Recent findings suggest that the distribution of protein intake throughout the day has an impact on various health outcomes in older adults, independently of the amount consumed. We evaluated the association between the distribution of dietary protein intake across meals and all-cause mortality in community-dwelling older adults. Data from 3225 older adults aged ≥ 60 years from the Seniors-ENRICA-1 cohort were examined. Habitual dietary protein consumption was collected in 2008–2010 and in 2012 through a validated diet history. Protein distribution across meals was calculated for each participant as the coefficient of variation (CV) of protein intake per meal, in sex-specific tertiles. Vital status was obtained from the National Death Index up to 30 January 2020. Cox proportional hazards regression was performed to determine the hazard ratios (HR) and their 95 % CI for the association between the distribution of daily protein intake across meals and all-cause mortality. Over a median follow-up of 10·6 years, 591 deaths occurred. After adjustment for potential confounders, the CV of total protein intake was not associated with all-cause mortality (HR and 95 % CI in the second and third tertile v. the lowest tertile: 0·94 (0·77, 1·15) and 0·88 (0·72, 1·08); Ptrend = 0·22). Similarly, the HR of all-cause mortality when comparing extreme tertiles of CV for types of protein were 0·89 (0·73, 1·10) for animal-protein intake and 1·02 (0·82, 1·25) for plant-protein intake. Dietary protein distribution across meals was not associated with all-cause mortality, regardless of protein source and amount, among older adults. Further studies should investigate whether this picture holds for specific causes of death.

Many epidemiological studies have emphasised the relation between carotenoid dietary intake and their circulating concentrations and beneficial health effects, such as lower risk of cardiometabolic diseases and cancer. However, there is dispute as to whether the attributed health benefits are due to native carotenoids or whether they are instead induced by their metabolites. Several categories of metabolites have been reported, most notably involving (a) modifications at the cyclohexenyl ring or the polyene chain, such as epoxides and geometric isomers, (b) excentric cleavage metabolites with alcohol-, aldehyde- or carboxylic acid-functional groups or (c) centric cleaved metabolites with additional hydroxyl, aldehyde or carboxyl functionalities, not counting their potential phase-II glucuronidated / sulphated derivatives. Of special interest are the apo-carotenoids, which originate in the intestine and other tissues from carotenoid cleavage by β-carotene oxygenases 1/2 in a symmetrical / non-symmetrical fashion. These are more water soluble and more electrophilic and, therefore, putative candidates for interactions with transcription factors such as NF-kB and Nrf2, as well as ligands for RAR–RXR nuclear receptor interactions. In this review, we discuss in vivo detected apo-carotenoids, their reported tissue concentrations, and potential associated health effects, focusing exclusively on the human situation and based on quantified / semi-quantified carotenoid metabolites proven to be present in humans.

In Bangladesh, only 34 % of the children aged 18–23 months old are given minimum acceptable diets of complementary foods. Objective of the study was to find the effects of complementary feeding counselling on nutritional status among 6–23 months old children of poor families. This was a community-based randomised control trial. A total of 192 children in two groups were randomly selected. Nutrition education was given for a period of 4 months with post-intervention follow-up for 2 months. After 4 months of intervention, the difference in height for age Z score, weight for height Z score and weight for age Z score were significantly higher in the intervention group than in the control group (1·01 ± 0·31 v. 0·19 ± 0·01, P =< 0·001; 1·34 ± 0·15 v 0·72 ± 0·11, P =< 0·001; 1·5 ± 0·24 v. 0·62 ± 0·04, P =< 0·001). Mid-upper arm circumference Z score also improved in the intervention group than in the control group (0·95 ± 0·03 v. 0·57 ± 0·12, P =< 0·001). Morbidity of the children in the intervention group significantly reduced than in the control group (49 % v 80·20 %, P =< 0·001). Higher feeding frequency (3–4 times) (71·9 % v. 45·8 %) and energy intake increased in the intervention group than in the control group. Promotion of complementary feeding from the family foods can improve the nutritional status of 6–23 months old children of poor families within a short period.

Olive oil (OO) polyphenols have been shown to improve HDL anti-atherogenic function, thus demonstrating beneficial effects against cardiovascular risk factors. The aim of the present study was to investigate the effect of extra virgin high polyphenol olive oil (HPOO) v. low polyphenol olive oil (LPOO) on the capacity of HDL to promote cholesterol efflux in healthy adults. In a double-blind, randomised cross-over trial, fifty participants (aged 38·5 (sd 13·9) years, 66 % females) were supplemented with a daily dose (60 ml) of HPOO (320 mg/kg polyphenols) or LPOO (86 mg/kg polyphenols) for 3 weeks. Following a 2-week washout period, participants crossed over to the alternate treatment. Serum HDL-cholesterol efflux capacity, circulating lipids (i.e. total cholesterol, TAG, HDL, LDL) and anthropometrics were measured at baseline and follow-up. No significant between-group differences were observed. Furthermore, no significant changes in HDL-cholesterol efflux were found within either the LPOO and HPOO treatment arms; mean changes were 0·54 % (95 % CI (0·29, 1·37)) and 0·10 % (95 % CI (0·74, 0·94)), respectively. Serum HDL increased significantly after LPOO and HPOO intake by 0·13 mmol/l (95 % CI (0·04, 0·22)) and 0·10 mmol/l (95 % CI (0·02, 0·19)), respectively. A small but significant increase in LDL of 0·14 mmol/l (95 % CI (0·001, 0·28)) was observed following the HPOO intervention. Our results suggest that additional research is warranted to further understand the effect of OO with different phenolic content on mechanisms of cholesterol efflux via different pathways in multi-ethnic populations with diverse diets.

Exercise and dietary interventions have been described to positively affect metabolic syndrome (MetS) via molecular-induced changes. The purpose of this study was to investigate the effects of dietary carbohydrate restriction and aerobic exercise (AE) on retinol binding protein 4 (RBP4) and fatty acid binding protein 5 (FABP5) in middle-aged men with MetS. The study had a randomised, double-blinded, parallel-controlled design. Forty middle-aged men with MetS (age: 53·97 ± 2·85 years, BMI = 31·09 ± 1·04 kg/m2) were randomly assigned to four groups, AE (n 10), ketogenic diet (KD; n 10), AE combined with KD (AE + KD; n 10) or control (C; n 10). RBP4, FABP5, body composition (body mass, BMI and body fat), insulin resistance, insulin sensitivity and MetS factors were evaluated prior to and after the 12-week intervention. AE + KD significantly decreased the body fat percentage (P = 0·006), BMI (P = 0·001), Zmets (P = 0·017), RBP4 (P = 0·017) and the homeostasis model of insulin resistance (HOMA-IR) (P = 0·001) as compared with control group and marginally significantly decreased the Zmets as compared with exercise group (P = 0·086). KD significantly decreased RBP4 levels as compared with control group (P = 0·041). Only the AE intervention (P = 0·045) significantly decreased FABP5 levels. Combining intervention of carbohydrate restriction with AE compared with carbohydrate restriction and AE alone improved RBP4, HOMA-IR as well as different body composition and MetS factors in middle-aged men with MetS.

As an internal time-keeping mechanism, circadian rhythm plays crucial role in maintaining homoeostasis when in response to nutrition change; meanwhile, branched-chain amino acids (BCAA) in skeletal muscle play an important role in preserving energy homoeostasis during fasting. Previous results from our laboratory suggested that fasting can influence peripheral circadian rhythm and BCAA metabolism in fish, but the relationship between circadian rhythm and BCAA metabolism, and whether circadian rhythm regulates BCAA metabolism to maintain physiological homoeostasis during fasting remains unclear. This study shows that the expression of fifteen core clock genes as well as KLF15 and Bcat2 is highly responsive to short-term fasting in fast muscle of Siniperca chuatsi, and the correlation coefficient between Clock and KLF15 expression is enhanced after fasting treatment. Furthermore, we demonstrate that the transcriptional expression of KLF15 is regulated by Clock, and the transcriptional expression of Bcat2 is regulated by KLF15 by using dual-luciferase reporter gene assay and Vivo-morpholinos-mediated gene knockdown technique. Therefore, fasting imposes a dynamic coordination of transcription between the circadian rhythm and BCAA metabolic pathways. The findings highlight the interaction between circadian rhythm and BCAA metabolism and suggest that fasting induces a switch in KLF15 expression through affecting the rhythmic expression of Clock, and then KLF15 promotes the transcription of Bcat2 to enhance the metabolism of BCAA, thus maintaining energy homoeostasis and providing energy for skeletal muscle as well as other tissues.

This review summarises evidence relating to a potential role for vitamin D supplementation in the prevention or treatment of coronavirus disease 2019 (COVID-19). Laboratory studies show that the active vitamin D metabolite 1,25-dihydroxyvitamin D induces innate antiviral responses and regulates immunopathological inflammation with potentially favourable implications for the host response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Meta-analyses of cross-sectional, case-control and longitudinal studies report consistent protective associations between higher circulating 25-hydroxyvitamin D [25(OH)D] concentrations or vitamin D supplement use and reduced risk and severity of COVID-19. However, Mendelian randomisation studies testing for associations between genetically predicted circulating 25(OH)D concentrations and COVID-19 outcomes have yielded consistently null results. Positive findings from observational epidemiological studies may therefore have arisen as a result of residual or unmeasured confounding or reverse causality. Randomised controlled trials of prophylactic or therapeutic vitamin D supplementation to reduce risk or severity of COVID-19 reporting to date have yielded inconsistent findings. Results of further intervention studies are pending, but current evidence is insufficient to support routine use of vitamin D supplements as a therapeutic or prophylactic agent for COVID-19, or as an adjunct to augment immunogenicity of SARS-CoV-2 vaccination. Accordingly, national and international bodies have not made any recommendations regarding a role for vitamin D in the prevention or treatment of COVID-19.

The human health benefits of cardiometabolic disease prevention can be accompanied by planetary co-benefits. Focusing efforts towards young people, including children and adolescents, is conducive to disease prevention. In the context of cardiometabolic disease prevention, this review paper critically summarises the available literature on the acute cardiometabolic responses to physical activity and breakfast manipulations among young people. Given the seriousness of global climate change, which will disproportionally affect our younger generations, this review paper offers new insights into the inherent interactions between child–adolescent behaviour and cardiometabolic health from an environmental sustainability perspective to aid climate change mitigation efforts, including exploring future research avenues. A growing evidence base suggests acute moderate- to high-intensity exercise bouts can attenuate postprandial plasma glucose, insulin and triacylglycerol concentrations for up to 24–48 h in young people. Whether accumulating physical activity throughout the day with short, frequent bouts promotes cardiometabolic risk marker attenuations is unclear. Breakfast consumption may enhance free-living physical activity and reduce glycaemic responses to subsequent meals for a possible additive impact. If repeated habitually, attenuations in these cardiometabolic risk factors would be conducive to disease prevention, reducing the greenhouse gas emissions associated with disease diagnosis and treatment. To progress current understanding with high public health and planetary relevance, research among samples of ‘at risk’ young people that span cellular-level responses to ecologically valid settings and address human and planetary health co-benefits is needed. Indeed, certain physical activity opportunities, such as active travel to school, offer important direct co-benefits to humans and planetary health.

Androgen deprivation therapy (ADT) in men with prostate cancer (PCa) is associated with significant side effects. With the transition of PCa from a foudroyant course to a chronic disease, managing these side effects has become increasingly important. There is growing evidence that nutritional changes and physical activity are beneficial in these patients. Here we examine the impact of written patient information on the physical activity and dietary habits of PCa patients receiving ADT and behaviour changes between baseline and 1 year, in the open-label, non-interventional LEAN study. In total, 959 patients with advanced hormone-sensitive PCa requiring ADT with the Leuprorelin Sandoz® implant were included from January 2014 to July 2015 and followed for ≥ 12 months. At the start of the study, urologists received a questionnaire concerning the written information provided to patients regarding their disease, patient advocacy groups, diet and physical activity. Patients received a questionnaire on their dietary habits and physical activity at the start and end of the study. Urologists from 147 study centres and 540 patients responded to the questionnaires. While 69 % of these patients received disease-specific information, only 30 % and 17 % received information regarding nutrition and physical activity, respectively. The majority of urologists estimate that their patients rarely or never follow guidance on nutrition or physical activity, yet > 90 % of patients indicate they would make use of this information, if provided. Few patients showed behavioural changes between baseline and 1 year without evident differences between patients that received information and those that did not.

Mid-upper arm circumference (MUAC) is simple to use and inexpensive in Ethiopia; both MUAC and target weight are employed, although the time to cure for MUAC is not indicated. The present study is aimed to determine cure time of MUAC for children in outpatient therapeutic program. A prospective cohort study was conducted among 414 severe acute malnourished under-five children admitted to selected health twenty-two posts from 1 February to 30 July 2021, in Oromia, Ethiopia. Data were coded, entered to Ep-data version 4.2 software, and transferred to SPSS for windows version 25 software for analysis. The Multivariate Cox Proportional Hazards model was used to fit independent determinants of time to cure. All tests were two-sided and statistical implications at P-values < 0⋅05. In the present study, the minimum week for a cure was 4 weeks, the maximum was 16 weeks and the overall time to cure severe acute malnutrition as measured by MUAC is judged to be 10 at 95 % CI (9⋅65–10⋅35). Families with six or more members are 2⋅16 times more at risk, children from homes with the lowest wealth index are at 1⋅4 times more risk, and children from food insecure families were 2⋅61 times more likely to require long-term treatment for MUAC. In the present study, the time to cure severe acute malnutrition by MUAC is determined as 10 weeks. Moreover, family size, low wealth index, and household food insecurity were risks to delay in cure time MUAC.

Adequate dietary protein intake is important in human subjects for maintaining muscle turnover, determining the protein content of tissues and thus the preservation of muscle mass and function as we age. A screening tool to assess if an older individual is likely to have a lower dietary protein intake (predicted probability of protein intake ≤1⋅0 g/kg per d), has been developed for a Netherlands dietary profile, but this has not been validated in a UK population. This study aimed to adapt and then validate the protein screening tool for use in a UK population. Amendment of the tool was undertaken using data from UK BioBank and the UK National Diet and Nutrition Survey to reflect protein sources in the UK diet. Validation of the amended version of the protein screener screening tool was conducted using protein intake derived from a food frequency questionnaire (FFQ) in a sample of UK adults (n = 184) (age range 18–91 years) as the reference standard. Using the FFQ, 40 % of respondents (n = 74) reported a protein intake of ≤1⋅0 g per kg body mass. The discriminative accuracy of the amended screener was tested using receiver operating characteristic (ROC) curves. The area under the curve for the ROC was 0⋅731 (95 % CI 0⋅657, 0⋅805), indicating that the amended screener may be a valid tool to screen for individuals consuming ≤1⋅0 g/kg adjusted BM/d in an adult UK population. This protein screener tool is a potential method to screen individuals with a likelihood of habitually consuming protein intakes of ≤1⋅0 g/kg per d. Further validation is needed using a more robust dietary intake methodology and for specific groups, such as older adults. The screener may be applicable across healthcare, clinical and research applications.