Ole Hels

The potential association between fruit intake and body weight--a review.

Both national and international bodies recommend an increased intake of fruits and vegetables in order to decrease the risk of overweight and obesity. However, there is a rationale to investigate the separate role of fruits. The aim of this paper was to systematically review and analyse published human intervention, prospective observational and cross‐sectional studies on fruit intake and body weight in adults. We identified three intervention, eight prospective observational and five cross‐sectional studies that explored this relationship. Two of the intervention studies showed that fruit intake reduced body weight, five of the prospective observational studies showed that fruit consumption reduced the risk of developing overweight and obesity, and four of the cross‐sectional studies found an inverse association between fruit intake and body weight. Important methodological differences and limitations in the studies make it difficult to compare results. However, the majority of the evidence points towards a possible inverse association between fruit intake and overweight. Future intervention and prospective observational studies examining the direct and independent role of fruit in body‐weight management in free‐living individuals are needed. Moreover, important determinants such as energy density, energy content, fruit and vegetable consumption, physical form of fruit and preparation methods need to be included in future studies.

25-hydroxyvitamin D3 affects vitamin D status similar to vitamin D3 in pigs--but the meat produced has a lower content of vitamin D.

In food databases, the specific contents of vitamin D3 and 25-hydroxyvitamin D3 in food have been implemented in the last 10 years. No consensus has yet been established on the relative activity between the components. Therefore, the objective of the present study was to assess the relative activity of 25-hydroxyvitamin D3 compared to vitamin D3. The design was a parallel study in pigs (n 24), which from an age of 12 weeks until slaughter 11 weeks later were fed approximately 55 microg vitamin D/d, as vitamin D3, in a mixture of vitamin D3 and 25-hydroxyvitamin D3, or 25-hydroxyvitamin D3. The end-points measured were plasma 25-hydroxyvitamin D3, and in the liver and loin the content of vitamin D3 and 25-hydroxyvitamin D3. Vitamin D3 and 25-hydroxyvitamin D3 in the feed did not affect 25-hydroxyvitamin D3 in the plasma, liver or loin differently, while a significant effect was shown on vitamin D3 in the liver and loin (P < 0.001). 25-Hydroxyvitamin D3 in the plasma, liver and loin significantly correlates with the sum of vitamin D3 and 25-hydroxyvitamin D3 in the feed (P < 0.05). Therefore, 25-hydroxyvitamin D3 should be regarded as having the same activity as vitamin D3 in food databases. Sole use of 25-hydroxyvitamin D3 as a vitamin D source in pig feed will produce liver and meat with a negligible content of vitamin D3, while an increased content of vitamin D3 in the feed will produce liver and meat with increased content of both vitamin D3 and 25-hydroxyvitamin D3.

Validation of the Danish 7-day pre-coded food diary among adults: energy intake v. energy expenditure and recording length.

Under-reporting of energy intake (EI) is a well-known problem when measuring dietary intake in free-living populations. The present study aimed at quantifying misreporting by comparing EI estimated from the Danish pre-coded food diary against energy expenditure (EE) measured with a validated position-and-motion instrument (ActiReg). Further, the influence of recording length on EI:BMR, percentage consumers, the number of meal occasions and recorded food items per meal was examined. A total of 138 Danish volunteers aged 20-59 years wore the ActiReg and recorded their food intake for 7 consecutive days. Data for 2504 participants from the National Dietary Survey 2000-2 were used for comparison of characteristics and recording length. The results showed that EI was underestimated by 12 % on average compared with EE measured by ActiReg (PreMed AS, Oslo, Norway). The 95 % limits of agreement for EI and EE were - 6.29 and 3.09 MJ/d. Of the participants, 73 % were classified as acceptable reporters, 26 % as under-reporters and 1 % as over-reporters. EI:BMR was significantly lower on 1-3 consecutive recording days compared with 4-7 recording days (P < 0.03). Percentage consumers of selected food items increased with number of recording days. When recording length was 7 d, the number of reported food items per meal differed between acceptable reporters and under-reporters. EI:BMR was the same on 4 and 7 consecutive recording days. This was, however, a result of under-reporting in the beginning and the end of the 7 d reporting. Together, the results indicate that EI was underestimated at group level and that a 7 d recording is preferable to a 4 d recording period.

Food consumption, energy and nutrient intake and nutritional status in rural Bangladesh: changes from 1981 - 1982 to 1995 - 96

Objective: To determine and evaluate changes in nutritional status, food consumption, energy and nutrient intake in rural Bangladesh, using appropriate statistical analyses.Design: Repeated cross-sectional surveys. Two seasons in 1981–1982 and 1995–1996.Setting: Two villages with different production patterns.Subjects: Anthropometric measurements of 1883 individuals, food consumption data of 404 households.Methods: Repeated measurements of one-day food weighing and anthropometry in two seasons in 1981–1982 and 1995–1996. Mixed model analyses were used to evaluate and quantify temporal changes and their interactions with determinants.Results: Prevalence of underweight children decreased from 82 to 70% (P=0.015), wasted children from 34% to 18% (P=0.009) and chronic energy deficient adults decreased from 78 to 64% (P<0.0001). Intake of fish and green leafy vegetables increased from (l.s. mean±s.e.) 23±3.0 to 40±1.8 g/person/day (P<0.001) and from 28±4.5 to 41±2.7 g/person/day (P=0.019), respectively. Rice intake remained unchanged: 463±12 g raw/person/day in 1981–1982 and 450±7.3 g raw/person/day in 1995–1996 (P=0.355). Calcium and iron intakes increased by 40% (P<0.0001) and 16% (P=0.0002), respectively, whereas vitamin A intake remained unchanged.Conclusions: Nutritional status improved and intakes of nutrient dense food groups, fat, iron and calcium increased from 1981–1982 to 1995–1996.Sponsorship: Supported by the Danish Council for Research in Developing Countries, the Bilateral Programme for Enhancement of Research Capacity in Developing Countries (ENRECA), Ministry of Foreign Affairs, Denmark and the Ford Foundation.

Effect of moderate intakes of different tea catechins and caffeine on acute measures of energy metabolism under sedentary conditions

Green tea may stimulate energy metabolism; however, it is unclear if acute effects are caused by specific catechins, caffeine or their combination. The objective of the present study was to examine the separate and combined effects of different catechins and caffeine on energy expenditure (EE) and fat oxidation over a single day. Fifteen healthy, normal-weight males received capsules containing placebo, caffeine alone (150 mg), or caffeine plus a catechin mixture (600 mg) enriched in either epigallocatechin-3-gallate (EGCG), epigallocatechin or a mix of catechins, in a randomised cross-over double-blinded design. On each test day EE, respiratory quotient (RQ) and substrate oxidation were measured under sedentary conditions in a respiratory chamber for 13.5 h. We found no significant treatment effect on EE (P = 0.20) or RQ (P = 0.68). EGCG with caffeine insignificantly raised EE and fat oxidation v. caffeine-only and placebo (EE 5.71 (SE 0.12) v. 5.68 (SE 0.14) v. 5.59 (SE 0.13) MJ/12.5 h, respectively; fat oxidation 84.8 (SE 5.2) v. 80.7 (SE 4.7) v. 76.8 (SE 4.0) g/12.5 h). Catechin/caffeine combinations at these dosages and mode of application had non-significant acute effects on EE and fat oxidation. The maximum observed effect on EE of about 2 % could still be meaningful for energy balance over much longer period of exposure. However, higher short-term effects reported in the literature may reflect variations in green tea extracts, added caffeine, or synergies with physical activity. The specific mechanisms and conditions that may underpin observed longer-term benefits of catechin-enriched green tea consumption on body composition remain to be confirmed.

Pork meat increases iron absorption from a 5-day fully controlled diet when compared to a vegetarian diet with similar vitamin C and phytic acid content

Meat increases absorption of non-haem iron in single-meal studies. The aim of the present study was to investigate, over a 5 d period, the potential increasing effect of consumption of pork meat in a whole diet on the fractional absorption of non-haem iron and the total absorption of iron, when compared to a vegetarian diet. A randomised cross-over design with 3 x 5 d whole-diet periods with diets containing Danish-produced meat, Polish-produced meat or a vegetarian diet was conducted. Nineteen healthy female subjects completed the study. All main meals in the meat diets contained 60 g of pork meat and all diets had high phytic acid content (1250 mumol/d). All main meals were extrinsically labelled with the radioactive isotope (59)Fe and absorption of iron was measured in a whole body counter. The non-haem iron absorption from the Danish meat diet was significantly higher compared to the vegetarian diet (P=0.031). The mean fractional absorption of non-haem iron was 7.9 (se1.1), 6.8 (se 1.0) and 5.3 (se 0.6) % for the Danish and Polish meat diets and vegetarian diet, respectively. Total absorption of iron was higher for both meat diets compared to the vegetarian diet (Danish meat diet: P=0.006, Polish meat diet: P=0.003). The absorption ratios of the present study were well in accordance with absorption ratios estimated using algorithms on iron bioavailability. Neither the meat diets nor the vegetarian diets fulfilled the estimated daily requirements of absorbed iron in spite of a meat intake of 180 g/d in the meat diets.

The effects of l-arabinose on intestinal sucrase activity: dose-response studies in vitro and in humans

BACKGROUND On the basis of results in cell cultures, rodents, and pigs, l-arabinose may inhibit intestinal sucrase activity and thereby delay sucrose digestion. OBJECTIVE The objective was to investigate the dose-response effects of l-arabinose on intestinal sucrase activity in vitro and glucose tolerance, appetite, and energy intake in humans. DESIGN In vitro, Caco-2 cells were cultured for 21 d, homogenized, and used as an enzyme preparation with sucrose as substrate in concentrations from 7 to 280 mmol/L with 0.84, 1.4, and 2.8 mmol l-arabinose/L as inhibitor. Released glucose was measured after 30 min. In the human studies, 15 healthy men participated in a randomized, double-blind, crossover study. Sucrose beverages (75 g in 300 mL) supplemented with 0%, 1.3%, 2.7%, and 4% by weight of l-arabinose were tested at breakfast. Blood for the measurement of glucose, insulin, C-peptide, incretin hormones, and triacylglycerol was collected under fasting conditions and for 3 h postprandially. Postprandial appetite sensations and energy intake at lunch were registered. RESULTS In vitro, the addition of l-arabinose resulted in uncompetitive inhibition of sucrase activity. In the human studies, supplementation with 4% l-arabinose produced an 11% lower glucose peak, a 33% lower and delayed insulin peak, a 23% reduction in the incremental area under the curve (iAUC) for insulin, a 23% lower and delayed C-peptide peak, a 9% reduction in the iAUC for C-peptide, a 53% increase in the iAUC for glucagon-like peptide-1 (GLP-1), and a 28% reduction in the iAUC for glucose-dependent insulinotropic polypeptide. No effects on triacylglycerol, gastrointestinal symptoms, appetite ratings, or energy intake were observed. CONCLUSIONS l-Arabinose inhibits sucrase activity from Caco-2 cells; 4% l-arabinose in sucrose beverages reduces postprandial glucose, insulin, and C-peptide responses and enhances the GLP-1 response in humans without gastrointestinal adverse effects. This trial is registered at clinicaltrials.gov as NCT00302302.

Long-term sustainability of a worksite canteen intervention of serving more fruit and vegetables

OBJECTIVE To analyse the 5-year sustainability of a worksite canteen intervention of serving more fruit and vegetables (F&V). DESIGN Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste. Data were collected by the canteen staff during a 3-week continuous period and compared to data from the same five canteens measured at baseline, at end point and at 1-year follow-up. The intervention used a participatory and empowering approach, self-monitoring and networking among the canteen staff, management and a consultant. The method focused on providing ideas for increased F&V for lunch, making environmental changes in the canteens by giving access to tasteful and healthy food choices and reducing the availability of unhealthy options. SETTING Five Danish worksites serving from 50 to 500 meals a day: a military base, an electronic component distributor, a bank, a town hall and a waste-handling facility. SUBJECTS Worksite canteen managers, canteen staff. RESULTS Four of the five worksite canteens were able to either maintain the intervention or even increase the consumption of F&V. The average increase from baseline to 5-year follow-up was 95 g per customer per meal per day (18, 144, 66, 105 and 141 g, respectively). On average, the five canteens at the long-term follow-up had an F&V consumption of 208 g/meal per customer. CONCLUSIONS The present study indicates that sustainability of F&V is possible in worksites where the participatory and empowering approach, self-monitoring, environmental change, dialogue with suppliers and networking among worksite canteens are applied.

Effect of phylloquinone supplementation on biochemical markers of vitamin K status and bone turnover in postmenopausal women.

While current intakes of phylloquinone (vitamin K1) in many populations are believed to be sufficient to maintain normal blood coagulation, these may be insufficient to cover the requirements for optimal bone metabolism. Therefore, the objective of the present study was to investigate the effect of increasing phylloquinone intakes above the usual dietary intake for 6 weeks on biochemical markers of vitamin K status and bone turnover in postmenopausal women. Thirty-one postmenopausal women completed this 3 x 6-week randomised cross-over study, in which volunteers were supplemented with 0 (placebo), 200, and 500 microg phylloquinone/d. In addition, the volunteers were given 10 microg vitamin D3/d throughout the study period. With increasing phylloquinone intake, the concentration of serum gamma-carboxylated and under-gamma-carboxylated osteocalcin was significantly increased and decreased, respectively, in a dose-dependent manner (P < 0.001). Mean serum phylloquinone concentration was significantly (P < 0.001) higher with daily supplementation with 500 microg phylloquinone/d compared with that during either of the placebo or 200 microg phylloquinone/d supplementation periods, which did not differ (P = 0.15). Serum total osteocalcin was significantly (P < 0.001) increased in response to daily supplementation with 500 (but not 200) microg phylloquinone compared with placebo. Serum bone-specific alkaline phosphatase as well as the urinary markers of bone resorption (N-telopeptide cross-links of collagen, pyridinoline and deoxypyridinoline) and urinary gamma-carboxyglutamate were unaffected by phylloquinone supplementation. In conclusion, while daily supplementation with 200 and 500 microg phylloquinone/d for 6 weeks increased vitamin K status in postmenopausal women, it had no effect on bone turnover.

Total zinc absorption in young women, but not fractional zinc absorption, differs between vegetarian and meat-based diets with equal phytic acid content.

Zn bioavailability is often lower in vegetarian diets mainly due to low Zn and high phytic acid contents. The objective of the present study was to determine the fractional and total absorption of Zn from a vegetarian diet in comparison with meat diets with equal concentrations of phytic acid. A randomized cross-over design, comprising three whole-day diet periods of 5 d each, with a vegetarian diet or diets containing Polish-produced meat or Danish-produced meat, was conducted. Twelve healthy female subjects completed the study. All diets had a high content of phytic acid (1250 micromol/d) and in the meat diets the main meals contained 60 g pork meat. All main meals were extrinsically labelled with the radioactive isotope 65Zn and absorption of Zn was measured in a whole-body counter. The mean Zn content of the whole-day diet was: Polish meat diet 9.9 (SE 0.14) mg, Danish meat diet 9.4 (SE 0.19) mg and vegetarian diet 7.5 (SE 0.18) mg. No difference was observed in the fractional absorption of Zn (Polish meat diet: 27 (SE 1.2) %, Danish meat diet: 27 (SE 1.9) % and vegetarian diet: 23 (SE 2.6) %). A significantly lower amount of total Zn was absorbed from the vegetarian diet (mean Zn absorption of Polish meat diet: 2.7 (SE 0.12) mg/d (P<0.001), Danish meat diet: 2.6 (SE 0.17) mg/d (P=0.006) and vegetarian diet: 1.8 (SE 0.20) mg/d). In conclusion, the vegetarian diet compared with the meat-based diets resulted in lower amounts of absorbed Zn due to a higher content of Zn in the meat diets, but no difference was observed in the fractional absorption of Zn.