BackgroundThere is increasing evidence of the multiple effects of diets on public health nutrition, society, and environment. Sustainability and food security are closely interrelated. The traditional Mediterranean Diet (MD) is recognized as a healthier dietary pattern with a lower environmental impact. As a case study, the MD may guide innovative inter-sectorial efforts to counteract the degradation of ecosystems, loss of biodiversity, and homogeneity of diets due to globalization through the improvement of sustainable healthy dietary patterns. This consensus position paper defines a suite of the most appropriate nutrition and health indicators for assessing the sustainability of diets based on the MD.MethodsIn 2011, an informal International Working Group from different national and international institutions was convened. Through online and face-to-face brainstorming meetings over 4 years, a set of nutrition and health indicators for sustainability was identified and refined.ResultsThirteen nutrition indicators of sustainability relating were identified in five areas. Biochemical characteristics of food (A1. Vegetable/animal protein consumption ratios; A2. Average dietary energy adequacy; A3. Dietary Energy Density Score; A4. Nutrient density of diet), Food Quality (A5. Fruit and vegetable consumption/intakes; A6. Dietary Diversity Score), Environment (A7. Food biodiversity composition and consumption; A8. Rate of Local/regional foods and seasonality; A9. Rate of eco-friendly food production and/or consumption), Lifestyle (A10. Physical activity/physical inactivity prevalence; A11. Adherence to the Mediterranean dietary pattern), Clinical Aspects (A12. Diet-related morbidity/mortality statistics; A13. Nutritional Anthropometry). A standardized set of information was provided for each indicator: definition, methodology, background, data sources, limitations of the indicator, and references.ConclusionThe selection and analysis of these indicators has been performed (where possible) with specific reference to the MD. Sustainability of food systems is an urgent priority for governments and international organizations to address the serious socioeconomic and environmental implications of short-sighted and short-term practices for agricultural land and rural communities. These proposed nutrition indicators will be a useful methodological framework for designing health, education, and agricultural policies in order, not only to conserve the traditional diets of the Mediterranean area as a common cultural heritage and lifestyle but also to enhance the sustainability of diets in general.

Strawberries contain many antioxidant phytochemicals such as vitamin C, carotenoids and phenolic compounds including anthocyanins (ACN). In the present study, antioxidant composition of fresh strawberries (FS) and stored strawberries (SS) and the bioavailability of the main strawberry bioactive compounds were determined in human subjects. Thirteen healthy volunteers consumed 300 g of FS and SS on two separate occasions. Blood, before and at different time points from meal consumption, as well as 24 h urine, was collected, and parent compounds and metabolites of the different compounds were determined by HPLC or LC/MS/MS. A reduction in a-carotene plasma concentrations v. baseline values was recorded after the consumption of FS, although the amount of this carotenoid was higher in the SS. On the contrary, a significant increase of plasma vitamin C after 2, 3 and 5 h (P,0·05) of FS and SS consumption was recorded. No quercetin and ACN were found in plasma, while coumaric acid, 4-hydroxybenzoic acid (4HBA, 56 and 54 % of pelargonidin-3-glucoside (Pel-glc) ingested with FS and SS, respectively) and protocatechuic acid (59 and 34 % of cyanidin-3-glucoside ingested with FS and SS, respectively) over 8 h from strawberry consumption were retrieved in the plasma. Pelargonidin glucuronide, pelargonidin glucoside and pelargonidin aglycone peaked in urine within 2 h of strawberry consumption, and the 24 h amount excreted was always approximately 0·9 % of the Pel-glc dose ingested. The data indicated that the content of phytochemicals in strawberries may influence the bioavailability of individual compounds. Furthermore, in the present study, the metabolism of Pel-glc was elucidated, and, for the first time, 4HBA was suggested to be a major human metabolite of Pel-glc.

BackgroundThe purpose of this study was to evaluate the overall diet quality effects, mainly on antioxidant nutritional status and some cytokines related to the cellular immune response as well as oxidative stress in a healthy Italian population group.MethodsAn observational study was conducted on 131 healthy free-living subjects. Dietary intake was assessed by dietary diary. Standardised procedures were used to make anthropometric measurements. On blood samples (serum, plasma and whole blood) were evaluated: antioxidant status by vitamin A, vitamin E, carotenoids, vitamin C, uric acid, SH groups, SOD and GPx activities; lipid blood profile by total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides; total antioxidant capacity by FRAP and TRAP; the immune status by TNF-α, and IL-10 cytokines; the levels of malondialdehyde in the erythrocytes as marker of lipid peroxidation.ResultsThe daily macronutrients intake (g/day) have shown a high lipids consumption and significant differences between the sexes with regard to daily micronutrients intake. On total sample mean Mediterranean Diet Score (MDS) was 4.5 ± 1.6 and no significant differences between the sexes were present. A greater adherence to a Mediterranean dietary pattern increases the circulating plasma levels of carotenoids (lutein plus zeaxanthin, cryptoxanthin, α and β-carotene), vitamin A and vitamin E. The levels of endogenous antioxidants were also improved. We observed higher levels in anti-inflammatory effect cytokines (IL-10) in subjects with MDS ≥ 6, by contrast, subjects with MDS ≤ 3 show higher levels in sense of proinflammatory (TNF α P < 0.05). Lower levels of MDA were associated with MDS > 4. Our data suggest a protective role of vitamin A against chronic inflammatory conditions especially in subjects with the highest adherence to the Mediterranean-type dietary pattern.ConclusionsMediterranean dietary pattern is associated with significant amelioration of multiple risk factors, including a better cardiovascular risk profile, reduced oxidative stress and modulation of inflammation.

The main objective of this research was to determine whether a commercial orange juice rich in anthocyanins could have an effect on body weight and on clinical parameters related to obesity including antioxidant status, lipid profile, and metabolic and inflammatory biomarkers. 11 women with an average BMI of 34.4 ± 4.8 kg/m2 were enrolled in a pilot study. Over a period of 12 weeks they received 500 mL daily dose into two doses (250 mL) of commercial red orange juice (COJ). The biochemical parameters were measured at baseline and at the end of the study (12 weeks). One month later upon free diet, a follow-up was performed measuring the same variables. The daily consumption of 500 mL of COJ had no significant effects on body weight, while there was a decrease in total cholesterol and LDL cholesterol. The grade of obesity implies different changes in inflammation biomarkers. In obese women, our data do not seem to support evidence that commercial red orange juice consumption acts as functional food preventing obesity and metabolic disorders such as insulin resistance and/or inflammatory status.

Objective: To report selected dietary intake and vitamin status at baseline of volunteers participating in the ZENITH study and the correlation of vitamin status with zinc. Design: A multicentre prospective intervention study employing a randomised double-blind design. Setting: Clermont-Ferrand, Theix (France), Coleraine (Northern Ireland), Grenoble (France), Rome (Italy). Participants: In total, 387 healthy middle-aged (55-70 y) and older (70-87 y) men and women participated in the study. Methods: Dietary intake was assessed by means of a validated 4-d recall record. Fasting blood samples were simultaneously analysed for retinol and a-tocopherol by the HLPC method. Erythrocyte folates were measured by a competitive immunoassay with direct chemiluminescence detection on an automatised immunoanalyser. Results: In all centres, men had a significantly (Po0.0001) higher mean nutrient intake than women. Comparison between age-groups showed that older individuals had significantly lower intakes of macro-and selected micronutrients than middleaged subjects (Po0.0001). A high fat intake (from 36 to 40% of total energy) was observed in all examined groups. In relation to biochemical measures of vitamin status, all parameters were above their respective cut-off values for normality and, thus, none of the subjects had biochemical evidence of deficiency of these selected vitamins. A moderate correlation was found with plasma vitamin A and serum zinc (r ¼ 0.12, Po0.05) or red blood cell zinc (r ¼ 0.12, Po0.01) and with erythrocyte folates and red blood cell zinc (r ¼ 0.11, Po0.05). Conclusions: There were only moderate differences in the nutrient intake of the ZENITH study volunteers among the four European centres. Their biochemical status for retinol, a-tocopherol and folate appeared adequate.

Background: Age-related decline in taste acuity may be both a cause and an effect of depleted zinc and/or increased zinc requirement. Objective: The aim of this study was to explore associations between zinc status and taste acuity in healthy older European adults aged 55-90 y. Sample: Volunteers were recruited within Italy (n ¼ 108 aged 70-90 y), the United Kingdom (UK) (n ¼ 93 aged 55-70) and two regions of France (n ¼ 186), Grenoble (aged 70-90 y) and Clermont-Ferrand (aged 55-70 y). Methods: A signal detection theory approach was adopted, employing a three-alternative, forced-choice procedure. The data were converted to R-indices and bivariate correlations were computed to explore relationships between serum zinc, erythrocyte zinc and taste acuity. ANOVA was undertaken to determine regional differences in zinc status. Results: Higher erythrocyte zinc status was associated with better acuity for salt (sodium chloride) taste in the sample as a whole (P ¼ 0.012) (n ¼ 385). Higher serum zinc levels were associated with greater sensitivity to sour taste (citric acid) (P ¼ 0.015) only in the older groups (aged 70-90 y). There were no apparent associations between serum or erythrocyte zinc status and acuity for bitter (quinine) or sweet (sucrose) tastes irrespective of age. Conclusion: These results agree with those previously suggesting that age-related detriment in sensitivity for salt taste may be associated with depleted zinc.

Taste acuity declines with age and may be dependent upon Zn status. The aim of the present double-blind, randomised controlled intervention trial has been to determine taste acuity in response to Zn supplementation (placebo, or 15 or 30 mg Zn/d). Healthy older European adults aged 70-87 years were recruited within Italy (Rome) (n 108) and France (Grenoble) (n 91) to the European Commission-funded Zenith project. A signal detection theory approach was adopted for taste assessment. The data were converted to R indices and analysed by repeated-measures ANOVA controlling for baseline taste acuity as well as serum and erythrocyte Zn. Serum Zn increased post-intervention, indicating compliance with the intervention. Results differed across geographical region. Salt taste acuity was greater in response to Zn (30 mg) than placebo post-intervention among those recruited in Grenoble. There was no apparent change in acuity for sweet, sour or bitter taste in response to Zn. Supplemented Zn may have potential to enhance salt taste acuity in those over the age of 70 years. Further research is required to determine if enhanced salt taste acuity is reflected in the eating experiences of older individuals.

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