Novel Approaches to Investigate One-Carbon Metabolism and Related B-Vitamins in Blood Pressure.

Hypertension, a major risk factor for heart disease and stroke, is the world's leading cause of preventable, premature death. A common polymorphism (677C→T) in the gene encoding the folate metabolizing enzyme methylenetetrahydrofolate reductase (MTHFR) is associated with increased blood pressure, and there is accumulating evidence demonstrating that this phenotype can be modulated, specifically in individuals with the MTHFR 677TT genotype, by the B-vitamin riboflavin, an essential co-factor for MTHFR. The underlying mechanism that links this polymorphism, and the related gene-nutrient interaction, with hypertension is currently unknown. Previous research has shown that 5-methyltetrahydrofolate, the product of the reaction catalysed by MTHFR, appears to be a positive allosteric modulator of endothelial nitric oxide synthase (eNOS) and may thus increase the production of nitric oxide, a potent vasodilator. Blood pressure follows a circadian pattern, peaking shortly after wakening and falling during the night, a phenomenon known as 'dipping'. Any deviation from this pattern, which can only be identified using ambulatory blood pressure monitoring (ABPM), has been associated with increased cardiovascular disease (CVD) risk. This review will consider the evidence linking this polymorphism and novel gene-nutrient interaction with hypertension and the potential mechanisms that might be involved. The role of ABPM in B-vitamin research and in nutrition research generally will also be reviewed.The PhD studentship of A.M. was funded by the Northern Ireland Department for Employment and Learning. DSM Nutritional Products Ltd. partly supported project costs associated with this work. The funders had no role in the design, analysis or writing of this paper

Validation of Folate-Enriched Eggs as a Functional Food for Improving Folate Intake in Consumers

Functional foods enriched with folate may be beneficial as a means of optimizing folate status in consumers. We recently developed novel eggs enriched with folate through folic acid supplementation of the hen’s feed, but their potential to influence consumer folate status is unknown because the natural folate forms incorporated into the eggs may not necessarily be retained during storage and cooking. This study aimed to determine the stability of natural folates in folate-enriched eggs under typical conditions of storage and cooking. Total folate was determined by microbiological assay following tri-enzyme treatment in folate-enriched eggs and un-enriched (barn and free-range) on the day they were laid, after storage (up to 27 days) and after using four typical cooking methods (boiling, poaching, frying, scrambling) for different durations. On the day of laying, the folate content of enriched eggs was found to be significantly higher than that of un-enriched barn or free-range eggs (mean ± SD; 123.2 ± 12.4 vs. 41.2 ± 2.8 vs. 65.6 ± 18.5 µg/100 g; p < 0.001). Storage at refrigerator and room temperature for periods up to the Best Before date resulted in no significant losses to the folate content of folate-enriched eggs. Furthermore, folate in enriched eggs remained stable when cooked by four typical methods for periods up to the maximum cooking time (e.g., 135 ± 22.5, 133.9 ± 23.0 and 132.5 ± 35.1; p = 0.73, for raw, scrambled for 50 s and scrambled for 2 min, respectively). Thus, natural folates in folate-enriched eggs remain highly stable with little or no losses following storage and cooking. These findings are important because they demonstrate the feasibility of introducing folate-enriched eggs into the diet of consumers as functional foods with enriched folate content. Further studies will confirm their effectiveness in optimizing the biomarker folate status of consumers

B-Vitamin Biomarkers in Relation to Immune Function in Older Adults: Preliminary Analysis from the TUDA Study

Background and objectives: Immune function typically declines with age, increasing susceptibility to disease. Many factors contribute to this decline, including nutritional status. Emerging evidence shows associations of folate and related B-vitamins (B12, B6, and riboflavin) with immune health, but these interactions are complex. The aim of this study was to investigate B-vitamin biomarkers in relation to immune function in ageing. We hypothesised that the higher status of certain B-vitamins will be associated with improved inflammatory markers. Methods: The data were analysed from the Trinity-Ulster-Department of Agriculture (TUDA) study, aimed at investigating health and lifestyle factors in relation to disease, in community-dwelling older adults recruited from the island of Ireland (2008–2012). Of the 5186 TUDA participants, 2724 fulfilled the inclusion criteria for the current investigation. We measured B-vitamin biomarkers, namely, red blood cell folate, serum B12, plasma pyridoxal-5-phosphate (PLP; B6), the erythrocyte glutathione reductase activation coefficient (EGRac; riboflavin), pro-inflammatory markers (interleukin IL-6, tumor necrosis factor-alpha [TNF-α], and c-reactive protein [CRP]), and the anti-inflammatory marker (IL-10). Results: Plasma PLP was negatively associated with CRP (β: −0.066; 95% CI: −0.005–0.000; p = 0.020), and plasma homocysteine was positively associated with CRP (β: 0.062; 95% CI: 0.003–0.066; p = 0.030) and TNF-α (β: 0.086; 95% CI: 0.023–0.124; p = 0.004). No other significant associations between B-vitamins and inflammatory markers were found. As regards general characteristics, the concentrations of IL-6 (p = 0.040) and CRP (p = 0.010) increased with age; CRP (p < 0.001); TNF-α (p = 0.024) increased with BMI; higher IL-6 (p = 0.041) was associated with living alone; and higher CRP (p < 0.001) was associated with smoking. Discussion: These preliminary findings suggest that improving vitamin B6 status and maintaining a healthy weight in older age may support a healthier immune system. Further investigation, particularly in the form of randomised controlled trials, is required to confirm the current findings and investigate the impact of B-vitamins on immune function

Nutrition-Related Factors and the Progression of Metabolic Syndrome Characteristics over Time in Older Adults: Analysis of the TUDA Cohort

Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus by an estimated two- and five-fold, respectively. Nutrition intervention could help to prevent the progression of MetS and associated pathologies with age, but the precise dietary components and related factors are not well understood. Therefore, the aim of this study was to evaluate the role of nutrition-related factors in MetS as well as the progression of MetS and its components over a 7-year follow-up period in older adults. This investigation involved the secondary analysis of data from the North–South of Ireland Trinity-Ulster-Department of Agriculture (TUDA) study of community-dwelling older adults (≥60 y), which were sampled at baseline (2008–2012; n = 5186) and follow-up (2015–2018; n = 953). Participants were deemed to have MetS if they met at least three of the following criteria: waist circumference (≥102 cm for males, ≥88 cm for females); HDL cholesterol (<1.0 mmol/L for males, <1.3 mmol/L for females); triglycerides (≥1.7 mmol/L); blood pressure (systolic ≥ 130 and/or diastolic ≥ 85 mmHg); and HbA1c (≥39 mmol/mol). The prevalence of MetS increased with advancing age (67% at baseline vs. 74% at follow-up). The factors at baseline that were predictive of a higher MetS risk at follow-up included waist circumference (OR 1.04, 95% CI 1.00–1.08; p = 0.038) and triglycerides (OR 1.77, 95% CI 1.21–2.59; p = 0.003). In a detailed dietary analysis conducted at the follow-up time point, higher protein intake (g/kg body weight) was associated with a lower risk of MetS (OR 0.06, 95% CI 0.02–0.20; p < 0.001), abdominal obesity (OR 0.10, 95% CI 0.02–0.51; p = 0.006), and hypertension (OR 0.022, 95% CI 0.00–0.80; p = 0.037), and a higher MUFA intake (g/day) was associated with a lower risk of MetS (OR 0.88, 95% CI 0.78–1.00; p = 0.030). No other dietary factors were significantly associated with MetS. In terms of protein quality, participants with MetS compared to those without consumed fewer high-quality protein foods (p = 0.009) and consumed more low-quality protein foods (p < 0.001). Dietary intervention along with other strategies focusing on potentially modifiable risk factors may delay the progression of MetS in older adults. Efforts to enhance the quantity and quality of protein intake may be warranted to reduce MetS in certain at-risk groups

Addressing nutrient shortfalls in 1- to 5-year-old Irish children using diet modeling: development of a protocol for use in country-specific population health

BACKGROUND: Dietary habits formed in early childhood can track into later life with important impacts on health. Food-based dietary guidelines (FBDGs) may have a role in improving population health but are lacking for young children. OBJECTIVES: We aimed to establish a protocol for addressing nutrient shortfalls in 1- to 5-y-old children (12–60 mo) using diet modeling in a population-based sample. METHODS: Secondary analysis of 2010–2011 Irish National Pre-School Nutrition Survey data (n = 500) was conducted to identify typical food consumption patterns in 1- to 5-y-olds. Nutrient intakes were assessed against dietary reference values [European Food Safety Authority (EFSA) and Institute of Medicine (IOM)]. To address nutrient shortfalls using diet modeling, 4-d food patterns were developed to assess different milk-feeding scenarios (human milk, whole or low-fat cow milk, and fortified milks) within energy requirement ranges aligned with the WHO growth standards. FBDGs to address nutrient shortfalls were established based on 120 food patterns. RESULTS: Current mean dietary intakes for the majority of 1- to 5-y-olds failed to meet reference values (EFSA) for vitamin D (≤100%), vitamin E (≤88%), DHA (22:6n–3) + EPA (20:5n–3) (IOM; ≤82%), and fiber (≤63%), whereas free sugars intakes exceeded recommendations of <10% energy (E) for 48% of 1- to 3-y-olds and 75% of 4- to 5-y-olds. “Human milk + Cow milk” was the only milk-feeding scenario modeled that predicted sufficient DHA + EPA among 1- to 3-y-olds. Vitamin D shortfalls were not correctable in any milk-feeding scenario, even with supplementation (5 µg/d), apart from the “Follow-up Formula + Fortified drink” scenario in 1- to 3-y-olds (albeit free sugars intakes were estimated at 12%E compared with ≤5%E as provided by other scenarios). Iron and vitamin E shortfalls were most prevalent in scenarios for 1- to 3-y-olds at ≤25(th) growth percentile. CONCLUSIONS: Using WHO growth standards and international reference values, this study provides a protocol for addressing nutrient shortfalls among 1- to 5-y-olds, which could be applied in country-specific population health

Review of recent innovations in portable child growth measurement devices for use in low- and middle-income countries

Acknowledgements: We would like to thank Ulster University colleagues, Professor John Anthony Byrne (principal investigator for the SAFEWATER project), Ms Vanessa Ross (SAFEWATER Project Manager) and Ms Anna Zmuda-Trzebiatowska (Global Grants Development Manager) for their guidance and support throughout the project. We are grateful to all the growth measurement device developers for sharing their product information with us. The authors accept full responsibility for this paper and have no competing interests. Funding The authors wish to acknowledge funding from the Department of Economy, The Global Challenges Research Fund (GCRF) Internal Pump Priming Call, in turn building upon a much larger GCRF, UK Research and Innovation grant for the SAFEWATER project (EPSRC Grant Reference EP/P032427/1).Peer reviewedPublisher PD