ActiReg® is an instrument that uses combined recordings of body position and motion to calculate energy expenditure (EE) and physical activity (PA). The aim of the study was to compare mean total energy expenditure (TEE) measured by ActiReg® and doubly labelled water (DLW) in obese subjects. TEE was measured by the DLW method during a period of 14 d in fifty obese men and women with metabolic risk factors. During the same period ActiReg® recordings were obtained for 7 d. RMR was measured by indirect calorimetry and also estimated by standardized equations. Because EE may be disproportionately increased in obese subjects during weight-bearing activities, we established a new set of physical activity ratios (PAR). These ratios were based on oxygen uptake measurements during treadmill walking. The mean TEE according to the DLW was 13·94 (sd 2·47) MJ/d. Mean TEE calculated from the ActiReg® data and measured RMR was 13·39 (sd 2·26) MJ/d, an underestimation of 0·55 MJ (95 % CI 0·13, 0·98; P = 0·012) or 3·9 %. RMR derived from standard equations based on weight, age and sex were overestimated while the RMR based on fat-free mass values in addition was underestimated. Despite slight underestimation ActiReg® may be used to measure TEE in obese subjects on two premises: RMR should be measured, and the increased EE during weight-bearing activities in obese subjects should be considered.

Studies on the effects of caffeine on health, while numerous, have produced inconsistent results. One of the most uncertain and controversial effects is on pregnancy outcome. Studies have produced conflicting results due to a number of methodological variations. The major challenge is the accurate assessment of caffeine intake. The aim of the present study was to explore different methods of assessing caffeine exposure in pregnant women. Twenty-four healthy pregnant women from the UK city of Leeds completed both a detailed questionnaire, the caffeine assessment tool (CAT) designed specifically to assess caffeine intake and a prospective 3 d food and drink diary. The women also provided nine saliva samples over two consecutive days for estimation of caffeine and a metabolite (paraxanthine). Caffeine intakes from the CAT and diary showed adequate agreement (intra-class correlation coefficient of 0·5). For saliva caffeine and paraxanthine measures, the between-sample variation (within the same woman) was greater than between-woman and between-day variation. However, there was still adequate agreement between these measures and the CAT. The CAT is a valuable tool that is now being used in a large prospective study investigating caffeine's role in pregnancy outcome.

Body cell mass (BCM) is a valuable measure of functional nutritional status in children. As BCM is related to body size, it is essential that BCM is adjusted for stature when interpreting BCM data in children. Our aim was to examine the relationship between height and BCM in healthy children to determine the power by which height should be raised to adjust BCM for stature. This cross-sectional study calculated BCM by 40K counting in 146 healthy children aged between 5 and 18 years. The relationship between BCM and height was explored using log–log regression. The present results demonstrate that the power by which height should be raised to adjust for BCM in females is 2·39 (se 0·09) and for males is 2·92 (se 0·10). A simplified sex-specific version of the index, BCM/height2·5 for females and BCM/height3 for males, was found to be statistically valid and numerically convenient, with the proportion of variation that could be attributed to height being less than 2 %. The present study shows that there is a difference in the relationship between height and BCM for males and females and that BCM can be adjusted in children using the BCM index of BCM/height2·5 for females and BCM/height3 for males.

A recent paper published in the British Journal of Nutrition suggested possible reductions in mortality in association with the use of dietary supplements

Individual plasma carotenoids have been associated with various chronic diseases but little is known about the relationship between total plasma carotenoids and risk factors for chronic diseases. In the Physicians' Health Study, we examined 492 men free of CVD and cancer for the relationship between total plasma carotenoids (the sum of α-carotene, β-carotene, lycopene, zeaxanthin, lutein and β-cryptoxanthin) and a wide variety of factors that predict chronic disease. Multivariate linear and logistic regression was performed to calculate parameter estimates (95 % CI) and OR (95 % CI) for total plasma carotenoids. In linear regression models, BMI, hypertension, alcohol intake and plasma levels of each lipid parameter and α-tocopherol significantly predicted levels of total plasma carotenoids. Upon adjustment for multiple chronic disease risk factors, the OR for levels of total plasma carotenoids greater than or equal to the median ( ≥ 1·301 μmol/l) was statistically significant for current smoking (OR 0·21; 95 % CI 0·06, 0·77), weekly alcohol ingestion (OR 2·30; 95 % CI 1·06, 4·99), daily alcohol ingestion (OR 2·46; 95 % CI 1·29, 4·67), each 100 mg/l increase in total cholesterol (OR 0·73; 95 % CI 0·58, 0·91), LDL-cholesterol (OR 1·48; 95 % CI 1·17, 1·89) and HDL-cholesterol (OR 1·58; 95 % CI 1·26, 1·99), each 100 mg/ml increase in intercellular adhesion molecule-1 (OR 0·70; 95 % CI 0·53, 0·93) and each 10 μmol/l increase in α-tocopherol (OR 1·33; 95 % CI 1·12, 1·57), using logistic regression. Few lifestyle and clinical risk factors appear to be related to levels of total plasma carotenoids; however, levels of biomarkers such as plasma lipids and α-tocopherol may be strongly related.

To examine the association between several eating behaviours and obesity, data were taken from a cross-sectional study conducted with 34 974 individuals aged 25–64 years, representative of the non-institutionalised Spanish population. Obesity was defined as BMI ≥ 30 kg/m2. Study associations were summarised with OR obtained from logistic regression, with adjustment for socio-demographic and lifestyle factors. The results showed that those skipping breakfast were more likely to be obese, both in men (OR 1·58; 95 % CI 1·29, 1·93) and women (OR 1·53; 95 % CI 1·15, 2·03). Moreover, obesity was more prevalent in those having only two meals per day than in those having three or four meals in men (OR 1·63; 95 % CI 1·37, 1·95) and women (OR 1·30; 95 % CI 1·05, 1·62). Also, snacking was associated with obesity in women (OR 1·51; 95 % CI 1·17, 1·95). However, no association was observed between obesity and having one or more of the main meals away from home, in either sex. In conclusion, skipping breakfast and eating frequency were associated with obesity. The lack of association between eating away from home and obesity is in contrast to most previous research conducted in Anglo-Saxon countries. Differences in the type of establishment frequented when eating out or in the characteristics of restaurant customers in a Mediterranean population might explain these conflicting results.

Recent increases in obesity prevalence among children in developed countries are of policy concern. While significant positive associations between households' food insecurity status and body weights have been reported for adults, it is known from the energy physiology literature that energy requirements depend on BMR, anthropometric measures and physical activity. It is therefore important to model the bi-directional relationships between body weights and households' food insecurity scores especially for children that have evolving nutrient and energy requirements. The present paper estimated dynamic random effects models for children's body weights and BMI, and households' food insecurity scores using longitudinal data on 7635 children in the USA enrolled in 1st, 3rd and 5th grades (1999–2003) of the Early Childhood Longitudinal Study-Kindergarten. The main findings were, first, physical exercise and numbers of siblings were significantly (P < 0·05) negatively associated with body weights, while households' food insecurity score was not a significant predictor. Moreover, children's body weights were significantly lower in households with higher parental education and incomes; time spent watching television and in non-parental care were positively associated with weights. Second, models for households' food insecurity scores showed that poverty and respondents' poor emotional and physical health significantly increased food insecurity. Moreover, households with children who were taller and heavier for their ages faced significantly higher food insecurity levels. Overall, the results showed that household food insecurity was unlikely to exacerbate child obesity in the USA and it is important that children receive balanced school meals and perform higher physical activity.

Dr Boucher raises the question of the use of vitamin D supplements in the prospective population-based study of mortality performed among

The role of flavonoids in CVD, especially in strokes, is unclear. Our aim was to study the role of flavonoids in CVD. We studied the association between the intakes of five subclasses (flavonols, flavones, flavanones, flavan-3-ols and anthocyanidins), a total of twenty-six flavonoids, on the risk of ischaemic stroke and CVD mortality. The study population consisted of 1950 eastern Finnish men aged 42–60 years free of prior CHD or stroke as part of the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. During an average follow-up time of 15·2 years, 102 ischaemic strokes and 153 CVD deaths occurred. In the Cox proportional hazards model adjusted for age and examination years, BMI, systolic blood pressure, hypertension medication, serum HDL- and LDL-cholesterol, serum TAG, maximal oxygen uptake, smoking, family history of CVD, diabetes, alcohol intake, energy-adjusted intake of folate, vitamin E, total fat and saturated fat intake (percentage of energy), men in the highest quartile of flavonol and flavan-3-ol intakes had a relative risk of 0·55 (95 % CI 0·31, 0·99) and 0·59 (95 % CI 0·30, 1·14) for ischaemic stroke, respectively, as compared with the lowest quartile. After multivariate adjustment, the relative risk for CVD death in the highest quartile of flavanone and flavone intakes were 0·54 (95 % CI 0·32, 0·92) and 0·65 (95 % CI 0·40, 1·05), respectively. The present results suggest that high intakes of flavonoids may be associated with decreased risk of ischaemic stroke and possibly with reduced CVD mortality.

The objective of this study was to examine the association between the scores of the Children's Eating Behaviour Questionnaire (CEBQ) and BMI in a sample of Portuguese children. Using a cross-sectional design, a sample of 240 children (123 females and 117 males) aged 3–13 years were recruited from clinic and community-based settings. Parents completed the CEBQ to indicate their child's eating style for three ‘food approach’ and four ‘food avoidant’ sub-scales. Factor analyses revealed an underlying structure similar to the original CEBQ. Children's height and weight were measured to calculate BMI and Centre for Disease Control BMI z-scores. Hierarchical regression analyses controlling for gender, age and socioeconomic status indicated that all CEBQ sub-scales were significantly associated with BMI z-scores (P = 0·03 to < 0·001). Food approach scales were positively related to BMI z-scores (β = 0·33–0·51) and food avoidance negatively related (β = − 0·17 to − 0·46). Our results support the use of the CEBQ to further understand eating style as a behavioural pathway to obesity.

Flaxseed lignan secoisolariciresinol diglucoside (SDG) has been reported to prevent and alleviate lifestyle-related diseases including diabetes and hypercholesterolaemic atherosclerosis. This study assesses the effect of SDG on the development of diet-induced obesity in mice and the effect of the SDG metabolite enterodiol (END) on adipogenesis in 3T3-L1 adipocytes. We compared body weight, visceral fat weight, liver fat content, serum parameters, mRNA levels of lipid metabolism-related enzymes and adiponectin in mice fed either a low-fat diet (5 % TAG), high-fat diet (30 % TAG) or high-fat diet containing 0·5 and 1·0 % (w/w) SDG for 4 weeks. Administration of SDG to mice significantly reduced high-fat diet-induced visceral and liver fat accumulation, hyperlipaemia, hypercholesterolaemia, hyperinsulinaemia and hyperleptinaemia. SDG also suppressed sterol regulatory element binding protein 1c mRNA level in the liver and induced increases in the adiponectin mRNA level in the white adipose tissue and carnitine palmitoyltransferase I mRNA level in the skeletal muscle. Differentiated 3T3-L1 adipocytes were treated with 0, 5, 10 and 20 μmol/l END and then assayed for mRNA expression of adipogenesis-related genes and DNA binding activity of PPARγ to the PPAR response element consensus sequence. END induced adipogenesis-related gene mRNA expression including adiponectin, leptin, glucose transporter 4 and PPARγ, and induced PPARγ DNA binding activity in 3T3-L1 adipocytes. In conclusion, SDG induced adiponectin mRNA expression and showed beneficial effects on lipid metabolism in diet-induced obesity in mice. Flaxseed lignans are suggested to regulate adipogenesis-related gene expressions through an increase in PPARγ DNA binding activity.

New strategies to improve Ca absorption and bone health are needed to address the current state of osteoporosis prevention and management. Inulin-type fructans have shown great promise as a dietary intervention strategy, but have not yet been tested in a young female model. Our objective was to investigate the effect of long chain (LC) inulin on bone mineralization and density in growing, female rats, as well as the quality of growth. Weanling Sprague–Dawley rats were assigned to inulin or cellulose treatments for either 4 or 8 weeks. Growth was measured weekly and quality of growth assessed using fat pad weights and dual-energy X-ray absorptiometry (DXA). Whole body (WB) and selected regions were analysed for bone mineral density (BMD) and body composition by DXA. Serum markers of bone turnover were assessed by enzyme-linked immunosorbent assays. Ca and P concentrations were determined in excised femurs by inductively coupled plasma spectrometry. Feeding inulin resulted in 4 % higher femoral weight (adjusted for body weight) and 6 % less feed intake. Inulin did not affect WB or regional BMD, but was associated with a 28 % lower parametrial fat pad mass, 21 % less WB fat mass and 5 % less WB mass. In summary, LC-inulin lowered body fat mass, without consequence to bone density in growing female rats.

Vitamin E and β-carotene affect the immune function and might influence the predisposition of man to infections. To examine whether vitamin E or β-carotene supplementation affects tuberculosis risk, we analysed data of the Alpha-Tocopherol Beta-Carotene Cancer Prevention (ATBC) Study, a randomised controlled trial which examined the effects of vitamin E (50 mg/d) and β-carotene (20 mg/d) on lung cancer. The trial was conducted in the general community in Finland in 1985–93; the intervention lasted for 6·1 years (median). The ATBC Study cohort consists of 29 023 males aged 50–69 years, smoking at baseline, with no tuberculosis diagnosis prior to randomisation. Vitamin E supplementation had no overall effect on the incidence of tuberculosis (risk ratio (RR) = 1·18; 95 % CI 0·87, 1·59) nor had β-carotene (RR = 1·07; 95 % CI 0·80, 1·45). Nevertheless, dietary vitamin C intake significantly modified the vitamin E effect. Among participants who obtained 90 mg/d or more of vitamin C in foods (n 13 502), vitamin E supplementation increased tuberculosis risk by 72  (95 % CI 4, 185)%. This effect was restricted to participants who smoked heavily. Finally, in participants not supplemented with vitamin E, dietary vitamin C had a negative association with tuberculosis risk so that the adjusted risk was 60 (95 % CI 16, 81) % lower in the highest intake quartile compared with the lowest. Our finding that vitamin E seemed to transiently increase the risk of tuberculosis in those who smoked heavily and had high dietary vitamin C intake should increase caution towards vitamin E supplementation for improving the immune system.

Regional differences in overweight and obesity levels in England have mirrored those of CVD, with higher levels in the North. It is unclear whether the increase in the prevalence of overweight and obesity over the last 15 years has been consistent in different regions of the country. BMI data from each of the health surveys for England conducted between 1993 and 2004 were analysed. Annual grouped estimates of the prevalence of overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) for the North and the South of England were produced by appropriately combining regional administrative authorities. Logistic regression analyses were performed to assess the independence of the geographical effect after adjustment for age and social class. The prevalence of both overweight and obesity in women has risen more quickly in the North than in the South between 1993 and 2004, leading to a widening of inequalities. The prevalence of both overweight and obesity in women in the South has remained reasonably stable since 1997. The prevalence rates of both conditions in men have risen in parallel in the North and the South between 1993 and 2004 by approximately 8 %. The OR for obesity for young women increased between 1993/98 and 1998/2004 from 1·07 (1·00, 1·14) to 1·21 (1·13, 1·30). Widening geographical inequalities in overweight and obesity rates in women could lead to widening inequalities in cardiovascular and other diseases.

Intensive physical exercise may cause muscular injury and increase oxidative stress. The purpose of this study was to examine the effect of an antioxidant, coenzyme Q10 (CoQ10), on muscular injury and oxidative stress during exercise training. Eighteen male students, all elite Japanese kendo athletes, were randomly assigned to either a CoQ10 group (n 10) or a placebo group (n 8) in a double-blind manner. Subjects in the CoQ10 group took 300 mg CoQ10 per d for 20 d, while subjects in the placebo group took the same dosage of a placebo. All subjects practised kendo 5·5 h per d for 6 d during the experimental period. Blood samples were taken 2 weeks before, during (1 d, 3 d, 5 d) and 1 week after the training. Serum creatine kinase (CK) activity and myoglobin (Mb) concentration significantly increased in both groups (at 3 d and 5 d). Serum CK (at 3 d), Mb (at 3 d) and lipid peroxide (at 3 d and 5 d) of the CoQ10 group were lower than those of the placebo group. The leucocyte counts in the placebo group significantly increased (at 3 d) and neutrophils significantly increased in both groups (at 3 d and 5 d). Serum scavenging activity against superoxide anion did not change in either group. These results indicate that CoQ10 supplementation reduced exercise-induced muscular injury in athletes.

We recently reported a null outcome from a study of n-3 long-chain PUFA supplementation in depressed mood(1).

Associations between eating behaviours and dietary variables have not been thoroughly investigated in healthy postmenopausal women in a real-life uncontrolled context. To investigate how eating behaviours (cognitive dietary restraint, disinhibition and susceptibility to hunger) were associated with food and drink consumption, energy density and meal pattern in 112 healthy postmenopausal women (age 56·8 (sd 4·4) years) not on hormonal therapy. Women completed a 3 d weighed food record and filled out the Three-Factor Eating Questionnaire. The sample was divided according to the median of the distribution of cognitive dietary restraint and disinhibition (9 and 6 respectively). Both subgroups of women with high restraint level (presenting either high or low disinhibition) consumed a diet with a lower energy density than subgroups of women with lower restraint level. Women with high restraint–low disinhibition had a lower consumption of red meat and processed meat and a lower consumption of diet soft drinks than women with low restraint–high disinhibition. They were also characterised by a higher intake of whole grains than women with high restraint–high disinhibition and than women with lower restraint level (with either high or low disinhibition). Women with high restraint–high disinhibition levels showed differences in dietary variables when compared with subgroups of women with lower restraint level, namely for refined grains and diet soft drinks. We conclude that in healthy postmenopausal women, dietary consumption of specific food and drink may be related to particular eating behaviours. Women with high restraint and low disinhibition levels generally showed the most healthy dietary pattern.