Essential minerals are cofactors for synthesis of neurotransmitters supporting cognition and mood. An 8-week fully-blind randomised controlled trial of multinutrients for attention-deficit/hyperactivity disorder (ADHD) demonstrated three times as many children (age 6–12) had significantly improved behaviour (‘treatment responders’) on multinutrients (54 %) compared with placebo (18 %). The aim of this secondary study was to evaluate changes in fasted plasma and urinary mineral concentrations following the intervention and their role as mediators and moderators of treatment response. Fourteen essential or trace minerals were measured in plasma and/or urine at baseline and week eight from eighty-six participants (forty-nine multinutrients, thirty-seven placebos). Two-sample t tests/Mann–Whitney U tests compared 8-week change between treatment and placebo groups, which were also evaluated as potential mediators. Baseline levels were evaluated as potential moderators, using logistic regression models with clinical treatment response as the outcome. After 8 weeks, plasma boron, Cr (in females only), Li, Mo, Se and vanadium and urinary iodine, Li and Se increased more with multinutrients than placebo, while plasma phosphorus decreased. These changes did not mediate treatment response. However, baseline urinary Li trended towards moderation: participants with lower baseline urinary Li were more likely to respond to multinutrients (P = 0·058). Additionally, participants with higher baseline Fe were more likely to be treatment responders regardless of the treatment group (P = 0·036.) These results show that multinutrient treatment response among children with ADHD is independent of their baseline plasma mineral levels, while baseline urinary Li levels show potential as a non-invasive biomarker of treatment response requiring further study.

Certain nutritional practices may reduce menstrual-related symptoms, but there is no current consensus on what foods/supplements are sufficiently evidenced to warrant promotion to reduce menstrual symptoms of naturally menstruating individuals. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two online databases were searched for published experimental studies that investigated the effects of foods/supplements on menstrual-related symptoms in eumenorrhoeic women. Extracted data and study characteristics were tabulated and grouped on the basis of food/supplement intervention and dosage compared with UK dietary reference values (DRV) and safe upper limits. In total, twenty-eight studies and twenty-one different foods/supplement interventions were included in the review. None of the studies reported a negative effect on symptoms, twenty-three reported a positive effect and five had no effect. Eighteen different ways of measuring menstrual-related symptoms were described across the studies. The results indicate a lack of consistency in studies to confidently provide information to eumenorrheic, naturally menstruating women regarding the use of foods/supplements to reduce menstrual symptoms. Determination of menstrual-related symptoms varied along with dose and duration of food or supplements provided. These data provide some evidence for the use of vitamin D, calcium, zinc and curcumin to reduce menstrual-related symptoms of non-hormonal contraceptive users, on an individual basis; however, further investigation is required prior to implementation with a focus on robust protocols to determine and measure changes in menstrual symptoms, with interventions adhering to DRV and safe upper limits.

Iodine supply is crucial during pregnancy to ensure that the proper thyroid function of mother and baby support fetal brain development. Little is known about iodine status or its dietary determinants in pregnant women in the Republic of Cyprus. We therefore recruited 128 pregnant women at their first-trimester ultrasound scan to a cross-sectional study. We collected spot-urine samples for the measurement of urinary iodine concentration (UIC, µg/l) and creatinine concentration (Creat, g/l), the latter of which allows us to correct for urine dilution and to compute the iodine-to-creatinine ratio (UI/Creat). Women completed a FFQ and a general questionnaire. We used a General Linear model to explore associations between maternal and dietary characteristics with UI/Creat. The median UIC (105 µg/l) indicated iodine deficiency according to the WHO criterion (threshold for adequacy = 150 µg/l), and the UI/Creat was also low at 107 µg/g. Only 32 % (n 45) of women reported the use of iodine-containing supplements; users had a higher UI/Creat than non-users (131 µg/g v. 118 µg/g), though this difference was NS in the adjusted analysis (P = 0·37). Of the dietary components, only egg intake was significantly associated with a higher UI/Creat in adjusted analyses (P = 0·018); there was no significant association with milk, dairy products or fish intake. Our results suggest that pregnant women in Cyprus have inadequate iodine status and are at risk of mild-to-moderate iodine deficiency. Further research on dietary sources in this population is required.

Grazing represents a sustainable alternative for the control of medusahead infestations but intake of medusahead by ruminants is typically low. We determined in sheep whether (1) high-energy supplements enhance medusahead intake and preference relative to a treatment without supplementation and (2) individual differences in medusahead intake transfer to individual differences in the ingestion of a silica-containing ration. Groups of lambs (n = 10) were individually penned and randomly assigned to three supplementation treatments: (1) Control (no supplement); (2) Calcium (Ca) Propionate (beet pulp : barley : Ca propionate, 67 : 30 : 3); or (3) Yeast (beet pulp : barley : yeast culture, 65 : 30 : 5). After supplementation, all animals had ad libitum access to medusahead in late vegetative to mid-reproductive (Trial 1), and late-reproductive phenological stages (Trial 2). Medusahead preferences were assessed by offering sheep a choice between medusahead and tall fescue hay. Plant part preferences were assessed by offering a choice between medusahead tops (mostly seedheads and awns) and mid-plant parts (mostly stems + leaves). Intake of medusahead was low and cyclic, declining towards the end of each trial (P < 0.0001) and there were no treatment differences (P > 0.10). Lambs preferred tall fescue hay to medusahead and medusahead tops to mid-plant parts (P < 0.0001). Supplemented lambs gained more weight than control lambs (P < 0.10). Thus, supplemented lambs performed better than nonsupplemented controls without reducing their intake of medusahead. In Trial 3, two new groups of lambs were formed based on their intake of medusahead during Trials 1 and 2 (n = 10). One group consistently ate more medusahead and more of a ration containing silica (alfalfa : silica, 97 : 3) than the other (P < 0.10). A significant and consistent degree of individual variation was measured among lambs—irrespective of treatment—regarding their ability to ingest medusahead and silica. This variation represents a promising option for maximizing use of medusahead by livestock in rangelands.

This study investigated the effects of different strategies for feeding supplements to grazing dairy cows on the proportions of fatty acids in milk. Two hundred and sixteen cows were fed supplementary grain and forage according to one of 3 different strategies; (1) Control: cows grazed perennial ryegrass pasture (14 kg dry matter/d) supplemented with milled barley grain fed in the milking parlour and pasture silage offered in the paddock; (2) Partial mixed ration 1 (PMR1): same pasture allotment and supplement as Control strategy, but the supplements presented as a mixed ration after each milking in feedpad, and; (3) Partial mixed ration 2 (PMR2): same pasture allotment, supplemented with a mixed ration of milled barley grain, alfalfa hay, corn silage and crushed corn grain fed in a feedpad. Within each strategy, cows were assigned to receive either 6, 8, 10 or 12 kg dry matter supplement/cow per d. Milk fatty acid proportions from cows fed Control and PMR1 strategies were similar and different from those fed PMR2, particularly at 10 to 12 kg dry matter supplement/cow per d. The reduction in milk fat yield and concentration in cows fed high amounts of supplement as Control and PMR1 was coincident with 4 × increase in 10t-18:1 proportion. The composition of the partial mixed ration (PMR) and the amount offered affected milk fatty acid proportions and milk fat content, however, the method of supplementation did not.

Most scholars acknowledge Matthew's debt to Mark in the composition of his own Gospel, and they are fully aware of his extensive redaction and expansion of this major source. Yet few scholars pose what is an obvious question that arises from these points: What was Matthew's intention for Mark once he had composed and circulated his own revised and enlarged account of Jesus' mission? Did he intend to supplement Mark, in which case he wished his readers to continue to consult Mark as well as his own narrative, or was it his intention to replace the earlier Gospel? It is argued in this study that the evidence suggests that Matthew viewed Mark as seriously flawed, and that he wrote his own Gospel to replace the inadequate Marcan account.

With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be >£13×109 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1% (about £99×106, 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multi-nutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0·56 (95% CI 0·41, 0·77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

In a feeding trial with 24 sheep, we used the alkanes, long-chain alcohols (LCOH) or both of these plant wax markers, to estimate the diet composition of animals offered diets comprising alkane-labelled cottonseed meal (CSM) together with up to four forages. The diets used were: Diet 1 subterranean clover (Trifolium subterraneum); Diet 2 subterranean clover + phalaris (Phalaris aquatica); Diet 3 subterranean clover, phalaris + annual ryegrass (Lolium rigidum); and Diet 4 subterranean clover, phalaris, annual ryegrass + wheat straw (Triticum aestivum). Estimates of diet composition were made following correction of faecal alkane or LCOH concentrations for incomplete faecal recovery, using recovery estimates derived from individual animals, mean recoveries for a given dietary treatment or grand mean recoveries. Estimated dietary proportions of CSM and known intakes of CSM were used to estimate forage intake. The LCOH concentrations of the diet components were much higher than their alkane concentrations, especially for phalaris. Multivariate analyses showed that the discriminatory information provided by the LCOH was additional to that provided by the alkanes, and that a combination of (LCOH + alkanes) discriminated better between diet components than either class of marker alone. Faecal recoveries of LCOH increased with increasing carbon-chain length; there were no differences in recovery attributable to diet. The most accurate estimates of diet composition were obtained with the combination of (LCOH + alkanes). Estimates of diet composition based on LCOH alone were not as good as alkanes alone, due to the high correlation between the LCOH profiles of phalaris and ryegrass. Total grass content of the diet was very accurately estimated using LCOH. Diet composition estimates provided estimates of whole-diet digestibility, which did not differ from the measured values. Trends in the accuracy of forage intake estimates reflected those found with diet composition and almost two-thirds of estimates based on (LCOH + alkanes) had lower error than those found with alkanes alone. The results confirm that supplements labelled with plant wax components can be used to estimate forage intake, and also show that the LCOH are useful markers for estimating diet composition. Intakes were also computed using a combination of natural LCOH concentrations in the diet and the daily dose rate of even-chain alkanes administered by intra-ruminal device. Differences between intakes so estimated and the measured intakes were closely related to the difference in faecal recovery between the LCOH/alkane pair used to estimate intake, by an amount close to that expected on theoretical grounds. It is concluded that the use of plant wax LCOH, especially in combination with alkanes, will result in improved estimates of diet composition and intake in grazing animals.

In a feeding trial with sheep, four animals each were fed one of the three roughages (perennial ryegrass (PR), meadow fescue (MF) and red clover (RC)) or one of the four different mixtures (g/day 250 : 250 : 250, 375 : 75 : 300, 525 : 187.5 : 37.5 and 75 : 525 : 150, respectively) of those three roughages, both with and without the inclusion of 100 g of beeswax-labelled barley. Further, four sheep received a pure lucerne diet to enlarge available data on single species faecal recoveries. All sheep except those fed single-component diets and the 250 : 250 : 250 roughage mix were administered intra-ruminal alkane controlled-release devices (CRD). The aim of the study was to investigate the effect of diet composition on faecal alkane recoveries, and to assess the accuracy of the alkane-based estimate of diet composition and intake based either upon a general set of faecal recoveries across diets or upon dietary recoveries and dietary samples more specifically attributable to individual dietary treatments. For each roughage component independently, the accuracy of diet composition estimates was assessed using linear regression across all diets. The estimates of the proportion of barley were analysed further using mean differences and mean prediction errors. Faecal alkane recovery increased with increasing chain length and was affected by diet composition. RC had a significantly higher faecal recovery for alkanes C25, C27, C29 and C31 than at least one of the other single-roughage diets. When considering mixed diets consisting of PR, MF, RC and barley, the composition of the roughage component significantly affected faecal recovery of all alkanes except C30 and C33. The inclusion of beeswax-labelled barley caused a decrease in faecal recovery of alkanes up to C29. This effect was attributable to the beeswax rather than the barley itself. By contrast, the decrease of faecal recovery of synthetic dosed alkanes from the CRD in diets containing barley, compared with the corresponding diets without barley, was attributable to the supplement itself. It was concluded that synthetic dosed alkanes behaved differently during gut transit from natural alkanes. The proportions of individual dietary components were estimated well over a wide range of proportions. Generally, the more information available, the more accurate the estimates achieved. However, a general set of faecal alkane recoveries and bulked samples of dietary components yielded estimates of diet composition sufficiently accurate for a large number of studies, especially in situations where groups of animals are of concern and not the individual animal.