1, 2, 4 and 6 h post feeding and analysed for antioxidant capacity (trolox equivalent antioxidant capacity; TEAC), xanthine oxidase activity (XO), hydrogen peroxide (H2O2), malondialdehyde (MDA) and TAG. Smoking status (P < 0·001) and time (P ≤ 0·01) effects were noted for all variables, with smokers demonstrating higher values compared with non-smokers for all variables except for TEAC, for which values were lower for smokers. XO, H2O2, MDA and TAG increased following feeding with a peak response at the 4 h post feeding time point, with the opposite response occurring for TEAC. Although no interaction effects were noted (P>0·05), contrasts revealed greater values in smokers compared with non-smokers for XO, H2O2, MDA and TAG, and lower values for TEAC at times from 1–6 h post feeding (P ≤ 0·05). Our findings indicate that young cigarette smokers experience an exaggerated oxidative stress response to feeding, as well as hypertriacylglycerolaemia, as compared with non-smokers. These data provide insight into another possible mechanism associating cigarette smoking with ill health and disease.

A human study was carried out to investigate whether tomato juice, rich in natural lycopene and fortified with vitamin C, is able to reduce several biomarkers of oxidative stress and inflammation and whether the effect can be attributed to lycopene, vitamin C or any other micronutrient. Following a 2-week depletion phase, volunteers were assigned randomly to ingest either tomato juice with (LC) or without (L) vitamin C fortification for 2 weeks (daily dose 20·6 mg lycopene and 45·5/435 mg vitamin C). Plasma and urine were analysed for carotenoids and vitamin C, lipid status, antioxidant capacity, thiobarbituric acid reactive substances (TBARS) and 8-epi-PGF2α, protein carbonyls, cytokines IL-1β and TNFα and C-reactive protein (CRP). The consumption of tomato juice led to a reduction in total cholesterol levels (L: 157·6 v. 153·2 mg/dl, P = 0·008; LC: 153·4 v. 147·4 mg/dl, P = 0·002) and that of CRP (L: 315·6 v. 262·3 μg/l, P = 0·017; LC: 319·2 v. 247·1 μg/l, P = 0·001) in both groups. The vitamin C-fortified juice slightly raised the antioxidant capacity in urine and decreased TBARS in plasma and urine. All other markers were affected to a lesser extent or remained unchanged. Cholesterol reduction was correlated with lycopene uptake (P = 0·003), whereas the other effects could not be related with particular micronutrients. Any beneficial effects of tomato consumption for human health cannot be attributed only to lycopene and, as the additional supplementation with ascorbic acid indicates, a variety of antioxidants might be needed to optimize protection against chronic diseases.

In Bangladesh, some commonly consumed, indigenous, freshwater small fish species (eaten whole with bone, head and eyes) such as mola (Amblypharyngodon mola) are nutrient-dense, containing preformed vitamin A as retinol and especially 3,4-dehydroretinol. The objective of the present randomised, controlled efficacy study was to evaluate the effects of mola on biochemical indicators of vitamin A status. Children (n 196), aged 3–7 years, with serum retinol 0·36–0·75 μmol/l, were randomly allocated to one of three treatment groups to receive a daily test meal (6 d/week for 9 weeks) of rice and vegetable curry (no vitamin A) ad libitum and 50 g fish curry consisting of: (1) mola, 600 retinol activity equivalents (RAE) (using 40 % biological activity of 3,4-dehydroretinol isomers) (experimental group, n 66); (2) rui (Labeo rohita), a large fish (no vitamin A), with added retinyl palmitate, 600 RAE (positive control group, n 65); or (3) rui, 0 RAE (negative control group, n 65). The nutrient compositions of the dishes were analysed. After 9 weeks, no significant treatment effects were observed for serum retinol (P = 0·52) and retinol-binding protein (P = 0·81) in the experimental group compared with the negative control, whereas the positive control improved significantly (P < 0·001). The present results do not suggest conversion of the large amount of 3,4-dehydroretinol in mola curry to retinol. Further research on the functional effect of mola in humans is needed. Mola is a nutrient-dense animal-source food, rich in haem Fe, Zn and especially Ca, thus consumption of mola in Bangladesh should continue to be encouraged.

The effects of a probiotic mixture (PRO), supplemented with either galacto-oligosaccharide (GOS) or polydextrose (PDX), on cell numbers of lactic acid bacteria (LAB) and bifidobacteria (BIF) were studied in conventional rats and healthy human subjects. In rats the baseline BIF cell numbers were below the detection limit and were increased by the 2-week GOSPRO intervention. In contrast baseline LAB numbers in rats were high and not affected by the treatments. The human study consisted of two independent but concurrent trials; both started with PRO followed by GOSPRO or PDXPRO periods. In the human subjects variation in numbers of BIF and LAB were high. The GOSPRO group exhibited high counts of faecal LAB and BIF at the start and showed little or no effects of the interventions. In contrast, the PDX group had low faecal LAB and BIF numbers at the start and clearly increased cell numbers of BIF after the PDXPRO period, and LAB after the PRO and PDXPRO period, compared with the run-in period. We propose here that responses to pro- and prebiotics are dependent on baseline numbers of LAB and/or BIF, and that the conventional rat model does not predict well the treatment responses in humans. The survival of PRO was presumably enhanced by the use of prebiotic supplementation and advocates the use of particular combinations of pro- and prebiotics.

Intramyocellular lipid (IMCL) and plasma NEFA are important skeletal muscle fuel sources. By raising blood insulin concentrations, carbohydrate ingestion inhibits lypolysis and reduces circulating NEFA. We hypothesised that differences in the postprandial glycaemic and insulin response to carbohydrates (i.e. glycaemic index; GI) could alter NEFA availability and IMCL use during subsequent exercise. Endurance-trained individuals (n 7) cycled for 90 min at 70 % V˙O2peak and then consumed either high GI (HGI) or low GI (LGI) meals over the following 12 h. The following day after an overnight fast, the 90 min cycle was repeated. IMCL content of the vastus lateralis was quantified using magnetic resonance spectroscopy before and after exercise. Blood samples were collected at 15 min intervals throughout exercise and analysed for NEFA, glycerol, glucose, insulin, and lactate. Substrate oxidation was calculated from expired air samples. The 90 min cycle resulted in >2-fold greater reduction in IMCL in the HGI trial (3·5 (sem 1·0) mm/kg wet weight) than the LGI trial (1·6 (sem 0·3) mm/kg wet weight, P < 0·05). During exercise, NEFA availability was reduced in the HGI trial compared to the LGI trial (area under curve 2·36 (sem 0·14) mEq/l per h v. 3·14 (sem 0·28) mEq/l per h, P < 0·05 respectively). No other differences were significant. The findings suggest that HGI carbohydrates reduce NEFA availability during exercise and increase reliance on IMCL as a substrate source during moderate intensity exercise.

Dietary intake of 18: 2n-6 and 18: 3n-3 may affect endogenous production and incorporation of n-3 long-chain PUFA (LCPUFA) from fish oils (FO). This double-blinded controlled 2 × 2-factorial 8-week intervention investigates the effects of high and low 18: 2n-6 intake in combination with FO-supplementation on tissue fatty acid composition. Healthy young men (n 64) were randomized to capsules with FO or olive oil (control) (4·4 (2·0–5·6) ml/d) and to either sunflower oil and margarine (S/B) or rapeseed oil and a butter spread (R/K) to provide a high or a low 18: 2n-6 intake. Diet was measured by 4-d weighed dietary records at baseline, during and 8 weeks after the intervention and tissue incorporation as fatty acid composition of peripheral blood mononuclear cells (PBMC). The fat intervention gave a mean difference in the 18: 2n-6 intake of 7·3 g/d (95 % CI 4·6, 10·0) and a similar 18: 3n-3 intake in the groups. The R/K groups had a 0·2 % fatty acid (FA%) (95 % CI 0·0, 0·4, P = 0·02) higher content of 22: 5n-3 in the PBMC, a tendency of slightly higher 20: 5n-3 (P = 0·06), but no more 22: 6n-3 (P = 0·83) than the S/B groups. FO effectively raised the PBMC content of all n-3 LCPUFA (P < 0·001). The fat intervention did not markedly influence the effect of FO; the mean PBMC content of n-3 LCPUFA was 10·3 (sem 0·3) FA% in the FO+S/B group and 10·6 (sem 0·2) FA% in the FO+R/K group. In conclusion, increasing the 18: 2n-6 intake did not have any pronounced effect on incorporation of n-3 LCPUFA in PBMC, either alone or with simultaneous FO supplementation.

We prospectively investigated whether organic food consumption by infants was associated with developing atopic manifestations in the first 2 years of life. The KOALA Birth Cohort Study in the Netherlands (n 2764) measured organic food consumption, eczema and wheeze in infants until age 2 years using repeated questionnaires. Diet was defined as conventional ( < 50 % organic), moderately organic (50–90 % organic) and strictly organic (>90 % organic). Venous blood samples taken from 815 infants at 2 years of age were analysed for total and specific IgE. Multivariate logistic regression models were fitted to control for potential confounding factors. Eczema was present in 32 % of infants, recurrent wheeze in 11 % and prolonged wheezing in 5 %. At 2 years of age, 27 % of children were sensitised against at least one allergen. Of all the children, 10 % had consumed a moderately organic diet and 6 % a strictly organic diet. Consumption of organic dairy products was associated with lower eczema risk (OR 0·64 (95 % CI 0·44, 0·93)), but there was no association of organic meat, fruit, vegetables or eggs, or the proportion of organic products within the total diet with the development of eczema, wheeze or atopic sensitisation. Further studies to substantiate these results are warranted.

A high dietary P intake is suggested to have negative effects on bone through increased parathyroid hormone secretion, as high serum parathyroid hormone (S-PTH) concentration increases bone resorption. In many countries the P intake is 2- to 3-fold above dietary guidelines, whereas Ca intake is too low. This combination may not be optimal for bone health. In a previous controlled study, we found that dietary P dose-dependently increased S-PTH and bone resorption and decreased bone formation. The aim of the present study was to investigate the dose–response effects of Ca intake on Ca and bone metabolism with a dietary P intake higher than recommended. Each of the twelve healthy female subjects aged 21–40 years attended three 24-h study sessions, which were randomized with regard to a Ca dose of 0 (control day), 600 or 1200 mg, and each subject served as her own control. The meals on each study day provided 1850 mg P and 480 mg Ca. S-PTH concentration decreased (P < 0·001) and serum ionized Ca concentration increased (P < 0·001) with increasing Ca doses. The bone formation marker, serum bone-specific alkaline phosphatase, did not differ significantly (P = 0·4). By contrast, the bone resorption marker, urinary N-terminal telopeptide of collagen type I, decreased significantly with both Ca doses (P = 0·008). When P intake was above current recommendations, increased Ca intake was beneficial for bone, as indicated by decreased S-PTH concentration and bone resorption. However, not even a high Ca intake could affect bone formation when P intake was excessive.

Soya isoflavones, genistein and daidzein, are the focus of numerous studies investigating their potential effects on health and results remain controversial. Bioavailability is clearly a crucial factor influencing their bioefficacy and could explain these discrepancies. This study aimed at assessing: (1) the isoflavone content of sixty-nine European soya-derivative products sold on the French market; (2) the bioavailability of isoflavones comparing supplement with food. Twelve healthy volunteers were recruited in a randomized two-way crossover trial and received 35 mg isoflavones equivalent aglycone either through supplements or through cheese, both containing different patterns of isoflavone conjugates and different daidzein:genistein ratios. A specific ELISA method was used to assess the plasma and urinary concentrations of isoflavones and thus the pharmacokinetic parameters, which were then normalized to mg of each isoflavone ingested. Results showed that the normalized Cmax of daidzein (P = 0·002) and similarly the normalized AUC0 → ∞ and Cmax of genistein (P = 0·002) from soya-based capsules were higher than that from soya-based cheese. In conclusion, this work completes studies on isoflavone bioavailability and presents new data regarding isoflavone concentrations in soya-derivative products. Assuming that isoflavone conjugation patterns do not influence isoflavone bioavailability, this study shows that isoflavones contained in capsules are more bioavailable than those contained in soya-based cheese. Although the supplement is more bioavailable, the relative importance of this is difficult to interpret as there is little evidence that supplements are biologically active in human subjects to date and further studies will be necessary for this specific supplement to prove its efficacy.

Blood pressure (BP) shows a continuous relationship with the risk of CVD. There is substantial evidence that dietary potassium exerts an anti-pressor effect. Most clinical trials have used KCl. However, the chloride ion may have a pressor effect and in foods potassium is associated with organic anions. In a double-blind randomized placebo-controlled trial we explored the effect on BP of two salts of potassium, KCl and potassium citrate (K-cit), in predominantly young healthy normotensive volunteers. The primary outcome was the change in mean arterial pressure as measured in a clinic setting. After 6 weeks of supplementation, compared with the placebo group (n 31), 30 mmol K-cit/d (n 28) changed mean arterial pressure by − 5·22 mmHg (95 % CI − 8·85, − 4·53) which did not differ significantly from that induced by KCl (n 26), − 4·70 mmHg ( − 6·56, − 2·84). The changes in systolic and diastolic BP were − 6·69 (95 % CI − 8·85, − 4·43) and − 4·26 (95 % CI − 6·31, − 2·21) mmHg with K-cit and − 5·24 (95 % CI − 7·43, − 3·06) and − 4·30 (95 % CI − 6·39, − 2·20) mmHg with KCl, and did not differ significantly between the two treatments. Changes in BP were not related to baseline urinary electrolytes. A greater treatment-related effect was observed in those with higher systolic BP. Increasing dietary potassium could therefore have a significant impact on the progressive rise in BP in the entire population.

Despite recent concerns about the high prevalence of sub-clinical vitamin D deficiency in adolescents, relatively few studies have investigated the underlying reasons. The objective of the present study was to investigate the prevalence and predictors of vitamin D inadequacy among a large representative sample of adolescents living in Northern Ireland (54–55°N). Serum concentrations of 25-hydroxyvitamin D (25(OH)D) were analysed by enzyme-immunoassay in a subgroup of 1015 of the Northern Ireland Young Hearts 2000 cohort; a cross-sectional study of 12 and 15 year-old boys and girls. Overall mean 25(OH)D concentration throughout the year was 64·3 (range 5–174) nmol/l; 56·7 and 78·1 nmol/l during winter and summer, respectively. Reported intakes of vitamin D were very low (median 1·7 μg/d). Of those adolescents studied, 3 % and 36 % were vitamin D deficient and inadequate respectively, as defined by serum 25(OH)D concentrations < 25 and < 50 nmol/l. Of the subjects, 46 % and 17 % had vitamin D inadequacy during winter and summer respectively. Gender differences were also evident with 38 % and 55 % of boys and girls respectively classified as vitamin D inadequate during winter (P < 0·001). Predictors of vitamin D inadequacy during winter were vitamin D intake and gender. In conclusion, there is a high prevalence of vitamin D inadequacy in white-skinned adolescents in Northern Ireland, particularly during wintertime and most evident in girls. There is a clear need for dietary recommendations for vitamin D in this age group and for creative strategies to increase overall vitamin D status in the population.