The aim of the present study was to examine the association of pre-pubertal dietary energy density (ED) with both age and body fatness at the start of the pubertal growth spurt (age at take-off, ATO). Analyses included 219 DOrtmund Nutritional and Anthropometric Longitudinally Designed Study participants with sufficient height measurements to estimate ATO who provided 3 d weighed dietary records at baseline, i.e. 2 and 3 years before ATO (mean age 6·9 (sd 1·2) years). Mean energy intakes and amounts of foods/drinks consumed at baseline were derived from the records. ED (kJ/g) was calculated based on (1) all foods and drinks (ED_all), (2) foods and energy-containing drinks (ED_energy), (3) foods and milk as a drink, but no other beverages (ED_milk) and (4) foods only, solid or liquid (ED_food). Using multiple regression analyses, the association between the ED variables and ATO was investigated. Furthermore, Z-scores of BMI and fat mass index (FMI) at ATO were considered as outcomes to reflect body fatness at puberty onset. The results showed that ED at baseline was not associated with ATO, regardless of the ED method used. For example, mean ATO in the lowest v. highest tertile of ED_food was 9·3 (95 % CI 9·0, 9·5) v. 9·4 (95 % CI 9·1, 9·7) years, Ptrend = 0·8 (adjusted for sex, maternal age, birth weight, dietary protein, dietary fibre, baseline BMI Z-score). Similarly, ED was not independently associated with BMI or FMI Z-score at ATO (Ptrend = 0·3–0·9). In conclusion, dietary ED in childhood did not influence timing or body fatness at ATO in this cohort of healthy, free-living children.

The aim of this study was to assess the economic benefits of improved cognitive development related to being breast-fed. Breast-feeding rates were assessed in the Avon Longitudinal Study of Parents and Children. Educational attainment was assessed at age 16 years with higher attainment defined as gaining five General Certificate of Secondary Education (GCSE) passes at a high grade. The economic benefit of being breast-fed was calculated in a decision model using a child’s educational attainment and the corresponding expected value of average income in later life. There was a positive association between being breast-fed and achieving higher educational attainment, which remained significant, after adjustment for possible confounders: being breast-fed <6 months yielded an OR of 1·30 (95 % CI 1·13, 1·51) and for ≥6 months yielded an OR of 1·72 (95 % CI 1·46, 2·05), compared with never breast-fed children. On the basis of UK income statistics, the present value of lifetime gross income was calculated to be £67 500 higher for children achieving 5 high-grade GCSE passes compared with not achieving this. Therefore, the economic benefit of being breast-fed <6 months would be £4208 and that for ≥6 months would be £8799/child. The model shows that the increased educational attainment associated with being breast-fed has a positive economic benefit for society, even from small improvements in breast-feeding rates. Within a total UK birth cohort of 800 000/year an increase by 1 % in breast-feeding rates would be worth >£33·6 million over the working life of the cohort. Therefore, breast-feeding promotion is likely to be highly cost-effective and policymakers should take this into consideration.

Exclusive breast-feeding until 6 months is advised by the WHO as the best practice to feed infants. Yet, some studies have suggested a gap between energy requirements and the energy provided by human milk for many infants at 6 months. In order to assess the adequacy of WHO recommendations in 6-month-old Senegalese lactating infants, a comprehensive study was designed to measure human milk intake by the dose-to-the mother 2H2O turnover method. Infants' energy intakes were calculated using daily breast milk intake and the energy content of milk was estimated on the basis of creamatocrit. Of the fifty-nine mother–infant pairs enrolled, fifteen infants were exclusively breast-fed (Ex) while forty-four were partially breast-fed (Part). Infants' breast milk intake was significantly higher in the Ex group (993 (sd 135) g/d, n 15) compared with the Part group (828 (sd 222) g/d, n 44, P= 0·009). Breast milk energy content as well as infants' growth was comparable in both groups. However, infants' energy intake from human milk was significantly higher (364 (sd 50) kJ/kg per d (2586 (sd 448) kJ/d)) in the Ex group than in the Part group (289 (sd 66) kJ/kg per d (2150 (sd 552) kJ/d), P< 0·01). Compared with WHO recommendations, the results demonstrate that energy intake from breast milk was low in partially breast-fed infants while exclusively breast-fed 6-month-old Senegalese infants received adequate energy from human milk alone, the most complete food for infants. Therefore, advocacy of exclusive breast-feeding until 6 months should be strengthened.

1. The total body calcium (Expt 1) of litter-mate male rats given a diet adequate in phosphorus and high (0·74%) or low (0·13%) in Ca from the age of 3 weeks was determined after 21, 48 and 60 weeks on the diet. In Expt 2, the ash content of ten groups of bones from 10-week-old rats given these same diets for 7 weeks was studied to ascertain whether all groups were equally affected by the difference in dietary Ca level. Four groups of bones, i.e. skull and mandibles, vertebras, the shafts and the ends of long bones, were consequently chosen for examination in Expt 3 where their growth and composition were studied in rats given the Ca diets for 24, 48 or 60 weeks from the age of 3 weeks.

2. Total body Ca (Expt 1), expressed as g Ca or as a percentage of the net body-weight or of net dry, fat-free carcass weight, was always significantly higher in rats given the higher level of Ca. The dietary effect was greatest after 21 weeks.

3. The higher level of dietary Ca led to a highly significant increase in the weight of the dry, fat-free bone and in the percentage ash content of all ten bone groups after 7 weeks (Expt 2). The greater treatment differences in ash content occurred with the less well mineralized bones.

4. In Expt 3, irrespective of diet, the four groups of bones developed at different rates. In rats given the diets for 24 weeks or longer, the vertebras and the shafts of long bones showed the greatest proportional increase in weight of dry, fat-free bone and ash relative to the corresponding values for 3-week-old rats; the greatest change in percentage ash content occurred in the ends of the long bones.

5. Increasing the level of Ca in the diet increased the weight of the dry, fat-free bone and its ash content. The effect of diet decreased with increasing time on the diets, in general persisting most strongly in the skull and mandibles and declining most rapidly in the ends of the long bones. The percentage Ca and P content of the bone ash was only slightly affected by diet and, except for the Ca in the ash of vertebras, significant differences were only found in the composition of the ash of bones from 27-week-old rats.

We conducted a prospective, observational study to determine the incidence of feeding intolerance (FI) within 7 d of initiating enteral nutrition (EN) in patients undergoing cardiopulmonary bypass (CPB) and to evaluate the association between FI and a poor prognosis. Patients who underwent CPB surgery at Fujian Medical University Union Hospital between March 2020 and June 2020 were enrolled. According to the presence or absence of FI within 7 d after EN, patients were divided into FI and non-FI groups. According to the occurrence of a poor prognosis (death, gastrointestinal haemorrhage, acute kidney injury, liver insufficiency, neurological events (cerebral infarction, cerebral haemorrhage and epilepsy) and prolonged mechanical ventilation (> 48 h)), patients were divided into poor prognosis and good prognosis groups. The mean age of the 237 CPB patients, including 139 men and ninety-eight women, was 53·80 (sd 12·25) years. The incidence of FI was 64·14 %. Multivariate logistic regression analysis showed factors independently associated with poor prognosis after CPB included FI (OR 2·138; 95 % CI 1·058, 4·320), age (OR 1·033; 95 % CI 1·004, 1·063), New York Heart Association (NYHA) class III/IV cardiac function (OR 2·410; 95 % CI 1·079, 5·383), macrovascular surgery (OR 5·434; 95 % CI 1·704, 17·333) and initial sequential organ failure assessment score (OR 1·243; 95 % CI 1·010, 1·530). Thus, the incidence of FI within 7 d of EN after CPB was high, which was associated with a poor prognosis.

A diet based on rice powder, soya-bean oil, glucose, egg-white and salts was given to twenty-six patients of different nutritional status aged 4–18 months with persistent diarrheoa and twenty-five age-matched controls without diarrhoea. Clinical response was monitored during 1 week of dietary treatment and absorption of macronutrients was estimated during a 72 h balance study. Twenty-one patients (81 %) recovered from diarrhoea within 7 d. There were significant relationships between nutritional indices, recovery, and absorption of total energy, fat and N. The absorption of fat, protein and carbohydrate in the better nourished controls without diarrhoea was significantly higher than in patients with persistent diarrhoea with better nutrition or malnutrition. The duration of diarrhoea was significantly longer in lighter patients (weight-for-age < 65% NCHS (1976) standard), in wasted patients (weight/height < 80% of NCHS) and those with mid upper arm circumference (MUAC) less than 110 mm. There were negative relationships between the period of recovery and the coefficient of absorption of fat (P < 0·001), total energy intake (P < 0·01) and MUAC (P < 0·05). Weight-for-age and MUAC showed most effective discriminative power for absorption of nutrients. However, the coefficients of absorption for carbohydrate were not different for any pair of nutritional groups. Absorption of all nutrients was also correlated negatively with severity of persistent diarrhoea on admission. The results of the present study indicate that a rice-based diet is highly effective in the management of persistent diarrhoea, while malnutrition aggravates nutrient malabsorption, increases duration and severity of diarrhoea and less severely malnourished patients do not absorb nutrients as well as healthy controls. Malnutrition and the initial severity of diarrhoea are significant determinants of clinical prognosis and nutrient absorption in persistent diarrhoea.

Intra-uterine growth restriction (IUGR) may induce significant metabolic and inflammatory anomalies, increasing the risk of obesity and CVD later in life. Similarly, alterations in the adipose tissue may lead to metabolic changes in children with a history of extra-uterine growth restriction (EUGR). These mechanisms may induce alterations in immune response during early life. The aim of the present study was to compare pro-inflammatory markers in prepubertal EUGR children with those in a reference population. A total of thirty-eight prepubertal children with a history of EUGR and a reference group including 123 healthy age- and sex-matched children were selected. Perinatal data were examined. In the prepubertal stage, the concentrations of inflammatory biomarkers were measured in both groups. The serum concentrations of C-reactive protein (CRP) and plasma concentrations of hepatocyte growth factor (HGF), IL-6, IL-8, monocyte chemotactic protein type 1 (MCP-1), neural growth factor, TNF-α and plasminogen activator inhibitor type 1 were determined. The plasma concentrations of inflammatory biomarkers CRP, HGF, IL-8, MCP-1 and TNF-α were higher in the EUGR group than in the reference group (P< 0·001). After adjustment for gestational age, birth weight and length, blood pressure values and TNF-α concentrations remained higher in the EUGR group than in the reference group. Therefore, further investigations should be conducted in EUGR children to evaluate the potential negative impact of metabolic, nutritional and pro-inflammatory changes induced by the EUGR condition.

n-3 Fatty acids, flavonoids and resveratrol are well publicised for their beneficial effects on human health and wellbeing. Identifying common, underlying biological mechanisms targeted by these functional foods would therefore be informative for the public health sector for advising on nutritional health and disease, food and drug product development and consumer interest. The aim of this study was to explore the potential effects of gene expression changes associated with n-3 fatty acids EPA and DHA, flavonoids and resveratrol on modifying biological systems and disease pathways. To test this, publicly available human microarray data for significant gene expression changes associated with dietary intervention with EPA/DHA, flavonoids and resveratrol was subjected to pathway analysis and significance testing for overlap with signals from genome-wide association studies (GWAS) for common non-communicable diseases and biological functions. There was an enrichment of genes implicated in immune responses and disease pathways which was common to all of the treatment conditions tested. Analysis of biological functions and disease pathways indicated anti-tumorigenic properties for EPA/DHA. In line with this, significance testing of the intersection of genes associated with these functional foods and GWAS hits for common biological functions (ageing and cognition) and non-communicable diseases (breast cancer, CVD, diabesity, neurodegeneration and psychiatric disorders) identified significant overlap between the EPA/DHA and breast cancer gene sets. Dietary intervention with EPA/DHA, flavonoids and resveratrol can target important biological and disease pathways suggesting a potentially important role for these bioactive compounds in the prevention and treatment of dietary-related diseases.

1. Studies were conducted to measure the influence of perinatal undernutrition of twin-bearing ewes on ewe milk yields and lamb performance in early lactation. Comparative studies were conducted with lambs to measure the effects of postnatal nutrition on lamb performance and carcass composition. The major objective of this work was to determine the extent of the influence of postnatal nutritional deprivation of lambs.

2. From 8 weeks prepartum to 4 weeks postpartum each of forty twin-bearing ewes was given daily 0.30 MJ of ME/kg body-weight (W)0.75. Measurements were made of ewe body-weight changes, milk yields during the first 4 weeks of lactation, and of lamb performance.

3. There were three postnatal experiments with lambs of ‘light’ and ‘normal’ birth weights, wcaned from the ewes at 72 h. One hundred and four lambs were used and they were individually reared on separate allowances of lamb milk-substitute for 8 weeks. They were subsequently given a lamb concentrate ration. In Expts 1 and 2 the lamb concentrate was fed ad lib. to ‘slaughter’ live weight. In Expt 3 the concentrate was restricted for 8 weeks post weaning and then fed ad lib. A carcass analysis (bone, muscle, fat content) was conducted on all lambs after slaughter. In the first experiment, half the lambs were slaughtered at 8 weeks of age on being weaned off the milk substitute, and a carcass analysis was carried out.

4. The mean net body-weight loss per ewe from commencement of late pregnancy to 28 d post partum was 23.8 kg. The over-all mean daily milk yield was 843 g/d. The mean growth rate of the lambs was 97 g/d during the 4-week measurement of ewe milk yields.

5. Live weight gain of lambs subjected to restricted milk-substitute allowance (125 g/dry matter (DM) per d) was low, irrespective of lamb birth weight. The average daily gain over the 8-week postnatal period was 86.5 g/d on restricted milk allowance compared with 244 g/d for those fed ad lib. Conversely, the food intake and growth rate of these lambs were almost identical during feeding on ad lib. concentrates. This clearly reflected a response to compensatory food intake which was independent of either birth weight or postnatal milk allowance. The average daily gain of lambs, before weaning, on the restricted milk allowance was very similar to that of the lambs being suckled by ewes subjected to perinatal undernutrition. The effects of postnatal undernutrition of lambs was particularly reflected in the time required to reach ‘slaughter’ live weight. The period of time varied from 117 d for those on ad lib. food intake to 169 d for lambs on restricted food intake.

6. The major effect of postnatal undernutrition on carcass composition was evident in the lambs slaughtered at 8 weeks in Expt 1. The percentage carcass fat was 4.7 for those on the low milk allowance. The carcass composition of all lambs at ‘slaughter’ live weight was similar. It would appear that lambs on a restricted milk intake before weaning deposited more fat during the subsequent period of compensatory food intake.

7. It is evident from the present results that postnatal growth retardation in lambs reflects either perinatal undernutrition of twin-bearing ewes, or postnatal undernutrition of the lambs due to inadequate milk availability from the dam.

The main objective of the present study was to determine the influence of acute deficits of protein and energy on the blood serum level of interferon-γ, a signature type 1 polarising inflammatory cytokine. In two 14 d experiments, male and female C57BL/6J mice, initial age 19 d, consumed a complete purified diet ad libitum or in restricted daily quantities, or had free access to an isoenergetic purified low-protein diet. A zero-time control group (age 19 d) was included in the second experiment. Serum interferon-γ was assessed in both experiments by sandwich ELISA and, in the second experiment, also by a bioassay based on inhibition of proliferation by WEHI-279 B lymphoma cells. The immunoassay detected interferon-γ inconsistently in all groups (range 0–14 pg/ml; detection limits 1·5 and 0·7 pg/ml in experiments 1 and 2, respectively). By contrast, interferon-γ bioactivity was found in all animals of each group (means 339, 499, 124 and 200 pg/ml in zero-time controls, age-matched controls, low-protein and restricted intake groups, respectively; detection limit, 12 pg/ml), and the mean serum bioactivity of each malnourished group was low compared with the age-matched control (P ≤ 0·05). The present study defines the physiological serum interferon-γ bioactivity of the adolescent mouse. Moreover, to the extent achievable by way of the blood, the results reflect the influence of metabolically diverse forms of acute malnutrition on the polarising type 1 cytokine profile within lymphoid microenvironments wherein immune responses arise. Therefore, the results suggest a mechanism underlying the cell-mediated inflammatory incompetence that characterises acute, prepubescent malnutrition.

The objective of the present study was to assess the impact of providing small-quantity lipid-based nutrient supplements (SQ-LNS) on the I status of young Burkinabe children. In total, thirty-four communities were assigned to intervention (IC) or non-intervention cohorts (NIC). IC children were randomly assigned to receive 20 g lipid-based nutrient supplements (LNS)/d containing 90 µg I with 0 or 10 mg Zn from 9 to 18 months of age, and NIC children received no SQ-LNS. All the children were exposed to iodised salt through the national salt iodization programme. Spot urinary iodine (UI), thyroid-stimulating hormone (TSH) and total thyroxine (T4) in dried blood spots as well as plasma thyroglobulin (Tg) concentrations were assessed at 9 and 18 months of age among 123 IC and fifty-six NIC children. At baseline and at 18 months, UI, TSH and T4 did not differ between cohorts. Tg concentration was higher in the NIC v. IC at baseline, but this difference did not persist at 18 months of age. In both cohorts combined, the geometric mean of UI was 339·2 (95 % CI 298·6, 385·2) µg/l, TSH 0·8 (95 % CI 0·7, 0·8) mU/l, T4 118 (95 % CI 114, 122) nmol/l and Tg 26·0 (95 % CI 24·3, 27·7) µg/l at 18 months of age. None of the children had elevated TSH at 18 months of age. Marginally more children in NIC (8·9 %) had low T4 (<65 nmol/l) compared with the IC (1·6 %) (P=0·052). Salt samples (n 106) were collected from randomly selected participants and assessed by titration for I content, which was on average 37 (sd 15) ppm (range 5–86 ppm); 95 % of households had adequately iodised salt (I>15 ppm). A reduction of SQ-LNS I content could be considered in settings with similarly successful salt iodisation programmes.

1. Groups of three colostomized germ-free (GF) and conventional (CV) chickens aged 4 months were maintained for successive periods of 8 d on a diet containing 200 g casein/kg without and with sodium bicarbonate at the rate of 20 mmol/d and a nitrogen-free diet without and with NaHCO3 at 9 mmol/d. Urine and faeces were collected during the last 3 d of each period.

2. Total N, uric acid- and ammonia-N were determined in urine and total N in faeces. Amino acids were measured in hydrolysates of faeces collected during the periods when no NaHCO3 was included in the diets.

3. The CV birds excreted more N on the casein diets but less on the N-free diets than did their GF counterparts, the differences being mainly shown in the urine.

4. On both diets hydrolysates of the faeces of CV birds contained smaller amounts of amino acids. On the N-free diet the proportions (g/160 g N) of serine, proline and threonine were reduced, suggesting some conservation of endogenous N by micro-organisms, and the proportions of histidine, alanine, lysine and methionine increased, possibly through microbial synthesis; on the casein diet, proportions of most amino acids were less, probably because bacterial deamination had occurred.

5. Urinary excretion of total N, uric acid and ammonia was much greater on the casein than on the N-free diets. Inclusion of NaHCO3 caused a sharp fall in urinary ammonia on both diets and in both environments.

6. It was concluded that the level of dietary protein and the regulation of acid-base balance have more effect than microbial activity on the urinary ammonia excretion.

The melanocortin-4 receptor (MC4R) is an essential regulator of food intake and energy homeostasis. Previous data suggest an influence of MC4R activity on TAG levels. Thus, the aim of the present study was to determine whether the presence of the rs12970134 polymorphism near the MC4R gene could influence postprandial lipoprotein metabolism in healthy subjects. A total of eighty-eight volunteers were selected, fifty-three homozygous for the common genotype (G/G) and thirty-five carriers for the minor A-allele (G/A and A/A). They were given a fat-rich meal containing 1 g fat and 7 mg cholesterol/kg body weight and vitamin A (60 000 IU/m2 body surface). Fat accounted for 60 % of energy, and protein and carbohydrates accounted for 15 and 25 % of energy, respectively. Blood samples were taken at time 0, every 1 h until 6 h and every 2·5 h until 11 h. Total cholesterol and TAG in plasma, and cholesterol, TAG and retinyl palmitate in TAG-rich lipoproteins (TRL, large and small TRL) were separated by ultracentrifugation. Individuals carrying the G/G genotype displayed a higher postprandial response of plasma TAG (P = 0·033), total cholesterol (P = 0·019) and large TRL–TAG (P = 0·023) than did carriers of the minor A-allele. Furthermore, G/G subjects showed a greater postprandial response of small TRL–apoB48 than did carriers of the A-allele (P = 0·032). These results suggest that the rs12970134 polymorphism near the MC4R gene region may partly explain the inter-individual differences in postprandial lipoprotein response in healthy subjects.

1. Newborn infants of low birth weight absorb both pteroylmonoglutamic acid and pteroylpolyglutamate.

2. There was a significant fall in serum folate concentrations during the first 14 d of life in these infants, but a daily supplement of 50 μg pteroylmonoglutamic acid or pteroylpolyglutamate was sufficient to prevent the development of subnormal serum folate concentrations.

A major benefit of supplementing non-ruminant feedstuffs with exogenous enzymes is presumed to be the degradation of plant cell-wall polysaccharides to metabolizable monosaccharide residues. In the present study, metabolic fates of (U-14C-labelled, 10 mM) glucose, galactose, mannose, xylose and arabinose were compared in the fowl, by measuring recoveries of 14C radioactivity in exhaled carbon dioxide, excreta and body tissues after administration either by wing vein (iv) or into the crop (ic). A further comparison was made with a tube-fed, enzyme-treated, U-14C-labelled cell-wall substrate, Festuca arundinacea and a final experiment tested possible competition for absorption between different cell-wall residues. Delays between iv and is treatments in recovery of 14C in CO2, which were assumed to reflect intestinal absorption, indicated that xylose was absorbed more slowly than glucose and galactose, but faster than mannose and arabinose. Total recoveries of 14C in CO2 and excreta over the whole test period indicated that metabolizabilities were highest with glucose, galactose and mannose, and lowest with arabinose. After testing, 14C recovery in caecal contents was highest with is arabinose, and recoveries in body tissues, with all sugar treatments, were in the order liver > breast and leg muscle > abdominal fat > plasma. Results with the Festuca substrate showed similar patterns of recovery in body tissues and confirmed an increase in metabolizability with addition of enzymes. The timing of the 14CO2 response with Festuca and a wet enzyme pretreatment was broadly similar to a ‘predicted Festuca’ response, based on the composition of the substrate and the measured responses with individual (ic) monosaccharides. There was no evidence of any competition for absorption or metabolism among cell-wall residues. It was concluded that glucose release from cellulose is potentially the most important product of cell-wall degradation to contribute to enzyme enhancement of metabolizable energy.

The present study investigated trends in reported energy intake, macronutrient intake, physical activity level (PAL) and body weight and effects of excluding under-reporters (UR). Dietary intake and time spent in sixteen activity categories were recorded by 887 female university students (median age 29 years) from 1988 to 2003. Energy expenditure (EE) and PAL were measured using a factorial method. All data collected were self-reported. Individuals with reported EI:EE<0·76 were classified as UR. The remainder were classified as non-under-reporters (NUR). Trends were determined from simple linear regression of median data for each year for the entire cohort (ALL) and for NUR and UR separately, and from multiple regression analysis with the subgroups (NUR and UR) as an additional predictor (BOTH). Prevalence of under-reporting and overweight increased between 1988 and 2003. In ALL and BOTH there were trends to increased body mass, protein intake (g/d and % energy) and carbohydrate intake (% energy only) and decreased fat and alcohol intakes (g/d and % energy). In BOTH there were also increases in reported EI and carbohydrate intake (g/d). None of the trends in NUR was significantly different from those in UR, but some trends in ALL and/or BOTH were not significant when UR were excluded. Trends remaining significant in NUR were increased reported energy intake, protein (g/d) and carbohydrate (g/d) intakes, and decreased fat (% energy only) intake. There were no significant trends in PAL. We conclude that some, but not all, dietary trends were affected by exclusion of UR.

1. Two groups of four 18-month-old ewes fitted with a rumen cannula and re-entrant cannulas in the proximal duodenum were fed on one of two diets based on varying proportions of dried-grass meal, ground straw and barley.

2. The apparent availability, retention and amount of the mineral reaching the proximal duodenum were measured for calcium, phosphorus, magnesium, copper and zinc. Significant differences were found between diets for Ca only. Net absorption of Mg occurred before the proximal duodenum and also, lower down the alimentary tract. Marked increases were observed in the amount of Cu, Zn and P reaching the proximal duodenum relative to that ingested.