Liquids have been shown to have a low satiating efficiency. The may be related to the high rate of consumption for liquids which may be higher than 200 g/min. In a number of studies, we showed that the positive relationship between eating rate and energy intake is mediated by oro-sensory exposure time. Longer sensory exposure times are consistently associated with lower food intakes. This observation maybe linked to the role of cephalic phase responses to foods. Cephalic phase responses are a set of physiological responses, which are conceived to prepare the digestive system for the incoming flow of nutrients after ingestion, with the aim of maintaining homeostasis. Results from various studies suggest that cephalic phase responses are much smaller (absent) for liquids compared to solids. It is hypothesised that the absence of cephalic phase responses to liquid foods may be one of the causes why liquid energies enter the body undetected and lead to weak energy intake compensation. This idea fits with the concept of the taste system as a nutrient-sensing system that informs the brain and the gastro-intestinal system about what is coming into our body. With liquids, this system is bypassed. Slower eating may help the human body to associate the sensory signals from food with their metabolic consequences. Foods that are eaten quickly may impair this association, and may therefore lead to overconsumption of energy, and ultimately to weight gain.

Health claims on food products, which aim at informing the public about the health benefits of the product, represent one type of nutrition communication; the use of these is regulated by the European Union. This paper provides an overview of the research on health claims, including consumers’ perceptions of such claims and their intention to buy products that carry health-related claims. This is followed by a discussion on the results from some recent studies investigating public perceptions and willingness to use products with health claims. In these studies, claims are presented in the form of messages of different lengths, types, framing, with and without qualifying words and symbols. They also investigate how perceptions and intentions are affected by individual needs and product characteristics. Results show that adding health claims to products does increase their perceived healthiness. Claim structure was found to make a difference to perceptions, but its influence depended on the level of relevance, familiarity and individuals’ need for information. Further, the type of health benefit proposed and the base product used also affected perceptions of healthiness. The paper concludes that while healthiness perceptions relating to products with health claims may vary between men and women, old and young and between countries, the main factor influencing perceived healthiness and intention to buy a product with health claim is personal relevance.

Aluminium is the most common metallic element, but has no known biological role. It accumulates in the body when protective gastrointestinal mechanisms are bypassed, renal function is impaired, or exposure is high – all of which apply frequently to preterm infants. Recognised clinical manifestations of aluminium toxicity include dementia, anaemia and bone disease. Parenteral nutrition (PN) solutions are liable to contamination with aluminium, particularly from acidic solutions in glass vials, notably calcium gluconate. When fed parenterally, infants retain >75% of the aluminium, with high serum, urine and tissue levels. Later health effects of neonatal intravenous aluminium exposure were investigated in a randomised trial comparing standard PN solutions with solutions specially sourced for low aluminium content. Preterm infants exposed for >10 d to standard solutions had impaired neurologic development at 18 months. At 13–15 years, subjects randomised to standard PN had lower lumbar spine bone mass; and, in non-randomised analyses, those with neonatal aluminium intake above the median had lower hip bone mass. Given the sizeable number of infants undergoing intensive care and still exposed to aluminium via PN, these findings have contemporary relevance. Until recently, little progress had been made on reducing aluminium exposure, and meeting Food and Drug Administration recommendations (<5 μg/kg per d) has been impossible in patients <50 kg using available products. Recent advice from the UK Medicines and Healthcare regulatory Authority that calcium gluconate in small volume glass containers should not be used for repeated treatment in children <18 years, including preparation of PN, is an important step towards addressing this problem.

Endothelial damage is central to the initiation and progression of atherosclerosis, while in addition vascular endothelial cells secrete several anti-atherogenic substances including the potent vasodilator nitric oxide. Increased adhesion molecule expression, in response to pathophysiological stimuli is perhaps the earliest indicator of compromised endothelial integrity. Obesity and adiposity are associated with an increased risk of CVD, influencing disease progression via a number of mechanisms, including enhanced endothelial activation. This review discusses possible mechanisms linking adiposity and more specifically regional fat depots with endothelial function and evaluates studies investigating the effect of weight loss on endothelial function, assessed by biochemical and physiological measurements. Overall, the research to date suggests that visceral adiposity is a stronger predictor of endothelial activation than overall adiposity, possibly mediated via the action of NEFA in circulation. While in general there is a suggestion that weight loss is associated with significant improvements in endothelial function, this is not apparent in all interventions and published literature to date provides less than convincing evidence for the effects of weight loss on endothelial activation.

Over a decade of intense research in the field of obesity has led to the knowledge that chronic, excessive adipose tissue expansion leads to an increase in the risk for CVD, type 2 diabetes mellitus and cancer. This is primarily thought to stem from the low-grade, systemic inflammatory response syndrome that characterises adipose tissue in obesity, and this itself is thought to arise from the complex interplay of factors including metabolic endotoxaemia, increased plasma NEFA, hypertrophic adipocytes and localised hypoxia. Plasma concentrations of vitamins and antioxidants are lower in obese individuals than in the non-obese, which is hypothesised to negatively affect the development of inflammation and disease in obesity. This paper provides a review of the current literature investigating the potential of nutraceuticals to ameliorate the development of oxidative stress and inflammation in obesity, thereby limiting the onset of obesity complications. Research has found nutraceuticals able to positively modulate the activity of adipocyte cell lines and further positive effects have been found in other aspects of pathogenic obesity. While their ability to affect weight loss is still controversial, it is clear that they have a great potential to reverse the development of overweight and obesity-related comorbidities; this, however, still requires much research especially that utilising well-structured randomised controlled trials.

The metabolic response to surgical trauma is mainly characterised by an increase in BMR, a negative N balance, increased gluconeogenesis and increased synthesis of acute-phase proteins. These reactions aim at ensuring the availability of endogenous substrates for healing wounds while the synthesis of acute-phase proteins enhances the scavenging process and helps repair. However, if this process is excessive or continues for too long, it leads to a progressive depletion of body compartment with a consequent adverse outcome. Obviously, the severity of such depletion is magnified if the patient is starving or is already malnourished and the consumption of lean body mass is not compensated by an exogenous supply of nutrients. The nutritional control of this metabolic reaction represents the traditional rationale for nutritional support of surgical patients. Subsequent data have shown that the negative effects of starvation are not simply due to the starvation per se but due to the starving gut, and peri-operative enteral nutrition has proven successful in blunting the metabolic response after injury and improving protein kinetics, net balance and amino acid flux across peripheral tissue and consequently in decreasing the complications. Finally, further clinical research has shown that many post-operative infections may result from immune suppression and that such state might be reversed to some degree by modulation of the immune response through specialised nutritional support in surgical patients, regardless of their nutritional status. This paper will focus on the updated evidence-based research on peri-operative nutrition (parenteral, enteral and immune-enhancing) in patients undergoing major surgery.

As long as health communications have existed in the USA, Americans have faced the task of sorting the agenda of the source from the advice it provides. That task has become more complicated as advances in the science of nutrition and the technology used to present it have heightened the complexity of nutrition communications. Getting consumers to adopt a healthier diet has been a protracted undertaking with limited successes along the way. The obesity epidemic has added urgency to this discourse: not only do we need to eat better, but most of us also need to eat less. This paper reviews the dynamics that have made the communication of accurate and actionable health behaviour information an ongoing challenge, and outlines strategies for moving ahead. It considers the interplay of four sets of factors: the evolutionary nature of the science on which recommendations are based; the many sources of communication about that science; the agendas or motivations of each source; and finally the multifaceted nature of consumers, the recipients of these communications. Communication alone has not been, and will not be, sufficient for consumers to adopt the behavioural changes endorsed by experts. Broad environmental interventions coupled with individual skills development will need to be part of the process. Ultimately, it is the consumer who decides what is for dinner. Media literacy will play a critical role in building consumer efficacy in sorting fact from fiction in order to select food for a healthful diet.

Investigations of the impact of physical activity on appetite control have the potential to throw light on the understanding of energy balance and therefore, upon body weight regulation and the development of obesity. Given the complexity of the landscape influencing weight regulation, research strategies should reflect this complexity. We have developed a research approach based on the concept of the psychobiological system (multi-level measurement and analysis) and an experimental platform that respects the operations of an adaptive regulating biological system. It is important that both sides of the energy balance equation (activity and diet) receive similar detailed levels of analysis. The experimental platform uses realistic and fully supervised levels of physical activity, medium-term (not acute) interventions, measurement of body composition, energy metabolism (indirect calorimetry), satiety physiology (gut peptides), homeostatic and hedonic processes of appetite control, non-exercise activity, obese adult participants and both genders. This research approach has shown that the impact of physical activity on appetite control is characterised by large individual differences. Changes in body composition, waist circumference and health benefits are more meaningful than changes in weight. Further, we are realising that the acute effects do not predict what will happen in the longer term. The psychobiological systems approach offers a strategy for simultaneously investigating biological and behavioural processes relevant to understanding obese people and how obesity can be managed. This experimental platform provides opportunities for industry to examine the impact of foods under scientifically controlled conditions relevant to the real world.