The availability of folate is implicated as a determinant of DNA methylation, a functionally important feature of DNA. Nevertheless, when this phenomenon has been examined in the rodent model, the effect has not always been observed. Several reasons have been postulated for the inconsistency between studies: the rodent is less dependent on folate as a methyl source than man; juvenile animals, which most studies use, are more resistant to folate depletion than old animals; methods to measure genomic DNA methylation might not be sensitive enough to detect differences. We therefore examined the relationship between folate and genomic DNA methylation in an elder rat model with a newly developed method that can measure genomic DNA methylation sensitively and precisely. Thirty-nine 1-year-old rats were divided into three groups and fed a diet containing 0, 4·5 or 18 μmol folate/kg (folate-deplete, -replete and -supplemented groups, respectively). Rats were killed at 8 and 20 weeks. At both time points, mean liver folate concentrations increased incrementally between the folate-deplete, -replete and -supplemented rats (P for trend <0·001) and by 20 weeks hepatic DNA methylation also increased incrementally between the folate-deplete, -replete and -supplemented rats (P for trend=0·025). At both time points folate-supplemented rats had significantly increased levels of DNA methylation compared with folate-deplete\ rats (P<0·05). There was a strong correlation between hepatic folate concentration and genomic DNA methylation in the liver (r 0·48, P=0·004). In the liver of this animal model, dietary folate over a wide range of intakes modulates genomic DNA methylation.

n-3 Fatty acids may protect against heart disease mortality by preventing fatal arrhythmias. Underlying effects on cardiac electrophysiology may be demonstrable in the standard electrocardiogram (ECG) and provide insight into the mechanism. Therefore, we investigated the effect of dietary n-3 fatty acids on heart-rate-corrected QT interval, T-loop width, spatial QRS-T angle and spatial U-wave amplitude in patients with frequent premature ventricular complexes. Seventy-four patients received either capsules providing 1·5 g n-3 fatty acids daily or placebo for approximately 14 weeks. ECG were recorded before and after intervention. None of the ECG characteristics was significantly affected by treatment. The present results do not provide additional support for the hypothesis that n-3 fatty acids prevent cardiac arrhythmia through generic electrophysiologic effects on heart cell membranes. However, we cannot exclude effects of n-3 fatty acids on clinical relevant endpoints that are not easily detected by prior changes in the ECG.

We investigated the feasibility of increasing ursodeoxycholic acid (UDCA) in the enterohepatic circulation of pigs by administering living bacteria capable of epimerising endogenous amidated chenodeoxycholic acid (CDCA) to UDCA. We first demonstrated that combining Bifidobacterium animalis DN-173 010, as a bile salt-hydrolysing bacterium, and Clostridium absonum ATCC 27555, as a CDCA to UDCA epimerising bacterium, led to the efficient epimerisation of glyco- and tauro-CDCA in vitro, with respective UDCA yields of 55·8 (se 2·8) and 36·6 (se 1·5)%. This strain combination was then administered to hypercholesterolaemic pigs over a 3-week period, as two daily preprandial doses of either viable (six experimental pigs) or heat-inactivated bacteria (six controls). The main effects of treatment were on unconjugated bile acids (P=0·035) and UDCA (P<0·0001) absorbed into the portal vein, which increased 1·6–1·7- and 3·5–7·5-fold, respectively, under administration of living compared with inactivated bacteria. In bile, UDCA did not increase significantly, but the increase in biliary lithocholic acid with time in the controls was not observed in the experimental pigs (P=0·007), and the same trend was observed in faeces. All other variables (biliary lipid equilibrium, plasma lipid levels and partition of cholesterol between the different lipoprotein classes) remained unaffected by treatment throughout the duration of the experiment. In conclusion, it is feasible to increase the bioavailability of UDCA to the intestine and the liver by administering active bacteria. This may represent an interesting new probiotic activity, provided that in future it could be expressed by a safe food micro-organism.

It is well known that early weaning causes marked changes in intestinal structure and function, and transforming growth factor-β (TGF-β) is believed to play an important regulatory role in post-weaning adaptation of the small intestine. The present study examined the distribution and expression intensity of TGF-β in the small intestinal mucosa of pre- and post-weaning pigs using a specific immunostaining technique and Western blot analysis. The level of TGF-β in the intestinal mucosa, as estimated by Western blot analysis, did not change significantly during weaning. However, when examined by the immunostaining technique, TGF-β1 (one of the TGF-β isoforms dominantly expressed in the tissue) at the intestinal villus epithelium, particularly at the apical membrane of the epithelium, decreased significantly 4 d after weaning, while the staining intensity increased significantly at the intestinal crypts compared with that in pre-weaning pigs. These changes were transient, with the immunostaining intensity for TGF-β1 at the intestinal villi and the crypts returning to the pre-weaning level by 8 d post-weaning. The transient decrease in TGF-β1 level at the intestinal villus epithelium was associated with obvious intestinal villus atrophy and marked reduction of mucosal digestive enzyme activities. Furthermore, the number of leucocytes staining positively for TGF-β1 increased significantly in the pig intestinal lamina propria 4 d after weaning. These findings strongly suggest that TGF-β plays an important role in the post-weaning adaptation process in the intestine of the pig.

A core part of any animal growth model is how it predicts the partitioning of dietary protein and energy to protein and lipid retention for different genotypes at different degrees of maturity. Rules of partitioning need to be combined with protein and energy systems to make predictions. The animal needs describing in relation to its genotype, live weight and, possibly, body composition. Some existing partitioning rules will apply over rather narrow ranges of food composition, animal and environment. Ideally, a rule would apply over the whole of the possible experimental space (scope). The live weight range over which it will apply should at least extend beyond the ‘slaughter weight range’, and ideally would include the period from the start of feeding through to maturity. Solutions proposed in the literature to the partitioning problem are described in detail and criticised in relation to their scope, generality and economy of parameters. They all raise the issue, at least implicitly, of the factors that affect the net marginal efficiency of using absorbed dietary protein for protein retention. This is identified as the crucial problem to solve. A problem identified as important is whether the effects of animal and food composition variables are independent of each other or not. Of the rules in the literature, several could be rejected on qualitative grounds. Those rules that survived were taken forward for further critical and quantitative analysis in the companion paper. (Sandberg et al. 2005)

Inflammation, a risk factor for cardiovascular disease, is associated with low plasma levels of antioxidant vitamins. In addition to vitamins, other antioxidants modulate the synthesis of inflammatory markers in vitro and contribute to the total antioxidant capacity (TAC) of a diet. However, the relationship between dietary TAC and markers of inflammation has never been evaluated in vivo. We investigated the relationship between dietary TAC and markers of systemic (high-sensitivity C-reactive protein (hs-CRP), leucocytes) and vascular (soluble intercellular cell adhesion molecule-1) inflammation in 243 non-diabetic subjects. General Linear Model (GLM) analysis showed a significant (P=0·005) inverse relationship between hs-CRP and quartiles of energy-adjusted dietary TAC, even when recognized modulating factors of inflammation, namely alcohol, fibre, vitamin C, α-tocopherol, β-carotene, BMI, waist circumference, HDL-cholesterol, hypertension, insulin sensitivity and plasma β-carotene, were included in the model as covariates (P=0·004). The relationship was stronger for subjects with hypertension (P=0·013 v. P=0·109 for normotensive individuals). Among dietary factors, TAC was significantly higher (5·3 (sd 3·0) v. 4·9 (sd 2·7) mmol Trolox/d; P=0·026) in subjects with low plasma hs-CRP (range: 0·0–4·1 mg/l) than in subjects with high plasma hs-CRP (range: 4·2–27·8 mg/l). We conclude that dietary TAC is inversely and independently correlated with plasma concentrations of hs-CRP and this could be one of the mechanisms explaining the protective effects against CVD of antioxidant-rich foods such as fruits, whole cereals and red wine. This could be of particular significance for subjects with high blood pressure.

This study was designed to investigate the possible effects of consuming Na-rich carbonated mineral water on bone remodelling and urinary mineral excretion in postmenopausal women. Women (n 18) included were amenorrhoeic (>1 year), healthy and not obese (BMI <30 kg/m2). No woman was taking oestrogen replacement therapy, mineral and vitamin supplements, phyto-oestrogens or medications known to affect bone and lipid metabolism. In two consecutive interventions that lasted 8 weeks each, women drank 1 litre of control mineral water daily and 1 litre of carbonated mineral water, rich in Na, HCO–3 inf super and Cl−, daily. Body weight and height were measured, BMI was calculated and blood pressure was measured. Blood samples were taken from fasting subjects and serum obtained to analyse the biochemical bone markers, procollagen I amino-terminal propeptide (PINP) and β-carboxy-terminal telopeptide of collagen (β-CTX). At the end of each period, 24 h urine samples were collected to determine Ca, Mg, P, Na+, K+, Cl−, urine excretion and urinary pH. No changes in body weight, BMI or blood pressure were observed during the experimental period. Ca excretion was lower after the intake of carbonated water than after intake of the control water (P=0·037) while P excretion was higher (P=0·015). Total urine, Na and Cl− excretion did not differ between the two periods but urinary pH was increased after the intake of carbonated mineral water. PINP and β-CTX did not differ between the two periods. Daily consumption of 1 litre of Na-rich carbonated mineral water for 8 weeks does not affect bone remodelling in healthy postmenopausal women.

The newborn infant leaves a germ-free intrauterine environment to enter a contaminated extrauterine world and must have adequate intestinal defences to prevent the expression of clinical gastrointestinal disease states. Although the intestinal mucosal immune system is fully developed after a full-term birth, the actual protective function of the gut requires the microbial stimulation of initial bacterial colonization. Breast milk contains prebiotic oligosaccharides, like inulin-type fructans, which are not digested in the small intestine but enter the colon as intact large carbohydrates that are then fermented by the resident bacteria to produce SCFA. The nature of this fermentation and the consequent pH of the intestinal contents dictate proliferation of specific resident bacteria. For example, breast milk-fed infants with prebiotics present in breast milk produce an increased proliferation of bifidobacteria and lactobacilli (probiotics), whereas formula-fed infants produce more enterococci and enterobacteria. Probiotics, stimulated by prebiotic fermentation, are important to the development and sustainment of intestinal defences. For example, probiotics can stimulate the synthesis and secretion of polymeric IgA, the antibody that coats and protects mucosal surfaces against harmful bacterial invasion. In addition, appropriate colonization with probiotics helps to produce a balanced T helper cell response (Th1 = Th2 = Th3/Tr1) and prevent an imbalance (Th1 > Th2 or Th2 > Th1) contributing in part to clinical disease (Th2 imbalance contributes to atopic disease and Th1 imbalance contributes to Crohn's disease and Helicobacter pylori-induced gastritis). Furthermore, a series of pattern recognition receptors, toll-like receptors on gut lymphoid and epithelial cells that interact with bacterial molecular patterns (e.g. endotoxin (lipopolysaccharide), flagellin, etc.), help modulate intestinal innate immunity and an appropriate adaptive immune response. Animal and clinical studies have shown that inulin-type fructans will stimulate an increase in probiotics (commensal bacteria) and these bacteria have been shown to modulate the development and persistence of appropriate mucosal immune responses. However, additional studies are needed to show that prebiotics can directly or indirectly stimulate intestinal host defences. If this can be demonstrated, then prebiotics can be used as a dietary supplement to stimulate a balanced and an appropriately effective mucosal immune system in newborns and infants.

European sea bass larvae were fed different dietary vitamin A levels. Growth, skeletal development and the expression of genes involved in larval morphogenesis were evaluated. From 7 to 42 d post-hatching, larvae were fed five isoproteic and isolipidic compound diets with graded levels of retinyl acetate (RA; RA0, RA10, RA50, RA250 and RA1000, containing 0, 10, 50, 250 and 1000 mg RA/kg DM, respectively), resulting in an incorporation of 12, 13, 31, 62 and 196 mg all-trans retinol/kg DM. Larvae fed extreme levels of RA had weights 19 % and 27 % lower than those of the RA50 group. The RA1000 diet induced a fall in growth with an increase of circulating and storage retinol forms in larvae, revealing hypervitaminosis. High levels of RA affected maturation of the pancreas and intestine. These data indicated that the optimal RA level was close to 31 mg/kg DM. Inappropriate levels of dietary RA resulted in an alteration of head organisation characterised by the abnormal development of the splanchnocranium and neurocranium, and scoliotic fish. Of the larvae fed RA1000, 78·8 % exhibited skeletal abnormalities, whereas the RA50 group presented with 25 % malformations. A linear correlation between vitamin A level and malformation percentage was observed and mainly associated with an upregulation of retinoic acid receptor-γ expression in the RA1000 group during the 2 first weeks after hatching. The expression of retinoid X receptor-α decreased during normal larval development when that of the retinoic acid receptors increased. This work highlights the involvement of retinoid pathways in the appearance of dietary-induced skeletal malformations during post-hatching development in sea bass.

Patients were fully informed as to the study objectives and benefits, and provided written consent prior to enrolment. The study protocol was approved by the Committee on Human Research at the Pomeranian Medical University, Szczecin, Poland. An intensification of free-radical reactions may contribute to accelerated atherosclerosis in kidney graft recipients. We examined the effect of a Mediterranean-type diet (MD) on the oxidative status of the plasma and erythrocytes of kidney graft recipients. Two patient groups were formed: a study group consuming the MD diet and a control group with a low-fat diet. C-reactive protein levels in plasma, oleic acid C18: 1n-9 and linoleic acid C18: 2n-6 concentrations in triacyloglycerols were determined. To determine the oxidative status, we measured the concentrations of α-tocopherol in plasma, the content of thiobarbituric acid-reactive species (TBARS) in plasma and erythrocytes, and the activities of superoxide dismutase, catalase and glutathione peroxidase in erythrocytes. In the MD group, the activities of erythrocyte enzymes changed significantly: those of superoxide dismutase increased (P<0.001 after 6 months), catalase decreased (P<0.001 after 6 months) and glutathione peroxidase decreased (P<0.05 after 2 months). The oleic acid content of triacylglycerols was increased (P<0.006) whereas that of linoleic acid was decreased (P<0.00005), α-tocopherol levels remaining unchanged. TBARS in plasma were decreased after 6 months of MD (P<0.05). No significant correlations were observed between TBARS, oleic acid, linoleic acid and α-tocopherol levels in plasma. MD appears to protect the erythrocytes against the action of free radicals, as reflected in the modified activities of some enzymes regulating the oxidative status of these blood cells.

Protein malnutrition can adversely affect all tissues. The aim of the present study was to test the hypothesis that protein deprivation influences gastric ulcer formation, as well as metabolism and organ growth, in rats. In the present study, there was a significant reduction in the body and organ weight of rats fed a low-protein diet (P<0·001). Malnourished rats were less susceptible to ulceration of the gastric mucosa in ethanol and indomethacin models of acute gastric ulcers when compared with rats fed a normoproteic diet (17 % protein). Mucus production and prostaglandin E2 formation increased in malnourished rats, possibly explaining the lower number of acute ulcers in these animals. Pylorus ligature altered gastric juice composition (increased pH and gastric volume, and decreased total acid concentration) in the animal group fed a low-protein diet compared with the group fed a diet containing 17 % protein (P<0·05). The gastric mucosa was more damaged in malnourished rats than in normal rats evaluated for 14 d after acetic acid injection (P<0·001). Malnourished rats exhibited resistance to acute gastric lesions, owing to an increase in prostaglandin GE2 release and mucus secretion, which protected their gastric mucosa. This phenomenon was not seen in subchronic gastric ulceration.

Previous studies of vitamin C absorption in man using stable isotope probes have given results which cannot easily be reconciled with those obtained using non-isotope measurement. In order to investigate some of the apparent paradoxes we have conducted a study using two consecutive doses of vitamin C, one labelled and one unlabelled, given 90 min apart. Compatibility of the experimental results with two feasible models was investigated. In Model 1, ingested vitamin C enters a pre-existing pool before absorption, which occurs only when a threshold is exceeded; in Model 2, ingested vitamin C is exchanged with a pre-existing flux before absorption. The key difference between these two models lies in the predicted profile of labelled material in plasma. Model 1 predicts that the second unlabelled dose will produce a secondary release of labelled vitamin C which will not be observed on the basis of Model 2. In all subjects Model 1 failed to predict the observed plasma concentration profiles for labelled and unlabelled vitamin C, but Model 2 fitted the experimental observations. We speculate on possible physiological explanations for this behaviour, but from the limited information available cannot unequivocally confirm the model structure by identifying the source of the supposed flux.

An adverse environmental experience of the growing fetus may lead to permanent changes in the structure and function of organs that may predispose the individual to chronic diseases in later life; however, nothing is known about the occurrence and mechanisms of heart failure. We employed a rat model in which pregnant dams were fed diets containing either 180 g (normal) or 90 g (low) casein/kg for 2 weeks before mating and throughout pregnancy. The ejection fraction (EF) of the pups exposed to the low-protein (LP) diet was severely depressed in the first 2 weeks of life and was associated with an increase in cardiomyocyte apoptosis. This early depressed cardiac function was followed by progressive recovery and normalization of the EF of the offspring in the LP group. The left ventricular (LV) internal diameters were increased between 24 h and 84 d (12 weeks) of age in the LP-exposed group. Although between 3 d and 2 weeks of age the LV wall of the heart in the LP group was thinner, a progressive increase in LV wall thickness was seen. At 40 weeks of age, although the EF was normal, a two-fold elevation in LV end-diastolic pressure, reduced cardiac output, decreased maximum rates of contraction and relaxation, and reduced mean arterial pressure were observed. Our findings demonstrate that exposure of the developing fetus to a maternal LP diet programs cardiac dysfunction in the offspring in later life.

Diet is known to modulate immune functions in multiple ways and to affect host resistance to infections. Besides the essential nutrients, non-essential food constituents such as non-digestible carbohydrates may also have an impact on the immune system, especially in the area of the gut-associated lymphoid tissue (GALT). Recent data now provide first evidence that prebiotics such as inulin/oligofructose (IN/OF) modulate functions of the immune system. In animal studies IN/OF primarily activated immune cells in Peyer's patches including IL-10 production and natural killer (NK) cell cytotoxicity. Other immune functions modulated by IN/OF included the concentration of secretory IgA in ileum and caecum, splenic NK cell cytotoxicity as well as splenocyte cytokine production. In different tumour models, a lower incidence of tumours was observed, which in the case of colonic tumours was associated with enhanced NK cell cytotoxicity in the GALT. Few human studies so far have investigated the effects of IN/OF alone or in combination with other dietary supplements on immunocompetence. Supplementation of IN/OF resulted in minor changes of systemic immune functions such as decrease in phagocytic activity. No data are available on the effects of IN/OF on the GALT in man. The mechanisms of the reported effects of IN/OF on the immune system are currently investigated and include: (i) direct effects of lactic acid-producing bacteria or bacterial constituents on immune cells; (ii) the production of SCFA and binding to SCFA receptors on leucocytes. In conclusion, the current data suggest that IN/OF primarily modulate immune parameters in the GALT, but splenocytes are also activated by IN/OF. Human studies are needed to find out whether IN/OF have the potential to modulate systemic immunity in wellnourished individuals and to lower the risk of diseases such as colon cancer.

Predicting aspects of pork quality becomes increasingly important from both a nutritional and a technological point of view. Little information is, however, available concerning the quantitative relation between nutrient intake and fatty acid (FA) deposition at the whole-animal level. In this study, eight blocks of five littermate barrows were used in a comparative slaughter trial. At 24 kg body weight (BW), one pig from each litter was slaughtered to determine the initial FA composition. The other littermates were assigned to one of four feeding levels (ranging from 70 % to 100 % of intake ad libitum) and were given a diet containing 0·36 g/kg lipid and 0·22 g/kg FA. The temperature for each block was maintained at either 23 or 30°C. At 65 kg, the pigs were slaughtered and the body lipid and FA composition was determined. Seventy per cent of the digested n-6 FA and 50 % of the n-3 FA were deposited. The average composition of de novo synthesised FA corresponded to 1·7, 30·3, 2·4, 19·7 and 45·9 % for 14: , 16: , 16: 1, 18: and 18: 1 FA, respectively. At 23°C and for feeding ad libitum, 33 % of 16: FA was deposited, 1·7 % shortened to 14: , 63 % elongated to 18: and 2·8 % unsaturated to 16: 1. Twenty-eight per cent of 18: FA was deposited and 72 % unsaturated to 18: 1. At 30°C, 18: FA desaturation was reduced by 3·5 %. Feed intake and temperature independently affected the elongation of 16: FA. A reduction in feed intake increased the elongation rate, whereas the increase in temperature reduced the elongation rate.

Literature solutions to the problem of protein and energy partitioning in the growing pig are quantitatively examined. Possible effects of live weight, genotype and food composition on the marginal response in protein retention to protein and energy intakes, on protein and energy-limiting foods are quantified. No evidence was found that the marginal response in protein retention to ideal protein supply, when protein intake is limiting, is affected by live weight, genotype or environmental temperature. There was good evidence that live weight does not affect the marginal response in protein retention to energy intake when protein intake is not limiting. Limited data for different genotypes suggested no effects on this response. A general quantitative partitioning rule is proposed that has two key parameters; ep* (the maximum marginal efficiency for retaining the first limiting amino acid) and R* (the maximum value of R, the energy to protein ratio of the food, MJ metabolisable energy (ME)/kg digestible crude protein (DCP), when ep* is just achieved). When R<R* the material efficiency of using ideal protein is (ep*/R*)× R. The value of ep* was determined to be 0·763 (se 0·0130). There was no good experimental evidence that ep* is different for different amino acids. The best estimate of R* was 67·9 (se 1·65) MJ ME/kg DCP. Live weight, genotype and temperature did not affect the values of either parameter. A more general understanding of partitioning, including the effects of ‘stressors’ such as disease, may be achieved by using the preferred rule as a starting point.

The present study was performed to investigate the effect of dietary fat and vitamin E on concentrations of cholesterol oxidation products (COP) in broiler muscle. A total of 144 1-d-old broiler chicks were fed diets with either palm oil, soyabean oil or linseed oil and vitamin E concentrations of 20, 40 or 200 mg/kg for 35 d. COP concentrations were analysed in raw, heat-processed (180°C, 20 min) and frozen-stored (−20°C, 6 months) breast and thigh muscles. COP concentrations were influenced by dietary vitamin E concentration, dietary fat, treatment and type of muscle (P<0·001). Increasing the dietary vitamin E concentration generally reduced the concentration of COP. This effect was strongest in broilers fed linseed oil and weakest in broilers fed palm oil; the effect of vitamin E was also stronger in heated muscles than in raw or frozen-stored muscles. Moreover, the concentration of COP in thigh muscle was more strongly influenced by dietary vitamin E than that in breast muscle. COP concentrations in muscles were on average highest in broilers fed linseed oil and lowest in broilers fed palm oil, but the effect of the dietary fat also depended on the vitamin E concentration, the treatment and the type of muscle. In conclusion, our study shows that dietary fat and vitamin E influence the concentrations of total COP in broiler muscle. However, the effects of these factors were not only influenced by interactions between each other, but also depended on the treatment of the muscle and the type of muscle.

Two incubation trials were carried out with the rumen-simulation technique (RUSITEC). In each trial, four vessels received a diet of grass hay and concentrate (600 and 400 g/kg DM, respectively; diet F), and the other four were fed a diet composed of concentrate and barley straw (900 and 100 g/kg DM, respectively; Diet C). Vessels were given 20 g of the corresponding diet daily, and half of them were supplemented with disodium malate to achieve a final concentration of 6.55 mM. There were no effects (P>0·05) of malate either on pH or on the daily production of NH3-N, but malate treatment increased (P<0·05) DM, neutral detergent and acid detergent fibre disappearance after 48 h incubation. The daily production of propionate and butyrate increased (P<0·001), and the ratio CH4:volatile fatty acids decreased (P<0·001) by supplementing both diets with malate. Whereas adding malate to the F diet produced an increase in acetate production (P=0·011) and the growth of solid-associated micro-organisms (P=0·037), no effects (P>0·05) were observed for diet C. For both diets, there were no differences (P>0·05) between treatments in the daily flow of liquid-associated micro-organisms measured using 15N as a microbial marker. These results indicate that malate stimulated the in vitro fermentation of both diets by increasing the apparent disappearance of the diet and decreasing the ratio of CH4:volatile fatty acids, but a greater response was observed with diet F. If these results are confirmed in vivo, malate could be used as a feed additive for ruminants fed diets containing medium proportions of forage (i.e. dairy animals) and not only in animals fed high-concentrate diets, as has so far been proposed.

Aleurone flour (ALF) is a rich source of natural folate (>500 μg/100 g wet weight). Our objective was to establish whether intake of ALF in man can significantly improve folate status and reduce plasma homocyst(e)ine. We performed a randomised, controlled intervention, of 16 weeks duration, in free-living healthy individuals (mean age 46–52 years). Participants were assigned to one of three groups: ALF, 175 g bread made with ALF and placebo tablet each day; PCS, 175 g bread made with pericarp seed coat (PCS) flour and placebo tablet each day (low-folate control); or FA, 175 g bread made with PCS flour and tablet containing 640 μg folic acid each day (high-folate control). The daily folate intake contributed by the bread and tablet was 233 μg in the PCS group, 615 μg in the ALF group and 819 μg in the FA group. The number of participants completing all phases of the PCS, ALF and FA interventions was twenty-five, twenty-five and eighteen, respectively. Plasma and red-cell folate increased significantly (P<0·0001) and plasma homocyst(e)ine decreased significantly (P<0·0001) in the ALF and FA groups only. Plasma folate and red-cell folate in the ALF group (mean, 95 % CI) increased from baseline values of 12·9 (9·9, 15·7) nmol/l and 509 (434, 584) nmol/l to 27·1 (22·5, 31·7) nmol/l and 768 (676, 860) nmol/l, respectively. Plasma homocyst(e)ine in the ALF group decreased from 9·1 (8·2, 10·0) μmol/l at baseline to 6·8 (6·2, 7·5) μmol/l after 16 weeks. In conclusion, moderate dietary intake of ALF can increase red-cell folate and decrease plasma homocyst(e)ine substantially.

The rationale for supplementing an infant formula with prebiotics is to obtain a bifidogenic effect and the implied advantages of a ‘breast-fed-like’ flora. So far, the bifidogenic effect of oligofructose and inulin has been demonstrated in animals and in adults, of oligofructose in infants and toddlers and of a longchain inulin (10 %) and galactooligosaccharide (90 %) mixture in term and preterm infants. The addition of prebiotics to infant formula softens stools but other putative effects remain to be demonstrated. Studies published post marketing show that infants fed a long-chain inulin/galactooligosaccharide mixture (0·8 g/dl) in formula grow normally and have no side-effects. The addition of the same mixture at a concentration of 0·8 g/dl to infant formula was therefore recognized as safe by the European Commission in 2001 but follow-up studies were recommended. It is thought that a bifidogenic effect is beneficial for the infant host. The rising incidence in allergy during the first year of life may justify the attempts to modulate the infant's flora. Comfort issues should not be confused with morbidity and are likely to be multifactorial. The functional effects of prebiotics on infant health need further study in controlled intervention trials.