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Dietary patterns for healthier cognitive ageing
Berendsen, Agnes A.M. - \ 2017
University. Promotor(en): Lisette de Groot; Edith Feskens, co-promotor(en): Ondine van de Rest. - Wageningen : Wageningen University - ISBN 9789463436014 - 190
meal patterns - feeding habits - aging - cognition - health - food supplements - dementia - nutritional intervention - elderly - elderly nutrition - nutrition and health - maaltijdpatronen - voedingsgewoonten - verouderen - kenvermogen - gezondheid - voedselsupplementen - dementie - maatregel op voedingsgebied - ouderen - ouderenvoeding - voeding en gezondheid
With ageing of our population and the accompanying increase in the number of people living with dementia, it is important to find modifiable risk factors to postpone the onset of cognitive decline. Diet has been proposed such a modifiable risk factor. To date, numerous studies have been conducted demonstrating a possible role of specific nutrients and foods in cognitive functioning. However, as people do not consume single nutrients, the research field has shifted towards studying dietary patterns in which synergistic effects of single nutrients and/or foods can be studied. The main aim of this thesis was to study the association of healthful dietary patterns with cognitive functioning. In addition, nutrient intake inadequacies were assessed and the potential to change dietary intake in older adults aged 65 years and older was studied.
Chapter 2 describes nutrient intake of 245 Dutch adults aged 65-80 years. We identified the contribution of nutrient dense foods, fortified foods and dietary supplements to the total intake of micronutrients. Nutrient density of foods was evaluated using the Nutrient Rich Food score 9.3. Nutrient intake inadequacies were observed for vitamin D, vitamin B6 and selenium. Conventional foods were the main source of vitamin D, vitamin B6 and selenium intake. Foods with the highest nutrient density contributed most to total vitamin B6 intake. In order to optimize nutrient intakes of elderly, combinations of natural food sources, fortified foods and dietary supplements should be considered.
Chapter 3 provides a systematic review of the literature on human studies up to May 2014 that examined the role of dietary patterns in relation to cognitive decline or dementia. The results demonstrate that better adherence to a Mediterranean diet was associated with less cognitive decline, dementia or Alzheimer’s Disease (AD) in four out of six cross-sectional studies, six out of 12 longitudinal studies, one trial and three meta-analyses. Other healthy dietary patterns, among which the Healthy Diet Indicator, have shown to be associated with reduced cognitive decline and/or a reduced risk of dementia in all six cross-sectional studies and six out of eight longitudinal studies. The conclusion of this literature review was that more conclusive evidence is needed to come to more targeted and detailed dietary guidelines to prevent or postpone cognitive decline.
In chapter 4 the association between the Healthy Diet Indicator (HDI) and cognitive functioning in older adults from three different cohort studies was investigated. The cohorts included in total 21,837 subjects from Europe (SENECA and the Rotterdam Study [RS]) and the Unites States (Nurses’ Health Study [NHS]). Cognitive functioning was measured using the Mini-Mental State Examination (MMSE) in SENECA and RS, and the Telephone Interview for Cognitive Status (TICS) in NHS. In all three cohorts, the HDI was not significantly associated with cognitive decline, nor with cognitive function.
In chapter 5 the association of long-term adherence to the Dietary Approaches to Stop Hypertension (DASH) diet with cognitive function and decline in older American women was examined. A total of 16,144 women from the Nurses’ Health Study, aged ≥70 years, who underwent cognitive testing a total of 4 times by telephone from 1995-2001 (baseline), with multiple dietary assessments between 1984 and the first cognitive exam were studied. Greater adherence to long-term DASH score was significantly associated with better average global cognition, verbal memory and TICS score at older ages, but not with cognitive decline.
In chapter 6, the same cohort as in chapter 5 was studied to examine the association between long-term adherence to a recently developed Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet with cognitive function and decline. Higher MIND diet scores were associated with better verbal memory at older ages, but not with cognitive decline over 6 years in global cognition, verbal memory or TICS.
Chapter 7 provides an overview of the NU-AGE (NUtrients and AGEing) dietary intervention study. The NU-AGE study is a randomized one-year intervention in 1,250 apparently healthy, independently living European subjects aged 65 to 80 years. Subjects were randomised into either the intervention group or the control group. Participants in the intervention group received dietary advice aimed at meeting the dietary recommendations of the ageing population. At the start of this thesis, the NU-AGE study was the first dietary intervention investigating the effect of a whole diet and providing targeted dietary recommendations for optimal health and quality of life in apparently healthy European elderly.
In chapter 8, we evaluated if the NU-AGE intervention could be effective to shift the dietary intake of apparently healthy older adults aged 65-80 years living in Italy, the UK, the Netherlands, Poland, and France towards a more healthful diet. The NU-AGE index was created to assess adherence to the NU-AGE diet. At baseline and after one-year follow-up dietary intake was assessed by means of 7-day food records. In total, 1,296 participants were randomized and 1,145 participants completed the intervention (571 in intervention group, 570 in control group). After one-year follow-up, the intervention group improved mean intake of 13 out of 16 dietary recommendations of the NU-AGE diet (p<0.05) with a significant increase of the total NU-AGE index, compared to the control group (mean change in NU-AGE index 21.3±15.9, p<0.01). The NU-AGE dietary intervention, based on dietary recommendations for older adults, may be a feasible strategy to improve dietary intake in an ageing European population.
Chapter 9 shows the results of the NU-AGE parallel randomized dietary intervention study on cognitive functioning in the Dutch NU-AGE subpopulation, including 252 older adults aged 65-80 years (123 intervention, 129 control). The primary outcome was one-year change in global cognition and in four cognitive domains as measured through a comprehensive neuropsychological test battery. Comparing the intervention with the control group, there was no effect of the intervention on cognitive functioning.
In chapter 10 the main findings of this thesis were summarized and a reflection on methodological aspects was given. When grading the reported associations in previous studies and studies in this thesis, it was concluded that there is probable evidence for a role of the Mediterranean diet on cognitive functioning. For the DASH and MIND diet there is a possible link with cognitive functioning; for the HDI and the NU-AGE diet there is no sufficient evidence yet to conclude that there is a relation with cognitive functioning. Not only is there a need for well-designed intervention and prospective studies, we also call for communication strategies to the general public about the consumption of healthier diets to not only impact cardiovascular but also potentially impact brain health as many individuals will face progressive cognitive decline in the near future.
Differences in transcriptional responses to acute and chronic dietary interventions with fatty acids
Matualatupauw, Juri C. - \ 2017
University. Promotor(en): Sander Kersten, co-promotor(en): Lydia Afman; J. Bouwman. - Wageningen : Wageningen University - ISBN 9789463432078 - 172
fatty acids - gene expression - genotyping - phenotypes - nutritional intervention - transcriptomics - fish oils - apolipoprotein e - adipose tissue - microarrays - polymerase chain reaction - vetzuren - genexpressie - fenotypen - maatregel op voedingsgebied - transcriptomica - visoliën - apolipoproteïne e - vetweefsel - polymerase-kettingreactie
Various types of dietary fatty acids have different effects on human health. The aim of this thesis was to increase our understanding of the molecular mechanisms underlying the effects of dietary fatty acids. To do this, we examined changes in whole genome gene expression profiles upon both acute as well as longer term dietary fatty acid interventions. Furthermore, from previous research, it is clear that large inter-individual differences in the response to dietary fatty acids exist. We used whole genome gene expression analyses to increase our understanding of the mechanisms underlying some of these inter-individual differences.
Many modifiable and non-modifiable factors can be the cause of these inter-individual differences. In chapter 2, we reviewed all studies that examined differences in the transcriptional response to dietary interventions based on the presence of one of these factors. These include gender, age, BMI, body composition, blood lipid levels and gut microbial composition. We conclude that transcriptome analyses are well-suited for studying the underlying mechanisms behind these differences in the response to diet. Nevertheless, the number of studies that use this approach remains limited.
Another factor that may modify the response to a dietary intervention is genetics, e.g. the apolipoprotein E4 (APOE4) variant. People who carry the APOE4 allele have an increased risk of cardiovascular disease. Fish-oil supplementation may help in the prevention of cardiovascular disease, though inter-individual differences in the response to n-3 polyunsaturated fatty acids on gene expression profiles have been observed. In chapter 3, we aimed to assess the impact of APOE4 on peripheral blood mononuclear cell (PBMC) whole genome gene expression at baseline and following a 6-month fish-oil intervention. We observed increased gene expression of IFN signaling and cholesterol biosynthesis pathways in APOE4 carriers, which might explain part of the association between APOE4 and CVD. Furthermore, fish-oil supplementation may be beneficial by decreasing interferon signalling-related gene expression in APOE4 carriers.
Another long-term dietary intervention with fatty acids was studied in chapter 4. We examined the effect of a 12-week high medium-chain saturated fatty acid diet on subcutaneous adipose tissue gene expression profiles. We observed increased expression of genes involved in oxidative energy metabolism and decreased inflammation-related gene expression due to the high medium-chain saturated fatty acid intake. Considering the role of the adipose tissue in sustaining the low-grade inflammation that is associated with obesity, these findings may be indicative of a more anti-inflammatory phenotype of the adipose tissue. We concluded that medium-chain saturated fatty acids may potentially have beneficial effects on adipose tissue functioning.
Besides studying the effects of long-term interventions with fatty acids on whole genome gene expression, we also examined the effects of acute high-fat challenges. In chapter 5, we determined the additional value of determining whole genome gene expression changes in response to a high-fat challenge compared to assessment at fasting only. In addition, we aimed to identify whether a 4 week high-fat high-calorie diet can induce a shift in gene expression profiles in healthy subjects towards a metabolic syndrome-like gene expression profile. We found that fasting whole blood whole genome gene expression profiles are highly responsive to a 4-week high-fat high-calorie diet, with changes in in the direction of a metabolic syndrome-like gene expression profile. High-fat challenge responses in healthy subjects show only minimal changes in gene expression upon the dietary intervention and a marginal shift in the direction of the metabolic syndrome. We concluded that fasting gene expression profiles are more responsive compared to high-fat challenge responses to a 4-week high-fat high-calorie diet.
Besides chapter 5, several other studies have also examined changes in whole genome gene expression in blood cells induced by high-fat challenges. In chapter 6, we combined microarray data from four high-fat challenge studies varying in study population, challenge composition and research laboratory. By performing this meta-analysis, we showed a general PBMC whole genome gene expression response to a high-fat challenge. We concluded that a meta-analysis provides added value for the discovery of consistently differentially expressed genes and pathways compared to selecting only those genes and pathways that are identified in all separate studies.
In conclusion, in this thesis we showed differences in the whole genome gene expression response to fish-oil supplementation in PBMCs of APOE4 carriers vs non-carriers. Furthermore, the effects on whole genome gene expression of the two long-term dietary interventions, i.e. the fish-oil supplementation in PBMCs of APOE4 carriers and the high medium-chain saturated fatty acid diet in adipose tissue, may be beneficial by downregulation of gene expression related to inflammation. We also showed that whole genome gene expression responses to high-fat challenges are affected by a 4-week high-fat high-calorie diet, though changes in fasting gene expression profiles are much more pronounced. Finally, we showed the value of meta-analysis of microarray data in high-fat challenge studies for identifying the general response to a high-fat challenge.
The aging immune system and nutritional interventions
Beek, Adriaan A. - \ 2017
University. Promotor(en): Huub Savelkoul; R.W. Hendriks, co-promotor(en): P.J.M. Leenen; Harry Wichers. - Wageningen : Wageningen University - ISBN 9789462579552 - 250
immune system - senescence - gastrointestinal microbiota - basophils - macrophages - dna - nutritional intervention - immuunsysteem - veroudering - microbiota van het spijsverteringskanaal - basofielen - macrofagen - maatregel op voedingsgebied
The increased numbers of elderly people pose a major burden to public health care and society. DNA damage is considered to be the major origin of age-related changes in the body. With aging, the immune system becomes deregulated and is characterized by a low-grade inflammation (inflammaging). In this thesis, we investigate the effects of nutritional and microbial interventions on the aging immune system.
In chapter 2, we elaborate on the role of basophils in the immune system, particularly in the initiation and perpetuation of allergic immune responses. We found that basophils and dendritic cells interact in vitro, which reciprocally affects their surface markers and cytokine production. Thus, by modulating cytokine production and surface marker expression on dendritic cells, basophils may act as accessory cells in immune responses. Because little is known about the effects of aging on basophils, we investigated in chapter 3 whether basophils are affected with aging. We found that frequencies of basophils in the spleen of aging mice are increasing, while their phenotype in bone marrow and spleen changes. Moreover, to investigate the role of microbiota in the aging process, we studied the effects of microbiota transfer from young or aged mice into germfree mice. Aging, and microbiota from aged mice, in particular affect differentiation and function of basophil precursors. These findings warrant further studies on the role of basophils in T helper-2 immune responses with aging.
The contribution of macrophages to inflammaging is described in chapter 4. Important aspects for macrophage polarization and function, like autophagy and cellular metabolism, are discussed. Targeting of aged macrophages by (nutritional) interventions may open up new therapeutic opportunities for elderly.
In chapter 5, we studied the in vitro interaction between bacterial supplementations and immune cells (whole spleen cells and macrophages). We noticed that aged immune cells mount a different response to bacterial strains than young immune cells. Based on these outcomes, we selected three bacterial strains (Lactobacillus plantarum WCFS1, Lactobacillus casei BL23, Bifidobacterium breve DSM20213) for in vivo application in chapter 6. We used Ercc1-/Δ7 mice, which lack fully functional ERCC1 protein. As a consequence, DNA repair is compromised, which results in accelerated aging features in all organs, including the immune system. We supplemented Ercc1-/Δ7 mice, as well as control Ercc1+/+ mice with the three selected bacterial strains. We observed that L. plantarum prevented the age-related decline in mucus barrier function of Ercc1-/Δ7 mice, whereas B. breve exacerbated the age-related decline in mucus barrier. L. casei supplementation elevated multiple systemic inflammatory markers in Ercc1-/Δ7 mice, including Ly6Chi monocytes, neutrophils, and Th17 cells in spleen. Strikingly, we found major changes in the mucus barrier and immune system after supplementation of Ercc1-/Δ7 mice with L. plantarum and L. casei, but not after supplementation of Ercc1+/+ mice. Therefore, we conclude that caution is needed in the selection of candidate probiotic strains for supplementation of aging individuals.
In chapter 7, we took a different approach to modulate the aging immune system by applying dietary tryptophan restriction in Ercc1+/+ and Ercc1-/Δ7 mice. We observed that in both mouse models dietary tryptophan restriction modulated B cell development and microbiota composition. In particular, we found a near-complete absence of B cell precursors in the bone marrow after dietary tryptophan restriction. The decline in B cell precursors was correlated with decreased abundance of the Akkermansia and Alistipes bacterial strains in the intestine. Thus, our results show that dietary tryptophan restriction is a powerful intervention to shape immunity and gut microbiota, also in aging. In chapter 8, we assessed the role of microbiota in the aging gut and immune system. Microbiota from young and aged mice were transferred to germfree mice. Aged microbiota induced higher T helper-1 cell and regulatory T cell frequencies in the spleen. In the ileum, the expression of inflammatory markers was increased after transferring aged microbiota, accompanied by differences in the abundance of microbial species. We conclude that senescent microbiota contribute to the inflammaging observed in aging mice.
In chapter 9, we discuss the findings presented in this thesis, concluding with directions for future research. In summary, our studies show that the aging gut and immune system of mice can be modulated by nutritional and/or microbial interventions. Interestingly, our mouse models clearly provide evidence that age-related effects could be reverted or prevented by these interventions. Nevertheless, our studies at the same time show the need for translational research in order to apply the presented dietary and microbial interventions in elderly.
LPS challenge in jonge biggen : VDI-12: effect voerinterventie op biggen
Greeff, Astrid de; Allaart, Janneke ; Bruijn, Carlijn de; Schokker, Dirkjan ; Roubos, Petra ; Winkelman-Goedhart, Hélène ; Vastenhouw, Stéphanie ; Ruuls, Lisette ; Rebel, Johanna ; Smits, Mari - \ 2016
Wageningen : Wageningen Livestock Research (Wageningen Livestock Research rapport 1009) - 21
biggen - maatregel op voedingsgebied - adequate immuniteit - diergezondheid - lipopolysacchariden - varkenshouderij - dierhouderij - immunologie - piglets - nutritional intervention - immune competence - animal health - lipopolysaccharides - pig farming - animal husbandry - immunology
Nutritional interventions to preserve skeletal muscle mass
Backx, Evelien M.P. - \ 2016
University. Promotor(en): Lisette de Groot; L.J.C. van Loon. - Wageningen : Wageningen University - ISBN 9789462579149 - 158
musculoskeletal system - nutritional intervention - skeletal muscle - vitamin d - creatine - leucine - nandrolone - protein intake - young adults - elderly - overweight - athletes - preservation - skeletspierstelsel - maatregel op voedingsgebied - skeletspier - vitamine d - nandrolon - eiwitinname - jongvolwassenen - ouderen - overgewicht - atleten - behoud
Muscle mass is the main predictor for muscle strength and physical function. The amount of muscle mass can decline rapidly during periods of reduced physical activity or during periods of energy intake restriction. For athletes, it is important to maintain muscle mass, since the loss of muscle is associated with decreased muscle strength, decreased physical performance and a longer recovery period. In the older and more clinically compromised populations, the consequences of muscle loss can substantially impact metabolic health, physical functioning, quality of life and mortality rates. In this thesis, the effects of different nutritional interventions on the preservation of muscle mass are being evaluated.
Vitamin D deficiency (serum 25-hydroxyvitamin D or 25(OH)D) has been associated with increased muscle loss and reduced muscle strength. In chapter 2, we identified seasonal changes in 25(OH)D concentration in elite athletes. We observed that 25(OH)D concentrations were highest at the end of summer (113±26 nmol/L), and lowest at the end of winter (78±30 nmol/L). Athletes that had a sufficient 25(OH)D concentration (>75 nmol/L) at the start of the study, still had a high risk (20%) of being deficient (<50 nmol/L) in late winter. Thus, a sufficient 25(OH)D concentration in summer does not guarantee a sufficient status in winter. In chapter 3, we assessed 25(OH)D concentrations in 128 highly-trained athletes and found that 70% had a deficient or insufficient 25(OH)D concentration at the end of the winter season. Supplementation with 2200 IU/d vitamin D resulted in a sufficient 25(OH)D concentration in 80% of the athletes after 12 months and was therefore a better dosage to improve 25(OH)D concentration than 400 or 1100 IU/d.
In the following chapters, we assessed the effects of creatine supplementation (chapter 4), leucine supplementation (chapter 5) and nandrolone administration (chapter 6) on the preservation of muscle mass during a short period of muscle disuse. For all of these compounds there is prior evidence for their efficacy in augmenting muscle mass and strength gains in combination with resistance-type exercise training and all have been suggested to attenuate the loss of muscle mass during a period of muscle disuse. During 7 days of single-leg immobilization, muscle mass decreased by ~6% and muscle strength decreased by ~8%. Surprisingly, none of the tested compounds attenuated the loss of muscle mass during 7 days of single-leg immobilization in healthy, young men.
In chapter 7, we performed a fully controlled dietary intervention to assess the impact of a high protein intake on the preservation of lean body mass during 12 weeks of energy intake restriction. Sixty-one overweight and obese men and women were randomly assigned to either a high protein diet (1.7 g/kg/d) or a normal protein diet (0.9 g/kg/d) during 12 weeks of 25% energy intake restriction. During the dietary intervention, subjects lost 9±3 kg body weight with a concomitant 2±2 kg decline in lean body mass with no differences between the two intervention groups. Thus, increasing protein intake above habitual intake levels (0.9 g/kg/d) did not preserve lean body mass during a period of energy intake restriction.
Finally, in chapter 8 we reflected on the main findings described in this thesis. In this chapter, we point out that the populations studied were all healthy and well-nourished. We conclude that in these populations, additional creatine, leucine and protein beyond habitual intakes did not preserve muscle mass. Older and/or malnourished individuals might be more responsive to these nutritional interventions. Future research could also focus on the combined effects of two or more nutritional compounds during disuse that are known to affect different mechanisms. Moreover, we speculate that the tested nutritional compounds could be effective in accelerating the regain of muscle mass and strength after a period of muscle loss. However, it should be noted that muscle loss during disuse occurs at a rate that is several-fold greater than muscle (re)gain during resistance type exercise training. Therefore, it is imperative that we continue our endeavors to identify nutritional or pharmaceutical compounds or exercise mimetics that may help to prevent or attenuate disuse atrophy.
Consumer acceptance of intervention strategies for healthy food choices
Bos, Colin - \ 2016
University. Promotor(en): Hans van Trijp, co-promotor(en): Ivo van der Lans; F.J. van Rijnsoever; Ellen Kampman. - Wageningen : Wageningen University - ISBN 9789462579125 - 169
food preferences - health foods - vending machines - low calorie foods - consumer behaviour - beverages - nutritional intervention - consumer attitudes - voedselvoorkeuren - gezondheidsvoedsel - verkoopautomaten - caloriearm voedsel - consumentengedrag - dranken - maatregel op voedingsgebied - houding van consumenten
The need for more effective interventions to combat the obesity problem has been expressed by many public health experts. While consumer support is important for intervention effectiveness, little is known about why consumers accept or do not accept food choice interventions. The present thesis therefore aims to examine the process underlying acceptance of intervention strategies for healthy food choices. Particularly the role that intervention characteristics (e.g. the source and the location of an intervention) and individual characteristics (i.e. consumers’ perceived barriers for behaviour) play in this process is investigated. Three research questions are formulated: 1) What are the drivers of consumer acceptance of intervention strategies for healthy food choices?; 2) How do consumers’ barriers for healthy food choices influence both food choices in real-life and acceptance of interventions?; 3) How does intervention intrusiveness influence acceptance and effectiveness of intervention strategies for healthy food choices?
General beliefs about the obesity problem and intervention-specific beliefs are identified as the main drivers of intervention acceptance in the food domain (Chapter 2). General beliefs comprised both people’s ideas about the magnitude of the obesity problem and the responsibility for food choices that consumers make. Intervention-specific beliefs, on the other hand, concerned people’s perceptions of whether an intervention will be effective, both personally and societally, in stimulating healthy food choices (perceived effectiveness) as well as whether the intervention is a fair way of stimulating healthier choices (perceived fairness).
Consumers’ motivation-related barriers are associated strongest with real-life food choices, with higher levels of motivation to choose healthy foods being related to higher proportions of healthy choices (Chapter 3). Barriers related to the perceived opportunity and ability to choose healthy foods are associated less strongly with real-life choices, with higher levels of opportunity and ability being related to higher proportions of healthy food choices. Three distinct barrier profiles regarding choosing healthy foods are identified: the no-barrier profile (consisting of those who perceive to have no barriers), the lack-of-opportunity profile (consisting of those who perceive to lack opportunity), and the lack-of-motivation profile (consisting of those who report not being motivated). Consumers with a no-barrier profile or a lack-of-opportunity profile perceive interventions to be more effective, more fair, and more acceptable than those with a lack-of-motivation profile (Chapter 4 and 5).
Acceptance of less intrusive interventions, such as calorie information provision, is higher than those of more intrusive interventions, such as elimination of unhealthy choices, both in hypothetical (Chapter 4) and realistic (Chapter 5) settings. In the hypothetical setting, the effect of intrusiveness on acceptance is mediated by both the perceived effectiveness and the perceived fairness of interventions: the more consumers perceive an intervention to be effective and fair, the more they accept it (Chapter 4). In the realistic setting, the effect of perceived intrusiveness on acceptance is mediated only by the perceived fairness of interventions (Chapter 5).
In a vending machine setting, the implementation of an intervention that eliminates 50% of unhealthy choices leads to higher proportions of healthy choices than the implementation of less intrusive interventions (providing calorie information through labelling and not intervening at all). Since acceptance does not differ between these interventions (Chapter 5), elimination of unhealthy choices appears to be the best way to stimulate consumers to make healthy choices.
Overall, this thesis show that consumers’ general- and intervention-specific beliefs drive acceptance of intervention strategies for healthy food choices. Intervention intrusiveness partly influences acceptance, depending on the setting in which consumers are confronted with them (hypothetical vs. realistic). Furthermore, barriers that consumers perceive to have in relation to choosing healthy foods impact acceptance of interventions as well. These insights provide implications for policy makers, both in terms of the development and the communication of intervention strategies for healthy food choices.
Effect of maternal antibiotic intervention in sows on gut development and microbiota in offspring : report of Feed4Foodure, VDI-2: 2013/2014
Greeff, A. de; Schokker, D. ; Roubos, P. ; Ramaekers, P. ; Peet-Schwering, C.M.C. van der; Bikker, P. ; Vastenhouw, S.A. ; Bree, F.M. de; Bossers, A. ; Harders, F.L. ; Smits, M.A. ; Rebel, J.M.J. - \ 2015
Wageningen : Wageningen UR Livestock Research (Livestock Research report 892) - 48
zeugen - antibiotica - microbiële besmetting - biggen - maatregel op voedingsgebied - varkenshouderij - diergezondheid - dierenwelzijn - veehouderij - sows - antibiotics - microbial contamination - piglets - nutritional intervention - pig farming - animal health - animal welfare - livestock farming
A significant contribution to microbial colonization of piglets comes from the sow: via vertical transmission of vaginal flora during birth and transmission of mucosal immune memory and flora by feaces, colostrum and milk. In this study we determine the effect of an maternal nutritional intervention with an antibiotic on early microbial colonization of piglets. We used antibiotic treatment as a harsh intervention to investigate the hypothesis that the microbial composition in sows, may have an effect on the early microbial colonization of piglets.
Nutritional intervention in animals: benchmarking of strategies, monitoring biomarkers and immune competence
Krimpen, M.M. van; Hulst, M.M. ; Meulen, J. van der; Schokker, D. ; Savelkoul, H.F.J. ; Tijhaar, E.J. ; Rutten, V.P.M.G. - \ 2014
Wageningen : Wageningen UR Livestock Research (Livestock Research report 800) - 116
maatregel op voedingsgebied - biomarkers - adequate immuniteit - vee - diergezondheid - immuunsysteem - biologische processen - veehouderij - voeding en gezondheid - diervoedering - dierenwelzijn - nutritional intervention - immune competence - livestock - animal health - immune system - biological processes - livestock farming - nutrition and health - animal feeding - animal welfare
The current study covers a review of literature regarding a number of topics related to immune competence in farm animals, which are introduced in chapter 1. These topics are: 1) A demonstration of the relationship between functional feed components and the expression of genes/biological processes that are involved in gut health of farm animals; 2) A description of available models, that can be used to investigate the effects of nutritional interventions on immune related parameters in animals; 3) A review of the effects of nutritional interventions in the maternal, neonatal and post-neonatal phase on the development of the innate and acquired immune system; 4) A review of the relationship between the immune system in the gut and in the upper airways, whereas the question will be addressed how the immune system in the upper airways can be affected by nutritional interventions.
Op weg naar een hogere groente- en fruitconsumptie: barrières en succesfactoren : eerste inventarisatie en verkenning van kennis en meest kansrijke interventies rondom het verhogen groente- en fruitconsumptie
Sluis, A.A. van der; Stijnen, D.A.J.M. ; Maaskant, A.J. ; Zeinstra, G.G. ; Vingerhoeds, M.H. ; Heuts, F. ; Heijnen, J. - \ 2013
Wageningen : Wageningen UR Food & Biobased (Rapport / Wageningen UR Food & Biobased Research 1431) - ISBN 9789461737007 - 91
consumptiepatronen - consumptie - voedselvoorkeuren - voedingsvoorkeuren - consumentenvoorkeuren - fruit - groenten - maatregel op voedingsgebied - voeding - consumption patterns - consumption - food preferences - feeding preferences - consumer preferences - vegetables - nutritional intervention - nutrition
Gezond eten en drinken is naast voldoende beweging, één van de belangrijkste manieren om zelf te zorgen dat je gezond en vitaal oud wordt. Een ongezond voedingspatroon en een ongezonde levensstijl zorgen voor een enorme stijging van de kosten voor medische zorg, verlies aan arbeidsproductiviteit en verlies aan gezonde levensjaren. Groente- en fruitproducten zijn een belangrijke bron van voedingsvezels en hebben een relatief hoog gehalte aan voedingstoffen die essentieel zijn voor de gezondheid. Zo leveren groenten en fruit een belangrijk aandeel in de inname van vitamines, mineralen en bioactieve stoffen. Bijkomend voordeel is dat groenten en fruit een relatief lage energiedichtheid hebben en vooral door de vezels een goede maagvulling zijn. Dat het eten van groenten en fruit bijdraagt aan een gezonde levensstijl is inmiddels voldoende bekend. Toch blijft de verkoop en consumptie van groenten en fruit veel lager dan de aanbevolen hoeveelheid. Tot dusver hebben campagnes en interventies deze lage consumptie niet of onvoldoende kunnen tegengaan. Dit rapport beschrijft het resultaat van een onderzoek naar de mogelijkheden om de groente- en fruitconsumptie in Nederland te verhogen. Het doel van dit onderzoek is het verkennen van het eetgedrag van consumenten rondom groente- en fruit en het inventariseren van recente interventies en strategieën om de groente- en fruitconsumptie te verhogen (welke hebben wel gewerkt, welke niet).
Dietary strategies to augment muscle mass in the elderly
Tieland, C.A.B. - \ 2013
University. Promotor(en): Lisette de Groot; L.J.C. van Loon. - S.l. : s.n. - ISBN 9789461735676 - 150
eiwittoevoegingen - lichaamsbeweging - spiergewicht - lichamelijke fitheid - ouderen - maatregel op voedingsgebied - protein supplements - exercise - muscle weight - physical fitness - elderly - nutritional intervention
Background: The world population is aging rapidly. This growth of the aging population is accompanied by an increased number of frail elderly people who are at risk of adverse health outcomes such as disability, co-morbidity and mortality. A dominant feature of frailty is the age related loss of muscle mass, strength and performance, also called sarcopenia. Resistance-type exercise training and dietary protein supplementation are considered promising strategies to reverse sarcopenia and subsequent frailty. However, strong evidence for the impact of protein supplementation with or without resistance exercise in frail elderly people is scarce. Well-designed intervention studies in frail elderly people are needed to define new leads for the development of nutritional and exercise interventions to effectively prevent or treat the progressive loss of muscle mass, strength and physical performance with aging. Therefore, the aims of this thesis are to study 1) the impact of protein supplementation and 2) the impact of protein supplementation during prolonged resistance-type exercise training on muscle mass, strength and physical performance in frail elderly people.
Methods: First, we studied various characteristics of dietary protein intake, including the distribution of dietary protein intake throughout the day, and the use of protein-containing food sources in various elderly populations. With this knowledge, we designed two large intervention trials to study the impact of dietary protein supplementation with or without prolonged resistance-type exercise training on muscle mass, strength and physical performance in frail elderly people. In addition, we assessed the usefulness of handgrip strength as a measure of post exercise strength differences and studied the association of vitamin D status and vitamin D intake on muscle mass, strength and physical performance in a frail elderly population.
Results: Dietary protein intake in frail and institutionalized elderly people were especially low at breakfast and lunch. Supplementing protein at breakfast and lunch did not increase muscle mass but improved physical performance in frail elderly people. Resistance-type exercise training improved muscle leg strength and physical performance, but not handgrip strength. Supplementing protein at breakfast and lunch was required to significantly increase muscle mass during prolonged resistance-type exercise training in frail elderly people. Furthermore, low vitamin D status and vitamin D intake were associated with impaired physical performance.
Conclusions: Although dietary protein supplementation does not increase muscle mass, it represents a promising strategy to improve physical performance in frail elderly people. Prolonged resistance-type exercise training represents an effective strategy to improve strength and physical performance, but dietary protein supplementation is required to allow muscle mass gain during exercise training in frail elderly people.
Voorbij het broodtrommeltje ; Hoe jongeren denken over voedsel
Tacken, G.M.L. ; Winter, M.A. de; Veggel, R.J.F.M. van; Sijtsema, S.J. ; Ronteltap, A. ; Cramer, L. ; Reinders, M.J. - \ 2010
Den Haag : LEI, onderdeel van Wageningen UR (Rapport / LEI : Onderzoeksveld Consumenten & gedrag ) - ISBN 9789086154784 - 134
voeding - voedselvoorkeuren - adolescenten - jeugd - keuzegedrag - maatregel op voedingsgebied - voeding en gezondheid - gezondheidsvoedsel - nutrition - food preferences - adolescents - youth - choice behaviour - nutritional intervention - nutrition and health - health foods
Dit onderzoek beschrijft de rol van voedsel bij jongeren in hun dagelijks leven en hoe ze hiermee omgaan. Jongeren zijn te motiveren tot duurzame en gezonde voedselkeuzes als alle partijen, die jongeren beïnvloeden, tot een integrale aanpak komen die aansluit bij de belevingswereld van jongeren.
Nutritional interventions and blood pressure : role of specific micronutrients and other food components
Mierlo, L.A.J. van - \ 2010
University. Promotor(en): Frans Kok, co-promotor(en): Marianne Geleijnse; P.L. Zock. - [S.l.] : S.n. - ISBN 9789085856900 - 187
bloeddruk - dieet - ziektepreventie - maatregel op voedingsgebied - sporenelementen - hypertensie - mineralen - blood pressure - diet - disease prevention - nutritional intervention - trace elements - hypertension - minerals
Elevated blood pressure is an important risk factor for cardiovascular diseases (CVD). Modest reductions in blood pressure at the population level, as can be achieved by dietary and lifestyle changes, have a large impact on the burden of CVD. Blood pressure is regulated by several physiological mechanisms, including vascular endothelial function.
The studies described in this thesis examined the potential effects of various micronutrients and other food components on blood pressure and endothelial function. The first aim was to assess the importance of selected minerals on population blood pressure levels and the second was to investigate the vascular effects of food components other than minerals that have recently attracted attention in the field of nutrition and blood pressure.
A review of 21 national surveys showed that current dietary potassium intakes are suboptimal (1.7-3.7 gram per day). We estimated that increasing intakes to the recommended level of 4.7 gram per day can reduce population systolic blood pressure by 2-3 mmHg in Western countries, this effect being similar to that which can be achieved by reducing current sodium intakes to recommended levels. Our meta-analysis of 40 randomized controlled intervention studies showed that increasing calcium intake by ~1200 mg per day significantly lowers systolic blood pressure by 2 mmHg and diastolic blood pressure by 1 mmHg. This effect tended to be stronger in populations with lower intakes (<800 mg per day). In an 8-week placebo controlled parallel study in 124 subjects with elevated blood pressure, we found no significant blood pressure lowering effects of skimmed milk enriched in potassium (1500 or 750 mg per daily serving) combined with calcium, magnesium, selenium, vitamin C and vitamin E. However, this study was not designed to detect reductions in systolic blood pressure of 2-3 mmHg, which are still relevant at the population level.
In two 4-week placebo controlled cross-over studies, in 162 subjects with untreated elevated blood pressure, we could not demonstrate an antihypertensive effect of a yogurt drink with lactotripeptides obtained by enzymatic hydrolysis (study 1: 10.2 mg per day; study 2: 4.6 mg per day plus 350 mg added potassium). In another 2-week placebo controlled cross-over study in 35 healthy males we found no consistent effect on endothelial function and blood pressure of ~800 mg polyphenols per day from either a wine-grape mix or grape seeds. Finally, a meta-analysis of 14 randomized controlled intervention studies showed that folic acid at a high dose (≥5000 g per day), which can not be attained with a regular diet, significantly improved flow-mediated dilation by 8%.
Adequate potassium and calcium intakes can play an important role in the prevention of hypertension at the population level. Lactotripeptides have no relevant effect on blood pressure in Caucasian populations. The potential of grape polyphenols and folic acid to improve endothelial function is limited.
Multiple actions are needed to lower blood pressure at the population level and reduce the burden of CVD. To improve intakes of potassium and calcium, public health measures should re-emphasize the intake of fruits, vegetables, and low-fat dairy products. Further optimization of mineral intakes, in particular reduction of sodium intake, requires collaborative actions of government and food industry.
Mediterranean diet and the metabolic syndrome
Bos, M.B. - \ 2009
University. Promotor(en): Lisette de Groot; Edith Feskens, co-promotor(en): Jeanne de Vries. - [S.l.] : S.n. - ISBN 9789085853756 - 96
stofwisselingsstoornissen - diabetes mellitus - hart- en vaatziekten - dieet - middellandse-zeegebied - ouderen - maatregel op voedingsgebied - metabolic disorders - cardiovascular diseases - diet - mediterranean region - elderly - nutritional intervention
Mediterranean diet and the metabolic syndrome
Background: The metabolic syndrome refers to a clustering of risk factors including
abdominal obesity, hyperglycaemia, low HDL-cholesterol, hypertriglyceridaemia,
and hypertension and it is a risk factor for diabetes mellitus type 2 and cardiovascular
disease. In this thesis we studied whether a Mediterranean diet favourably affects the
Methods: We assessed the association between a Mediterranean diet and the metabolic
syndrome in apparently healthy elderly European subjects (SENECA study) and in
a Dutch study population that was oversampled with subjects with impaired glucose
tolerance or diabetes mellitus type 2 (CoDAM study). In addition, we conducted a
controlled-feeding trial to compare the effects of replacing a high saturated fatty acids
(SFA) diet with a high monounsaturated fatty acids (MUFA) diet or a Mediterranean
diet on characteristics of the metabolic syndrome: HDL-cholesterol, triglycerides and
glucose metabolism (glucose concentration and insulin sensitivity).
Results: In both the SENECA study and the feeding trial we find support for the
hypothesis that a Mediterranean diet has a beneficial effect on two characteristics of
the metabolic syndrome, namely HDL-cholesterol and triglyceride concentrations.
In addition, the findings of the SENECA study suggested that subjects with good
adherence to a Mediterranean diet had a lower prevalence of the metabolic syndrome
(prevalence ratio 0.81, 95%CI 0.65; 1.03) and a smaller waist circumference (-1.1 cm,
95%CI -2.4; 0.3) than subjects with poor adherence. In the CoDAM study, we did not
find these associations. In none of our studies we found support for the hypothesis
that a Mediterranean diet has a beneficial effect on glucose concentration, insulin
sensitivity or blood pressure.
Conclusion: This thesis finds support for a beneficial effect on two out of five
characteristics of the metabolic syndrome and also suggests a beneficial effect on a
third characteristic (abdominal obesity). We therefore conclude that a Mediterranean
diet may help to prevent the metabolic syndrome and consequently diabetes mellitus
type 2 and cardiovascular disease.
Zuivelconsumptie, bloeddruk en hypertensie : observationele studies en interventieonderzoek
Engberink, M.F. - \ 2009
University. Promotor(en): Evert Schouten; Frans Kok, co-promotor(en): Marianne Geleijnse. - [S.l. : S.n. - ISBN 9789085853619 - 143
melkproducten - bloeddruk - hypertensie - gestuurd experiment met verloting - epidemiologische onderzoeken - maatregel op voedingsgebied - voedselopname - dieetrichtlijnen - nederland - milk products - blood pressure - hypertension - randomized controlled trials - epidemiological surveys - nutritional intervention - food intake - dietary guidelines - netherlands
Diet and lifestyle play an important role in maintaining a healthy blood pressure. Whether intake of dairy products could reduce population blood pressure remains to be established. We examined the association of (specific types of) dairy food intake with blood pressure and risk of hypertension using data from two Dutch population-based cohort studies; i.e. the MORGEN study and the Rotterdam study. Blood pressure level was not consistently associated with overall dairy intake or intake of specific dairy foods in 21,553 Dutch adults from the MORGEN study. However, both in the MORGEN study and in the Rotterdam study, the risk of hypertension was reduced by ~20% in subjects who consumed more than 150 mL of low-fat dairy per day. Other dairy foods, i.e. fermented dairy, high-fat dairy, milk and milk products, and cheese, were not consistently associated with risk of hypertension. In addition, we assessed the effect of two dairy components on human blood pressure, i.e. lactotripeptides and cis-9, trans-11 conjugated linoleic acid, in controlled intervention studies. These dairy components did not affect blood pressure.
Nutrigenomics in human peripheral blood mononuclear cells : the effects of fatty acids on gene expression profiles of human circulating cells as assessed in human intervention studies
Bouwens, M. - \ 2009
University. Promotor(en): Michael Muller, co-promotor(en): Lydia Afman. - [S.l. : S.n. - ISBN 9789085853275 - 128
genotype-voeding interactie - vetzuren - bloedcellen - genexpressie - visoliën - maatregel op voedingsgebied - nutrigenomica - genotype nutrition interaction - fatty acids - blood cells - gene expression - fish oils - nutritional intervention - nutrigenomics
Research on the effects of nutrition on the function and health of organs in the human body, such as liver and intestine, is difficult, because for this research organ tissue is needed. Since nutrition research is usually performed in healthy volunteers, this tissue is difficult to obtain. However, to find out what happens on cellular level we do need human cells. Because blood cells are transported through the entire body and are relatively easy to obtain, these cells are ideal to study the effect of nutrition on cellular level. For this research we used the latest molecular genomics techniques to study the activity (on/off switching, increase/decrease) of all our genes at once. We found that consumption of different types of fat, both directly after consumption and after continued intake, changed the activity of specific groups of genes in these cells. With this research we have shown that the subtle effects of nutrition can be studied using nutrigenomics techniques in humans by using blood cells.
Impact of nutritional factors on eating behavior and feather damage of laying hens
Krimpen, M.M. van - \ 2008
University. Promotor(en): Martin Verstegen; Leonard den Hartog, co-promotor(en): Rene Kwakkel. - [S.l.] : S.n. - ISBN 9789085049487 - 227
hennen - pluimvee - pluimveevoeding - maatregel op voedingsgebied - voedingsgedrag - verenpikken - voersamenstelling - spijsvertering - diervoeding - hens - poultry - poultry feeding - nutritional intervention - feeding behaviour - feather pecking - feed formulation - digestion - animal nutrition
Feather pecking remains one of the major problems facing the poultry industry. It is assumed that feather pecking behavior is a substitute for normal ground pecking or feeding behavior in the absence of adequate foraging incentives. This justifies a nutritional approach of this problem. Although energy and Non Starch Polysaccharides (NSP) concentrations and particle size of the added NSP source seem to reduce feather pecking behavior in laying hens, these nutritional factors were often confounded in experimental diets
Een energiebalans programma voor pasgepensioneerden : impact op lichaamssamenstelling, lichamelijke activiteit en voeding = An energy balance intervention at retirement : impact on body composition, physical activity and diet
Werkman, A.M. - \ 2007
University. Promotor(en): Evert Schouten; Frans Kok, co-promotor(en): A.J. Schuit. - [S.l.] : S.n. - ISBN 9789085048473 - 160
pensionering - energiebalans - maatregel op voedingsgebied - lichaamssamenstelling - lichamelijke activiteit - dieet - retirement - energy balance - nutritional intervention - body composition - physical activity - diet
background Occupational retirement is a life event that is likely to induce lifestyle changes leading to a positive energy balance, and hence weight gain and accumulation of abdominal fat mass. aims The aims of this thesis are 1) to systematically develop an energy balance intervention to prevent the unfavourable effects of retirement and 2) to evaluate the effectiveness of this programme on waist circumference, body weight, body composition, physical activity, diet and related psychosocial determinants. population and methods We invited participants from pre-retirement workshops. They were apparently healthy, aged 55-65 years, maximum six month before or after retirement and not undergoing interfering medical treatment. In total 415 recent retirees were included in the study of which 2 resigned before randomisation. Study participants were randomised according to the pre-retirement workshop they had attended (cluster randomisation) to avoid adoption of the intervention programme by the control group. The low-intensity intervention programme was offered to the intervention group (n=209) over the course of one-year. It consisted of a toolbox, two CD-ROMs providing computer tailored feedback on (1) energy balance and related behaviours and (2) four options for behavioural change: physical activity, portion size, fat consumption and fibre intake. The intervention group also had access to all pages of the study website with an interactive weight management programme (accessible for 6 months) and received newsletters. The control group (n=204) received newsletters and had access to a small part of the website. Effectiveness was evaluated after the one-year intervention period (0-12 months), one year after cessation of the intervention (12-24 months) and over the total two year period (0-24 months). results Contrary to our hypothesis this study indicated that waist circumference (wc (cm)) and body weight (bw (kg)) of the participant on average decreased after retirement. Although in men the changes were in favour of the intervention group (n=166; wc: -2.3±3.2; bw: -1.9±3.1), no significant differences with the control group (n=169; wc: -1.9±3.1; bw: -1.6±3.0) could be observed. Among women the decreases (n=20; wc: -2.5±6.0; bw: -2.4±3.8) were larger in the control group than in the intervention group (n=33; wc: -0.8±4.2; bw: -1.4±3.1), but the differences were not statistically significant. Physical activity (PASE) non-significantly increased among men and women of both groups and energy intake (MJ/day) only decreased significantly among the men. Again no significant differences between the intervention and control group were observed. conclusion We could not demonstrate our intervention programme to be effective in preventing accumulation of abdominal fat mass and weight gain among recent retirees. Both intervention and control group on average showed improvements in body composition and energy balance behaviour(s).
Iron and zinc deficiencies in China: existing problems and possible solutions
Guansheng Ma, - \ 2007
University. Promotor(en): Frans Kok; Evert Jacobsen. - [S.l.] : S.n. - ISBN 9789085045601 - 160
ijzergebrekanemie - gebreksziekten - zink - ijzer - voedingsstoffenbeschikbaarheid - fytinezuur - fytaten - fortificatie - maatregel op voedingsgebied - cost effective analysis - iron deficiency anaemia - deficiency diseases - zinc - iron - nutrient availability - phytic acid - phytates - fortification - nutritional intervention - cost effectiveness analysis
Micronutrient deficiencies affect the health and development of the population of China as well as its socia] and economic development. Iron and zinc deficiencies are quite prevalent, while insufficient intake and poor bioavailability are the major causes. Phytate is be!ieved to bc a potent inhibitor. Feasible, cost-effective and sustainable intervention programs to combat iron and zinc deficiencies need to be identified and developed.
Nutritional Health of Indonesian Adolescent Girls: the role of riboflavin and vitamin A on iron status
Dillon, D. - \ 2005
University. Promotor(en): J.G.A.J. Hautvast; C.E. West, co-promotor(en): Hans Verhoef. - [S.l.] : S.n. - ISBN 9085041597 - 129
anemie - ijzergebrekanemie - riboflavine - retinol - riboflavinetekort - vitamine a tekort - vitaminetoevoegingen - maatregel op voedingsgebied - voedingstoestand - gezondheid - meisjes - adolescenten - indonesië - anaemia - iron deficiency anaemia - riboflavin - riboflavin deficiency - vitamin a deficiency - vitamin supplements - nutritional intervention - nutritional state - health - girls - adolescents - indonesia
In developing countries, adolescent girls often have anemia and micronutrient deficiencies. The objective of this thesis was to investigate the role of riboflavin or vitamin A as determinant of anemia and iron deficiency in Indonesian adolescent girls.
Carotenoid status in man: effects on biomarkers of eye, skin and cardiovascular health
Broekmans, W.M.R. - \ 2002
University. Promotor(en): Frans Kok; G. van Poppel. - S.l. : S.n. - ISBN 9789058086310 - 199
carotenoïden - ziektemerkers - maatregel op voedingsgebied - oogziekten - huidziekten - hart- en vaatziekten - chronische infecties - vruchten - groenten - biologische indicatoren - carotenoids - disease markers - nutritional intervention - eye diseases - skin diseases - cardiovascular diseases - chronic infections - fruits - vegetables - biological indicators
<font size="3"><p>Observational epidemiological studies have consistently shown that a diet rich in carotenoid-containing fruit and vegetables is associated with a reduced risk of chronic diseases. Because intervention studies with hard endpoints are time-consuming and costly, the use of biomarkers could be a promising approach. We studied the relation between serum carotenoid concentrations in a normal physiological range and biomarkers of eye, skin and cardiovascular health.</p><p>In a cross-sectional study among 376 subjects the associations between serum and adipose tissue lutein and macula pigment (MP) density in the eye were stronger in men than in women. MP density was inversely associated with lens density. Lens density was not related to serum and adipose tissue concentrations of lutein after adjustment for age. A modifying effect was observed on the association between serum carotenoids and minimal erythema dose, a marker of skin sensitivity to UV light. Several carotenoids were inversely associated with markers of inflammation markers and endothelial function.</p><p>In a 1-year randomized double blind placebo-controlled trial among 341 subjects, the effects of 0, 7, 10 and 17 g/d consumption of sucrose polyesters (SPE) on serum carotenoids and functional biomakers were studied. Lipid standardized carotenoid concentrations decreased by 13<FONT FACE="Symbol">-</font>33% in the group consuming 17 g/d SPE in comparison with the control group. Decreases of serum carotenoids in the 10 g/d and 7 g/d SPE groups were less. No negative effects were observed on markers of oxidation, eye health, cardiovascular health, and immune status. In a 4-week randomized single blind placebo-controlled trial among 47 subjects, the effect of 500 g/d fruit and vegetables + 200 mL fruit juice was studied in comparison with 100 g/d fruit and vegetables consumption on serum carotenoids and biomarkers of cardiovascular health. Serum carotenoids increased by 22<FONT FACE="Symbol">-</font>128%. Homocysteine concentrations decreased by 11%. No effect was observed on serum lipids, blood pressure and fibrinolysis/coagulation variables.</p><p>Overall, our studies used biomarkers that are indicative of biological processes currently thought to be important in disease etiology. But the predictive value has not been established. Therefore, our studies cannot be conclusive for disease risk. However, they seem to add proof to the hypothesis that serum carotenoid decreases or increases within normal physiological ranges in periods up to one year, have no or limited impact on biomarkers related to eye, skin and cardiovascular health.