Vitamin D is metabolised by a hepatic 25-hydroxylase into 25-hydroxyvitamin D (25(OH)D) and by a renal 1α-hydroxylase into the vitamin D hormone calcitriol. Calcitriol receptors are present in more than thirty different tissues. Apart from the kidney, several tissues also possess the enzyme 1α-hydroxylase, which is able to use circulating 25(OH)D as a substrate. Serum levels of 25(OH)D are the best indicator to assess vitamin D deficiency, insufficiency, hypovitaminosis, adequacy, and toxicity. European children and young adults often have circulating 25(OH)D levels in the insufficiency range during wintertime. Elderly subjects have mean 25(OH)D levels in the insufficiency range throughout the year. In institutionalized subjects 25(OH)D levels are often in the deficiency range. There is now general agreement that a low vitamin D status is involved in the pathogenesis of osteoporosis. Moreover, vitamin D insufficiency can lead to a disturbed muscle function. Epidemiological data also indicate a low vitamin D status in tuberculosis, rheumatoid arthritis, multiple sclerosis, inflammatory bowel diseases, hypertension, and specific types of cancer. Some intervention trials have demonstrated that supplementation with vitamin D or its metabolites is able: (i) to reduce blood pressure in hypertensive patients; (ii) to improve blood glucose levels in diabetics; (iii) to improve symptoms of rheumatoid arthritis and multiple sclerosis. The oral dose necessary to achieve adequate serum 25(OH)D levels is probably much higher than the current recommendations of 5–15 μg/d.

The purpose of the present study was to determine the effect of abomasal casein infusion on glucose uptake and abundance of the Na+/glucose co-transporter (SGLT1) 1 in the ovine small intestine. Lambs (body weight 35 (SEM 1·0) kg) were surgically fitted with abomasal infusion catheters and were fed diets containing equal portions of wheat hay and cracked maize. Lambs were infused with either 500 g water/d or with 500 g water containing 35 g casein/d. The infusion period lasted 10 d, after which lambs were killed, exsanguinated and eviscerated. Brush border membrane vesicles (BBMV) were prepared using mucosa from different small intestinal regions. Intake and total tract digestibility of nutrients were similar between treatments and averaged 1134, 1142 and 486 g/d and 67, 70, and 94 % for DM, organic matter and non-structural carbohydrates respectively. Crude protein (N×6·25) digestibility was 15 % greater in the casein-infused than control lambs. Glucose uptake to BBMV ranged from 101 to 337 pmol/mg protein per s along the small intestine and was greatest in the mid-section of the small intestine. In the mid-jejunum, glucose uptake was greater (P<0·07) in lambs infused with casein and averaged 120 pmol/mg protein per s compared with 68 pmol/mg protein per s in the control group. SGLT1 affinity was similar between treatments and averaged 104 μM in the different segments of the small intestine of lambs. However, lambs infused with casein exhibited similar values along the small intestine and affinity averaged 106 μm, while in the control group a greater affinity (85 μm) was measured in the mid-jejunum. SGLT1 protein abundance was correlated with glucose uptake in the BBMV in the casein-treated lambs, but not in the control group. These results suggest that glucose uptake along the small intestine of lambs is influenced by casein or its derivatives in the small intestine via SGLT1 affinity and activity at the brush border membrane, and that SGLT1 activity may be regulated by post-translational events affected by amino acids and peptides.

The effect of 4-coumaric and 3,4-dihydroxybenzoic (protocatechuic) acid on the basal oxidative DNA damage of rat colonic mucosa in vivo was studied, relative to vitamin E. F344 rats were treated with 4-coumaric or protocatechuic acid mixed in the diet (25 or 50 mg/kg for 2 weeks). It was observed that 4-coumaric acid (50 mg/kg) significantly decreased the basal level of the oxidative damage assessed as 8-OH-2′-deoxyguanosine levels in DNA and by the comet assay. Moreover, it was found that vitamin E (10 mg/kg) had no effect on colonic mucosa oxidation damage, whereas at a higher dose (55 mg/kg) it actually enhanced oxidative stress. The effect of 4-coumaric acid (50 mg/kg) on the expression of some glutathione-related enzymes (glutathione-S-transferase (GST)-P, GST-M2, GST-M1, γ-glutamylcysteine synthetase, glutathione peroxidase (GSPX)1 and GSPX4) was also investigated at the level of the colonic mucosa. Only the expression of GST-M2 was significantly induced by 4-coumaric acid, while protocatechuic acid was inactive. The data suggest that 4-coumaric acid acts as an antioxidant in the colonic mucosa in vivo.

We have conducted studies with juvenile yellow perch (Perca flavescens) over a period of 20 weeks to address the question of the interaction between water- and lipid-soluble antioxidant vitamins. Fish (2·25±0·14 g) were divided into twelve groups, and triplicate groups were fed one of four casein-based, semi-purified diets formulated to contain low or high vitamin E levels of either 5 or 160 mg/kg without or with vitamin C supplementation (250 mg/kg). Diets were designated as −C−E, −C+E, +C−E, or +C+E, respectively. The fish fed the +C+E diet showed significantly higher weight gain, feed intake, and feed efficiency than the groups fed vitamin C-deficient diets. Total ascorbate concentrations of liver were significantly higher in fish fed vitamin C-supplemented diets than in fish fed the vitamin C-deficient diet after 16 and 20 weeks. The liver α-tocopherol concentrations were increased by supplemental vitamin C in vitamin E-deficient dietary groups which indicates a sparing or regenerating effect of vitamin C on vitamin E. Fish fed vitamin C-deficient diets (−C−E and −C+E) exhibited severe deficiency symptoms, such as scoliosis, lens cataracts, anorexia, and haemorrhages. The cumulative mortality was significantly higher in the −C−E groups. The thiobarbituric acid-reactive substances value was significantly higher in blood plasma of fish fed a diet unsupplemented with both vitamins. The findings in the present study with yellow perch support the hypothesis that vitamin C regenerates and/or spares vitamin E in vivo.

The effects of fructans in the diet on the mucosal morphometry (height of villi, depth of the crypts, number of goblet cells), the thickness of the epithelial mucus layer and the histochemical composition of intestinal mucosubstances in the distal jejunum and the distal colon were investigated by comparing germ-free (GF) rats, rats harbouring Bacteroides vulgatus and Bifidobacterium longum (diassociated (DA) rats), and rats with a human faecal flora (HFA). The rats were fed either a commercial standard diet (ST) or ST + (50 g oligofructose (OF)–long-chain inulin (lcIN))/kg. Changes in total bacteria, bifidobacteria and Bacteroides–Prevotella in response to feeding these diets were investigated by fluorescent in situ hybridization with 16S rRNA-targeted probes both in intestinal contents (lumen bacteria) and tissue sections (mucosa-associated bacteria). The OF–lcIN-containing diet resulted in higher villi and deeper crypts in bacteria-associated, but not in GF rats. In DA and HFA rats, the colonic epithelial mucus layer was thicker and the numbers of the goblet cells were greater than in GF rats. These effects were enhanced by the OF–lcIN-containing diet. In both dietary groups, bacterial colonization of GF rats caused an increase in neutral mucins in the distal jejunum and colon. Bacteria-associated rats had more acidic mucins in the colon than GF rats, and the OF–lcIN-containing diet stimulated sulfomucins as the predominant type of acidic mucins, while sialomucins dominated in the ST-fed groups. The number of mucosa-associated bifidobacteria detected in the colon of DA and HFA rats was greater with OF–lcIN than ST (4·9 and 5·4 v. 3·5 and 4·0 log10/mm2 mucosal surface respectively), whereas the number of luminal bifidobacteria was only affected by fructans in DA rats. Bacteroides did not differ between the groups. The stabilisation of the gut mucosal barrier, either by changes in the mucosal architecture itself, in released mucins or by stimulation of mucosal bifidobacteria with fructans, could become an important topic in the treatment and prophylaxis of gastrointestinal disorders and health maintenance.

There has been much recent interest in the cardiovascular benefits of dietary isoflavones. The aim of the present in vitro studies was to investigate potential anti-thrombogenic and anti-atherogenic effects of the isoflavones genistein and daidzein in platelets, macrophages and endothelial cells. Pre-treatment with either isoflavone inhibited collagen-induced platelet aggregation in a dose-dependent manner. In a macrophage cell line (RAW 264·7) activated with interferon γ plus lipopolysaccharide, both isoflavones were found to inhibit NO production and tumour necrosis factor α (TNF-α) secretion dose-dependently, but they did not affect mRNA levels for inducible nitric oxide synthase and cyclo-oxygenase-2. Both isoflavones also dose-dependently decreased monocyte chemoattractant protein-1 secretion induced by TNF-α in human umbilical vein endothelial cells. Compared with daidzein, genistein exerted greater inhibitory effects for all parameters studied. The present data contributes to our knowledge on the molecular mechanisms by which isoflavones may protect against coronary artery disease. Further studies are required to determine whether the effects of isoflavones observed in the current in vitro studies are relevant to the aetiology of coronary artery disease in vivo.

It is not known if the ruminant animal gastrointestinal tract (GIT) can oxidise essential amino acids (AA) other than leucine. Therefore, the oxidation of four essential AA (leucine, lysine, methionine and phenylalanine), supplied systemically as labelled 1-13C forms, was monitored across the mesenteric-drained viscera (MDV; small intestine) and portal-drained viscera (PDV; total GIT), as part of a 4×4 Latin square design, in four wether sheep (35–45 kg) fed at 1·4 × maintenance. Oxidation was assessed primarily by appearance of 13CO2, corrected for sequestration of [13C]bicarbonate. The GIT contributed 25 % (P<0·001) and 10 % (P<0·05) towards whole-body AA oxidation for leucine and methionine respectively. This reduced net appearance across the PDV by 23 and 11 % respectively. The contribution of MDV metabolism to total PDV oxidation was 40 % for leucine and 60 % for methionine. There was no catabolism of systemic lysine or phenylalanine across the GIT. Production and exchange of secondary metabolites (e.g. 4-methyl-2-oxo-pentanoate, homocysteine, 2-aminoadipate) across the GIT was also limited. Less AA appeared across the PDV than MDV (P<0·001), indicative of use by tissues such as the forestomach, large intestine, spleen and pancreas. The PDV: MDV net appearance ratios varied (P<0·001) between AA, e.g. phenylalanine (0·81), lysine (0·71), methionine (0·67), leucine (0·56), histidine (0·71), threonine (0·63) and tryptophan (0·48). These differences probably reflect incomplete re-absorption of endogenous secretions and, together with the varied oxidative losses measured, will alter the pattern of AA net supply to the rest of the animal.

The aim of the present study was to investigate the potential nutritional and metabolic impact of trans (t) fatty acids (FA) on an appropriate experimental dietary model. Since previously reported experimental designs have been matter of concern, we developed a dietary model to compare the effect of t isomers and/or the saturation of FA independently of other variables. Wistar rats were fed diets containing identical amounts of nutrients and high levels of dietary fats (200 g/kg) for 30 d. Dietary fat rich in t-FA was compared with fat rich in saturated (s) FA or rich in cis (c) FA, maintaining the same length of C chain of the FA. The fats were obtained through isomerization or hydrogenation of the c-FA present in the control fat. Apparent fat absorption, energy efficiency and triacylglycerol levels in serum and liver were different in rats fed t-FA or s-FA than c-FA. The apparent fat absorption was (%): s-FA 85·7 (SD 3·4)<T-FA 93·1 (sd 0·4)<c-FA 96·7 (sd 1·1) (P<0·05). The efficiency of energy utilization was lower in t-FA (11·7 %) and s-FA (18·5 %) diets, reaching statistical significance only between s-FA and c-FA. A striking finding was the change in the lipid profile in serum and liver. Serum and hepatic triacylglycerol levels were greater for t-FA and s-FA diets than in c-FA; however, the increases on serum triacylglycerol concentrations were greater with the s-FA diet and the increases on hepatic triacylglycerol content were greater with t-FA. Knowledge of the t-FA effects on this kind of experimental dietary model could contribute to determine the potential risk of t-FA intake for man.

Capric (10:0) and lauric (12:0) acid and conjugated linoleic acid (CLA) have been shown to increase paracellular permeability across human intestinal-like Caco-2 cell monolayers. While this has generated interest in terms of improved drug absorption and delivery, little has been done in terms of their potential effect on nutrient transport across the intestinal epithelium. Therefore, the objective of the present study was to investigate the effect of these fatty acids on transepithelial Ca transport in Caco-2 cells. Cells were seeded onto permeable transport membranes and allowed to differentiate, over 21 d, into intestinal-like cell monolayers. Monolayers (n 9 per treatment) were exposed to 0 (control) or 80 μM-10:0, 80 μM-12:0, 80 μM-18:2, 80 μM-CLA (mixed isomers), 80 μM-cis-9,trans-11 CLA or 80 μM-trans-10,cis-12 CLA for 22 d after seeding (chronic effect) or for 24 h before Ca transport studies (acute effect) on day 22. After exposure, transepithelial and transcellular transport of 45Ca, fluorescein transport (a marker of paracellular Ca transport) and transepithelial electrical resistance (TEER, an indicator of permeability) were measured. Overall Ca transport and TEER in Caco-2 cells were unaffected by exposure to any of the fatty acids for 24 h, or to 18:2, CLA blend or cis-9,trans-11 CLA for 22 d. Paracellular (but not total transepithelial and transcellular) Ca transport across Caco-2 cells was significantly increased (P<0·01, by about 1·5-fold relative to the control value) by exposure to 10:0, 12:0 and trans-10,cis-12 CLA for 22 d, suggesting that these non-esterified fatty acids could potentially enhance Ca absorption in vivo.

Digestion and portal net flux of nutrients were studied in sheep fed twice daily with fresh orchard-grass. Digestive flows were measured in six fistulated sheep using the double-marker technique. Three sheep were fitted with catheters and blood-flow probes, allowing nutrient net flux measurements across the portal-drained viscera (PDV), the mesenteric-drained viscera (MDV) and the rumen. Total tract apparent digestion of N was similar to portal net appearance of N, calculated as the sum of free amino acids (FAA), peptide amino acids (PAA), NH3, and urea net fluxes. PAA accounted for 25 % of non-protein amino acid net release across the PDV. With the exception of glycine and glutamate, the small intestine was the main contributor to this PAA net release. The essential amino acid (EAA) apparent disappearance between the duodenum and the ileum was lower than the net appearance of EAA (FAA + PAA) across the MDV. The value of PDV:MDV flux of free EAA was, on average, 78 %. The rumen accounted for 30 % of the net uptake of EAA by the PDV tissues not drained by the mesenteric vein. Rumen net release of acetate, propionate, butyrate, 3-hydroxybutyrate, and lactate accounted for 70, 55, 46, 77 and 52 %, respectively, of their portal net releases. Conversely, the small intestine was a net consumer of arterial acetate and 3-hydroxybutyrate. Dynamic study of nutrient net fluxes across the PDV showed that throughout a feeding cycle, the liver faced a constant flux of amino acids (AA), whereas volatile fatty acid and NH3 net fluxes varied in response to the meal. The present study specified, in forage-fed sheep, the partitioning of nutrient net fluxes across the PDV and the role of peptides in portal net release of AA.

Considerable evidence exists that smoking significantly lowers the concentration of plasma antioxidants. While for most antioxidants this effect appears to result mainly from altered dietary habits, ascorbic acid has recently been shown to be depleted by smoking per se. However, the direct cause of ascorbate depletion remains unclear. Erythorbic acid is a stereoisomer of ascorbic acid commonly used as antioxidant in foodstuffs and has the same redox properties as ascorbic acid. We therefore investigated if erythorbic acid could be used as a non-isotopic marker of smoking-induced oxidative stress. In a sample of smokers (n 10) and non-smokers (n 10), the pharmacokinetics of erythorbic acid were followed after a single oral dose (1 g) and subsequently, the effect of a 2-week ascorbic acid supplementation (0·5 g/d) on erythorbic acid kinetics was studied in a double-blind, placebo-controlled fashion. There were no significant effects of smoking or supplementation on relative bioavailability (difference in area under curve, AUC0-∞) of erythorbic acid (smokers 357 (SD 119), non-smokers 414 (SD 142) μmol·h/l; P=0·34). Time to reach maximum plasma concentration (Tmax) was significantly less in smokers (P=0·03). If the relative pharmacokinetics of erythorbic acid between smokers and non-smokers compares with those of AA, our present results do not suggest that altered pharmacokinetics is likely to play a major role in the ascorbic acid depletion consistently observed in smokers.

Zn is an essential mineral. The role of Zn in atherosclerosis is not clear. Epidemiological studies, which have reported contradictory results, are limited by the use of serum Zn levels as a marker of intake. We assessed the association of toenail Zn, which integrates dietary Zn intake over 3 to 12 months, with the risk of a first myocardial infarction. Toenail Zn concentrations were determined by neutron activation analysis in the European multi-centre case–control study on antioxidants, myocardial infarction and breast cancer. This multi-centre case–control study included 684 cases and 724 controls from eight European countries and Israel. Toenail Zn levels of controls (adjusted for age and study centre) were positively associated with age, α-tocopherol and Se, but not with additional dietary variables or with classical risk factors for CHD. Average toenail Zn was 106·0 mg/kg in cases (95 % CI 103·1, 108·9) and 107·5 mg/kg in controls (95 % CI 104·5, 110·7). After controlling for cardiovascular risk factors and for centre, the adjusted odds ratios of myocardial infarction for quintiles 2–5 of toenail Zn with respect to the first quintile were 0·97 (95 % CI 0·59, 1·58), 1·15 (95 % CI 0·72, 1·85), 0·91 (95 % CI 0·56, 1·50), and 0·85 (95 % CI 0·52, 1·39). The P for trend was 0·45. In conclusion toenail Zn levels (reflecting long-term dietary intake) were not significantly associated with acute myocardial infarction.

Studies on animal and human subjects have shown that greatly increasing the amount of linseed (also known as flaxseed) oil (rich in the n−3 polyunsaturated fatty acid (PUFA) α-linolenic acid (ALNA)) or fish oil (FO; rich in the long-chain n−3 PUFA eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) in the diet can decrease a number of markers of immune function. The immunological effects of more modest doses of n−3 PUFA in human subjects are unclear, dose–response relationships between n−3 PUFA supply and immune function have not been established and whether ALNA has the same effects as its long-chain derivatives is not known. Therefore, the objective of the present study was to determine the effect of enriching the diet with different doses of FO or with a modest dose of ALNA on a range of functional responses of human monocytes and lymphocytes. In a randomised, placebo-controlled, double-blind, parallel study, forty healthy males aged 18–39 years were randomised to receive placebo or 3·5 g ALNA/d or 0·44, 0·94 or 1·9 g (EPA+DHA)/d in capsules for 12 weeks. The EPA:DHA ratio in the FO used was 1·0:2·5. ALNA supplementation increased the proportion of EPA but not DHA in plasma phospholipids. FO supplementation decreased the proportions of linoleic acid and arachidonic acid and increased the proportions of EPA and DHA in plasma phospholipids. The interventions did not alter circulating mononuclear cell subsets or the production of tumour necrosis factor-α, interleukin (IL) 1β, IL-2, IL-4, IL-10 or interferon-γ by stimulated mononuclear cells. There was little effect of the interventions on lymphocyte proliferation. The two higher doses of FO resulted in a significant decrease in IL-6 production by stimulated mononuclear cells. It is concluded that, with the exception of IL-6 production, a modest increase in intake of either ALNA or EPA+DHA does not influence the functional activity of mononuclear cells. The threshold of EPA+DHA intake that results in decreased IL-6 production is between 0·44 and 0·94 g/d.

The effect of dietary conjugated linoleic acid (CLA) isomers mixture on antibody titres against sheep blood erythrocytes (SRBC) and immunoglobulin (Ig) G concentration in plasma was studied in broiler chickens. In experiment 1, male and female broiler chicks (11 d of age, Cobb strain) were fed a diet supplemented with 10 g CLA or 10 g safflower-seed oil/kg diet for 2 weeks. An SRBC suspension (5:100, v/v) in a phosphate buffer was intravenously injected at 18 d of age and a blood sample was taken from the wing vein at 25 d of age. Chicks fed the CLA-supplemented diet had enhanced first antibody titres in plasma to SRBC as compared with those fed the safflower-seed oil-supplemented diet, irrespective of sex differences. In experiment 2, male broiler chicks (8 d of age, Ross strain) were fed a basal diet or a diet containing 10 g CLA/kg diet for 3 weeks. CLA in the CLA diet partially replaced the soyabean oil in the basal diet. The SRBC suspension was intravenously injected at 15 and 25 d of age and a blood sample was obtained at 21 and 29 d of age. The first antibody titres against SRBC were higher in chicks fed the CLA diet than those in chicks fed the basal diet, but the second titres were not. Plasma IgG concentrations in chicks fed the CLA diet were higher than those in chicks fed the basal diet on both sampling days. The results showed that dietary CLA enhanced antibody production in broiler chickens.

As a result of evidence documenting harmful effects of Zn supplementation on immune function and Cu status, thirty-eight men were recruited onto a Zn supplementation trial. The aim was to examine the effects of chronic Zn supplementation on circulating levels of peripheral blood leucocytes and lymphocyte subsets. Subjects (n 19) took 30 mg Zn/d for 14 weeks followed by 3 mg Cu/d for 8 weeks to counteract adverse effects, if any, of Zn supplementation on immune status resulting from lowered Cu status. A control group (n 19) took placebo supplements for the duration of the trial. Dietary intakes of Zn approximated 10 mg/d. Blood samples, taken throughout the trial, were assessed for full blood profiles and flow cytometric analyses of lymphocyte subsets. Putative indices of Cu status were also examined. Results indicate that there was no effect of Zn supplementation on circulating levels of peripheral blood leucocytes or on lymphocyte subsets. Cu status was also unaltered. Independent of supplement, there appeared to be seasonal variations in selected lymphocyte subsets in both placebo and supplemented groups. Alterations in circulating levels of B cells (cluster of differentiation (CD) 19), memory T cells (CD45RO) and expression of the intracellular adhesion molecule-1 (CD54) on T cells were observed. Findings indicated no adverse effects of Zn supplementation on immune status or Cu status and support the US upper level of Zn tolerance of 40 mg/d. The seasonal variations observed in lymphocyte subsets in the group as a whole could have implications for seasonal variability in the incidence of infectious diseases.

The present paper describes a nutritional survey carried out among Japanese-Brazilian subjects living in Bauru, south-eastern Brazil. Data were from a cross-sectional population-based study of 1283 first-generation Japanese-Brazilian subjects (Japan-born; 127 men and 121 women) and second-generation Japanese-Brazilian subjects (Brazil-born; 456 men and 573 women) aged 30–90 years. Anthropometric measurements and % body fat were measured and BMI and waist:hip ratio calculated. Dietary assessment was performed using a validated food-frequency questionnaire. A considerable proportion of men (51 %) and women (47 %) had excess weight (BMI>24·9 kg/m2). A greater waist circumference in men and women (age-adjusted by covariance analysis) was observed among Brazil-born participants. In general, only 10 % of the participants reported current practice of sports or other vigorous physical activity. Age-adjusted mean energy intakes and % energy from macronutrients were found to be similar across generations. The age-adjusted mean daily % energy intake from fat were similar across generations: among Japan-born participants, they were 31·5 (95 % CI 30·6, 32·4) % for men and 32·6 (95 % CI 31·7, 33·5) % for women. The respective figures for Brazil-born subjects were 32·1 (95 % CI 31·6, 32·6) % and 33·2 (95 % CI 32·7, 33·5) %. These values are quite different from the usual intakes reported in Japan during the last decades (about 25 %). Taking into account the traditional Japanese diet, a high energy density diet and a sedentary lifestyle may be implicated in the high prevalence of central obesity and metabolic syndrome observed among Japanese-Brazilian subjects across gender and generations.

Hypertension has been associated with abnormalities of Ca and bone metabolism. Consequently, dietary strategies aimed at reducing blood pressure may also benefit bone health; however, this issue has received little attention. Therefore, the objective of the present study was to investigate the effect of two antihypertensive-type diets on blood pressure and bone metabolism and composition in normotensive (Wistar-Kyoto NHsd, WKY) and hypertensive (spontaneously hypertensive NHsd, SHR) rats. Thirty WKY and thirty SHR male rats, 14 weeks old, were separately randomized by weight into three groups of ten rats each. One group from each strain was given a control diet while the other two groups were fed two anti-hypertensive (high fruit and vegetable (F/V) and high fruit and vegetable and low-fat dairy produce (combination)) diets for 8 weeks. SHR rats were significantly (P<0·01) heavier than WKY rats. Blood pressure and femoral length, width, dry weight, ash, Ca, Mg, P and bone mineral mass were significantly (P<0·0001) greater in SHR than WKY rats, but were unaffected by diet, irrespective of strain. While markers of bone formation (serum osteocalcin) and bone resorption (urinary pyridinoline and deoxypyridinoline) were similar in both strains, these markers were significantly (P<0·05) lower (28–31, 16–23, 31–33 % respectively) in the SHR rats fed the combination diet relative to those fed the control and F/V diets. Bone turnover in WKY rats was unaffected by diet. In conclusion, these findings suggest that the combination diet may benefit bone metabolism in hypertensive animals. However, as blood pressure was unaffected by this diet, the mechanism by which it reduced bone turnover requires further investigation.

Patients with chronic obstructive pulmonary disease (COPD) often suffer from weight loss. The aim of the present study was to gain insight into the energy balance of depleted ambulatory COPD patients, in relation to their habitual level of physical activity and consumption of oral nutritional supplements. Clinically stable and weight-stable patients (n 20; BMI 19·8± SD 2·0 kg/m2) were studied 1 and 3 months after rehabilitation or recovery in the clinic and were at random assigned to a control or intervention group with regard to nutritional supplementation. Energy intake was measured with a 7 d food record. Energy expenditure was estimated from a simultaneous 7 d assessment of physical activity with a tri-axial accelerometer for movement registration in combination with measured BMR. Body mass was measured at several time points. The body mass remained stable in both groups after 1 or 3 months and mean energy balances were comparable for both groups. The mean body-mass change between month 1 and 3 was negatively related to the mean physical activity level (r −0·49; P=0·03). Weight change over the 3 months was negatively associated with the physical activity level. These results suggest that knowledge about the individual physical activity level is necessary for the estimation of the energy need of the COPD patient.

Fighting against inactivity and inadequate nutritional intake are of utmost importance in the elderly. To our knowledge, the few studies which have been performed were conducted for only a short period and the results do not permit formal conclusions to be drawn. We therefore tried to fill this gap in our knowledge by determining whether an intervention combining an acceptable progressive exercise programme and nutritional supplements would be feasible for a long-term period in the very frail elderly, and would bring about concomitant benefits in body composition and muscle power. Accordingly, this exercise and nutritional combination was assessed in the frail elderly in a 9-month randomised trial with a factorial design. Fifty-seven elderly volunteers over 72 years, from sixteen retirement homes in Lyon, France participated in the study. Dietary supplements were compared with placebo, and physical exercise was compared with memory training. Main outcome measures were fat-free mass (FFM) and muscle power. FFM was determined by labelled water, and muscle power was measured by a leg-extensor machine. At 9 months, the compliance was 63 % for exercise sessions, and 54 % for nutritional supplements. In patients with dietary supplements, muscle power increased by 57 % at 3 months (P=0·03), and showed only a tendency at 9 months; although FFM increased by 2·7 % at 9 months, the difference was not significant (P=0·10). Exercise did not improve muscle power at 9 months, but improved functional tests (five-time-chair rise, P=0·01). BMI increased with supplements (+3·65 %), but decreased with placebo (−0·5 %) at 9 months (P=0·007). A long-term combined intervention is feasible in frail elderly individuals with a good rate of compliance. Nutritional supplements and exercise may improve muscle function. Despite no significant results on FFM, due to the limited number of volunteers, combined intervention should be suggested to counteract muscle weakness in the frail elderly.