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Background Maternal thyroid hormones facilitate optimal foetal neurodevelopment, however the exact role of the thyroid hormones on specific cognitive outcomes is unknown. Objectives This study aimed to investigate associations between maternal thyroid function and neurodevelopmental outcomes at 20 months in the Seychelles Child Development Study (SCDS, n=1535). Methods Maternal free thyroid hormones (fT3, fT4 and fTSH) were assessed at 28 weeks gestation with a range of child cognitive outcomes analysed at 20 months. Dietary iodine intake was analysed for a subset of women through a Food Frequency Questionnaire (FFQ) (n=422), with a median iodine intake of 233µg/d, slightly below the recommended iodine intake for pregnancy as advised by the WHO (>250µg/d). Linear regression analysis was used to test associations between serum concentrations of fT3, fT4 and fTSH and child cognitive outcomes. Thyroid hormones were analysed both as continuous data and also categorised as quintiles. 95% of mothers had optimal thyroid function based on their TSH concentrations. Results Results show that maternal fT3, fT4 and TSH were not significantly associated with any cognitive outcomes at 20 months in this high fish-eating population. However, a positive association, using quintiles for fT3, was reported for Motor Development Index (MDI; a subtest of the Bayley’s Scales of Infant Development), between Q3 vs Q4 (β 0.073; p 0.043) and for Q3 vs Q5 (β value 0.086; p 0.018). Conclusions Thus, it is possible mothers in our cohort, who largely have optimal thyroid function and iodine intakes, are able to regulate thyroid function throughout pregnancy to meet neurodevelopmental needs. However, it is likely that minor imbalances of fT3, as indicated from our quintile analysis, may impact offspring neurodevelopment. Thus, further investigation is warranted, particularly focusing on thyroid hormone fluctuation throughout pregnancy in relation to possible associations with infant neurodevelopment.

The health effects of vitamin D are well documented, with increasing evidence of its roles beyond bone. There is, however, little evidence of the effects of vitamin D on hospitalisation among older adults. This study aimed to prospectively determine the relationship of vitamin D status in older adults with hospital admission and emergency department (ED) attendance. Trinity University of Ulster Department of Agriculture (TUDA) is a large cross-sectional study of older adults with a community population from three disease-defined cohorts (cognitive dysfunction, hypertension, and osteoporosis). Participants included in this analysis were recruited between 2008 and 2012. ED and hospital admission data were gathered from the date of TUDA participation until June 2013, with a mean follow up of 3.6 years. Of the 3093 participants, 1577 (50.9%) attended the ED during the period of follow-up. Attendees had lower mean serum 25(OH)D concentrations than non-attendees (59.1 vs. 70.6 nmol/L). Fully adjusted models showed an inverse association between vitamin D and ED attendance (Hazard Ratio (HR) 0.996, 95% Confidence Interval (CI) 0.995–0.998, p &lt, 0.001). A total of 1269 participants (41%) were admitted to hospital during the follow-up. Those admitted had lower mean vitamin D concentrations (58.4 vs. 69.3 nmol/L, p &lt, 0.001). In fully adjusted models, higher vitamin D was inversely associated with hospital admission (HR 0.996, 95% CI 0.994–0.998, 0.001) and length of stay (LOS) (β = −0.95, p = 0.006). This study showed independent prospective associations between vitamin D deficiency and increased hospitalisation by older adults. The need for further evaluation of current recommendations in relation to vitamin D supplementation, with consideration beyond bone health, is warranted and should focus on randomised controlled trials.

Maternal BMI has been shown to be inversely correlated with vitamin D status (25-hydroxyvitamin D (25(OH)D) concentrations) during pregnancy. Pregnant women with obesity and with vitamin D deficiency are at risk of many adverse health outcomes in pregnancy.The aim of this study was to examine differences in maternal vitamin D status across normal weight, overweight and obese pregnant women in early pregnancy.Data collected at baseline from a double-blind randomised vitamin D intervention study (MO-VITD) were used. Pregnant women without pregnancy complications, aged > 18 years and having a singleton pregnancy were recruited between January 2016 and August 2017 at antenatal clinics in the Western Health and Social Care Trust, Northern Ireland. Non-fasting blood samples were collected at 12 weeks gestation and analysed for total serum 25(OH)D, using liquid chromatography tandem mass spectrometry. Data from 239 pregnant women (80 normal weight, 79 overweight, 80 obese) were included in the current analysis.The mean ± SD 25(OH)D concentration of all pregnant women at 12 weeks gestation was 52.0 ± 21.6 nmol/L. Women classed as obese or overweight had significantly lower 25(OH)D concentrations compared to women of normal weight (48.8 ± 20.3 vs 49.8 ± 20.4 vs. 57.5 ± 23.1 nmol/L, P = 0.019; obese, overweight, normal weight respectively). A total of 45% of all pregnant women were found to be either vitamin D deficient (25(OH)D < 25nmol/L; 13%) or insufficient (25–50 nmol/L; 32%) in early pregnancy. BMI was significantly negatively correlated with 25(OH)D concentrations (r = -0.168; P = 0.009). Regression analyses showed that BMI (β = -0.165; P = 0.006), season (β = 0.220; P = < 0.0001), supplement use (β = -0.268; P < 0.0001) and a sun holiday within the previous 6 months (β = -0.180; P = 0.010) were significant predictors of 25(OH)D concentrations. In early pregnancy, 62% of pregnant women reported using a supplement containing vitamin D and 38% reported no supplement use. Supplement users had a significantly higher vitamin D status than non-supplement users in all BMI categories but overall, 37% of supplement users were still classified as vitamin D insufficient. Vitamin D status was significantly lower in winter months compared to summer months. In early pregnancy, especially during winter months, pregnant women with obesity, particularly non-supplement users, are at higher risk of low vitamin D status. Based on the lower vitamin D status observed in early pregnancy in obese women, the effect of BMI on vitamin D supplementation throughout pregnancy needs to be examined.

Pregnant women who are overweight/obese are particularly vulnerable to vitamin D insufficiency owing to higher physiological requirements and lower status (25(OH)D concentrations) associated with obesity. Achieving adequate maternal vitamin D status with current recommendations (10μg/d) remains controversial.This study examined supplementation effects (10μg-vs-20μg vitamin D3/d) throughout pregnancy (12 weeks gestation until delivery) on vitamin D status of normal weight, overweight and obese pregnant women and on cord blood, using a double-blind randomised vitamin D intervention study (MO-VITD). 240 pregnant women were recruited throughout the year at antenatal clinics in Northern Ireland (equal numbers of normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (> 30kg/m2)). Non-fasting maternal blood samples were collected at 12, 28 and 34–36 weeks gestation and from the umbilical cord after delivery and analysed for total serum 25(OH)D using LCMS.A high prevalence of vitamin D insufficiency (25–50nmol/L) was found in the 1st trimester in both treatment groups (41.5% and 48.8%; 10μg vs. 20μg respectively). Maternal 25(OH)D concentrations increased from the 1st to 3rd trimester in both the 10μg/d and 20μg/d groups, with a higher increase in the 20μg group (17.1 ± 24.7 and 28.8 ± 33.3nmol/L, P = 0.002). There was no difference in cord blood 25(OH)D concentrations between treatment groups.Women who started pregnancy with insufficient 25(OH)D concentrations remained insufficient throughout pregnancy in the 10μg/d group (49.9 ± 28.2nmol/L at trimester 3). In the 20μg/d group, women starting pregnancy as insufficient achieved levels of sufficiency in the 2nd (58.9 ± 30.6nmol/L) and 3rd (64.0 ± 35.9nmol/L) trimesters. Women who started pregnancy with sufficient vitamin D status (25(OH)D > 50nmol/L), maintained levels of sufficiency throughout pregnancy irrespective of treatment group (83.1 ± 24.4 and 96.7 ± 30.7 at trimester 3 in 10μg/d and 20 μg/d groups respectively); findings were similar across all BMI categories.Obese women who started pregnancy with an insufficient status were found to have deficient cord blood (25(OH)D < 25 nmol/L) in both the 10μg/d and 20μg/d groups (19.4 ± 20.2 vs. 19.5 ± 9.4nmol/L respectively), whilst obese women who started pregnancy with sufficient status (> 50nmol/L) had cord blood concentrations considered insufficient (40.2 ± 18.4 vs. 44.2 ± 15.6nmol/L; 10μg vs. 20μg groups respectively).Based on our findings of the high prevalence of vitamin D insufficiency in early pregnancy, maternal vitamin D supplementation of 20μg/d is advisable to maintain maternal vitamin D status in pregnant women in Northern Ireland.

Recently adopted regulatory standards on infant and follow-on formula for the European Union stipulate that from February 2020 onwards, all such products marketed in the European Union must contain 20-50 mg omega-3 DHA (22:6n-3) per 100 kcal, which is equivalent to about 0.5-1% of fatty acids (FAs) and thus higher than typically found in human milk and current infant formula products, without the need to also include ω-6 arachidonic acid (AA; 20:4n-6). This novel concept of infant formula composition has given rise to concern and controversy because there is no accountable evidence on its suitability and safety in healthy infants. Therefore, international experts in the field of infant nutrition were invited to review the state of scientific research on DHA and AA, and to discuss the questions arising from the new European regulatory standards. Based on the available information, we recommend that infant and follow-on formula should provide both DHA and AA. The DHA should equal at least the mean content in human milk globally (0.3% of FAs) but preferably reach 0.5% of FAs. Although optimal AA intake amounts remain to be defined, we strongly recommend that AA should be provided along with DHA. At amounts of DHA in infant formula up to ∼0.64%, AA contents should at least equal the DHA contents. Further well-designed clinical studies should evaluate the optimal intakes of DHA and AA in infants at different ages based on relevant outcomes.

ContextEmerging evidence suggests that deficiencies of folate-related B vitamins can arise with metformin treatment and are independently linked with cognitive dysfunction, a comorbidity of diabetes.ObjectiveTo determine the impact of hyperglycemia and metformin use on relevant B vitamin biomarkers and cognitive outcomes in older adults.Setting and ParticipantsCommunity-dwelling older adults (74.1 ± 8.3 years, n = 4160) without dementia, recruited to the Trinity, Ulster and Department of Agriculture cohort study in 2008 to 2012, were classified as normoglycemic (n = 1856) or hyperglycemic, based on HbA1c ≥5.7% (39 mmol/mol), either with (n = 318) or without (n = 1986) metformin treatment.Main Outcome MeasuresBiomarkers of folate, vitamin B12, vitamin B6, and riboflavin were measured. Cognitive assessments included the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and the Frontal Assessment Battery (FAB).ResultsMetformin use was associated with higher risk of deficiency of vitamin B12 (combined B12 index ≤−1; OR 1.45; 95% CI, 1.03 to 2.02) and vitamin B6 (plasma pyridoxal 5-phosphate ConclusionsUse of metformin by older adults is associated with poorer cognitive performance; B vitamin deficiency may be implicated. Fortified foods can optimize B vitamin status and may be beneficial for maintaining better cognitive health in older people with or at risk for diabetes.

Following an application from Flan-Biotech GmbH, submitted for authorisation of a health claim pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of Germany, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to Symbiosal((R)), lowering of blood pressure and reduced risk of hypertension. The Panel considers that the food, Symbiosal((R)), which is the subject of the health claim, and the food, table salt, which Symbiosal((R)) should replace, are sufficiently characterised. Lowering of blood pressure is a beneficial physiological effect. Increased blood pressure is a risk factor for hypertension. In weighing the evidence, the Panel took into account that one human study with some methodological limitations showed an effect of Symbiosal((R)) on blood pressure in the context of a self-selected diet with a maximum of 3 g/day added salt. The Panel also took into account that no other human studies in which these results have been replicated were provided, that the animal studies did not support the results of the human study, that no evidence was provided in support of a mechanism by which Symbiosal((R)) could induce a decrease in blood pressure upon oral consumption as compared to table salt in vivo in humans, and the low biological plausibility of the effect observed in the human intervention study. The Panel concludes that a cause and effect relationship has not been established between the consumption of Symbiosal((R)) and lowering of blood pressure. (C) 2018 European Food Safety Authority. EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority.

Mitigation of risk associated with snow avalanches in the United States has traditionally required intensive effort by winter maintenance crews during peak storm periods to forecast and subsequently release high-risk avalanche sites with explosives. Though the approach is common in Europe, a novel approach in the United States is to implement avalanche starting zone structures to hold the snowpack in place and prevent the release of an avalanche. This approach eliminates the need for active management of the avalanche and frees up resources during winter storms. The Wyoming Department of Transportation has embraced the use of this technology for the Milepost 151 Avalanche near Jackson, Wyoming. This paper describes the critical aspects of the design of snow-supporting structures (SSSs) and details a research project that is under way to monitor both snowpack conditions and the resulting quasistatic snowloads on one SSS by using field instrumentation. The instrumentation includes transducers to measure snow pressure, strain gauges to measure SSS axial strains, and snow depth gauges to track snowpack depth immediately uphill of the SSS. Preliminary results from winter season 2014–2015 are presented, and their impact on the design of SSSs is discussed.

Following an application from Unilever NV, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Ireland, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to black tea and improvement of attention. The scope of the application was proposed to fall under a health claim based on newly developed scientific evidence. The food proposed by the applicant as the subject of the health claim is black tea. The Panel considers that black tea characterised by its content of tea solids, caffeine and L-theanine, which is the subject of the health claim, is sufficiently characterised in relation to the claimed effect. The claimed effect proposed by the applicant is 'improves attention'. The Panel considers that improvement of attention is a beneficial physiological effect. Three human intervention studies provided by the applicant show an effect of black tea on attention under the conditions of used proposed by the applicant. The applicant proposed that the claimed effect depends on the concerted action of two substances, caffeine and L-theanine, both of which are present in black tea. The Panel considers that the effect of black tea on attention observed in the three human intervention studies provided by the applicant can be explained by its caffeine content. The Panel concludes that a cause and effect relationship has been established between the consumption of black tea and improvement of attention. The Panel considers that the effect of black tea on attention can be explained by its caffeine content. The following wording reflects the scientific evidence: 'Owing to its caffeine content, black tea improves attention'. In order to obtain the claimed effect, 2-3 servings of black tea providing at least 75 mg of caffeine in total should be consumed within 90 min. (C) 2018 European Food Safety Authority. EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority.

Following an application from Specialised Nutrition Europe (formerly IDACE), submitted pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to vitamin D and contribution to normal development of bones and teeth. The food constituent, vitamin D, which is the subject of the health claim, is sufficiently characterised. Contribution to normal development of bones and teeth is a beneficial physiological effect for infants and young children. A claim on vitamin D and maintenance of normal bones and teeth in the general population has already been assessed with a favourable outcome. The Panel considers that the role of vitamin D in bone and tooth mineralisation and homeostasis applies to all ages, including infants and young children (from birth to three years). The Panel concludes that a cause and effect relationship has been established between the dietary intake of vitamin D and contribution to normal development of bones and teeth.

Elevated concentrations of the pro-inflammatory cytokines IL-1β and IL-6 have been associated with impaired cognitive performance. There are, however, few studies that have examined the relationship between cytokine production and specific aspects of cognition in healthy older individuals. Two-colour flow cytometry was used to determine intracellular cytokine production by activated monocytes, and neuropsychological tests were performed using the Cambridge Neuropsychological Test Automated Battery (CANTAB) in 93 apparently healthy men and women aged 55–70 years. A series of hierarchical regression analyses was carried out to examine the contribution of IL-1β and IL-6 (% expression and production (antibody binding capacity (ABC))) to recognition, attention and working memory, after controlling for socio-demographic variables (age, sex and social class). IL-1β% expression and IL-6 production predicted aspects of working memory. Recognition memory was found to be sensitive to the affects of age and social class. The current study suggests that higher intracellular cytokine production by activated monocytes may be predictive of lower cognitive performance in working memory in healthy older individuals. These findings indicate that utilization of models for in vivo cytokine production upon immune challenge may be useful in studying specific aspects of memory affected during inflammatory responses, for example in individuals at risk for cognitive decline owing to age-related inflammatory disorders.

SUMMARY Following an application from Cambridge Theranostics Ltd. submitted pursuant to Article 14, of Regulation (EC) No 1924/2006 via the Competent Authority of United Kingdom, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver an opinion on the scientific substantiation of a health claim related to lycopene-whey complex (bioavailable lycopene) and reduction of the risk of atherosclerotic plaques. The scope of the application was proposed to fall under a health claim referring to disease risk reduction. The food constituent that is the subject of the health claim is a lycopene-whey complex (bioavailable lycopene). Lycopene-whey complex is prepared using a patented process by mixing tomato extract containing 10% lycopene with whey protein to form a granulated product. The amount of the active constituent, lycopene, is 2% in the final product. The lycopene-whey complex has been shown to have bioavailability similar to tomato paste in human subjects.

SUMMARY Following an application from Mead Johnson & Company submitted pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of France, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver an opinion on the scientific substantiation of a health claim related to docosahexaenoic acid and arachidonic acid and brain development. The scope of the application was proposed to fall under a health claim referring to children’s development and health. The food constituents that are the subject of the health claim are docosahexaenoic acid (DHA) and arachidonic acid (ARA), which are well characterised fatty acids that can be quantified in foods by established methods. The absorption of DHA and ARA is well documented. The Panel considers that the food constituents DHA and ARA are sufficiently characterised. The claimed effect is the contribution to the optimal brain development of infants and young children. The target population proposed by the applicant is infants and young children (from birth to three years of age). The Panel considers that contribution to the normal development of the brain is beneficial for infants’ and children’s development and health. The applicant identified a total 33 publications as being pertinent to the health claim for humans. A total of 13 full publications which report original data from RCTs on the effects of 1 For citation purposes: Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies on a request from Mead

We demonstrate in this study that the n-3 polyunsaturated fatty acids derived from fish oil, namely, eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA), can increase levels of tissue inhibitors of metalloproteinase-1 (TIMP-1) in the renal cell carcinoma cell line caki-1 by 26% and 17.42% respectively. The result of this elevation in TIMP-1 levels is a reduction of 48.48% in caki-1 invasion through the basement membrane component matrigel when cells are treated with DHA. By inhibition of 2-series prostaglandin production, a similar increase in TIMP-1 was observed in caki-1 cells. We conclude that the polyunstaurated fatty acid DHA, a component of fish oil, is capable of significantly reducing the invasive profile of renal cell carcinoma, and that this reduction is regulated by levels of 2-series prostaglandin production.

The science of nutrition has characterized the essential nature of nutrients their functions and their pathologies of deficiency. In the past two decades the science of nutrition has moved the goalposts away from the provision of nutrient intake merely to avoid the pathologies of deficiency towards the concept that nutrients have disease prevention functions at intakes above the deficiency threshold. Just as technology-driven diagnoses and therapies will affect diet and health at the individual level technology-driven solution in terms of food structure will also be available to the population or those lucky enough to have the economic resources to use them. In trying to predict how the future will look in terms of food choice several factors must be taken into account: potential deterioration of the global environment population growth availability of land farming and existing and unforeseen technological resolutions of conflicts between the environment and the population. What cannot be predicted is the ability of the technological advances to stretch the balance between resources of the earth to sustain mankind and mankinds demand on those resources. One final barrier that needs to be overcome is the physical inactivity. If the developed world is content to be physically inactive then the strategy for optimal nutrition may be dependent on the state and optimal nutrition for the slob may be more difficult to define than that for the physically active.

Following an application from Laboratoire Vie et Sante submitted pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of France, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver an opinion on the scientific substantiation of a health claim based on newly developed science and including proprietary data related to Catalgine® and contributes to the reduction in the number of hot flushes. Catalgine® bouffees de chaleur (also called OM3® menopause) is a dietary supplement made with concentrated wild fish oil that is sufficiently characterised. The reduction in the frequency of episodes of hot flushes is considered beneficial to the health of peri- and post-menopausal women. Two publications (three studies) were identified by the applicant as being pertinent to the claim. Two studies were uncontrolled with respect to the supplement. The third was a post-hoc analysis of a subsample of women participating in a randomised, placebo controlled intervention evaluating the effects of Catalgine® on psychological distress. A number of weaknesses in this study, including unsuccessful blinding and limited power, greatly limit its value as a source of data to substantiate the claimed effect. The Panel concludes that a cause and effect relationship has not been established between the consumption of Catalgine® bouffees de chaleur and the reduction in the frequency of episodes of hot flushes.