Vitamin D is vital to bone health and prolonged severe deficiency can lead to rickets in children and osteomalacia/osteoporosis in adults. Vitamin D is an exceptional nutrient in that its main source is exposure of the skin to UV rays, whilst it can also be ingested through diet. This study aimed to investigate the relative contribution of vitamin D supplementation and individual sunlight exposure in raising vitamin D levels, throughout winter, in ethnically identical adult women living in opposite latitudes. Within two parallel placebo-controlled randomized controlled trials (RCT), with identical study designs, 135 Brazilian women, (England, n = 56, 51˚N; Brazil, n = 79, 16˚S), were randomized to receive daily 15 μg vitamin D3 supplements or placebo, for 12 weeks. Oral vitamin D supplementation of 15 μg daily was effective at raising 25-hydroxivitamin D [25(OH)D] concentrations over winter, regardless of latitude, and the response was dependent on baseline vitamin D status. In both latitudes, supplementation prevented the seasonal concomitant increase in plasma parathyroid hormone (PTH) levels. Additionally, the individual UV radiation level was strongly correlated with 25(OH)D concentrations. The research also showed: 1) an optimal vitamin D status for bone health around 70–80 nmol/l; 2) the required UV radiation to achieve this status was 1.5 SED; 3) the vitamin D dietary intakes required to achieve these serum levels were 4.5 μg/d at a low latitude (16˚S) and 37 μg/d at high latitude (51˚N). The strength of these results is the novel analysis that directly links human in vivo individual sunlight radiation, increased vitamin D intake and 25(OH)D status, within two parallel RCTs in opposite latitudes. This study demonstrated that a daily supplement of 15 μg vitamin D3 was an effective strategy to significantly raise vitamin D status throughout the winter months in adult females, with important implications for bone health through the simultaneous lowering of PTH, regardless of latitude. Our data gives a two-fold contribution to the vitamin D field: firstly it will help raise awareness of the risk for vitamin D deficiency in low latitude regions such as most countries in South America as well as amongst South-Americans living in higher latitudes, particularly in the UK; secondly it provides key data for setting appropriate vitamin D recommendations for Brazil (which currently follows US recommendations) as well as for similar latitudes.

Non-nutritive sweeteners (NNS) are suggested to reduce sugar and energy content of diet, but there is growing evidence that they can exacerbate obesity and diabetes through increasing appetite and energy intake. Stevia (stevioside extract), a natural sweetener, is being increasingly consumed, yet limited studies have looked at their effects on satiety and energy intake. The aim of this study is to investigate the effects of preloads of stevia on food intake, satiety and postprandial blood glucose levels when compared to water and sugar. Thirty participants (10 males/20 females; 26 ± 10.5 years; BMI: 23.44 ± 3.42 Kg/m2) took part in a three-arm single-blinded crossover trial. On separate test days, they received three different preloads (300 ml) containing water, sugar (60g) and stevia (1g) followed by an ad-libitum pizza lunch after 30 minutes. Breakfast was standardized. Blood glucose samples were collected before preload and lunch, and then at 30-minute intervals until 120 min post lunch. Volunteers recorded their feelings of satiety and hunger on visual analogue scales (VAS) before preload and after meal intake. A one-day diet diary was collected for each test day. Data was analysed using repeated measures ANOVA (SPSS Inc., Chicago, IL, USA). Despite the difference in energy content between preloads, there were no significant differences in energy intake at lunch between the three interventions (F (2, 56) = 0.25, p = 0.78). Furthermore, participants did not compensate by consuming more energy during the day after the stevia preload (1660 ± 584 Kcal) compared to sugar preload (1770 ± 763 Kcal, p = 0.82). There were no significant differences in VAS scores between stevia and sugar preloads, but participants scored significantly higher rates of hunger (before and after lunch) and desire to eat (before lunch) following water preload (p < 0.05). No significant differences between water, sugar and stevia were noted for postprandial glucose levels (120 min post lunch) when adjusted from baseline (F (2, 58) = 2.56, p = 0.09). Area under the curve (AUC) for glucose did not differ between water and stevia (p = 0.2). Results are in line with several clinical trials showing that the consumption of sweeteners does not lead to an increase in hunger and energy intake, and could therefore present a useful strategy to assist with weight loss. Further studies looking at long-term effects of stevia on weight regulation are needed to support these findings.

The food system is responsible for around 70% of global freshwater use. Pathways toward responsible consumption and production of food are therefore critically needed to ensure the planetary boundary for freshwater use is not transgressed. There is also an uneven spatial distribution of freshwater resources and human water demands, meaning that water-scarcity is acute in some regions but a lesser concern in others. Quantifying the water-scarcity impacts associated with food consumption is therefore a complex challenge due to the diversity of individual eating patterns, the very large number of individual food products available, and the many different regions where food is grown or processed. To our knowledge, this is the first study to calculate water footprints for a large number of self-selected diets. Life cycle assessment was used to model the water-scarcity footprints of 9,341 individual Australian adult diets obtained through 24-hour recall as part of the most recent Australian Health Survey. Three water-scarcity indicators were used, including the AWARE model recently developed by a project group working under the auspices of the United Nations Environment Programme (UNEP) / Society of Environmental Toxicology and Chemistry (SETAC) Life Cycle Initiative (www.lifecycleinitiative.org). In addition, a diet quality score was calculated for each of these diets. Our objective was to identify pathways toward healthier diets with lower water-scarcity impacts. Dietary water-scarcity footprints averaged 362 L-eq person-1 day-1 and were highly variable (sd. 218 L-eq person-1 day-1), reflecting the diversity of eating habits in the general community. The largest water-scarcity impacts were related to the excessive consumption of discretionary foods (alcoholic beverages, processed meat products, dairy desserts, cream, butter, muesli bars, confectionery, chocolate, biscuits, cakes, waffles, fried potato and extruded snacks, etc.). The potential to reduce dietary water-scarcity impacts is large, although the opportunity to intervene through amended dietary guidelines is not straightforward due to the large variations in water-scarcity footprint intensity between individual foods within a food group, and the inability of consumers to identify lower water-scarcity footprint products without food labeling. Reductions in the water-scarcity footprint of Australian food consumption are likely best achieved through reductions in food waste, technological change to improve water-use efficiency in food production, as well as the implementation of product reformulation and procurement strategies in the food manufacturing sector to avoid higher water-scarcity footprint intensity ingredients.

Breakfast cereals are known to provide a nutrient-dense meal and are a useful source of carbohydrate, fibre and micronutrients. However, in the UK cereal products are the primary contributor of free sugars in the diets of children aged 1.5 to 10 years; and are the second leading source of free sugars in children aged 11 to 18 years and adults aged 19 to 64 years. For this reason, breakfast cereals were included among food items recommended by the UK government for a 20% reduction in sugar by 2020 for childhood obesity prevention. Therefore, this study aimed to investigate the nutrient contents, including sugars, of breakfast cereals sold in the UK, in particular those marketed to children. Nutritional information and ingredients of cereal products available in five major online supermarkets in the UK, in 2018, were collected into a comprehensive database for analysis. A systematic process flow approach was utilised to separate products into nine distinct categories. Children's products were stratified both on being wholegrain rich (≥ 50%, WG) or not (NWG), and on total sugar content; with > 12.3g/100 g defined as ‘highly flavoured and sweetened’ (HFS) versus ‘plain’ containing ≤ 12.3g/100 g (the target set by the UK for industry sugar reduction). Of the 757 unique products surveyed, 97 cereals were categorised as children's. Cereals not explicitly marketed to children were categorised as either ‘family favourites’ (containing < 50% wholegrains), ‘free-from and organic’, ‘porridge and oats’, ‘healthier with dried fruits’, or ‘healthier without dried fruits’ (healthier defined as wholegrain rich, ≥ 50%). Children's HFS products (n = 78) contained by far the highest sugar contents of all cereals examined. While there was no difference in total sugar between NWG/HFS (n = 69, median [range]: 29.0g/100 g [12.4, 41.0]) and WG/HFS (n = 9, 22.0g/100 g [13.6, 26.0]) cereals; these were much higher (P < 0.01) than the median sugar contents (8.8–19.0g/100g) observed in the other seven product categories. Children's NWG cereals contained dramatically lower fibre (NWG/HFS: 3.5 [0, 8.7], NWG/Plain: 1.6g/100 g [1.3, 7.2]) than all other product categories (7.3–9.1g/100 g; P < 0.001). Similarly, NWG/HFS cereals were lower in protein content (7.4/100 g [3.6, 17.2]) than the non-children's cereals (8.8–11g/100 g; P < 0.05). In conclusion, children's categories of cereal contain significantly greater amounts of sugar and lower amounts of fibre and protein than other cereal categories. Despite their fortification with vitamins and minerals, reformulation of this food category should be a priority alongside additional sugar-reducing strategies.

D-Fagomine (1,2 dideoxynojirimycin) is an iminosugar, a carbohydrate analogue that includes an endocyclic nitrogen instead of oxygen, that is naturally present in buckwheat and buckwheat-based foodstuffs. This study examines the long-term functional effect of d-fagomine on sucrose-induced factors of metabolic syndrome and explores possible molecular mechanisms behind its action. We evaluated Wistar Kyoto rats fed a standard diet were given a 35% sucrose (glucose/fructose) solution with d-fagomine (or not, for comparison) or mineral water (controls) for 24 weeks. The variables measured were body weight and energy intake; glucose tolerance (oral glucose tolerance test); plasma leptin concentration; plasma lipid profile; the populations of Bacteroidetes, Firmicutes, bacteroidales, clostridiales, enterobacteriales, and Escherichia coli in feces; blood pressure; urine uric acid and F2t isoprostanes (F2-IsoPs); perigonadal fat deposition and hepatic histology and diacylglycerols (DAGs) in liver and adipose tissue. We found that d-Fagomine reduced sucrose induced hypertension, urine uric acid, F2-IsoPs as markers of oxidative stress (OS), steatosis and liver DAGs (32:1, 32:2, 34:1 and 36:2) without affecting perigonadal (visceral) fat deposition or DAG levels in visceral adipose tissue. It showed a slight tendency to reduce sugar induced impaired glucose tolerance. d-Fagomine also promoted excretion of enterobacteriales generated by the dietary intervention. We postulate that fructose increases visceral fat deposition independently of liver de novo liposynthesis and that d-fagomine attenuates steatosis and blood pressure mainly by reducing liver fructose levels. The reduction of blood pressure may be associated with an effect on uric acid synthesis while the reduced levels of selected active liver DAGs may explain the weak effect on sucrose-induced impaired glucose tolerance, which may be primarily induced by visceral fat deposition. In conclusion, the increased populations of excreted enterobacteriales may be connected to the levels of excreted uric acid. d-Fagomine counteracts sucrose-induced steatosis and hypertension presumably by reducing the postprandial levels of fructose in the liver as a consequence of intestinal sucrase inhibition.

Several dietary factors have been extensively investigated for associations with risk of breast cancer, but to date unequivocal evidence only exists for alcohol consumption. We sought to systematically evaluate the association between 92 dietary factors and breast cancer risk using a nutrient-wide association study approach. Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression with age as the time scale and adjustment for potential confounders, was used to quantify the association between each food or nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to evaluate in the independent replication cohort, the Netherlands Cohort Study (NLCS). During a median follow-up time of 15 years, 10,979 incident invasive breast cancers were identified in the women from the EPIC study. Six foods and nutrients were associated with risk of breast cancer when controlling the FDR at 0.05. Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% confidence interval (CI) 1.03–1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03–1.06 and 1.04, 95% CI 1.02–1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94–0.98; 0.96, 95% CI 0.94–0.99; and 0.96, 95% CI 0.95–0.98, respectively). When evaluated in the NLCS (2368 invasive breast cancer cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk of breast cancer in the NLCS. Our findings confirm the well-established increased risk of breast cancer associated with alcohol consumption, and suggest that higher intake of dietary fibre, and possibly fruit and carbohydrates, might be associated with reduced breast cancer risk.

Recently, increased attention has been drawn to the composition of the intestinal microbiota and its possible role in metabolic syndrome and type 2 diabetes (T2DM). However, potential variation in gut microbiota composition across ethnic groups is rarely considered despite observed unequal prevalence for these diseases. Our objective was therefore to study the gut microbiota composition across health, metabolic syndrome and T2DM in a multi-ethnic population residing in the same geographical area. 16S rRNA gene sequencing was performed on fecal samples from 3926 participants to the HELIUS cohort (Amsterdam, The Netherlands), representing 6 ethnic groups (Dutch, Ghanaians, Moroccans, Turks, Surinamese of either African or South-Asian descent). Included participants completed a questionnaire and underwent a physical examination and overnight fasted blood sampling. Gut microbiota composition was compared across metabolic status (diabetes with and without metformin use, metabolic syndrome and its subsequent components, health) and ethnicities using Wilcoxon-Mann-Withney tests and logistic regressions. Overall, the gut microbiota alpha-diversity (richness, Shannon index and phylogenetic diversity) decreased with worsening of the metabolic state (comparing health to metabolic syndrome to T2DM) but this was only partially reproduced in ethnic-specific analyses. In line, a lower alpha-diversity was found in relation to all metabolic syndrome components as well as in T2DM subjects using metformin compared to non-users. Alterations, mainly decreased abundances, were also observed at the genus level (many Clostridiales) in metabolic syndrome subjects and more strongly in T2DM subjects with differences across ethnic groups. In particular, we observed decreased abundances of members of the Peptostreptococcaceae family and of Turicibacter and an increased abundance of a member of the Enterobacteriaceae family. Our data highlight several compositional differences in the gut microbiota of individuals with metabolic syndrome or T2DM. These features, confirming prior observations, give some insights into potential key intestinal bacteria related to a worsening of metabolic state. Our results also underscore possible ethnic-specific profiles associated with these microbiota alterations that should be further explored.

Dietary inorganic nitrate has been shown to lower blood pressure (BP) and improve endothelial function(1). The main sources of dietary nitrate are vegetables (root and green leafy varieties) as well as drinking water but data available on dietary analysis software on nitrate levels in vegetables and vegetable-based foods is very limited. To date, very few studies have investigated the relationship between the level of consumption of dietary nitrate on BP and other cardiovascular disease (CVD) risk factors in a representative UK population. The aim of the study was to address this knowledge gap using data from the National Diet and Nutrition Survey (NDNS) years 1–8, a cross-sectional study conducted in 3339 men and women aged 19–64 y between 2008/09–2011/12. A comprehensive database was first developed to evaluate the nitrate and nitrite levels in vegetables, cured meats and composite dishes to more accurately estimate the dietary nitrate intakes of the NDNS participants. The population was then classified into quartiles of daily nitrate intake, with quartile 1 (Q1: 26–106 mg/d) and quartile 4 (Q4: 183–559 mg/d) representing diets with the lowest and highest intakes, respectively. ANCOVA analysis was performed to determine the relationship between the level of daily nitrate intake with available data on biomarkers of CVD risk (including BP (systolic, diastolic and pulse pressure), lipid profile, (total, high-density lipoprotein and low-density lipoprotein (LDL-C) cholesterol), C-reactive protein, anthropometric measures (body mass index and waist to hip ratio) and glycaemic control (glucose and glycated haemoglobin). There were significant differences in systolic (P-trend = 0.008) and diastolic (P-trend = 0.025) BP across increasing quartiles of dietary nitrate intake, with BP significantly lower in Q3 than all other quartiles. Pulse pressure (calculated as systolic–diastolic BP) was also found to be significantly different across quartiles (P-trend = 0.001), with diets of participants in Q3 and Q4 being associated with significantly lower pulse pressures than those in Q1 (P-Q1 vs. Q3 = 0.005, P-Q1 vs. Q4 = 0.007). All of the other CVD risk markers were not different between quartile groups. Our preliminary results suggest that the level of dietary nitrate intake may be significantly associated with BP, a key independent CVD risk factor. There is an urgent need to more accurately estimate the dietary nitrate intake in the UK population and to determine whether the source of dietary nitrate (vegetables vs cured meats) impacts on the significant relationship with BP.

Taste perception is the main biological determinant of food choice. It has thus been hypothesized that fatty acid sensitivity may affect fat intake. The aim of this study was to examine the relationship between fatty acid sensitivity, frequency of consumption of high-fat products, polymorphism of genes encoding proteins involved in fat taste perception, and body mass.

421 people aged 20–40 were enrolled in Poznań, Poland. Body composition was measured using a Bod Pod. The frequency of consumption of high-fat foods was analyzed using an application for mobile devices based on the ecological momentary assessment approach. Food intake was assessed with dietary records. Salad dressings with varying concentrations of canola oil (from 2.5% to 40.0%) were used as stimuli to test fatty acid sensitivity. The individuals were then divided into groups with higher and lower fatty acid sensitivity. Lower sensitivity means that individuals were able to distinguish samples when the oil concentration exceeded 20%. Genotyping of rs1761667 (CD36), rs1573611 (FFAR1), and rs17108973 (FFAR4) was performed using TaqMan probes.

57% men and 61% women had higher sensitivity to fatty acids. Higher fatty acid sensitivity was associated with the GG genotype of CD36 (OR = 2.05, p < 0.05). People with different taste sensitivity did not differ in their frequency of consumption of high-fat foods or in their macronutrient intake. There was no association between body mass index (BMI) and fatty acid sensitivity, but people with BMI values below 25 more often ate high-fat products with favorable lipid profiles and less often ate meat high-fat products than subjects with BMI values over 25 (p < 0.001 and p < 0.05, respectively). There was no association between CD36 or FFAR4 genotype and fat intake or frequency of consumption of high-fat foods. People with the minor FFAR1 allele ate sweet high-fat products less often than major allele homozygotes (p < 0.05). Moreover, women ate high-fat products with favorable lipid profiles and sweet and savory high-fat products more frequently than men (p < 0.05, p < 0.001, and p < 0.01), but men ate meat high-fat products more frequently than women (p < 0.01).

Concluding, fatty acid sensitivity is associated with polymorphism of the CD36 gene. The frequency of consumption of high-fat foods depends on sex, but not on fatty acid sensitivity, BMI, or CD36 variants.

The project was financed by a National Science Centre award (decision number grant no. 2014/15/B/NZ9/02134).

Optimal maternal polyunsaturated fatty acid (PUFA) status is essential for foetal development. The desaturase enzymes, encoded by the fatty acid desaturase (FADS) genes, are involved in the endogenous synthesis of long chain (LC)PUFA and influence maternal LCPUFA concentrations. The minor allele of various FADS SNPs has been associated with increased maternal concentrations of the precursors linoleic acid (LA) and α-linolenic acid (ALA), and lower concentrations of the LCPUFA arachidonic acid (AA) and docosahexaenoic acid (DHA); however, there is limited research to date on the influence of FADS genotype on cord PUFA status. The aim of the current study was to investigate the influence of maternal and child genetic variation on cord blood PUFA status in a high fish-eating cohort.

Cord blood samples collected from mother-child pairs (n = 1088) taking part in the Seychelles Child Development Study (SCDS) Nutrition Cohort 2 (NC2) were analysed for total serum PUFA. Maternal (n = 1088) and child genotype (n = 592) were determined for the FADS SNPs rs174537, rs174561, rs174575, and rs3834458. Regression analysis determined associations between maternal and child FADS genotype and cord PUFA status. In all regression models, the major allele homozygote genotype for each SNP was used as the reference group.

Directions of significant associations were as predicted. In mothers, the minor allele homozygote genotype for SNPs rs174537, rs174561 and rs3834458 was associated with lower cord DHA and lower total n-3 PUFA when compared to the major allele homozygous genotype (p < 0.05 for all). The heterozygous genotype was associated with increased concentrations of LA compared to the reference genotype for rs174561 (p = 0.021) and rs383448 (p = 0.023). In children, the heterozygous genotype was associated with lower AA concentrations and lower cord n-6:n-3 ratio for all SNPs (p < 0.05 for all) compared to those with the major allele homozygous genotype. A lower cord AA:LA ratio was also observed for children heterozygous for rs174547, rs174561 and rs174575 (p < 0.05 for all). Contrary to expected, there were no associations between cord PUFA concentrations and child minor allele homozygous genotype.

The current study indicates that variation in maternal and child FADS genotype influences cord PUFA concentrations, despite the high intake of preformed dietary LCPUFA from fish in this population. The sample size for minor allele homozygous children was likely too small to observe any statistically significant associations in the current analysis. Further research is needed to determine whether increased dietary intake can compensate for lower PUFA status as a result of FADS genotype.

In the field of nutritional epidemiology, principal component analysis (PCA) has been used to derive dietary patterns, but this has never been conducted in a large, nationally representative sample of older adults in Ireland. The aim was to identify dietary patterns amongst older adults in Ireland derived through PCA and to examine cross-sectional associations with common comorbidities of ageing.

PCA was performed using data from Wave 3 of TILDA (2014), a nationally representative cohort of community-dwelling adults aged ≥ 54 (n = 4,395). We derived major dietary patterns from a PCA of reported intake from a Food Frequency Questionnaire (FFQ). Objective measures for Body Mass Index (BMI), diabetes (HbA1c), bone density(heel bone ultrasound), blood pressure and total cholesterol were collected during a health assessment. The Mini-Mental State Examination (MMSE) was also performed during health assessment with trained interviewers, as a measure of global cognitive function.

Statistical analyses were conducted using multivariate logistic regression, adjusting for age, sex, marital status, income, educational attainment, alcohol consumption, smoking and physical activity.

With the use of PCA, five dietary patterns were identified in the sample - Pattern 1 (fresh fruit, vegetable, fresh fish and dairy), Pattern 2 (confectionary, fatty and processed foods), Pattern 3 (meats, processed meats and salty foods), Pattern 4 (carbohydrates and processed foods) and Pattern 5 (savoury snacks, spreads and processed foods). Those characterized by Pattern 4 were more likely to be overweight (adjusted RRR 0.12, 95% CI 0.05–0.20; p = 0.001), obesity (adjusted RRR 0.18, 95% CI 0.10–0.27; p = 0.001) and have diabetes (adjusted RRR 0.10, 95% CI 0.01–0.19; p = 0.024) after adjusting for known covariates.

Our results suggest that in the older adult population of Ireland, a dietary pattern typified by consumption of refined grains and processed carbohydrates is associated with higher prevalence of overweight, obesity and diabetes.