Dietary Sodium and Potassium Intake in Hungarian Elderly: Results from the Cross-Sectional Biomarker2019 Survey.

High sodium intake and inadequate potassium intake are associated with high blood pressure. The elderly are more salt sensitive than other age groups, yet a reliable estimate of the dietary sodium and potassium intake of this age group in Hungary is unavailable. The study aimed to estimate the sodium and potassium intakes in the Hungarian elderly from 24 h urine sodium and potassium excretion. In this cross-sectional study, participants were selected from patients of general practitioners practicing in western Hungary. The participants comprised 99 men and 90 women (mean age 67.1 (SD 5.4] years) who participated in the Biomarker2019 survey and returned a complete 24 h urine collection. We assessed dietary sodium and potassium by determining 24 h urinary sodium and potassium excretions and 3-day dietary records. The mean urinary sodium was 188.8 (73.5) mmoL/day, which is equivalent to 11.0 g of salt/day; and the mean urinary potassium was 65.8 (24.3) mmoL/day, which is equivalent to 3.03 g of potassium/day, after adjusting for non-urinary potassium losses. Only 7% of the subjects met the World Health Organization's recommended target of less than 5 g of salt/day, and 33% consumed at least the recommended potassium amount of 3.5 g/day, based on the estimates from 24 h urine excretion. For most elderly, sodium intake exceeds, and potassium does not reach, dietary recommendations. The results underline the need to intensify salt reduction efforts in Hungary.

High sugar content of European commercial baby foods and proposed updates to existing recommendations.

The aim was to determine whether commercial baby foods marketed within Europe (up to 36 months of age) have inappropriate formulation and high sugar content and to provide suggestions to update European regulations and recommendations as part of a nutrient profile model developed for this age group. The latter was produced following recommended World Health Organization (WHO) steps, including undertaking a rapid literature review. Packaging information from countries across the WHO European region was used to determine mean energy from total sugar by food category. The percentage of products containing added sugar and the percentage of savoury meal-type products containing pureed fruit were also calculated. A total of 2,634 baby foods from 10 countries were summarised: 768 sold in the United Kingdom, over 200 each from Denmark (319), Spain (241), Italy (430) and Malta (243) and between 99-200 from Hungary, Norway, Portugal, Estonia and Slovenia. On average, approximately a third of energy in baby foods in these European countries came from total sugar, and for most food categories, energy from sugar was higher than 10%. Use of added sugars was widespread across product categories, with concentrated fruit juice most commonly used. Savoury meal-type purees did not contain added sugars except in United Kingdom and Malta; however, fruit as an ingredient was found in 7% of savoury meals, most frequently seen in UK products. Clear proposals for reducing the high sugar content seen in commercial baby foods were produced. These suggestions, relating to both content and labelling, should be used to update regulations and promote product reformulation.

Traditional Eastern European diet and mortality: prospective evidence from the HAPIEE study.

PURPOSE: Cardiovascular disease (CVD) and cancer mortality rates in Eastern Europe are among the highest in the world. Although diet is an important risk factor, traditional eating habits in this region have not yet been explored. This analysis assessed the relationship between traditional dietary pattern and mortality from all-causes, CVD and cancer in Eastern European cohorts. METHODS: Data from the Health, Alcohol and Psychosocial factors in Eastern Europe prospective cohort were used, including participants from Russia, Poland and the Czech Republic. Based on food frequency questionnaire data, we constructed an Eastern European diet score (EEDS) from nine food groups which can be considered as traditional in this region. The relationship between categorical (low, moderate, high) and continuous (range 0-18) EEDS and mortality was estimated with Cox-regression. RESULTS: From 18,852 eligible participants, 2234 died during follow-up. In multivariable adjusted models, participants with high adherence to the traditional Eastern European diet had significantly higher risk of all-cause (HR 1.23; 95% CI 1.08-1.42) and CVD (1.34; 1.08-1.66) deaths compared to those with low adherence. The association with cancer mortality was only significant in Poland (high vs. low EEDS: 1.41; 1.00-1.98). From the specific EEDS components, high consumption of lard was significantly positively related to all three mortality outcomes, while preserved fruit and vegetable consumption showed consistent inverse associations. CONCLUSION: Our results suggest that traditional eating habits may contribute to the poor health status, particularly the high CVD mortality rates, of populations in Eastern Europe. Adequate public health nutritional interventions in this region are essential.

Good practice criteria for childhood obesity prevention in kindergartens and schools-elaboration, content and use.

Background: In accordance with the policy actions that address childhood overweight and obesity at European level and as a contribution to the EU Action Plan on Childhood Obesity 2014-20, a Joint Action on Nutrition and Physical Activity (JANPA) was established. As part of JANPA work package 6, an evaluation framework to identify good practices, targeting childhood obesity prevention in kindergartens and schools, was developed. This article describes the WP 6 JANPA framework of good practice criteria and its development, compares it to other frameworks and discusses its potential for future use. Methods: Based on the analysis of scientific literature, a set of 47 potential good practice criteria was drafted, that was then revised and complemented through a series of online Delphi consultations. Results: A final list of 48 good practice criteria (9 of which were rated as core criteria) was developed and grouped into three categories: intervention characteristics (n = 17), implementation (n = 17) and monitoring and evaluation (n = 14). Conclusion: The identified JANPA framework of good practice criteria complements the existing frameworks by focussing on kindergarten- and school-based initiatives and provides guidance for evaluators, programme planners and decision makers bearing in mind that a one-size-fits-all approach is inadequate. To ensure the effectiveness of future practices, programme planners should endeavour to meet at least the nine JANPA core criteria.

[Hungarian Diet and Nutritional Status Survey - The OTAP2014 study. V. Vitamin intake of the Hungarian population]. / Országos Táplálkozás- és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. V. A magyar lakosság vitaminbevitele.

INTRODUCTION AND AIM: The Hungarian Diet and Nutritional Status Survey was implemented on a sub-sample of the European Health Interview Survey. In this paper, the authors present the data on the vitamin intake of the Hungarian population. METHOD: The survey represents the vitamin intake of the Hungarian non-institutionalised adult population of 18 years and older. There are significant differences between men's and women's vitamin intake. RESULTS: The intake of all water-soluble vitamins except for vitamin C is higher in men than in women, and the difference between the genders regarding the intake of vitamin E and D is significant. The intake of vitamin B1, B2, B6, B12, niacin and vitamin C is in line with the recommendations, however, there is an unfavourable decrease in the intake of vitamin A and ß-carotene in the case of men compared to the previous survey. Vitamin D and folic acid intakes are critically low, particularly in the elderly, and mainly in case of vitamin D. The population's intake of panthotenic acid and biotin did not reach the recommendations. CONCLUSION: In order to reach the dietary reference intakes and to prevent deficiencies, it is necessary to inform the population and to make healthy food choices available. Orv Hetil. 2017; 158(33): 1302-1313.

[Hungarian Diet and Nutritional Status Survey - The OTAP2014 study. IV. Microelement intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. IV. A magyar lakosság mikroelem-bevitele.

INTRODUCTION AND AIM: The Hungarian Diet and Nutritional Status Survey examined the dietary habits of the Hungarian population. This publication presents the microelement intake. METHOD: The survey represents the microelement intake of the Hungarian non-institutionalised adult population of 18 years and older. RESULTS: While the intake of iron, copper and manganese corresponded with the recommendations in males, in females it was insufficient. The iron intake of women in their reproductive age (9.8 mg/d) stayed well below the recommendation, thus representing a high health risk. In comparison to earlier Hungarian data chromium intake decreased significantly in both sexes (men p = 0.000, women p = 0.008) and the zinc intake of men (9.6 mg/d) decreased below recommended. CONCLUSION: Since the consumption of whole grain products with high microelement content in Hungary is very low, it would be favourable to increase the proportion of these foods in the diet. In case of women it is also necessary to increase the consumption of food groups (e.g. meat, fruits) contributing to the iron intake. Furthermore, communication of adequate nutrition, and the availability of healthy foods is essential for the entire population. Orv Hetil. 2017; 158(21): 803-810.

[Hungarian Diet and Nutritional Status Survey - OTÁP2014. III. Macroelement intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. III. A magyar lakosság makroelem-bevitele.

INTRODUCTION AND AIM: The Hungarian Diet and Nutritional Status Survey examined the dietary habits of the Hungarian adult population. The aim of the study is to present the macroelement intake of the population. METHOD: The study represents the macrolement intake of the population with age 18 or over on the day of 31 December 2013, of those who are non-institutionalised. RESULTS: Salt intake decreased compared to the findings of the previous study in 2009 but it is still extremely high (15.9 g in men and 11.2 g in women). The potassium intake is below the recommendation, which together with a high sodium intake increases the risk of high blood pressure. Calcium intake in the youngest age group reached the recommendations, whereas the intake in the oldest age group was well below the references. Magnesium intake complied with the recommendation, the intake of phosphorus however exceeded it. High sodium intake still represents substantial public health risk. CONCLUSION: The reduction that occured in the population's salt intake since 2009 demonstrates the effectiveness of implemented prevention programs, cooperation with the industry and public awareness campaigns. Orv Hetil. 2017; 158(17): 653-661.

[Hungarian Diet and Nutritional Status Survey - OTÁP2014. II. Energy and macronutrient intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. II. A magyar lakosság energia- és makrotápanyag-bevitele.

INTRODUCTION AND AIM: The aim of the study was to assess and monitor the dietary habits and nutrient intake of Hungarian adults. METHOD: Three-day dietary records were used for dietary assessment, the sample was representative for the Hungarian population aged ≥18ys by gender and age. RESULTS: The mean proportion of energy from fat was higher (men: 38 energy%, women: 37 energy%), that from carbohydrates was lower (men: 45 energy%, women: 47 energy%) than recommended, the protein intake is adequate. CONCLUSION: Unfavorable change compared to the previous survey in 2009 was the increase of fat and saturated fatty acid energy percent in women, the decrease in fruit and vegetable consumption, which explains the decreased fiber intake. An increasing trend in added sugar energy percent in each age groups of both genders was observed compared to 2009. Interventions focusing on the promotion of fruit and vegetable consumption and decreasing of saturated fat and added sugar intake are needed. Orv. Hetil., 2017, 158(15), 587-597.

[Present and future of genotype-based personalized nutrition]. / A genetikaiprofil-alapú, személyre szabott táplálkozás jelene és jövoje.

After the completion of the Human Genome Project, the era of providing personalized dietary advice based on an individual's genetic profile seemed near. Since then more than a decade has passed and the pace of development has been slower than expected. Genotyping single nucleotide polymorphisms which may determine susceptibility to multifactorial diseases is cheaper and more accessible than it was ten years ago. However, few of them are supported by such solid scientific evidence which would justify their use for personalized dietary advice. The future of genotype-based personalized nutrition depends on whether a sufficient amount of gene-diet-disease interactions are identified and scientifically confirmed.

[Hungarian Diet and Nutritional Status Survey -- the OTAP2009 study. V. Intake of microelements in the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat - OTÁP2009. V. A magyar lakosság mikroelem-bevitele.

UNLABELLED: For a healthy status the adequate intake of microelements is vital. AIM AND METHOD: The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. The present paper demonstrates the microelement intake. RESULTS: While the intake of iron, copper and zinc was sufficient in males, it was deficient in females according to the Hungarian recommendations. Especially women in their reproductive age ingested iron below the recommendation, thus representing a health risk. In comparison to earlier Hungarian data, zinc and chromium intake decreased unfavorable. CONCLUSIONS: Since in Hungary the consumption of the whole grain products with high trace element content is traditionally low, as also reflected in the present study, it would be desirable to increase the contribution of these foods in the diet in order to enhance the intake of microelements.

[Hungarian Diet and Nutritional Status Survey - the OTAP2009 study. IV. Macroelement intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat - OTÁP2009. IV. A magyar lakosság makroelem-bevitele.

UNLABELLED: The adequate intake of minerals is basically important for healthy nutrition. AIM AND METHOD: The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. The present publication describes the macroelement intake. RESULTS: The salt intake is unusually high (17.2 g in men and 12.0 g in women), the potassium intake remains well below the recommendation. These factors substantially increase the risk of cardiovascular diseases including high blood-pressure. The calcium intake stays below the recommendation except in the youngest males, the oldest men and women are at risk from this point of view. While magnesium intake suited the recommendation, the intake of phosphorus exceeded it twice. CONCLUSIONS: Focusing on marcroelements, high sodium/salt intake represents the highest public health risk. The implementation of STOP SALT! National Salt Reducing Programme, i.e. decrease the salt content of processed food and provide proper information to the population about excessive salt consumption, should result in a beneficial change of salt intake and ameliorate the public health conditions.

[Hungarian Diet and Nutritional Status Survey -- the OTAP2009 study. II. Energy and macronutrient intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat - OTÁP2009. II. A magyar lakosság energia- és makrotápanyag-bevitele.

UNLABELLED: The Hungarian Diet and Nutritional Status Survey is the fourth in the row of the Hungarian national dietary surveys conducted by the Institute for Food and Nutrition Science. AIMS: The present study was performed to provide valid, up-to-date data on energy and nutrient intakes and dietary habits of the Hungarian adult population. METHODS: The energy and nutrient intakes were calculated on validated three-day dietary records of a representative sample by age and gender of the Hungarian population aged ≥ 18 ys. RESULTS: The energy percentage of fat was too high (39 E% for men and 36 E% for women), that of carbohydrate was too low (45 E% for men and 48 E% for women), whereas that of protein met the recommendation (15 E% for men and 15 E% for women). CONCLUSIONS: Reduction of the nutritional risk factors would greatly reduce the mortality and morbidity rates of nutrition-related diseases.

Characterization of desnutrin functional domains: critical residues for triacylglycerol hydrolysis in cultured cells.

Murine desnutrin/human ATGL is a triacylglycerol (TAG) hydrolase with a predicted catalytic dyad within an alpha-beta hydrolase fold in the N-terminal region. In humans, mutations resulting in C-terminal truncation cause neutral lipid storage disease with myopathy. To identify critical functional domains, we measured TAG breakdown in cultured cells by mutated or truncated desnutrin. In vitro, C-terminally truncated desnutrin displayed an even higher apparent V(max) than the full-length form without changes in K(m), which may be explained by our finding of an interaction between the C- and N-terminal domains. In live cells, however, C-terminally truncated adenoviral desnutrin had lower TAG hydrolase activity. We investigated a role for the phosphorylation of C-terminal S406 and S430 residues but found that these were not necessary for TAG breakdown or lipid droplet localization in cells. The predicted N-terminal active sites, S47 and D166, were both critical for TAG hydrolysis in live cells and in vitro. We also identified two overlapping N-terminal motifs that predict lipid substrate binding domains, a glycine-rich motif (underlined) and an amphipathic alpha-helix (bold) within amino acid residues 10-24 (ISFAGCGFLGVYHIG). G14, F17, L18, and V20, but not G16 and G19, were important for TAG hydrolysis, suggesting a potential role for the amphipathic alpha-helix in TAG binding. This study identifies for the first time critical sites in the N-terminal region of desnutrin and reveals the requirement of the C-terminal region for TAG hydrolysis in cultured cells.

AdPLA ablation increases lipolysis and prevents obesity induced by high-fat feeding or leptin deficiency.

A main function of white adipose tissue is to release fatty acids from stored triacylglycerol for other tissues to use as an energy source. Whereas endocrine regulation of lipolysis has been extensively studied, autocrine and paracrine regulation is not well understood. Here we describe the role of the newly identified major adipocyte phospholipase A(2), AdPLA (encoded by Pla2g16, also called HREV107), in the regulation of lipolysis and adiposity. AdPLA-null mice have a markedly higher rate of lipolysis owing to increased cyclic AMP levels arising from the marked reduction in the amount of adipose prostaglandin E(2) that binds the Galpha(i)-coupled receptor, EP3. AdPLA-null mice have markedly reduced adipose tissue mass and triglyceride content but normal adipogenesis. They also have higher energy expenditure with increased fatty acid oxidation within adipocytes. AdPLA-deficient ob/ob mice remain hyperphagic but lean, with increased energy expenditure, yet have ectopic triglyceride storage and insulin resistance. AdPLA is a major regulator of adipocyte lipolysis and is crucial for the development of obesity.

Identification and functional characterization of adipose-specific phospholipase A2 (AdPLA).

Phospholipases A(2) (PLA(2)s) catalyze hydrolysis of fatty acids from the sn-2 position of phospholipids. Here we report the identification and characterization of a membrane-associated intracellular calcium-dependent, adipose-specific PLA(2) that we named AdPLA (adipose-specific phospholipase A(2)). We found that AdPLA was highly expressed specifically in white adipose tissue and was induced during preadipocyte differentiation into adipocytes. Clearance of AdPLA by immunoprecipitation significantly decreased PLA activity in white adipose tissue lysates but had no effect on liver lysates, where expression was hardly detectable. In characterizing AdPLA, we employed radiochemical assays with TLC analysis of the enzyme activity of lysates from COS-7 cells overexpressing AdPLA. For kinetic studies, we produced purified recombinant AdPLA for use in a lipoxidase-coupled spectrophotometric assay. AdPLA generated free fatty acid and lysophospholipid from phosphatidylcholine with a preference for hydrolysis at the sn-2 position. Although we found low but detectable lysophospholipase activity, AdPLA showed no significant activity against a variety of other lipid substrates. Calcium was found to activate AdPLA but was not essential for activity. Studies with known phospholipase inhibitors, including bromoenolactone, methyl arachidonyl fluorophosphate, AACOCF(3), 7,7-dimethyl-5,8-eicosadienoic acid, and thioetheramide, supported that AdPLA is a phospholipase. Mutational studies showed that His-23 and Cys-113 are critical for activity of AdPLA and suggested that AdPLA is likely a His/Cys PLA(2). Overall, although AdPLA is similar to other histidine phospholipases in pH and calcium dependence, AdPLA showed different characteristics in many regards, including predicted catalytic mechanism. AdPLA may therefore represent the first member of a new group of PLA(2)s, group XVI.

Regulation of lipolysis in adipocytes.

Lipolysis of white adipose tissue triacylglycerol stores results in the liberation of glycerol and nonesterified fatty acids that are released into the vasculature for use by other organs as energy substrates. In response to changes in nutritional state, lipolysis rates are precisely regulated through hormonal and biochemical signals. These signals modulate the activity of lipolytic enzymes and accessory proteins, allowing for maximal responsiveness of adipose tissue to changes in energy requirements and availability. Recently, a number of novel adipocyte triacylglyceride lipases have been identified, including desnutrin/ATGL, greatly expanding our understanding of adipocyte lipolysis. We have also begun to better appreciate the role of a number of nonenzymatic proteins that are critical to triacylglyceride breakdown. This review provides an overview of key mediators of lipolysis and the regulation of this process by changes in nutritional status and nutrient intakes.

Regulation of triglyceride metabolism. IV. Hormonal regulation of lipolysis in adipose tissue.

Triacylglycerol (TAG) stored in adipose tissue can be rapidly mobilized by the hydrolytic action of lipases, with the release of fatty acids (FA) that are used by other tissues during times of energy deprivation. Unlike synthesis of TAG, which occurs not only in adipose tissue but also in other tissues such as liver for very-low-density lipoprotein formation, hydrolysis of TAG, lipolysis, predominantly occurs in adipose tissue. Until recently, hormone-sensitive lipase was considered to be the key rate-limiting enzyme responsible for regulating TAG mobilization. However, recent studies on hormone-sensitive lipase-null mice have challenged such a concept. A novel lipase named desnutrin/ATGL has been recently discovered to play a key role in lipolysis in adipocytes. Lipolysis is under tight hormonal regulation. Although opposing regulation of lipolysis in adipose tissue by insulin and catecholamines is well understood, autocrine/paracrine factors may also participate in its regulation. Intricate cooperation of these endocrine and autocrine/paracrine factors leads to a fine regulation of lipolysis in adipocytes, needed for energy homeostasis. In this review, we summarize and discuss the recent progress made in the regulation of adipocyte lipolysis.

Triacylglycerol metabolism in adipose tissue.

Triacylglycerol (TAG) in adipose tissue serves as the major energy storage form in higher eukaryotes. Obesity, resulting from excess white adipose tissue, has increased dramatically in recent years resulting in a serious public health problem. Understanding of adipocyte-specific TAG synthesis and hydrolysis is critical to the development of strategies to treat and prevent obesity and its closely associated diseases, for example, Type 2 diabetes, hypertension and atherosclerosis. In this review, we present an overview of the major enzymes in TAG synthesis and lipolysis, including the recent discovery of a novel adipocyte TAG hydrolase.