Since the vegetarian diet lacks the substrate for pancreatic elastase-1 as an enzyme, a decreased secretion of this enzyme could be expected. We aimed therefore to assess the changes of exocrine pancreatic secretion in a prospective way in a group of healthy omnivores who modified their diet by abstaining from meat for 1 month. Twenty healthy omnivores (fourteen females and six males) were used in the study. The nutrient intake was assessed for 7 d before commencing the study (omnivore diet) and after 1 month of dietary modification (modified diet; meat excluded). Similarly, the faecal output of pancreatic enzymes (elastase-1, chymotrypsin and lipase) was assessed before and 1 month after the period of dietary modification. Statistical differences between two points of the assessment (paired data) were calculated with the use of the Wilcoxon rank test. The relationship between the changes of faecal enzyme output and the changes in nutrient intake was assessed using multiple regression analysis. The dietary changes resulted in statistically significant decrease of faecal elastase-1 output (P < 0·05), whereas for chymotrypsin and lipase no changes were observed. No significant change in stool weight was recorded. No statistically significant correlation between changes in energy and nutrient consumption and changes in faecal output of pancreatic enzymes has been found. It was concluded that the exclusion of meat from the diet for a 1-month period results in significant changes in pancreatic secretion with a selective decrease of elastase-1 output. However, the underlying factor remains unclear.

Childhood malnutrition is known to be associated with visible lightening of hair colour (hypochromotrichia). Nevertheless, no systematic investigations have been carried out to determine the biochemical basis of this change. We used an HPLC method to measure melanins in the scalp hair of thirteen Jamaican children, diagnosed as having primary malnutrition, during various stages of their treatment and after recovery. During treatment for malnutrition, a progressive decrease in total melanin content along the hair shaft from tip to root (root:tip ratio: 0·62 (sd 0·31)) was observed. This ratio was significantly different (P = 0·003) from the ratio observed among children sampled several months after discharge from hospital (0·93 (sd 0·23)) and among normal control children (0·97 (sd 0·12)). Thus, it appears that a decrease in melanin content is associated with periods of malnutrition. The low root:tip ratio during malnutrition presumably arises because the tips reflect prior hair growth during ‘normal’ nutrition and the roots reflect hair growth during malnutrition; a return of the root:tip ratio to that seen among controls reflects ‘recovery’ from malnutrition. It is possible that reduced intake or availability of tyrosine, a key substrate in melanin synthesis, may play a role in the reduction of hair melanin content during periods of malnutrition. The precise mechanisms by which melanin content is reduced, and the role of aromatic amino acid availability in hair colour change and other features of childhood malnutrition remain to be explored.

Some blood orange juice (BOJ) flavanones may have antioxidant, anti-inflammatory, anti-allergic, hypolipidaemic, vasoprotective and anticarcinogenic properties. The aim of the present study was to evaluate the pharmacokinetics of hesperetin and naringenin in human subjects after BOJ intake. In a cross-over study, seven healthy female volunteers consumed 150 and 300 ml BOJ corresponding to about 51–102 mg hesperetin and to 6–12 mg naringenin, respectively. Plasma samples were collected before, each hour for 8 h and 24 h after BOJ administration and analysed for their content of hesperetin and naringenin by liquid chromatography–MS/MS. The plasma concentrations of these compounds were dose dependent and the peak concentration (Cmax) was reached in 5·1 (sd 0·6) h after BOJ intake. The Cmax of hesperetin was 43·4 (sd 32·4) and 79·8 (sd 60·1) ng/ml after 150 and 300 ml intake, respectively. For naringenin the plasma peak was 16·4 (sd 11·9) and 34·0 (sd 20·6) ng/ml. Moreover, the conjugated forms of these flavanones represent more than 95 % of the plasma concentration. The results indicate that both hesperetin and naringenin are bioavailable after BOJ intake; naringenin seemingly more so than hesperetin.

The effectiveness of low-fat milk, alone and with an additional 20 mmol/l NaCl, at restoring fluid balance after exercise-induced hypohydration was compared to a sports drink and water. After losing 1·8 (sd 0·1) % of their body mass during intermittent exercise in a warm environment, eleven subjects consumed a drink volume equivalent to 150 % of their sweat loss. Urine samples were collected before and for 5 h after exercise to assess fluid balance. Urine excretion over the recovery period did not change during the milk trials whereas there was a marked increase in output between 1 and 2 h after drinking water and the sports drink. Cumulative urine output was less after the milk drinks were consumed (611 (sd 207) and 550 (sd 141) ml for milk and milk with added sodium, respectively, compared to 1184 (sd 321) and 1205 (sd 142) ml for the water and sports drink; P < 0·001). Subjects remained in net positive fluid balance or euhydrated throughout the recovery period after drinking the milk drinks but returned to net negative fluid balance 1 h after drinking the other drinks. The results of the present study suggest that milk can be an effective post-exercise rehydration drink and can be considered for use after exercise by everyone except those individuals who have lactose intolerance.

Malnutrition is associated with an increased incidence of perioperative morbidity and mortality. To evaluate the effect of malnutrition on the metabolic and inflammatory response to surgery in patients with oesophageal cancer, we studied the effects of oesophagectomy in six patients with major (13·9 (se 1·3) %) weight loss and five patients with minor (0·7 (se 0·6) %) weight loss in the 6 months before to surgery. Rates of appearance (Ra) of glucose, glycerol, leucine and urea were determined by stable isotopically labelled tracer infusion before and after surgery. C-reactive protein was measured as an inflammation marker. BMI was lower in the patients with major weight loss than those with minor weight loss (20·3 (se 0·7) and 24·9 (se 1·5) kg/m2, P = 0·02). With the exception of greater glucose Ra in the major weight loss than minor weight loss subjects (11·1 (se 0·3) v. 9·5 (se 0·3) μmol/kg per min, P = 0·01), there were no differences in substrate kinetics before surgery between groups. Surgery increased glucose Ra, leucine Ra and urea Ra by 41, 24 and 58 %, respectively, in the total group. Changes in substrate kinetics in response to surgery were not different between patients with major and minor weight loss. Surgery increased C-reactive protein concentrations to a comparable extent in both groups. In conclusion, major upper gastrointestinal tract surgery in patients with oesophageal cancer elicits a catabolic response, characterized by increased inflammation, glucose production and protein breakdown. However, this catabolic response does not seem to be influenced by pre-operative nutritional status.

There has been considerable interest in the role of carotenoids in the chemoprevention of cancer. However, few studies have examined the association between intake of specific carotenoids and the risk of epithelial ovarian cancer and the results for carotenoids have been inconclusive. To investigate whether the intake of α-carotene, β-carotene, β-cryptoxanthin, lutein and zeaxanthin, and lycopene is inversely associated with ovarian cancer risk, a case–control study was conducted in China during 1999–2000. The cases were 254 patients with histologically confirmed epithelial ovarian cancer and 652 age-matched controls were randomly recruited during the same period. Habitual dietary intake and lifestyle were collected by face-to-face interview using a validated and reliable FFQ. The US Department of Agriculture nutrient composition database was used to calculate the intake of specific carotenoids. Unconditional logistic regression analyses were used to estimate OR and 95 % CI, accounting for age, locality, education, BMI, smoking, tea drinking, parity, oral contraceptive use, hormone replacement therapy, menopausal status, family history of ovarian cancer, physical activity and energy intake. Compared with the highest v. the lowest quartile of intake, the adjusted OR were 0·39 (95 % CI 0·23, 0·66) for α-carotene, 0·51 (95 % CI 0·31, 0·84) for β-carotene, 0·51 (95 % CI 0·31, 0·83) for β-cryptoxanthin, 0·45 (0·27, 0·76) for lutein and zeaxanthin, and 0·33 (95 % CI 0·20, 0·56) for total carotenoids, with statistically significant tests for trend. It is concluded that a higher intake of carotenoids can reduce the risk of epithelial ovarian cancer.

Within a prospective cohort study, we explored the long-term reproducibility of the food-frequency questionnaire (FFQ) and dietary changes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort. After a mean follow-up time of 68·8 (sd 4·1) months the dietary assessment by means of a validated FFQ was repeated in 21 462 participants in the EPIC-Heidelberg cohort. The correlation and test–retest reproducibility of both dietary intake measurements was explored. The long-term correlation coefficients ranged from 0·41 (vegetables in men) to 0·77 (alcoholic beverage consumption in women). The median intake of potatoes, added fat, sugar/confectionary, cakes and alcoholic beverages was lower in the second than in the first FFQ, whereas the median intake of fruits, vegetables, cereals/cereal products and non-alcoholic beverages were higher. Consistently for food groups, 60–70 % of the participants in both genders were re-classified to the same or adjacent quintile of intake. The results of fairly high correlation coefficients indicate good agreement between both measurements. It is acknowledged that this result reflects to a substantial extent the measurement error of the FFQ and conclusions on real changes in the diet should be drawn very carefully. For some nutrients the dietary changes were consistent with results from independent national surveys. The performance of the FFQ gives confidence in the dietary data to be used as long-term exposure variables.

Established dietary predictors of plasma total homocysteine (tHcy) include folate, riboflavin, and vitamins B6 and B12, while information is scarce regarding other dietary components. The aim of this study was to examine the relation between a variety of food groups, food items and nutrients, and plasma tHcy in a large population-based study. The study population included 5812 men and women aged 47–49 and 71–74 years who completed a 169-item FFQ. tHcy was examined across quartiles of dietary components by multiple linear regression analyses adjusting for age, sex, energy intake, various risk factors for elevated tHcy, as well as for dietary and plasma B-vitamins. Among 4578 non-users of vitamin supplements, intake of vegetables, fruits, cereals, eggs, fish and milk, as well as chicken and non-processed meats were inversely associated with tHcy level. The estimated mean difference in tHcy per increasing quartile of intake ranged from − 0·11 (95 % CI − 0·21, − 0·01) μmol/l for milk to − 0·32 (95 % CI − 0·42, − 0·22) μmol/l for vegetables. Positive associations were found for sweets and cakes. Whole-grain bread was significantly inversely related to tHcy only after additional adjustment for dietary and plasma B-vitamins. The nutrients folate, vitamin B6, B12, and riboflavin were inversely related to tHcy. Complex carbohydrates were inversely, and fat positively associated with tHcy, also after adjustment for dietary and plasma B-vitamins. In conclusion, food items rich in B-vitamins and with a low content of fat and sugar were related to lower tHcy levels. Eggs, chicken, non-processed meat, fish and milk were inversely associated with tHcy.

Because HIV/AIDS negatively impacts on the food security status of households, it is crucial to identify how households respond to these impacts, in order to identify positive food security entry points and design strategies that can effectively alleviate food insecurity among the households of people living with HIV/AIDS (PLWHA). A cross-sectional study was thus undertaken to establish how HIV affected households in an urban Ugandan setting in terms of response to food shortages and the interrelations between the practice of agriculture by PLWHA households within and around town, food security, access to food aid and dietary diversity among these households. Data for this cross-sectional study were collected using quantitative methods from 144 randomly recruited households of PLWHA (aged 15–49 years) residing in Jinja town in Eastern Uganda. The study showed that the HIV/AIDS pandemic has increased the inability of affected households in the study area to put enough food on the table, possibly because of the continued decreased productivity in these households and the high expenditure on medical costs. Various coping mechanisms identified in the households of PLWHA may contribute to poor adherence to antiretroviral regimes and poor quality of life for all household members. However, the practice of agriculture by PLWHA households was one of the positive coping mechanisms to alleviate food insecurity.

Studies on the impact of single nutrients on the risk of CVD have often given inconclusive results. Recent research on dietary patterns has offered promising information on the effects of diet as a whole on the risk of CVD. The Cardiovascular Risk in Young Finns Study is an ongoing, prospective cohort study with a 21-year follow-up to date. The subjects were children and adolescents at baseline (3–18 years, n 1768) and adults at the latest follow-up study (24–39 years, n 1037). We investigated the associations between two major dietary patterns and several risk factors for CVD. In longitudinal analyses with repeated measurements, using multivariate mixed linear regression models, the traditional dietary pattern (characterised by high consumption of rye, potatoes, butter, sausages, milk and coffee) was independently associated with total and LDL cholesterol concentrations, apolipoprotein B and C-reactive protein concentrations among both genders, and also with systolic blood pressure and insulin levels among women and concentrations of homocysteine among men (P < 0·05 for all). A dietary pattern reflecting more health-conscious food choices (such as high consumption of vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and alcoholic beverages) was inversely, but less strongly associated with cardiovascular risk factors. Our results support earlier findings that dietary patterns have a role in the development of CVD.

Tetrahydrofuran (THF) has commonly been used to deliver carotenoids to cells but the use of THF is associated with cytotoxicity and low uptake efficiency of carotenoids. Here, we used fetal bovine serum (FBS) as the delivery vehicle for lycopene in comparison with THF, THF containing 0·0025 % butylated hydroxytoluene (THF/BHT), methyl-β-cyclodextrin (M-β-CD) and micelles in two human prostate cancer cell lines, DU145 and PC-3. Lycopene (10 mm) solubilized in THF/BHT and then diluted in FBS at ratios of 5 and 10 gave the highest lycopene uptake in DU145 cells. Using a dilution factor of 10, we found that lycopene (10 μm) carried in FBS in a cell-free system led to significantly less loss of lycopene than in THF, THF/BHT and M-β-CD within 24 h of incubation. Lycopene solubilized in micelles was more stable than that in FBS within 24 h, but the micelle itself led to marked cytotoxicity to DU145 cells. Lycopene at 10 μm in FBS led to significantly higher uptake of lycopene in both cell lines than that in THF, THF/BHT or M-β-CD within 24 h of incubation. When FBS was replaced with lipoprotein-deficient serum, the uptake of lycopene by DU145 cells was markedly decreased and was not significantly different from that of THF or THF/BHT. These results demonstrate that FBS is superior to THF, THF/BHT, M-β-CD and micelles as a delivery vehicle for lycopene in prostate cell lines and that the lipoprotein of FBS is likely responsible for the improved stability and cellular uptake of lycopene.