Summary Introduction What are unsaturated fatty acids? Unsaturated fatty acids in the UK diet Unsaturated fatty acids in health and disease Unsaturated fatty acids and public health Conclusions Acknowledgements References Summary  Fat provides energy; indeed it is the most energy dense of all the macronutrients, with 1 g providing 37 kJ (9 kcal). However, the constituent parts of fat, fatty acids, are required by the body for many other functions than simply as an energy source, and there is an increasing awareness of the potential health benefits of specific types of fatty acids. Fatty acids are long hydrocarbon chains, with a methyl group at one end (the omega or n‐end) and an acid group at the other. Unsaturated fatty acids are hydrocarbon chains containing at least one carbon–carbon double bond; monounsaturated fatty acids contain one double bond, and polyunsaturated fatty acids (PUFAs) contain many double bonds. The position of the double bond relative to the omega end determines whether a PUFA is an n‐3 (omega 3) or an n‐6 (omega 6) fatty acid. Most fatty acids can be synthesised in the body, but humans lack the enzymes required to produce two fatty acids. These are called the essential fatty acids and must be acquired from the diet. In humans, the essential fatty acids are the n‐3 PUFA α‐linolenic acid and the n‐6 PUFA linoleic acid. Although humans can elongate dietary α‐linolenic acid to the long chain n‐3 PUFAs eicosapentaenoic acid and docosahexaenoic acid, the rate of synthesis may not be sufficient to meet requirements, and it is, therefore, recommended that good sources of these fatty acids, namely, oil‐rich fish, are also included in the diet. Fat is found in most food groups, and foods containing fat generally provide a range of different fatty acids, both saturated and unsaturated. In the UK, the major dietary sources of unsaturated fatty acids include meat & meat products, cereals & cereal products and potatoes & savoury snacks; primarily as a result of the vegetable oil used in processing. Recommended intakes of both total fat and the different types of fatty acids have been set for the UK population, and it is possible to monitor fat intake from the data collected in nationwide dietary surveys. As a population, we are not currently meeting these recommendations, so there is still scope for dietary change. In Western diets, n‐6 fatty acids are the predominant PUFAs, and this is in line with current dietary advice to consume a minimum of 1% energy as n‐6 PUFAs and 0.2% energy as n‐3 PUFAs. The balance of n‐3 and n‐6 PUFAs in Western diets has changed substantially over the last 100 years or so, and as the two families of PUFAs share a common metabolic pathway, concerns have been raised that this might be detrimental to health; what is becoming increasingly clear is that both n‐3 and n‐6 PUFAs have independent health effects in the body, and as intakes of the n‐6 PUFAs are within the guidelines for a healthy diet, concerns about the n‐6 to n‐3 ratio are driven by low intakes of n‐3 rather t...

BackgroundDeficiencies of micronutrients can affect the growth and development of children. There is increasing evidence of vitamin D deficiency world-wide resulting in nutritional rickets in children and osteoporosis in adulthood. Data on the micronutrient status of children in Malaysia is limited. The aim of this study was to determine the anthropometric and micronutrient status of primary school children in the capital city of Kuala Lumpur.MethodsA cross sectional study of primary aged school children was undertaken in 2008. A total of 402 boys and girls aged 7-12 years, attending primary schools in Kuala Lumpur participated in the study. Fasting blood samples were taken to assess vitamin D [as 25(OH)D], vitamin B12, folate, zinc, iron, and ferritin and haemoglobin concentrations. Height-for-age and body mass index for age (BMI-for-age) of the children were computed.ResultsMost of the children had normal height-for-age (96.5%) while slightly over half (58.0%) had normal BMI-for-age. A total of 17.9% were overweight and 16.4% obese. Prevalence of obesity was significantly higher among the boys (25%) than in the girls (9.5%) (χ2 = 22.949; P < .001). Most children had adequate concentrations of haemoglobin, serum ferritin, zinc, folate and vitamin B12. In contrast, 35.3% of the children had serum 25(OH)D concentrations indicative of vitamin D deficiency(≤37.5 nmol/L) and a further 37.1% had insufficiency concentrations (> 37.5-≤50 nmol/L). Among the boys, a significant inverse association was found between serum vitamin D status and BMI-for-age (χ2 = 5.958; P = .016).ConclusionsThis study highlights the presence of a high prevalence of sub-optimal vitamin D status among urban primary school children in a tropical country. In light of the growing problem of obesity in Malaysian children, these findings emphasize the important need for appropriate interventions to address both problems of obesity and poor vitamin D status in children.

SUMMARY INTRODUCTION SKELETAL FUNCTIONS OF CALCIUM Bone Bone growth Body calcium changes Fetal growth Pre‐term infants Infancy Childhood and adolescence Attainment of peak bone mass Skeletal calcium changes in later life Calcium and dental health REGULATORY ROLE OF CALCIUM Introduction Intracellular calcium Role in blood clotting Role in digestion Role in neurological and muscular function CALCIUM HOMEOSTASIS AND METABOLISM Plasma calcium homeostasis Absorption Markers of calcium absorption and status Excretion Factors that influence urinary calcium excretion DIETARY REFERENCE VALUES Dietary reference values Guidance on high intakes SOURCES OF CALCIUM IN THE DIET Milk and dairy products Cereal products Plant foods Additional sources of calcium CALCIUM INTAKE IN THE UK Main dietary sources Current intakes in the UK Trends in intake BIOAVAILABILITY OF CALCIUM FROM FOODS Dietary factors affecting calcium absorption Vitamin D Fat Protein Other dietary factors Bioavailability from different dietary sources Milk and milk products Calcium from plants Other food sources BONE CALCIUM LOSS Bone calcium loss Pregnancy and lactation Factors affecting age‐related bone loss Osteoporosis Definition Public health implications Primary and secondary osteoporosis Dietary calcium, bone mass and age‐related loss of bones Bone loss and calcium supplementation in early‐post‐menopausal women Bone loss and calcium supplementation in late‐post‐menopausal women Fracture risk CALCIUM IN HEALTH AND DISEASE Calcium and cancer Calcium and cardiovascular disease Calcium and weight management Hypercalcaemia Calcium stone formation CONCLUSIONS ACKNOWLEDGEMENTS REFERENCES Summary  Calcium is an essential nutrient as all living cells require calcium to remain viable; calcium is also required for a number of specific roles in the body. The majority (∼99%) of calcium present in the body is found in bone, with a smaller amount found in teeth. The remainder (<1%) is found in soft tissues and body fluids. The average adult skeleton contains 1200 g of calcium, present in the form of hydroxyapatite, an inorganic crystalline structure made up of calcium and phosphorus [Ca10(PO4)6(OH)2], which provides rigidity. Calcium is essential for bone growth as it is required for the mineralisation (impregnation of the bone matrix with minerals) of bone; the rate of calcium deposition in bone is proportional to rate of growth. An adequate intake of calcium is one of a number of factors which are important for acquiring bone mass and attaining peak bone mass (PBM). Diets containing insufficient amounts of calcium may lead to a low bone mineral density, which may have implications for bone health, notably risk of osteoporosis, in later life. As well as having a skeletal function, calcium plays a regulatory role in a number of specialised functions in the...

A daily intake of approximately 0.7 g DHA increases LDL cholesterol by 7% in middle-aged men and women. It is suggested that DHA down-regulates the expression of the LDL receptor.

The intake of (n-3) long-chain PUFA is associated with a decreased risk of fatal myocardial infarction. Whether this effect is attributable to the effects of docosahexaenoic acid [22:6(n-3) (DHA)] on vascular function, particularly at intakes <1 g/d, is unknown. We report a randomized, double-blind, crossover, placebo controlled trial of 0.7 g DHA/d as a purified algal derived triacylglycerol (1.5 g/d) vs. placebo (1.5 g olive oil/d) on vascular function and biochemical indices of endothelial dysfunction in 38 healthy men and women, aged 40-65 y. Each treatment phase lasted 3 mo, separated by a 4 mo washout period. Supplementation increased the proportion of DHA in erythrocytes lipids by 58%, compared with placebo. Arterial compliance and endothelium independent and dependent responses, plasma concentrations of C-reactive protein, soluble thrombomodulin, E-selectin, von Willebrand factor antigen, and urinary microalbumin and isoprostane excretion were unaffected by treatment. Diastolic blood pressure decreased by 3.3 mm Hg (95% CI -6.1 to -0.6; P = 0.01). Heart rate tended to be 2.1 beats/min lower after DHA treatment than after the placebo period (P = 0.15). The results indicate that a moderate increase in the daily intake of DHA to approximately 0.7 g DHA lowers diastolic BP but does not influence indices of endothelial function or arterial stiffness in the short term.

Uncertainty remains regarding the efficacy of low intakes of ergocalciferol (vitamin D2 or D2) and cholecalciferol (vitamin D3 or D3) provided in food to increase serum 25-hydroxy-vitamin D (25-OH-D) metabolite concentrations when UV-B exposure is low. We recruited 40 healthy men and women into a double-blind, parallel design, randomized controlled trial. Participants received placebo or 1 of 4 experimental treatments (D2 or D3 at 5 or 10 μg/d) supplied as a malted milk drink for 4 wk during a period of minimal UV-B exposure in the UK. The primary outcome was a change in serum 25-OH-D2 and 25-OH-D3 concentrations measured by ultra-performance liquid chromatography tandem MS. The secondary outcomes were changes in concentrations of plasma parathyroid hormone and serum calcium (Ca(2+)). Baseline concentrations (geometric mean ± SD) of 25-OH-D2, 25-OH-D3, and total 25-OH-D were 3 ± 4, 32 ± 22, and 37 ± 22 nmol/L, respectively. Both D2- and D3-fortified drinks resulted in dose-dependent increases (P < 0.001) in their respective 25-OH metabolites that did not significantly differ in size. Increments from baseline compared with the placebo group following 5 and 10 μg/d of D2 were (mean ± SEM) 9.4 ± 2.5 and 17.8 ± 2.4 nmol/L for 25-OH-D2 and following 5 and 10 μg/d of D3 were 15.1 ± 4.7 and 22.9 ± 4.6 nmol/L for 25-OH-D3, respectively. There was no difference between D2 and D3 groups in the incremental AUC of their respective metabolites. These findings suggest that D2 and D3 are equipotent in increasing 25-OH-D in healthy men and women with negligible UV-B exposure.

. (2012) Improving the dietary intake of under nourished older people in residential care homes using an energy-enriching food approach: a cluster randomised controlled study. J Hum Nutr Diet. 26, 387-394 doi:10.1111/jhn.12020 AbstractBackground: To examine whether the nutritional status of aged undernourished residents in care could be improved through dietary modification to increase energy intake but not portion size. Methods: A 12-week cluster randomised controlled trial was carried out in 21 residential care homes. Participants comprised undernourished residents with a body mass index (BMI) <18.5 kg m -2 . All menus were analysed to

Effecting positive dietary change is one of the major health challenges facing the government and health professionals and is likely to be influenced by an understanding of the factors that shape food choice. On behalf of the Food Standards Agency, the British Nutrition Foundation recently completed an in-depth, critical review of the factors that influence food choice, attempting to identify effective mechanisms and highlight existing gaps in the evidence base. This article provides a summary of the findings and recommendations of that review.