Objective: To investigate the effect of a probiotic milk product containing the culture CAUSIDO 1 and of two alternative products on risk factors for cardiovascular disease in overweight and obese subjects. Design: An 8 week randomized, double-blind, placebo-and compliance-controlled, parallel study. Subjects: Seventy healthy, weight-stable, overweight and obese (25.0`BMI`37.5 kgam 2 ) males (n 20) and females (n 50), 18 ± 55 y old, were randomly assigned into ®ve groups. Intervention: Four groups consumed 450 ml fermented milk products (yoghurt) daily. Group 1: a yoghurt fermented with two strains of Streptococcus thermophilus and two strains of Lactobacillus acidophilus (StLa). Group 2: a placebo yoghurt fermented with delta-acid-lactone (PY). Group 3: a yoghurt fermented with two strains of Streptococcus thermophilus and one strain of Lactobacillus rhamnosus (StLr). Group 4: a yoghurt fermented with one strain of Enterococcus faecium and two strains of Streptococcus thermophilus (CAUSIDO 1 culture), GAIO 1 (G). The dietary composition of the yoghurt was otherwise similar. The ®fth group was given two placebo pills (PP) daily. Results: When comparing all ®ve treatment groups, unadjusted for changes in body weight, no statistical effects were observed in week 8 in the G-group on low density lipoproteins (LDL)-cholesterol (P 0.29). After adjustment for small changes in body weight, LDL-cholesterol decreased by 8.4% (0.26 AE 0.10 mmolal; P`0.05) and ®brinogen increased (0.74AE 0.32 mmolal; P`0.05) after 8 weeks in the G-group. This was signi®cantly different from the group consuming chemically fermented yoghurt and the group consuming placebo pills (P`0.05). After 8 weeks, systolic blood pressure was signi®cantly more reduced in the StLa and Ggroup compared to StLr. No other differences were found. Conclusion: The CAUSIDO 1 culture reduced LDL-cholesterol and increased ®brinogen in the overweight subjects at a 450 ml consumption daily for 8 weeks. The effect on LDL-cholesterol con®rms previous studies. An immunostimulation by one of the strains in the product might explain the effect on ®brinogen in the G-group.

BCG vaccination poses a risk to infants perinatally infected with HIV and to other primary immunodeficient children. The proposed pediatric BCG disease classification reflects clinically relevant disease categories in HIV-infected children. The suggested diagnostic and treatment guidelines should improve existing case management and surveillance. Prospective evaluation of management strategies for BCG disease in HIV-infected and HIV-uninfected children is essential.

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Objective: (1) To determine whether nutritional supplementation (energy and micronutrients) in institutionalised elderly has a positive effect on dietary intake and nutritional status. (2) To investigate whether individuals tend to compensate for the energy content of the intervention product by decreasing their habitual food consumption. Methods: A 24-week, randomised, double-blind, placebo-controlled, intervention trial in homes for the elderly (n ¼ 3), in nursing homes (n ¼ 3) and 'mixed' homes (n ¼ 3) in The Netherlands. Institutionalised elderly people (n ¼ 176) older than 60 years of age, with a body mass index p30 kg/m 2 and a Mini-Mental State Examination score of 10 points or higher, randomly received a nutrient-enriched drink or a placebo drink twice a day during 24 weeks in addition to their usual diet. Allocation to treatment took into account of sex, the Mini-Mental State Examination score and the plasma homocysteine level. Body weight and several nutrition-related analyses in fasting blood samples were measured in all participants. Data on dietary intake were collected in a subsample (n ¼ 66). Results: A significantly favourable effect (Po0.001) of the intervention drink was observed on vitamin intake, mineral intake and vitamin status in blood (for example, homocysteine decreased from 14.7 to 9.5 mmol/l in the intervention group as compared with that in the placebo group (17.2-15.9)). The difference in change in total energy intake between the two treatment groups was 0.8 MJ/day (P ¼ 0.166). Energy intake from food decreased in both groups to the same extent (À0.5 MJ/day). Therefore, this decrease cannot be considered as compensation for the energy content of the product. Conclusions: This group of institutionalised elderly people does not compensate for the energy content of a concentrated nutritional supplement. Therefore, this supplement is effective for counteracting the development of malnutrition in this population.

Shortcomings in methodology varying from the duration of intervention to outcome measures partly explain discrepancies in findings. Despite the heterogeneity in trial design, the results of this review suggest that nutritional supplements may improve the cognitive functioning of elderly persons and do no harm. Further well-designed studies are needed to support these findings.

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Objectives To assess changes in prevalence of malnutrition and its associated factors among people living in Dutch nursing homes in 2009, 2013 and 2018. Design Secondary data analysis of the International Prevalence Measurement of Care Quality (LPZ) study. Setting Dutch nursing homes. Participants Residents living at a psychogeriatric or somatic ward in Dutch nursing homes in 2009, 2013 or 2018. Measurements weight and height, unintentional weight loss over the last month and last six months, age, sex, length of stay up to the measurement day, care dependency, and the presence of various diseases (dementia, diabetes mellitus, stroke, diseases of the respiratory system, respiratory diseases and pressure ulcers). Results In total, 14,317 residents were included in this study with a mean age of 82.2, 70.9 female and 66.8% was living on a psychogeriatric ward. Results of this study show relative stability in background characteristics of the nursing home population over the last decade. In the total sample, 16.7% was malnourished and these percentages were 16.6% in 2009, 17.5% in 2013 and 16.3% in 2018. Multiple binary logistic regression analyses revealed having a pressure ulcer, female sex and living on a psychogeriatric department to be positively associated and having diabetes mellitus to be negatively associated with malnutrition throughout the years. These associations were strong and similar across years. Conclusion Even though much attention has been paid to prevent malnutrition in Dutch nursing homes over the last decades, results show a relatively stable malnutrition prevalence rate of around 16%. This leads to the question if nursing staff is able to sufficiently recognize residents with (a risk of) malnutrition, and if they are aware of interventions they could perform to decrease this rate.