Human perceptions and selection of food are derived from the prevailing and momentary food, agro-economic and cultural environment, cognitive and biological characteristics of individuals, and the real and perceived intrinsic and extrinsic attributes of foods themselves. The range of items typically chosen and consumed within a given population is largely determined by interaction of the external environmental context with guiding sets of implicit and explicit social and psychobiological ‘rules’. Within the rather broad limits of biology, individual food choices and intake behaviours relate to and reflect aspects of food availability, existing habitual behaviours, learning mechanisms, and individual beliefs and expectations. Many of the relevant features of these variables are uniquely human, together determining what is ‘food’, when, how, by and with whom it is chosen and eaten, and in what quantities. They also provide the opportunities for individuals to establish and maintain a relatively stable set of culturally and biologically determined affective responses (‘likes’) and intake behaviours. Understanding of the potential contribution of these influences under different conditions can serve to explain many of the observed characteristics of human eating, and highlight potential avenues for intervention.

Obesity is now a major public health problem in both developed and developing countries. In the UK over 16 % men and 17.5 % women are obese, an increase of more than 100 % since 1980. However, interventions to prevent and treat obesity are hampered by an inadequate understanding of the aetiology of this condition. The present paper considers the current state of knowledge regarding the causes of obesity, including some of the genetic, metabolic, behavioural and environmental factors which influence energy balance. The present paper comprises The Nutrition Society Medal Lecture and focuses in particular on the research carried out at the MRC Dunn Nutrition Centre in Cambridge. It argues that despite decades of intensive research there is relatively little evidence of genetic or metabolic defects to explain the majority of cases of human obesity. Instead we must look to behavioural and/or environmental factors which may be underpinning the current epidemic of obesity.

An ideal diet is one that promotes optimal health and longevity. Throughout history, human societies have developed varieties of dietary patterns based on available food plants and animals that successfully supported growth and reproduction. As economies changed from scarcity to abundance, principal diet-related diseases have shifted from nutrient deficiencies to chronic diseases related to dietary excesses. This shift has led to increasing scientific consensus that eating more plant foods but fewer animal foods would best promote health. This consensus is based on research relating dietary factors to chronic disease risks, and to observations of exceptionally low chronic disease rates among people consuming vegetarian, Mediterranean and Asian diets. One challenge to this consensus is the idea that palaeolithic man consumed more meat than currently recommended, and that this pattern is genetically determined. If such exists, a genetic basis for ideal proportions of plant or animal foods is difficult to determine; hominoid primates are largely vegetarian, current hunter—gatherer groups rely on foods that can be obtained most conveniently, and the archeological record is insufficient to determine whether plants or animals predominated. Most evidence suggests that a shift to largely plant-based diets would reduce chronic disease risks among industrialized and rapidly industrializing populations. To accomplish this shift, it will be necessary to overcome market-place barriers and to develop new policies that will encourage greater consump-tion of fruits, vegetables and grains as a means to promote public health.

The purpose of the present review is to examine the role played by nutrients in controlling feed intake in ruminants, in light of their particular anatomical, physiological, nutritional and behavioural characteristics. The ration is first digested in the rumen for several hours by microbial fermentation. Volatile fatty acids, which constitute 50–75 % of a ruminant’s energy supply, considerably depress feed intake when administered by short-term infusion into the rumen. However, this effect seems to be largely due to osmolarity problems. Only propionate seems to have a specific action, unrelated to osmolarity, in the mesenteric or portal veins. Nitrogenous nutrients have little short-term effect on feed intake, except when there is excess NH3 in the rumen. Metabolic cues from intestinal digestion, particularly of glucose and starch, have very little short-or long-term influence in controlling feed intake, in comparison with rumen digestion cues. However, the short-term responses in feeding behaviour do not always reflect longer-term effects on feed intake control. The effects of volatile fatty acid infusion on feed intake are much less significant over the long term, except in the case of propionate. The nutrients required for good microbial activity (proteins in the rumen) generally promote feed intake, whereas nutrients that disrupt rumen functioning (lipids) reduce feed intake. After a learning period, preferences are always governed by a tendency toward optimum rumen functioning, rather than by animal nutritional requirements, although the two factors are not independent. Ruminants, due to their particular anatomical and nutritional characteristics, have, in the course of their evolution, developed specific feed intake control mechanisms based on nutritional cues.Résumé L’objet de cette revue est d’étudier le rôle des nutriments dans les mécanismes de contrôle de la prise alimentaire chez les ruminants, en tenant compte de leurs particularités anatomiques, physiologiques, nutritionnelles et comportementales. La digestion de la ration se déroule d’abord pendant de nombreuses heures dans le rumen par fermentation des aliments par des microbes. Les acides gras volatils, qui constituent 50–75 % des nutriments énergétiques d’un ruminant, présentent des effets rassasiants marqués lorsqu’ils sont perfusés dans le rumen. Cependant, ces effets semblent liés dans une large mesure à des problèmes d’osmolarité. Seul le propionate semble agir avec une action spécifique autre que l’osmolarité au niveau des veines mésentériques ou porte. Les nutriments azotés ont peu d’effet à court terme sur la prise alimentaire, excepté en cas d’excès d’ammoniac du rumen. Les signaux métaboliques provenant de l’absorption intestinale, en particulier le glucose ou l’amidon, ont très peu d’effet, à court ou long terme, dans le contrôle de la prise d’aliment comparativement aux signaux provenant de la digestion ruminale. Mais les réponses observées à court terme dans le contrôle de la prise alimentaire ne présagent pas toujours des effets à plus long terme dans la régulation des quantités ingérées. Les effets des acides gras volatils sur les quantités ingérées sont beaucoup moins nets à long terme, sauf pour le propionate. Les nutriments indispensables au bon fonctionnement de l’activité microbienne (protéines dans le rumen) ont des effets favorables sur l’ingestion alors que les nutriments qui perturbent le fonctionnement du rumen (lipides) diminuent les quantités ingérées. Après apprentissage, les choix alimentaires s’orientent toujours vers une recherche d’un fonctionnement optimal du rumen plus que vers une bonne adéquation des apports aux besoins de l’animal, même si les deux ne sont pas indépendants. Les ruminants présentent donc, de par leurs spécificités anatomique et nutritionnelle, des adaptations originales dans les mécanismes de régulation des quantités ingérées à partir des signaux nutritionnels.

The present lecture begins with a brief overview of the professional and scientific journey taken by Rudolf Schoenheimer, before turning to a discussion of the power of isotopic tracers in nutrition research. Schoenheimer's remarkable contributions to the study of intermediary metabolism and the turnover of body constituents, based initially on compounds tagged with 2H and later with 15N, spanned a mere decade. It is difficult, however, to overestimate the enormous impact of Schoenheimer's research on the evolution of biological science. After a relative hiatus, following Schoenheimer's death in 1941, in the use of stable nuclides as tracers in metabolism and nutrition, especially in human subjects, there is now an expanded and exciting range of techniques, experimental protocols and stable-isotope tracer compounds that are helping to probe the dynamic aspects of the metabolism of the major energy-yielding substrates, amino acids and other N-containing compounds, vitamins and mineral elements in human subjects. Various aspects of the contemporary applications of these tracers in nutrition research are covered in the present lecture.

Regulation of short-term energy intake involves the balance of positive drives to eat arising from the sight, smell and palatability of food with negative feedback signals from learned associations, gastrointestinal and metabolic signals. The stomach and small intestine are major sites in the feedback inhibition of food intake and subsequent period of appetite suppression. The present paper reviews the evidence that not only does the nature of the regulatory signal suppressing food intake depend on the type and energy content of nutrient consumed, but also the specific chemical composition of the nutrients and the site at which they are delivered. It is evident that feedback inhibition of feeding can be modulated by the particular chemical structure of nutrients (e.g. specific sugar or triacylglycerol structures). These differences in response are likely to be a consequence of differences in physical properties of particular nutrients depending on their chemical structure, and may also result from different receptor affinities for specific dietary structures. Moreover, the site of administration of nutrients can also profoundly affect the size and nature of the subsequent feeding response, suggesting that feed-forward interactions occur between the taste of foods and gastrointestinal stimulation.

Fundamental changes in the global structure of food demand will lead to an extra-ordinary increase in the importance of developing countries in global food markets. Economic growth in developing countries is changing consumption patterns, with slower growth (and in many countries actual declines) in per capita food consumption of grains and rapidly growing per capita and total meat consumption, combined with induced growth in cereal feed consumption. The present paper examines the hypothesis, suggested by some researchers, that high-meat diets in developed countries limit improvement in food security in developing countries. These analysts argue that reduced meat consumption in developed countries would release cereals from livestock feed to food for poorer populations, thus improving food security in developing countries. Using the International Food Policy Research Institute (Washington, DC, USA) global food projections model, the international model for policy analysis of agricultural com-modities and trade (see Rosegrant et al. 1995), we first analyse the implications for future global cereal and meat supply and demand resulting from changes in global income, population growth and other structural changes, then simulate alternative sce-narios to examine the effect of large reductions in meat consumption in developed coun-tries on food consumption and food security in developing countries. The paper shows that while the long-term prospects for food supply, demand and trade indicate a strength-ening of world cereal and livestock markets, the improvement in food security in the developing world will be slow, and changes in the dietary patterns in developed countries are not an effective route to improvement in food security in developing countries.

Lipogenesis occurs in all vertebrate species and has a critical role in energy balance, providing a means whereby excess energy can be stored as a fat. The metabolic pathways involved and their tissue distribution in different species, including man, are well known. The responses of lipogenesis to diet and to physiological and pathological states have been the subject of many studies. At a molecular level the major rate-controlling enzymes have been identified and their acute, and to a lesser extent chronic, control by hormones have been investigated extensively. However, there is no reason to suppose that all factors regarding lipogenesis have been identified (e.g. the recent discovery of acylation-stimulating protein). Little is known about the movement of newly-synthesized triacylglycerols in cells, either for secretion or storage. The production of leptin and tumour necrosis factor α by adipocytes provides a novel means of feedback control of triacylglycerol production, leptin by decreasing appetite and tumour necrosis factor α by inducing insulin resistance. The synthesis of these peptides appears to vary with the amount of triacylglycerol in adipocytes, but the molecular basis of this process is unknown. Elucidation of the signalling systems involved in the acute and chronic regulation of lipogenesis is also important, both with respect to some homeorhetic adaptations and also in some pathological conditions (e.g. non-insulin-dependent diabetes). Finally, molecular biology is revealing unexpected complexities, such as multiple promoters and different isoforms of enzymes (e.g. acetyl-CoA carboxylase; EC 6.4.1.2) exhibiting tissue specificity. Molecular biology, through transgenesis, also offers novel and powerful means of manipulating lipogenesis.

In order to better understand the factors that may influence and regulate the intake of the macronutrients carbohydrate, fat and protein a 7 d diet diary technique was employed to study eating behaviour in the natural environment of free-living human subjects. In general, factors that promote energy intake tend to promote fat and protein intake to a greater extent than carbohydrate intake. This increased intake occurs as the result of: environmental factors such as social facilitation and the time of day, week or lunar phase; subjective factors such as hunger and elation; individual difference factors such as obesity, restraint and ageing. There are indications that the intake of macronutrients is regulated by negative feedback systems. In the short term, the amount of protein remaining in the stomach at the onset of a meal appears to have a restraining effect on intake, especially protein intake. Over several days, macronutrient intake appears to be affected by a nutrient-specific delayed negative feedback. Protein intake during 1 d is negatively associated with protein intake 2 and 3 d later, while carbohydrate intake is negatively related to later carbohydrate intake, and fat intake to later fat intake; both peaking after a 2 d delay. Studies of the intakes of twins suggested that many aspects of the control of macronutrient intake are influenced by inheritance; these factors include the overall amounts ingested, the before-meal stomach contents and the responsiveness of the subject to the negative impact of the stomach contents. The results indicate that macronutrient intakes are regulated by multiple persistent processes that are to a large extent inherited.

Fe seems to be the only nutrient deficiency that industrialized and low-income countries have in common. Thus, Fe is one of the most critical nutrition requirements to be met in most diets in human subjects. Fe deficiency is caused not only by too low an intake, but is also the result of low bioavailability, as well as an increased Fe requirement due to physiological variables or clinical problems which are not met by an increased dietary intake of Fe. In low-income countries poor dietary quality rather than Fe intake seems to be the key determinant of impaired Fe status. Sometimes the Fe intake even exceeds that in populations of industrialized countries. The interaction of all enhancers (e.g. ascorbic acid and meat), as well as inhibitors (such as bran, polyphenols, egg yolk, soyabean products, Ca, Ca3(PO4)2 and phytic acid (or phytate)) is what determines the bioavailability of non-haem-Fe in the meal. Dietary composition seems to be particularly important when Fe reserves are low, or in the presence of Fe deficiency. Furthermore, the development of anaemia as a result of Fe deficiency, secondary to Fe-stress situations, is dependent on the Fe balance in the host. With respect to the dietary intake of Fe, other products in the food consumed as well as previous treatment of the product (e.g. heat treatment and processing) may also influence bioavailability. Despite all efforts to counteract Fe deficiency it still represents one of the dominant problems in the micronutrient sphere. It is apparent that there is no simple solution to the problem, and the fact that Fe deficiency still occurs in affluent societies consuming a mixed diet speaks for itself; a more holistic view of total dietary composition and the role of enhancers and inhibitors is needed.

New techniques in air-displacement plethysmography seem to have overcome many of the previous problems of poor reproducibility and validity. These have made body-density measurements available to a larger range of individuals, including children, elderly and sick patients who often have difficulties in being submerged underwater in hydrodensitometry systems. The BOD POD air-displacement system (BOD POD body composition system; Life Measurement Instruments, Concord, CA, USA) is more precise than hydrodensitometry, is simple and rapid to operate (approximately 1 min measurements) and the results agree closely with those of hydrodensitometry (e.g. ± 3.4 % for estimation of body fat). Body line scanners employing the principles of three-dimensional photography are potentially able to measure the surface area and volume of the body and its segments even more rapidly (approximately 10s), but the validity of the measurements needs to be established. Advances in i.r. spectroscopy and mathematical modelling for calculating the area under the curve have improved precision for measuring enrichment of 2H2O in studies of water dilution (CV 0.1–0.9 % within the range of 400–1000 μl/1) in saliva, plasma and urine. The technique is rapid and compares closely with mass spectrometry (bias 1 (SD 2) %). Advances in bedside bioelectrical-impedance techniques are making possible potential measurements of skinfold thicknesses and limb muscle mass electronically. Preliminary results suggest that the electronic method is more reproducible (intra- and inter-individual reproducibility for measuring skinfold thicknesses) and associated with less bias (+ 12 %), than anthropometry (+40%). In addition to these selected examples, the ‘mobility’ or transfer of reference methods between centres has made the distinction between reference and bedside or field techniques less distinct than in the past.

Surveys have shown that 20–50 % of hospital admissions suffer from nutritional depletion and that there is failure to recognize its existence and significance. More emphasis must be placed in clinical medicine on identifying subjects who are at high risk of developing disease-related malnutrition. There is a need to screen patients on admission to hospital to identify those at risk of nutrition-related complications. More formal determination of nutritional status should be carried out to define the nutritional status of the patient and to monitor changes in nutritional status during nutritional support. The most frequently used tests of nutritional status include dietary, anthropometric, biochemical and functional indices of nutritional status. It is important, and indeed is the skill of the nutritional care team (particularly the dietitian) to be able to evaluate these measurements, as many of them are affected by non-nutritional factors. There is no consensus on the best method for the accurate assessment of nutritional status. Practical difficulties arise with individual measurements and in their interpretation in the acute setting. The aim of the present paper is to identify the most relevant variables to measure in clinical medicine, and to discuss the limitations of their use in the acute setting.

Up to 80 % of breast, bowel and prostate cancers are attributed to dietary practices, and international comparisons show strong positive associations with meat consumption. Estimates of relative risk obtained from cohort investigations are in the same direction, although generally weak, and red and processed meats rather than white meat seem to be associated with elevated risk of colon cancer. In breast cancer, there are consistent associations with total meat intake and there is evidence of a dose response. Despite these associations with meat, existing studies suggest that vegetarians do not have reduced risk of breast, bowel or prostate cancer, but there are no quantitative estimates of amounts of meat consumed by meat eaters in these cohort studies. Possible mecha-nisms underlying epidemiological associations include the formation of heterocyclic amines in meat when it is cooked. These heterocyclic amines require acetylation by P450 enzymes, and individuals with the fast-acetylating genotype who eat high amounts of meat may be at increased risk of large-bowel cancer. NH3 and N-nitroso compounds (NOC) formed from residues by bacteria in the large bowel are probably also important. NH3 is a promotor of large-bowel tumours chemically induced by NOC, and some of the chromosomal mutations found in human colo-rectal cancer are consistent with effects of NOC and heterocyclic amines. However, the type, amount, and cooking method of meat or protein associated with increased risk are not certain. The effects of high levels of meat on NH3 and NOC output are not reduced by increasing the amount of fermenta-ble carbohydrate in the diet, but interaction between meat, NSP and vegetable intakes on the risk of cancer has not been studied comprehensively. The interaction between dietary low-penetrance genetic polymorphic and somatic mutation factors has also been investigated to a limited extent. Current Department of Health (1998) recommendations are that meat consumption should not rise, and that consumers at the top end of the distribution should consider a reduction in intakes.

Cafestol and kahweol, coffee lipids present in unfiltered coffee brews, potently increase LDL-cholesterol concentration in human subjects. We searched for an animal species in which cafestol similarly increases LDL-cholesterol. Such an animal model could be used subsequently as a model to study the mechanism of action of cafestol and kahweol. Cafestol and kahweol increased serum lipids in African green monkeys (Cercopithecus aethiops), cebus (Cebus apella) and rhesus (Macaca mulatta) monkeys, hamsters, rats and gerbils differently from the increase in human subjects. In African green monkeys, the rise in total cholesterol was less pronounced than that in human subjects. In addition, the increase in total cholesterol was predominantly due to a rise in HDL-cholesterol rather than LDL-cholesterol. Thus, the rise in plasma lipids might illustrate the mechanism in these monkeys rather than the mechanism in human subjects. In other animal species, cafestol and kahweol did not raise cholesterol consistently. The variability in effects on serum lipids could not be explained by the mode of administration or dose of diterpenes, nor by the amount of cholesterol in the diet. In conclusion, we did not find an animal model in which cafestol and kahweol elevate plasma lipoproteins to the same extent as in human subjects. For the time being, therefore, studies on the mechanism of action should be done preferably in human subjects.

In the present paper we deal with the problems of explaining and predicting diet selection of animals under controlled conditions, i.e. conditions that can be described and in which any influences of the environment can be either controlled or at least monitored. Diet selection is considered within an integrative framework of feeding behaviour that views both food intake and diet selection as an outcome of the animal's internal state and knowledge of the feeding environment. Three questions that arise from the framework are considered: (1) how do animals learn about foods available to them as a choice? (2) what changes in internal state affect diet selection? (3) how much time is needed for a change in the animal's internal state to be detected and for it to react to this change through a modification of its diet selection? It is proposed that animals have developed behavioural mechanisms that allow them to recognize foods on the basis of their nutritional as well as other properties. The rate at which animals learn about foods depends largely on the extent of the animal's deficiency and on the extent of the post-ingestive consequences induced by the foods. There is little evidence that animals modify their diet selection in response to short-term systemic fluctuation of their internal environment. On the other hand, long-term changes in the internal state of the animal lead to consequent long-term changes in diet selection. The time needed for a change in diet selection to be observed depends on the deviation created in the animal's internal state, either as a result of a physiological change or as a consequence of feeding. Thus, a more appropriate question to consider is not 'what time period matters to the animal?' but 'how much change or deviation in the internal state is the animal prepared to accept?'