Equol is a metabolite of the isoflavone daidzein (Dz) and is produced by the bacterial microflora in the distal intestine and colon. Some epidemiological studies have reported an association between increased equol production and intakes of green tea or dietary fibre, which are ingredients of the standard Japanese diet. We examined the effects of a diet supplemented with Dz and tea catechin or dietary fibre on equol production and bone mineral density in ovariectomised (OVX) mice. Female mice of the ddY strain were either sham operated or OVX. OVX mice were fed a control diet, a 0·1 % Dz-supplemented diet or a 0·1 % Dz diet supplemented with one of the food components commonly consumed in the Japanese diet. The mice were given 1 % tea catechin (w/w) as part of the diet in Expt 1 or 5 % polydextrose (PD) and 5 % raffinose (Raf) (w/w) as part of the diet in Expt 2. Catechin reduced serum equol levels and attenuated the beneficial effect of Dz on femoral bone loss. The soluble dietary fibres PD and Raf stimulated equol production, and enhanced the bone-protective effects of Dz on femoral bone. These results suggest that dietary fibre, in particular, PD, may alter the bioavailability of isoflavones and prevent osteopenia in OVX mice.

Neutering is a risk factor for obesity in companion animals. In a study to determine the total energy requirements of kittens (15–52 weeks) the impact of neutering and age when neutered on intake and body weight (BW) was investigated. Females (n 14), neutered when 19 (early neuter; EN) or 31 (conventional neuter; CN) weeks old (n 7/group), were individually fed to maintain an ideal body condition score (BCS). EN kittens gained weight gradually whilst CN kittens’ BW gain slowed from week 24, weighing less than EN kittens from week 30 with a reduced energy intake (kcal/kg BW0·67) in weeks 24–32 (P < 0·05). Following neutering, CN cats’ BW and energy intake increased rapidly (energy intake CN > EN in weeks 36–40). Although EN required earlier diet restriction, acute hyperphagia and increased rate of BW gain following neutering were not observed. Earlier neutering may aid healthy weight management through growth when regulating intake to maintain an ideal BCS.

Enhancing performance through dietary measures is constantly sought as some supplements have shown modest performance enhancement in rodents and human subjects. To evaluate a proprietary dietary supplement, a study was undertaken to assess the effect of diet and exercise on blood physiological parameters during a tracking American Fox Hound field championship. Ten dogs were assigned to two different groups. Group A received a commercial kibble and Group B received the same diet with the addition of a supplement added to the dietary premix for 4 weeks before the field event. Blood was collected at rest, immediately following days 1 and 2 of the event and 48 h after day 2. Blood chemistry, complete blood cell counts and cortisol concentrations were analysed. Competition performance was also documented for all dogs using a points system for tracking events. Many chemistry parameters and blood cell counts changed significantly due to exercise. Differences between the dietary groups showed that Group B had significantly lower aspartate aminotransferase on days 1 and 2 of exercise and lower creatine kinase on day 2. Based on tracking scores, dogs in Group B out-performed dogs in Group A. This study suggests that endurance hunting dogs develop changes in serum markers of musculoskeletal integrity that might be mitigated by the addition of the supplement, resulting in better performance. Although intriguing, follow-up controlled studies are needed to ensure that the enhanced performance was not biased due to lack of randomisation.

The objective of the present study was to evaluate intakes and serum levels of vitamin A, vitamin E, and related compounds in a cohort of maternal–infant pairs in the Midwestern USA in relation to measures of health disparities. Concentrations of carotenoids and tocopherols in maternal serum were measured using HPLC and measures of socio-economic status, including food security and food desert residence, were obtained in 180 mothers upon admission to a Midwestern Academic Medical Center labour and delivery unit. The Kruskal–Wallis and independent-samples t tests were used to compare measures between groups; logistic regression models were used to adjust for relevant confounders. P < 0·05 was considered statistically significant. The odds of vitamin A insufficiency/deficiency were 2·17 times higher for non-whites when compared with whites (95 % CI 1·16, 4·05; P = 0·01) after adjustment for relevant confounders. Similarly, the odds of being vitamin E deficient were 3·52 times higher for non-whites (95 % CI 1·51, 8·10; P = 0·003). Those with public health insurance had lower serum lutein concentrations compared with those with private health insurance (P = 0·05), and living in a food desert was associated with lower serum concentrations of β-carotene (P = 0·02), after adjustment for confounders. Subjects with low/marginal food security had higher serum levels of lutein and β-cryptoxanthin compared with those with high food security (P = 0·004 and 0·02 for lutein and β-cryptoxanthin). Diet quality may be a public health concern in economically disadvantaged populations of industrialised societies leading to nutritional disadvantages as well.

Obesity levels in cats are increasing and the main causative factor is higher energy intake v. energy expenditure over time. Therefore, altering energy expenditure by enhancing physical activity of the cat could be a strategy to reduce obesity. Hydrating commercial dry diets with water increased activity in cats; however, no study has compared this approach with feeding high-moisture canned diets. Eight healthy male neutered domestic shorthair cats were fed four different dietary treatments in a Latin square design. Treatments were a canned diet ‘as is’ (82 % moisture) and freeze-dried (4 %), a dry diet ‘as is’ (3 %) and with added water (70 %). Cat activity was measured continuously using Actical® accelerometers. Cats were group housed during the first 14 d of each period and then moved to individual cages for 7 d with faecal and urine production measured over the final 4 d. Intake was similar for each diet. The average activity over 24 h was not different between treatments (P > 0·05). However, the ratio between average activity during the day v. at night was higher when cats were fed the dry diet (P = 0·030). Total water intake and urine volume increased when the canned diet was fed (P < 0·001). The similarity in total activity of the cats on the treatments indicates that dietary moisture or diet type did not have a major effect on these cats. However, the stronger diurnal activity patterns observed in the cats when they were fed the dry diet are intriguing and require further study.

Animal by-product meals have large variability in crude protein (CP) content and digestibility. In vivo digestibility procedures are precise but laborious, and in vitro methods could be an alternative to evaluate and classify these ingredients. The present study reports prediction equations to estimate the CP digestibility of meat and bone meal (MBM) and poultry by-product meal (PM) using the protein solubility in pepsin method (PSP). Total tract CP digestibility of eight MBM and eight PM samples was determined in dogs by the substitution method. A basal diet was formulated for dog maintenance, and sixteen diets were produced by mixing 70 % of the basal diet and 30 % of each tested meal. Six dogs per diet were used to determine ingredient digestibility. In addition, PSP of the MBM and PM samples was determined using three pepsin concentrations: 0·02, 0·002 and 0·0002 %. The CP content of MBM and PM ranged from 39 to 46 % and 57 to 69 %, respectively, and their mean CP digestibility by dogs was 76 (2·4) and 85 (2·6) %, respectively. The pepsin concentration with higher Pearson correlation coefficients with the in vivo results were 0·0002 % for MBM (r 0·380; P = 0·008) and 0·02 % for PM (r 0·482; P = 0·005). The relationship between the in vivo and in vitro results was better explained by the following equations: CP digestibility of MBM = 61·7 + 0·2644 × PSP at 0·0002 % (P = 0·008; R2 0·126); and CP digestibility of PM = 54·1 + 0·3833 × PSP at 0·02 % (P = 0·005; R2 0·216). Although significant, the coefficients of determination were low, indicating that the models were weak and need to be used with caution.

The recommended daily dose of vitamin D is 2000 IU was found to be insufficient in many patients. The objective of the present study is to find whether the daily dose of vitamin D should be based on BMI. Two hundred and thirty patients with an established vitamin D deficiency (serum level of 25 Hydroxy vitamin D3 (25OHD3) of ≤20 ng/ml) and patients with BMI ≥30 kg/m2 were included in the study. Demographic data, comorbidities and BMI were recorded. Pre-treatment and post-treatment serum 25OHD3, calcium, phosphorus and parathyroid hormone (PTH) were tested at 0-, 3- and 6-month periods. Patients were treated with a standard dose of 50 000 IU of vitamin D weekly and 600/1200 mg of calcium a day. Once their level of 25OHD3 reached ≥30 ng/ml, patients were randomised into two groups. Group A received a standard recommended maintenance dose of 2000 IU daily and Group B patients received 125 IU/kg/m2 of vitamin D3. The data were entered in the database and analysed. The mean age of Group A was 50⋅74 ± 7⋅64 years compared to 52⋅32 ± 7⋅21 years in Group B. In both groups, pre-treatment vitamin D level was ≤15 ng/ml and increased to 34⋅6 ± 2⋅6 and 33⋅7 ± 2⋅4 ng/ml at the end of 3 months treatment with a dose 50 000 IU of vitamin D3 and calcium 600/1200 mg once a day for group A and group B, respectively. At 6 months, patients in Group A 25OHD3 level was 22⋅8 ± 3⋅80 and in Group B was 34⋅0 ± 1⋅85 ng/ml (P < 0⋅001). This preliminary study suggests that obese patients need higher dosage of vitamin D than the recommended dose. It is prudent that the dosage should be based on the BMI to maintain normal levels for a healthy musculoskeletal system.

Cancer is the third leading cause of death in Kenya. However, there is scarce information on the nutritional status of cancer patients to guide in decision making. The present study sought to assess the risk of malnutrition, and factors associated with malnutrition and cachexia, among cancer out-patients, with the aim of informing nutrition programmes for cancer management in Kenya and beyond. This was a facility-based cross-sectional study performed at Kenyatta National Hospital and Texas Cancer Centre in Nairobi, Kenya. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool (MUST). Diagnoses of malnutrition and cachexia were done using the European Society of Clinical Nutrition and Metabolism (ESPEN) and Fearon criteria, respectively. A total of 512 participants were assessed. Those at risk of malnutrition were 33·1 % (12·5 % at medium risk, 20·6 % at high risk). Prevalence of malnutrition was 13·4 %. The overall weight loss >5 % over 3 months was 18·2 % and low fat-free mass index was 43·1 %. Prevalence of cachexia was 14·1 % compared with 8·5 % obtained using the local criteria. Only 18·6 % participants had received any form of nutrition services. Age was a predictor of malnutrition and cachexia in addition to site of cancer for malnutrition and cigarette smoking for cachexia. The use of the MUST as a screening tool at the first point of care should be explored. The predictive value of current nutrition assessment tools, and the local diagnostic criteria for malnutrition and cachexia should be reassessed to inform the development of appropriate clinical guidelines and future capacity-building initiatives that will ensure the correct identification of patients at risk for timely care.

The aim of the present study was to assess the relative validity of a new web-based 24-h dietary recall (R24W) in terms of vegetable and fruit (VF) intake assessment using serum carotenoid concentrations as reference biomarkers. A total of seventy-four women and seventy-three men (mean age 47·5 (sd 13·3) years; mean BMI 25·5 (sd 4·4) kg/m2) completed the R24W four times to assess their VF intake. Serum carotenoids were obtained from 12-h fasted blood samples and measured by HPLC. Raw and de-attenuated partial Spearman's correlations were performed to determine how usual vegetable and/or fruit intake was associated with serum carotenoids. Relevant confounders were selected using a stepwise regression analysis. Finally, cross-classification was used to determine agreement between intake of VF and serum carotenoids. Intake of total dietary carotenoids was significantly associated (r 0·40; P < 0·01) with total serum carotenoids (without lycopene). Total VF intake was also associated with total serum carotenoid concentrations without lycopene (r 0·44; P < 0·01). HDL-cholesterol, waist circumference and age were identified as confounders in the association between total VF intake and total serum carotenoids (without lycopene). De-attenuated partial correlation adjusted for these confounders increased the associations between dietary carotenoids and total serum carotenoids without lycopene (r 0·49; P < 0·01) and between total VF intake and total serum carotenoids without lycopene (r 0·48; P < 0·01). Almost 80 % of respondents were classified in the same or the adjacent quartile for total VF intake and total serum carotenoids without lycopene, while less than 6 % were classified in the opposite quartile. Overall, these observations support the appropriateness of the R24W to assess the dietary intake of VF.

Circumstantial evidence suggests that substitution of glucose or sucrose by the low-glycaemic index sugar galactose in the diet may lead to greater thermogenesis and/or fat oxidation. Using ventilated hood indirect calorimetry, we investigated, in twelve overnight-fasted adults, the resting energy expenditure (REE) and respiratory quotient (RQ) for 30 min before and 150 min after ingestion of 500 ml of water containing 60 g of glucose, fructose or galactose in a randomised cross-over design. REE increased similarly with all three sugars, reaching peak values after 50–60 min, but its subsequent fall towards baseline values was faster with galactose and glucose than with fructose (P < 0·001). RQ increased with all three sugars, but to a much greater extent with galactose and fructose than with glucose, particularly after 1 h post-ingestion. When ingested as a sugary drink, postprandial thermogenesis and utilisation of fat after galactose are not higher than after glucose or fructose.

Currently it is estimated that about 1 billion people globally have non-alcoholic fatty liver disease (NAFLD), a condition in which liver fat exceeds 5 % of liver weight in the absence of significant alcohol intake. Due to the central role of the liver in metabolism, the prevalence of NAFLD is increasing in parallel with the prevalence of obesity, insulin resistance and other risk factors of metabolic diseases. However, the contribution of liver fat to the risk of type 2 diabetes mellitus and CVD, relative to other ectopic fat depots and to other risk markers, is unclear. Various studies have suggested that the accumulation of liver fat can be reduced or prevented via dietary changes. However, the amount of liver fat reduction that would be physiologically relevant, and the timeframes and dose–effect relationships for achieving this through different diet-based approaches, are unclear. Also, it is still uncertain whether the changes in liver fat per se or the associated metabolic changes are relevant. Furthermore, the methods available to measure liver fat, or even individual fatty acids, differ in sensitivity and reliability. The present report summarises key messages of presentations from different experts and related discussions from a workshop intended to capture current views and research gaps relating to the points above.

The Mediterranean (MED) diet was associated with a reduced risk of chronic disease, but the epidemiological studies reported inconsistent findings related to the MED diet and non-alcoholic fatty liver disease (NAFLD) risk. This age and the gender-matched case-control study were conducted among 247 adult patients. The MED diet score was obtained based on the Trichopoulou model. Multivariate logistic regression was used to examine the association between the MED diet and NAFLD risk. NAFLD prevalence in people with low, moderate and high adherence to the MED diet was 33, 13⋅1 and 4⋅6 %, respectively. The increasing intake of the MED diet was significantly related to the increment intake of nuts and fruits, vegetables, monounsaturated fatty acid/polyunsaturated fatty acid ratio, legumes, cereals and fish. However, total energy consumption, low-fat dairy and meats intake were reduced (P for all < 0⋅05). Following control for age, the person in the highest of the MED diet tertile compared with the lowest, the odds of NAFLD decreased (OR: 0⋅40, 95 % CI: 0⋅17–0⋅95). This relation became a little stronger after further adjusting for sex, diabetes, physical activity and supplement intake (OR: 0⋅36, 95 % CI: 0⋅15–0⋅89). However, this association disappeared after adjusting for body mass index, waist and hip circumference (OR: 0⋅70, 95 % CI: 0⋅25–1⋅97). High adherence to the MED diet was associated with a 64 % reduction in NAFLD odds before some anthropometric variable adjustments. However, further prospective studies are required, particularly in BMI-stratified models.

Little information exists on how to garner political commitment to strengthen large-scale breastfeeding policies and programmes by targeting key decision makers. The present study aims to map and describe the influence of stakeholders involved in breastfeeding policy and programming and identify opportunities to strengthen the breastfeeding-friendly environment in Mexico. A total of nine key informants from seventeen stakeholder organisations were selected based on their in-depth knowledge of the breastfeeding environment in Mexico and were individually interviewed using Net-Map methodology. This participatory interview technique combines stakeholder mapping, social network analysis and influence mapping to identify relevant stakeholders. Participants identified a total of fifty-five stakeholders shaping breastfeeding programmes and policies through four domains of influence: commands (n 32 stakeholders), dissemination (n 40), funding (n 35) and technical assistance (n 37). The Federal Ministry of Health emerged as the most influential stakeholder of breastfeeding policy and programming decisions in Mexico among all domains of influence. The Ministry of Finance and Public Credit as well as the National Institute of Public Health were identified as additional key stakeholders providing funding and technical assistance to the Federal Ministry of Health, respectively. Engaging identified key stakeholders can generate a multisectoral commitment to breastfeeding and strengthen the breastfeeding-friendly environment in Mexico.

Increasingly domestic cats live in an overfeeding and underexercising environment where obesity is a major health concern. One strategy to aid healthy body weight maintenance is dietary energy dilution. Published data indicate that increasing dietary moisture content leads to a reduction in energy intake and increased activity. However, a number of different methodologies were employed in these studies and associated changes in physical activity have only been measured once. The aim of the present study was to determine the effect of diets of three different moisture contents offered in excess of energy requirements, on body weight, energy intake and physical activity in adult neutered cats. Sixty-nine adult cats randomised into three groups, received 100 % of their daily individual maintenance energy requirements (IMER) of dry diet or dry diet hydrated to 40 or 80 % total moisture content (tmc). Baseline activity, intake, body weight and body composition were measured. Following this baseline phase, the cats received the same diets at 200 % of daily IMER and the measurements repeated over the next 28 d. When offered the diets at 200 % IMER, cats fed the dry diet significantly increased body weight and percentage of body fat (P < 0·01), while those offered the hydrated diets did not (P > 0·01). The levels of physical activity in cats offered the hydrated 80 % tmc diet were significantly (P < 0·01) higher than those offered the dry or 40 % tmc diet. We suggest that dietary energy dilution by addition of water may be a useful strategy for healthy body weight maintenance in overfed cats.

The aim of the present study was to scrutinise the influence of maternal high-fat diet (mHFD) consumption during gestation and lactation on exercise performance and energy metabolism in male mouse offspring. Female C3H/HeJ mice were fed either a semi-synthetic high-fat diet (HFD; 40 % energy from fat) or a low-fat diet (LFD; 10 % energy from fat) throughout gestation and lactation. After weaning, male offspring of both groups received the LFD. At the age of 7·5 weeks half of the maternal LFD (n 20) and the mHFD (n 21) groups were given access to a running wheel for 28 d as a voluntary exercise training opportunity. We show that mHFD consumption led to a significantly reduced exercise performance (P < 0·05) and training efficiency (P < 0·05) in male offspring. There were no effects of maternal diet on offspring body weight. Lipid and glucose metabolism was disturbed in mHFD offspring, with altered regulation of cluster of differentiation 36 (CD36) (P < 0·001), fatty acid synthase (P < 0·05) and GLUT1 (P < 0·05) gene expression in skeletal muscle. In conclusion, maternal consumption of a HFD is linked to decreased exercise performance and training efficiency in the offspring. We speculate that this may be due to insufficient muscle energy supply during prolonged exercise training. Further, this compromised exercise performance might increase the risk of obesity development in adult life.

Malnutrition among adolescents is often associated with inadequate dietary diversity (DD). We aimed to explore the prevalence of inadequate DD and its socio-economic determinants among adolescent girls and boys in Bangladesh. A cross-sectional survey was conducted during the 2018–19 round of national nutrition surveillance in Bangladesh. Univariate and multivariable logistic regression was performed to identify the determinants of inadequate DD among adolescent girls and boys separately. This population-based survey covered eighty-two rural, non-slum urban and slum clusters from all divisions of Bangladesh. A total of 4865 adolescent girls and 4907 adolescent boys were interviewed. The overall prevalence of inadequate DD was higher among girls (55⋅4 %) than the boys (50⋅6 %). Moreover, compared to boys, the prevalence of inadequate DD was higher among the girls for almost all socio-economic categories. Poor educational attainment, poor maternal education, female-headed household, household food insecurity and poor household wealth were associated with increased chances of having inadequate DD in both sexes. In conclusion, more than half of the Bangladeshi adolescent girls and boys consumed an inadequately diversified diet. The socio-economic determinants of inadequate DD should be addressed through context-specific multisectoral interventions.

The aim of the study was to investigate the effect of prebiotic fibres on appetite-regulating hormones, subjective feeling of appetite and energy intake in subjects with type 2 diabetes. Data presented are secondary outcomes of a study investigating the effect of prebiotics on glucagon-like peptide-1 and glycaemic regulation. We conducted a randomised and placebo-controlled crossover trial to evaluate the effects of 16 g/d of inulin-type fructans or a control supplement (maltodextrin) for 6 weeks in randomised order, with a 4-week washout period in-between, on appetite in thirty-five men and women with type 2 diabetes. Data were collected at visits before and after each treatment: plasma concentration of the satiety-related peptides ghrelin and peptide YY (PYY) were assessed during a standardised mixed meal. The subjective sensation of appetite was evaluated in response to an ad libitum lunch by rating the visual analogue scale. Twenty-nine individuals (twelve women) were included in the analyses. Compared to control treatment, the prebiotics did not affect ghrelin (P =0⋅71) or the ratings of hunger (P = 0⋅62), satiety (P = 0⋅56), fullness (P = 0⋅73) or prospective food consumption (P = 0⋅98). Energy intake also did not differ between the treatments. However, the response of PYY increased significantly after the control treatment with mean (sem) 11⋅1 (4⋅3) pg/ml when compared to the prebiotics −0⋅3 (4⋅3) pg/ml (P = 0⋅013). We observed no effect of inulin-type fructans on appetite hormones, subjective feeling of appetite or energy intake in patients with type 2 diabetes.

Dietary patterns high in fibre and green leafy vegetables have shown an inverse association with lower risks of type 2 diabetes mellitus and improved glycaemic control. The study aimed to investigate the effects of increased vegetable intake and conventional diabetes diet on glycaemic control among type 2 diabetic patients. White-collar workers from one telecommunication company with type 2 diabetes were assigned to two treatment groups by cluster randomisation. Individuals with known type 2 diabetes and poor glycaemic control (HbA1c ≥8 g%) were eligible and a total of 84 subjects were recruited. Subjects in the intervention group (n 41) were offered to attend seminars and intensive coaching weekly to encourage them to increase raw vegetable intake. The control group (n 40) followed the conventional diet according to the guidelines of the Indonesian Society of Endocrinology. Glycated haemoglobin (HbA1c), plasma lipids, blood pressure, vegetable intake and anthropometric measurements were assessed at baseline and end line of 12 weeks intervention. A regression analysis was conducted using differences in HbA1C between baseline and 12 weeks as the dependent variable. Student's t test was conducted for the changes of biochemical indicators from baseline to end line during the period of 12 weeks intervention. Glycaemic control improved in the intervention group and mean HbA1C, fasting blood glucose and post-prandial blood glucose in the intervention group decreased significantly along with body weight, waist circumference and total cholesterol. The finding suggested that the intervention which emphasised raw vegetable intake contributed to improved glycaemic control among Indonesian adults with type 2 diabetes mellitus.