Search

Observational research, mainly prospective cohort studies (PCS), has represented a long-standing challenge for those attempting to draw up consistent policy recommendations in the area of diet and health. This has been due to the inherent limitations in ascribing causality from observed associations due to problems of confounding of the findings and publication and citation bias. Developments in nutritional epidemiology research over the past 20–30 years have enabled causal criteria to be derived from observational studies and the totality of the primary literature to be reviewed objectively, reducing previous focus on narrative accounts of individual studies. The gold standard approach to assessing causal relationships is via randomised controlled trials (RCT), but neither RCT nor PCS provide direct evidence for biological plausibility, which is a key criterion for assessing causality. Although extensive mechanistic data are available in the literature, a systematic approach to select and assess quality and relevance of published studies has not been available. This limits their use in the development of diet and health policy. Recent studies have investigated a proposed two-step framework and novel methodologies for integrating heterogeneous data from cell, animal and human studies. Pilot and feasibility studies have shown this to be a useful novel approach to studies of diet and cancer, but further refinements are required, including development of appropriate quality criteria which are less dependent on RCT designs. Future studies are needed to fully verify the approach and its potential for use in other diet–disease relationships.

The regulation of health claims for foods by the Nutrition and Health Claims Regulation is intended, primarily, to protect consumers from unscrupulous claims by ensuring claims are accurate and substantiated with high quality scientific evidence. In this position paper, the Academy of Nutrition Sciences uniquely recognises the strengths of the transparent, rigorous scientific assessment by independent scientists of the evidence underpinning claims in Europe, an approach now independently adopted in UK. Further strengths are the separation of risk assessment from risk management, and the extensive guidance for those submitting claims. Nevertheless, four main challenges in assessing the scientific evidence and context remain: (i) defining a healthy population, (ii) undertaking efficacy trials for foods, (iii) developing clearly defined biomarkers for some trial outcomes and (iv) ensuring the composition of a food bearing a health claim is consistent with generally accepted nutrition principles. Although the Regulation aims to protect the consumer from harm, we identify some challenges from consumer research: (i) making the wording of some health claims more easily understood and (ii) understanding the implications of the misperceptions around products bearing nutrition or health claims. Recommendations are made to overcome these challenges. Further, the Academy recommends that a dialogue is developed with the relevant national bodies about Article 12(c) in the Regulation. This should further clarify the GB Guidance to avoid the current non-level playing field between health professionals and untrained ‘influencers’ who are not covered by this Article about the communication of authorised claims within commercial communications.

Scope Dietary fat composition is an important modulator of vascular function. Non-esterified fatty acids (NEFA) enriched in saturated fatty acids (SFA) are thought to reduce vascular reactivity by attenuating insulin signalling via vasodilator pathways (phosphoinositide 3-kinase (PI3K)/Akt/endothelial nitric oxide synthase (eNOS)) and enhancing signalling via pro-inflammatory pathways. Methods To examine the effects of fatty acids on these pathways, human aortic endothelial cells were incubated with single fatty acids, and mixtures of these fatty acids to mimic typical NEFA composition and concentrations achieved in our previous human study. RNA was extracted to determine gene expression using real-time RT-PCR and cell lysates prepared to assess protein phosphorylation by Western blotting. Results Oleic acid (OA, 100 µM) was shown to down regulate expression of the insulin receptor, PTEN and a PI3K catalytic (p110β) and regulatory (p85α) subunit compared to palmitic, linoleic and stearic acids (P 1177. Both concentration and composition of the SFA and SFA plus n-3 polyunsaturated fatty acids (PUFA) mixtures had significant effects on genes involved in the PI3K/Akt pathway. Greater up-regulation was found with 800 than 400 µM concentration (respective of concentrations in insulin resistant and normal individuals), whereas greater down-regulation was evident with SFA plus n-3 PUFA than SFA mixture alone. Conclusion Our findings provide novel insights into the modulation of the PI3K/Akt/eNOS pathway by single fatty acids and fatty acid mixtures. In particular, OA appears to promote signalling via this pathway, with further work required to determine the primary molecular site(s) of action.

The food industry faces the difficult challenge of reformulating many of their products to meet increasingly stringent targets to reduce energy density by adjusting fat and sugar levels. However, reducing fat in products raises multiple risks for consumer satisfaction because of the consequent effects on both the multimodal sensory experience of the product and the extent to which satiety post‐ingestion meets expected satiety. Recognising that this complex problem requires an interdisciplinary approach, the Mouth‐Gut‐Brain project brought together academic expertise in food and sensory science, the psychology of appetite and the biophysics of food microstructure, with the support of seven industry partners, to develop novel, innovative approaches to enable successful reformulation of fat in a snack context. The project recognised the multifaceted nature of fat perception, and how it affects the psychological and physiological responses to consumption and ingestion. The outcomes of the research programme, comprising the characterisation of sensory and satiety responses of volunteers in the context of two novel fat‐reduced snack products, will be published over the next year and will help inform future novel approaches to fat reduction.

This Position Paper from the Academy of Nutrition Sciences is the first in a series which describe the nature of the scientific evidence and frameworks that underpin nutrition recommendations for health. This first paper focuses on evidence which underpins dietary recommendations for prevention of non-communicable diseases. It considers methodological advances made in nutritional epidemiology and frameworks used by expert groups to support objective, rigorous and transparent translation of the evidence into dietary recommendations. The flexibility of these processes allows updating of recommendations as new evidence becomes available. For CVD and some cancers, the paper has highlighted the long-term consistency of a number of recommendations. The innate challenges in this complex area of science include those relating to dietary assessment, misreporting and the confounding of dietary associations due to changes in exposures over time. A large body of experimental data is available that has the potential to support epidemiological findings, but many of the studies have not been designed to allow their extrapolation to dietary recommendations for humans. Systematic criteria that would allow objective selection of these data based on rigour and relevance to human nutrition would significantly add to the translational value of this area of nutrition science. The Academy makes three recommendations: (i) the development of methodologies and criteria for selection of relevant experimental data, (ii) further development of innovative approaches for measuring human dietary intake and reducing confounding in long-term cohort studies and (iii) retention of national nutrition surveillance programmes needed for extrapolating global research findings to UK populations.

On 26 April 2016, the British Nutrition Foundation (BNF) held a half-day conference in London on ‘Nutrition science – past, present and future’. This began by considering the dramatic changes that have influenced diets over the past 25 years in relation to government policy, the food supply, food in schools and communications. Dietary surveys, particularly the National Diet and Nutrition Survey, have allowed the nation's dietary intake to be monitored over this period. These surveys have played an important role in supporting science and policy, and highlighted changes and trends in nutrient intakes and status of the UK population over the past 25 years. In terms of health, there has been a dramatic increase in average life expectancy globally during the 20th century and the conference considered recent advances in understanding of the ageing process, epigenetics and nutrition across the life-course. A number of lifestyle factors are recognised to influence risk of chronic diseases in later life. For example, dietary recommendations reflect the link between fat, particularly saturated fatty acids, and cardiovascular disease, although this has been widely debated in recent years. The conference concluded with considerations to what the future might hold for nutrition, as we grapple with decisions about what to grow and produce to ensure sustainability of the food supply in the face of likely climate change and a growing and more prosperous global population.

Healthy nutritional status is found to be associated with health outcomes across the life course. As people age, nutritional status becomes more important; nutritional risk and malnutrition may impede older adults’ ability to maintain overall well-being, limit their physical strength, and ultimately impact their mobility within their environment. However, the relationship between nutritional risk and declines in life-space mobility is unknown. Using the University of Alabama-Birmingham (UAB) Study of Aging II, we examined the effects of nutritional risk on life-space mobility among 412 community-dwelling older adults age 75+ in Alabama. We used the Mini Nutritional Assessment (MNA®), a well-validated assessment tool for nutritional risk. Life-space mobility scores range from 0 (“totally bed-bound”) to 120 (“traveled out of town every day without assistance”). We employed multivariate regression models that adjusted for demographic factors, baseline life-space mobility, and other measures of health. We found that the life-space mobility scores declined by 4.3 (p

Purpose of review Recently published meta-analyses of cohort studies and randomized controlled trials (RCTs) have challenged the link between saturated fatty acid (SFA) intake and coronary heart disease (CHD) risk. This review considers the outcome of these studies in the context of other evidence. Recent findings Recent meta-analyses of cohort studies suggest that reducing SFA intakes has little impact on CHD risk when replaced by carbohydrates. The evidence for benefits on CHD risk of replacing SFA with unsaturated fatty acids in cohort studies is stronger and is also supported by data from a recent Cochrane analysis of RCTs of dietary SFA reduction and CHD risk. This review highlights the challenges of cohort studies involving diet because of the changing patterns of dietary behaviour and other multifactorial risk factors. The studies included are normally conducted over many years and are often dependent on a single measurement of dietary intake. Summary The link between SFA intake, plasma cholesterol, and CHD risk is based on a broad range of evidence including mechanistic studies, RCTs of surrogate end points and clinical outcomes, as well as multinational population comparisons. Public health nutrition policy should continue to take into account the totality of evidence with recognition of the limitations of dietary cohort studies.

BACKGROUND: Although many randomized controlled trials (RCTs) have examined the effects of the n-3 (ω-3) fatty acids eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3) on blood pressure (BP) and vascular function, the majority have used doses of EPA+DHA of >3 g/d, which are unlikely to be achieved by dietary manipulation. OBJECTIVE: The objective was to examine, by using a retrospective analysis from a multicenter RCT, the impact of recommended EPA+DHA intakes achievable through diet on systolic and diastolic BPs and microvascular function in adults in the United Kingdom. METHODS: In a double-blind, placebo-controlled RCT, healthy men and women (n = 312) consumed a control oil or fish oil (FO) providing 0.7 or 1.8 g EPA+DHA/d, in random order, each for 8 wk. Fasting BP and microvascular function (using laser Doppler iontophoresis) were assessed and plasma collected for the quantification of markers of vascular function. Participants were retrospectively genotyped for the endothelial nitric oxide synthase (eNOS) rs1799983 variant. RESULTS: No effects of n-3 fatty acid treatment or any treatment × eNOS genotype interactions were evident in the group as a whole for any of the clinical or biochemical outcomes. Assessment of response according to hypertension status at baseline indicated a significant (P = 0.046) FO-induced reduction (mean: 5 mm Hg) in systolic BP, specifically in those with isolated systolic hypertension (n = 31). No dose response was observed. CONCLUSIONS: These findings indicate that in adults with isolated systolic hypertension, daily doses of EPA+DHA as low as 0.7 g show clinically meaningful BP reductions, which, at a population level, could be associated with lower cardiovascular disease risk. Confirmation of findings in an RCT in which participants are prospectively recruited on the basis of BP status is required to draw definite conclusions.

The UAB Life-Space Assessment (LSA) is a validated patient-reported outcome to measure community mobility and social participation. We have previously shown that LSA predicts adverse health outcomes including mortality, nursing home admission, and cognitive decline, but the role of life-space in healthcare utilization among older adults in general is not known. Participants (N=400) were drawn from the UAB Study of Aging II, a longitudinal study of community-dwelling adults age ≥75 identifying predictors of mobility decline. LSA scores at each monthly follow-up interview were used to predict emergency department (ED) visits and hospitalizations over the next 30 days using generalized estimating equations, adjusting for baseline age, race, gender, education, Charlson comorbidity score, physician visits in the last month, and living alone. Over 35-months of follow-up, 55.8% of participants reported at least one ED visit or hospitalization. In multivariable models, a 10-point lower life-space was associated with a 12% increase in healthcare utilization (p

Evidence from human studies demonstrates that consumption of various flavonoid subclasses are associated with cognitive benefits. We investigated the effects of an anthocyanin-rich blueberry beverage (BB), or matched placebo, on vascular and cognitive function in healthy younger and older adults. Stiffness index (SI), blood pressure (BP) and levels of brain-derived neurotrophic factor (BDNF) were recorded at baseline and one hour, whilst cognitive function was measured at baseline, 2 and 5 hours post-treatment. An MRI study was included to determine changes in cerebral blood flow (CBF). BB treatment produced better cognitive performance and higher circulating levels of BDNF. Correspondingly, increased CBF was observed in the precentral and middle frontal gyrus, as well as the angular gyrus, following BB. This suggests that acute BB treatment results in cognitive benefits mediated by an action on BDNF signalling pathways, in addition to vasodilatory properties and subsequent CBF increases.

A Review of Social Constructionism in Vocational Psychology and Career DevelopmentEdited by Peter McIlveen and Donna E. SchultheissRotterdam, The Netherlands: Sense, 2012, 136 pp., $30.60 USReviewe...

Objective To determine the association between reductions in government healthcare spending (GHS) on maternal mortality in 24 countries in the European Union (EU) over a 30-year period, 1981–2010. Design Retrospective study. Setting and population Twenty-four EU countries (a total population of 419 million as of 2010). Methods We used multivariate regression analysis, controlling for country-specific differences in healthcare, infrastructure, population size and demographic structure. GHS was measured as a percentage of gross domestic product. Five-year lag-time analyses were performed to estimate longer standing effects. Main outcome measures Maternal mortality rates. Results An annual 1% decrease in GHS is associated with significant rises in maternal mortality rates [regression coefficient [R] 0.0177, P = 0.0021, 95% confidence interval [95% CI] 0.0065–0.0289]. For every annual 1% decrease in GHS, we estimate 89 excess maternal deaths in the EU, a 10.6% annual increase in maternal mortality. The impact on maternal mortality was sustained for up to 1 year (R 0.0150, P = 0.0034, 95% CI 0.0050–0.0250). The associations remained significant after accounting for economic, infrastructure and hospital resource controls, in addition to out-of-pocket expenditure, private health spending and total fertility rate. However, accounting for births attended by skilled staff removed the significance of these effects. Conclusions Reductions in GHS were significantly associated with increased maternal mortality rates, which may occur through changes in the provision of skilled health professionals attending births. Examples of reduced GHS such as the implementation of austerity measures and budgetary reductions are likely to worsen maternal mortality in the EU.

This study tested a theoretical model of one mediator and 4 moderators of the relationships between 2 masculinity variables (Traditional Masculinity Ideology and Gender Role Conflict) and Attitudes Toward Seeking Professional Psychological Services (Attitudes). Self-stigma was the hypothesized mediator, and the hypothesized moderators were (a) Depression, (b) General Self-efficacy, (c) Precontemplation, and (d) Barriers to Help-seeking. A sample of 654 men responded to an online survey of 9 questionnaires. After evaluating mediation in the absence of moderation, moderated path analyses were conducted for each moderator. The relationship between Traditional Masculinity Ideology and Attitudes was partially mediated by Self-stigma, whereas that between Gender Role Conflict and Attitudes was completely mediated. No indirect or direct paths involving Gender Role Conflict were moderated by any moderators. Both Depression and Barriers to Help-seeking demonstrated mediated moderation by moderating both Stage 1 (the path from Traditional Masculinity Ideology to Self-stigma) of the mediated relationships and the direct effects between Traditional Masculinity Ideology and Attitudes. Precontemplation moderated the direct effect between Traditional Masculinity Ideology and Attitudes. The findings suggest that the relationships between masculinity variables and men's negative help-seeking attitudes may be better understood through their relationships with other variables that serve as mediators and moderators. Findings from the present study may offer some direction in the design of interventions to remediate men's negative help-seeking attitudes.

Objectives To assess the feasibility of recruitment, retention, outcome measures and intervention training/delivery among teachers, parents and children. To calculate a sample size estimation for full trial. Design A single-centre, unblinded, cluster feasibility randomised controlled trial examining Social Stories delivered within a school environment compared with an attentional control. Setting 37 primary schools in York, UK. Participants 50 participants were recruited and a cluster randomisation approach by school was examined. Participants were randomised into the treatment group (n=23) or a waiting list control group (n=27). Outcome measures Acceptability and feasibility of the trial, intervention and of measurements required to assess outcomes in a definitive trial. Results An assessment of the questionnaire completion rates indicated teachers would be most appropriate to complete the primary outcome measure. 2 outcome measures: the Social Responsiveness Scale (SRS)-2 and a goal-based measure showed both the highest levels of completion rates (above 80%) at the primary follow-up point (6 weeks postintervention) and captured relevant social and behaviour outcomes. Power calculations were based on these 2 outcome measures leading to a total proposed sample size of 180 participant groups. Conclusions Results suggest that a future trial would be feasible to conduct and could inform the policy and practice of using Social Stories in mainstream schools. Trial registration number ISRCTN96286707; Results.

Scope: To determine the contribution of intestinally and liver-derived lipoproteins to the postprandial plasma triacylglycerol (TAG) response in APOE3/E3 and E3/E4 individuals following chronic dietary fat manipulation. Methods and results: In sequential order, participants (n = 12 E3/E3, n = 11 E3/E4) followed low fat (LF); high-fat, high-saturated fat (HSF); and HSF with 3.45 g/day docosahexaenoic acid (HSF-DHA) diets, each for 8 weeks. After each dietary period, an acute test meal with a macronutrient profile representative of the dietary intervention was consumed. Apolipoprotein (apo)B isoforms were determined in isolated TAG-rich lipoprotein fractions (Sf>400, Sf 60–400 and Sf 20–60) by specific ELISA. A genotype*meal/diet interaction for the Sf>400 fraction apoB-48 response (P400 particles. Fasting Sf 60–400 and 20–60 apoB-48 concentrations were also significantly higher in E4 carriers. No impact of genotype on the apoB-100 responses was evident. Conclusion: Our study revealed marked effects of dietary fat composition on the Sf>400 apoB-48 response and particle TAG content in E4 carriers relative to the ‘wild-type’ E3/E3 genotype, which suggest APOE genotype is a potential modulator of chylomicron particle synthesis.

BACKGROUND: Compared with the postprandial events after a single meal, different events occur when a second meal is ingested 4-6 h after a first meal. There is a rapid appearance of chylomicrons in the circulation carrying fat ingested with the first meal, with a peak 1 h after the second meal. OBJECTIVE: Our goal was to examine whether different dietary oils have effects on the storage of triacylglycerol as a result of differences in their digestion, absorption, and incorporation into chylomicrons. DESIGN: A single-blind, randomized, within-subject crossover design was used to study the effects of palm oil, safflower oil, a mixture of fish and safflower oil, and olive oil on postprandial apolipoprotein (apo) B-48, retinyl ester, and triacylglycerol in the S(f) > 400 fraction with the use of a sequential meal protocol. RESULTS: For triacylglycerol, retinyl ester, and apo B-48, the time to reach peak concentration was significantly earlier after the second meal than after the first meal (P < 0.005). This was apparent with each of the dietary oils. The pattern of the apo B-48 response differed significantly among the dietary oils, with olive oil resulting in higher concentrations after both meals (P = 0.003). The ratio of triacylglycerol to apo B-48 was significantly lower after olive oil feeding than after feeding with the other oils (P = 0.02). CONCLUSIONS: The rapid entry of chylomicrons after the ingestion of a second meal 5 h after a first meal was seen with all of the oils investigated. The short-term ingestion of olive oil produced more chylomicrons than did the other dietary oils, which may have been due to differences in the metabolic handling of olive oil within the gut.

Background: Reported associations between Tumor Necrosis Factor-alpha (TNFA) and the postprandial\ud triacylglycerol (TAG) response have been inconsistent, which could be due to variations in the TNFA gene, meal fat composition or participant’s body weight. Hence, we investigated the association of TNFA polymorphism\ud (−308G → A) with body mass index (BMI) and postprandial lipaemia and also determined the impact of BMI on the\ud association of the polymorphism with postprandial lipaemia.\ud Methods: The study participants (n = 230) underwent a sequential meal postprandial study. Blood samples were taken\ud at regular intervals after a test breakfast (t = 0, 49 g fat) and lunch (t =330 min, 29 g fat) to measure fasting and\ud postprandial lipids, glucose and insulin. The Metabolic Challenge Study (MECHE) comprising 67 Irish participants who\ud underwent a 54 g fat oral lipid tolerance test was used as a replication cohort. The impact of genotype on postprandial\ud responses was determined using general linear model with adjustment for potential confounders.\ud Results: The -308G → A polymorphism showed a significant association with BMI (P = 0.03) and fasting glucose\ud (P = 0.006), where the polymorphism explained 13 % of the variation in the fasting glucose. A 30 % higher incremental\ud area under the curve (IAUC) was observed for the postprandial TAG response in the GG homozygotes than A-allele\ud carriers (P = 0.004) and the genotype explained 19 % of the variation in the IAUC. There was a non-significant trend in\ud the impact of BMI on the association of the genotype with TAG IAUC (P = 0.09). These results were not statistically\ud significant in the MECHE cohort, which could be due to the differences in the sample size, meal composition, baseline\ud lipid profile, allelic diversity and postprandial characterisation of participants across the two cohorts.\ud Conclusions: Our findings suggest that TNFA -308G → A polymorphism may be an important candidate for BMI,\ud fasting glucose and postprandial TAG response. Further studies are required to investigate the mechanistic effects of\ud the polymorphism on glucose and TAG metabolism, and determine whether BMI is an important variable which\ud should be considered in the design of future studies.\ud Trial registration: NCT01172951.

Scope Our aim was to determine the effects of chronic dietary fat manipulation on postprandial lipaemia according to apolipoprotein (APO)E genotype. Methods and results Men (mean age 53 (SD 9) years), prospectively recruited for the APOE genotype (n = 12 E3/E3, n = 11 E3/E4), were assigned to a low fat (LF), high fat, high-saturated fat (HSF), and HSF diet with 3.45 g/day docosahexaenoic acid (HSF-DHA), each for an 8-week period in the same order. At the end of each dietary period, a postprandial assessment was performed using a test meal with a macronutrient profile representative of that dietary intervention. A variable postprandial plasma triacylglycerol (TAG) response according to APOE genotype was evident, with a greater sensitivity to the TAG-lowering effects of DHA in APOE4 carriers (p ≤ 0.005). There was a lack of an independent genotype effect on any of the lipid measures. In the groups combined, dietary fat manipulation had a significant impact on lipids in plasma and Svedberg flotation rate (Sf) 60–400 TAG-rich lipoprotein fraction, with lower responses following the HSF-DHA than HSF intervention (p < 0.05). Conclusion Although a modest impact of APOE genotype was observed on the plasma TAG profile, dietary fat manipulation emerged as a greater modulator of the postprandial lipid response in normolipidaemic men.

International audience; Scope: Several insulin receptor substrate-2 (IRS-2) polymorphisms have been studied in relation to insulin resistance and type 2 diabetes. To examine whether the genetic variability at the IRS-2 gene locus was associated with the degree of insulin resistance and plasma fatty acid levels in metabolic syndrome (MetS) subjects. Methods and results: Insulin sensitivity, insulin secretion, glucose effectiveness, plasma fatty acid composition and three IRS-2 tag-single nucleotide polymorphisms (SNPs) were determined in 452 MetS subjects. Among subjects with the lowest level of monounsaturated (MUFA) (below the median), the rs2289046 A/A genotype was associated with lower glucose effectiveness (p < 0.038), higher fasting insulin concentrations (p < 0.028) and higher HOMA IR (p < 0.038) as compared to subjects carrying the minor G-allele (A/G and G/G). In contrast, among subjects with the highest level of MUFA (above the median), the A/A genotype was associated with lower fasting insulin concentrations and HOMA-IR, whereas individuals carrying the G allele and with the highest level of omega-3 polyunsaturated fatty acids (above the median) showed lower fasting insulin (p < 0.01) and HOMA-IR (p < 0.02) as compared with A/A subjects. Conclusion: The rs2289046 polymorphism at the IRS2 gene locus may influence insulin sensitivity by interacting with certain plasma fatty acids in MetS subjects.

The cardioprotective actions of the fish oil (FO)-derived long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been demonstrated, and dose-response relationships have been defined. However, there is a substantial and well-recognized within-population heterogeneity in response to FO, the etiology of which is poorly understood. Genetic variation may influence responsiveness. Here we review the available literature relating to gene variants shown to influence tissue LC n-3 PUFA status and response to FO intervention. From this review we conclude that the available evidence is relatively limited. A number of individual genotype × LC-n3 PUFA × phenotype associations have been described, but few have been investigated in subsequent cohorts or confirmed in independent studies. In the context of a more stratified approach to the provision of dietary advice, there is a need for further research to refine current dietary EPA and DHA recommendations.

The purpose of this study was to explore the factor structure and assess the reliability of the Health Behavior Inventory-20 (HBI-20), and to assess its relationships with several measures of masculine gender socialization constructs and attitudes toward seeking psychological help. Three hundred and

There is emerging evidence to show that high levels of NEFA contribute to endothelial dysfunction and impaired insulin sensitivity. However, the impact of NEFA composition remains unclear. A total of ten healthy men consumed test drinks containing 50 g of palm stearin (rich in SFA) or high-oleic sunflower oil (rich in MUFA) on separate occasions; a third day included no fat as a control. The fats were emulsified into chocolate drinks and given as a bolus (approximately 10 g fat) at baseline followed by smaller amounts (approximately 3 g fat) every 30 min throughout the 6 h study day. An intravenous heparin infusion was initiated 2 h after the bolus, which resulted in a three- to fourfold increase in circulating NEFA level from baseline. Mean arterial stiffness as measured by digital volume pulse was higher during the consumption of SFA (P P = 0·089) compared with the control. Overall insulin and gastric inhibitory peptide response was greater during the consumption of both fats compared with the control (P P ≤ 0·048). There was no effect of the test drinks on glucose, total nitrite, plasminogen activator inhibitor-1 or endothelin-1 concentrations. The present study indicates a potential negative impact of elevated NEFA derived from the consumption of SFA on arterial stiffness and sI-CAM levels. More studies are needed to fully investigate the impact of NEFA composition on risk factors for CVD.

Background: Insulin sensitivity (Si) is improved by weight loss and exercise, but the effects of the replacement of saturated fatty acids (SFAs) with monounsaturated fatty acids (MUFAs) or carbohydrates of high glycemic index (HGI) or low glycemic index (LGI) are uncertain.Objective: We conducted a dietary intervention trial to study these effects in participants at risk of developing metabolic syndrome.Design: We conducted a 5-center, parallel design, randomized controlled trial [RISCK (Reading, Imperial, Surrey, Cambridge, and Kings)]. The primary and secondary outcomes were changes in Si (measured by using an intravenous glucose tolerance test) and cardiovascular risk factors. Measurements were made after 4 wk of a high-SFA and HGI (HS/HGI) diet and after a 24-wk intervention with HS/HGI (reference), high-MUFA and HGI (HM/HGI), HM and LGI (HM/LGI), low-fat and HGI (LF/HGI), and LF and LGI (LF/LGI) diets.Results: We analyzed data for 548 of 720 participants who were randomly assigned to treatment. The median Si was 2.7 x 10(-4) mL . mu U-1 . min(-1) (interquartile range: 2.0, 4.2 x 10(-4) mL . mu U-1 . min(-1)), and unadjusted mean percentage changes (95% CIs) after 24 wk treatment (P = 0.13) were as follows: for the HS/HGI group, -4% (-12.7%, 5.3%); for the HM/HGI group, 2.1% (-5.8%, 10.7%); for the HM/LGI group, -3.5% (-10.6%, 4.3%); for the LF/HGI group, -8.6% (-15.4%, -1.1%); and for the LF/LGI group, 9.9% (2.4%, 18.0%). Total cholesterol (TC), LDL cholesterol, and apolipoprotein B concentrations decreased with SFA reduction. Decreases in TC and LDL-cholesterol concentrations were greater with LGI. Fat reduction lowered HDL cholesterol and apolipoprotein A1 and B concentrations.Conclusions: This study did not support the hypothesis that iso-energetic replacement of SFAs with MUFAs or carbohydrates has a favorable effect on Si. Lowering GI enhanced reductions in TC and LDL-cholesterol concentrations in subjects, with tentative evidence of improvements in Si in the LF-treatment group. This trial was registered at clinicaltrials.gov as ISRCTN29111298. Am J Clin Nutr 2010;92:748-58.

Objectives To investigate the impact of apolipoprotein E (apoE) genotype on the response of the plasma lipoprotein profile to eicosapentaenoic acid (EPA) versus docosahexaenoic acid (DHA) intervention in humans. Methods and results 38 healthy normolipidaemic males, prospectively recruited on the basis of apoE genotype ( n =20 E3/E3 and n =18 E3/E4), completed a double-blind placebo-controlled cross-over trial, consisting of 3×4 week intervention arms of either control oil, EPA-rich oil (ERO, 3.3g EPA/day) or DHA-rich oil (DRO, 3.7g DHA/day) in random order, separated by 10 week wash-out periods. A significant genotype-independent 28% and 19% reduction in plasma triglycerides in response to ERO and DRO was observed. For total cholesterol (TC), no significant treatment effects were evident; however a significant genotype by treatment interaction emerged ( P =0.045), with a differential response to ERO and DRO in E4 carriers. Although the genotype×treatment interaction for LDL-cholesterol ( P =0.089) did not reach significance, within DRO treatment analysis indicated a 10% increase in LDL ( P =0.029) in E4 carriers with a non-significant 4% reduction in E3/E3 individuals. A genotype-independent increase in LDL mass was observed following DRO intervention ( P =0.018). Competitive uptake studies in HepG2 cells using plasma very low density lipoproteins (VLDL) from the human trial, indicated that following DRO treatment, VLDL 2 fractions obtained from E3/E4 individuals resulted in a significant 32% ( P =0.002) reduction in LDL uptake relative to the control. Conclusions High dose DHA supplementation is associated with increases in total cholesterol in E4 carriers, which appears to be due to an increase in LDL-C and may in part negate the cardioprotective action of DHA in this population subgroup.

This article reports the results of an evaluation of the factor structure, reliability, and construct validity of the Male Role Norms Inventory—Revised (MRNI–R). Results of a principal-axis factor analysis with 593 undergraduate participants (341 men, 251 women, 1 other) support the hypothesized factor dimensionality and, to a lesser extent, item placement. Evidence was found for internal consistency of the MRNI–R total score and the seven factor scores. Analyses of the men’s scores provided evidence for convergent validity through a significant correlation of the MRNI–R with the Male Role Attitudes Scale; for divergent validity, through the nonsignificant correlation with the Personal Attributes Questionnaire; and for concurrent validity, through the significant correlations with the Conformity to Masculine Norms Inventory, the Gender Role Conflict Scale, and the Normative Male Alexithymia Scale.

To examine the impact of age and the natural menopause on the postprandial triacylglycerol (TAG) response in healthy women.Thirty-seven premenopausal and sixty-one postmenopausal women underwent a sequential meal postprandial investigation, in which blood samples were taken at regular intervals after a test breakfast and lunch given at 0 and 330 min respectively. Lipids and glucose were measured in the fasting sample, with TAG analysed in the postprandial samples. Postmenopausal women were shown to have higher fasting total cholesterol, low density lipoprotein cholesterol (LDL-C) and glucose (P0.02). Marked differences in the postprandial TAG response were evident between the groups, with a greater incremental area under the curve (IAUC) and maximum TAG concentration in the postmenopausal women (P0.04). Multivariate regression analysis revealed both age and fasting TAG to be independently associated with the summary measures of the postprandial TAG response in the premenopausal women only. Interestingly, sub-division of the women into both younger and older pre- and postmenopausal subgroups, showed the most marked difference in TAG-IAUC to be between the younger and the older premenopausal women, whereas differences in fasting LDL-C were most evident between the older premenopausal and the younger postmenopausal women.Our results suggest a divergence in the relationship of age and menopausal status with fasting LDL-C and postprandial TAG which may reflect differences in the metabolic effects of age and the menopause on these lipid risk markers or a greater impact of early oestrogen decline on pathways of TAG rather than LDL metabolism.

Meal fatty acids have been shown to modulate the size and composition of triacylglycerol (TAG)-rich lipoproteins influencing the magnitude and duration of the postprandial plasma TAG response. As a result there is considerable interest in the origin of these meal fatty-acid induced differences in particle composition. Caco-2 cells were incubated over 4 days with fatty acid mixtures resembling the composition of saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acid (PUFA)-rich meals fed in a previous postprandial study to determine their impact on lipoprotein synthesis and secretion. The MUFA- and PUFA-rich mixtures supported greater intracellular TAG, but not cholesterol accumulation compared with the SFA-rich mixture (P < 0.001). The MUFA-rich mixture promoted significantly greater TAG and cholesterol secretion than the other mixtures and significantly more apolipoprotein B-100 secretion than the PUFA-rich mixture (P < 0.05). Electron microscopy revealed the SFA-rich mixture had led to unfavourable effects on cellular morphology, compared with the unsaturated fatty acid-rich mixtures. Our findings suggest the MUFA-rich mixture, may support the formation of a greater number of TAG-rich lipoproteins, which is consistent with indirect observations from our human study. Our electron micrographs are suggestive that some endocytotic uptake of MUFA-rich taurocholate micelles may promote greater lipoprotein synthesis and secretion in Caco-2 cells.

Dysregulation of lipid and glucose metabolism in the postprandial state are recognised as important risk factors for the development of cardiovascular disease and type 2 diabetes. Our objective was to create a comprehensive, standardised database of postprandial studies to provide insights into the physiological factors that influence postprandial lipid and glucose responses. Data were collated from subjects (n = 467) taking part in single and sequential meal postprandial studies conducted by researchers at the University of Reading, to form the DISRUPT (DIetary Studies: Reading Unilever Postprandial Trials) database. Subject attributes including age, gender, genotype, menopausal status, body mass index, blood pressure and a fasting biochemical profile, together with postprandial measurements of triacylglycerol (TAG), non-esterified fatty acids, glucose, insulin and TAG-rich lipoprotein composition are recorded. A particular strength of the studies is the frequency of blood sampling, with on average 10–13 blood samples taken during each postprandial assessment, and the fact that identical test meal protocols were used in a number of studies, allowing pooling of data to increase statistical power. The DISRUPT database is the most comprehensive postprandial metabolism database that exists worldwide and preliminary analysis of the pooled sequential meal postprandial dataset has revealed both confirmatory and novel observations with respect to the impact of gender and age on the postprandial TAG response. Further analysis of the dataset using conventional statistical techniques along with integrated mathematical models and clustering analysis will provide a unique opportunity to greatly expand current knowledge of the aetiology of inter-individual variability in postprandial lipid and glucose responses.

The purpose of this study was to directly compare traditional masculinity ideology, conformity to masculine norms, and gender role conflict to determine to what degree these masculinity variables are associated with self-reported risky health behaviors and negative attitudes toward seeking psychological help. Based on correlational analyses of the responses of 137 college men, higher gender role conflict was related to greater risky health behaviors, and higher levels of all three masculinity variables were related to more negative attitudes toward seeking psychological help. Using regression analyses, higher gender role conflict was a unique predictor of greater health risk behaviors, but traditional masculinity ideology was, unexpectedly, inversely associated with risky health behaviors. Conformity to masculine norms was a unique predictor of negative attitudes toward seeking psychological help. The limitations resulting from the overlap of the masculinity measures, the psychometric properties of the health risks measure, and the use of a college sample, as well as implications for practice and suggestions for future research, are discussed.

For postmenopausal women and those undergoing menopause, the risk of developing cardiovascular disease is significantly elevated. Changes to cholesterol and lipid profiles in women at this time can lead to a number of deleterious effects including abdominal fat deposition, reduced glucose tolerance, and increased blood pressure. As a result, cardiovascular disease has become the leading cause of morbidity and mortality in postmenopausal women, accounting for nearly 50% of all female deaths in developed countries. In response to the current situation, a panel of women’s health and nutrition experts have developed a new, six-step plan of dietary recommendations to support cholesterol management during the menopause. The importance of developing such recommendations has been supported by research demonstrating that nearly half of women surveyed stated that they would prefer to take control of their menopausal symptoms through alterations to their diet and lifestyle rather than by medication.

The aim of this pilot research project was to assess the efficacy of Alexithymia Reduction Treatment (ART), a six-session manualized psychoeducational group intervention. A quasi-experimental design was used. The six participants in the Treatment Group were recruited at a university-based counseling center and the seven participants in the Treatment as Usual group were from a hospital-based day treatment program. Participants in the Treatment Group demonstrated significant reductions in normative male alexithymia and the endorsement of traditional masculinity ideology from pre-test to post-test. The Treatment as Usual group did not demonstrate significant reductions in these variables pre-test to post-test. Neither group showed significant change in attitudes toward seeking professional psychological help.

The present review comes from the authors of the recent Scientific Advisory Committee on Nutrition (SACN) review Update on Trans Fatty Acids and Health, and focuses on assessing the strength of the evidence for a link between trans-fatty acid (trans-FA) intake and cancer. It evaluates a range of human ecological, case–control and prospective studies with trans-FA exposure assessed using either dietary assessment methods or trans-FA levels in tissues. Relevant animal studies are also presented in order to elucidate potential mechanisms. It concludes that there is weak and inconsistent evidence for a relationship between trans-FA and breast or colorectal cancer. Evidence for an association between trans-FA and prostate cancer is limited, but a recent large case–control study has shown a strong interaction between risk and trans-FA intake for the RNASEL QQ/RQ genotype that is present in about 35 % of the population. This potential association requires further investigation. The single study on non-Hodgkin's lymphoma reported a strong positive association, but only used a single assessment of dietary trans-FA made at the start of the study in 1980, and the significant changes in trans-FA intakes between then and the end of follow-up in 1994 limit the reliability of this observation. There is insufficient evidence to allow any differentiation between the effects of trans-FA from animal or vegetable origin on cancer risk.

We compared young people with high-functioning autism spectrum disorders (ASDs) with age, sex and IQ matched controls on emotion recognition of faces and pictorial context. Each participant completed two tests of emotion recognition. The first used Ekman series faces. The second used facial expressions in visual context. A control task involved identifying occupations using visual context. The ability to recognize emotions in faces (with or without context) and the ability to identify occupations from context was positively correlated with both increasing age and IQ score. Neither a diagnosis of ASD nor a measure of severity (Autism Quotient score) affected these abilities, except that the participants with ASD were significantly worse at recognizing angry and happy facial expressions. Unlike the control group, most participants with ASD mirrored the facial expression before interpreting it. Test conditions may lead to results different from everyday life. Alternatively, deficits in emotion recognition in high-functioning ASD may be less marked than previously thought.

We examined whether students with access to a supplemental course Web site enhanced with e-mail, discussion boards, and chat room capability reacted to it more positively than students who used a Web site with the same content but no communication features. Students used the Web sites on a voluntary basis. At the end of the semester, students using the enhanced site earned more points in the class than students using the basic Web site. Additionally, students using the enhanced site reported using it more often and reported higher satisfaction with the Web site, course, and instructor. We discuss practical implications of these findings.