Omega-3 supplements and insulin resistance in hepatitis C patients

n-3 polyunsaturated fatty acid supplementation reduces insulin resistance in hepatitis C virus infected patients: a randomised controlled trial

Freire et al., JHND Early View


Insulin resistance promotes liver disease progression and may be associated with a lower response rate in treated hepatitis C virus (HCV) infected patients. n-3 polyunsaturated fatty acid (PUFA) supplementation may reduce insulin resistance.

The present study aimed to evaluate the effect of n-3 PUFA supplementation on insulin resistance in these patients.


In a randomised, double-blind clinical trial, 154 patients were screened. After applying inclusion criteria, 52 patients [homeostasis model assessment index of insulin resistance (HOMA-IR ≥2.5)] were randomly divided into two groups: n-3 PUFA (n = 25/6000 mg day−1 of fish oil) or control (n = 27/6000 mg day−1 of soybean oil). Both groups were supplemented for 12 weeks and underwent monthly nutritional consultation. Biochemical tests were performed at baseline and after intervention. Statistical analysis was performed using the Wilcoxon Mann–Whitney test for comparisons and the Wilcoxon test for paired data. Statistical package r, version 3.02 (The R Project for Statistical Computing) was used and P < 0.05 (two-tailed) was considered statistically significant.


Comparisons between groups showed that n-3 PUFA supplementation was more effective than the control for reducing HOMA-IR (P = 0.015) and serum insulin (P = 0.016). The n-3 PUFA group not only showed a significant reduction in HOMA-IR 3.8 (3.2–5.0) versus 2.4 (1.8–3.3) (P = 0.002); serum insulin 17.1 (13.8–20.6) μIU mL−1 versus 10.9 (8.6–14.6) μIU mL−1 (P = 0.001); and glycated haemoglobin 5.4% (5.0–5.7%) versus 5.1% (4.8–5.6%) (P = 0.011), but also presented an increase in interleukin-1 97.5 (0.0–199.8) pg mL−1 versus 192.4 (102.2–266.8) pg mL−1 (P = 0.003) and tumour necrosis factor 121.2 (0.0–171.3) pg mL−1 versus 185.7 (98.0–246.9) pg mL−1(P = 0.003).


n-3 PUFA supplementation reduces insulin resistance in genotype 1 HCV infected patients.

Face-to-face social networks and quality of life in coeliac disease

Coeliac disease: the association between quality of life and social support network participation

Lee et al., JHND Early View


There is little information available on the use of social support systems for patients with coeliac disease (CD). We performed a cross-sectional study aiming to examine the association between participation in different types of social support networks and quality of life (QOL) in adults with CD.


A survey including a validated CD specific QOL instrument was administered online and in-person to adults with CD who were following a gluten-free diet. Participation in social support networks (type, frequency and duration) were assessed.


Among the 2138 participants, overall QOL scores were high, averaging 68.9 out of 100. Significant differences in QOL scores were found for age, length of time since diagnosis and level of education. Most (58%) reported using no social support networks. Of the 42% reporting use of social support networks (online 17.9%, face-to-face 10.8% or both 12.8%), QOL scores were higher for those individuals who used only face-to-face social support compared to only online support (72.6 versus 66.7; < 0.0001). A longer duration of face-to-face social support use was associated with higher QOL scores (< 0.0005). By contrast, a longer duration and increased frequency of online social support use was associated with lower QOL scores (< 0.03).


Participation in face-to-face social support networks is associated with greater QOL scores compared to online social support networks. These findings have potential implications for the management of individuals with CD. Emphasis on face-to-face support may improve long-term QOL and patient outcomes.

Estimating energy intake in chronic kidney disease

Comparison of energy estimates in chronic kidney disease using doubly-labelled water

Sridharan et al., JHND Early View


Total energy expenditure (TEE) is estimated in clinical practice as a combined measure of resting energy expenditure and physical activity level. Commonly available questionnaires to estimate physical activity level have not been validated in patients with kidney disease using the doubly-labelled water method.


This prospective, cross-sectional study was conducted on 40 patients with chronic kidney disease stages 1–5 with the objective of validating two physical activity questionnaires: the Recent Physical Activity Questionnaire (RPAQ) and the Stanford 7-day recall questionnaire. TEE was measured using doubly-labelled water technique. TEE was also estimated using predicted resting energy expenditure and estimated physical activity measures from the questionnaires.


Measured TEE correlated better with TEE estimated from RPAQ compared to that from the Stanford questionnaire. In Bland–Altman analysis, TEE estimated from RPAQ had the least bias and narrower limits of agreement compared to the measured TEE. A metabolic equivalent of task value of 1.3 for the unaccounted time in RPAQ provided the best approximation of estimated TEE to the measured TEE.


RPAQ is an acceptable questionnaire tool for assessing physical activity level in patients with chronic kidney disease.

Complementary feeding in German infants

Home-made and commercial complementary meals in German infants: results of the DONALD study

Hilbig et al., JHND Early View


Infant complementary food can be home-made or bought as ready-to-eat commercial products. The nutrient composition of commercial products is regularised in a European Commission guideline, whereas the preparation of home-made complementary meals is the responsibility of caregivers. In the present study, the composition of commercial and home-made complementary meals as eaten by healthy German infants was compared.


Of 8226 complementary meals (74% commercial and 26% home-made) recorded in 1083, 3-day weighed dietary records from 396 participants (6–12 months old) of the German DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study were analysed.


Median energy density (kcal 100 g–1) was highest in commercial and home-made cereal–milk meals (89 kcal 100 g–1). In home-made savoury and cereal–fruit meals, the energy density was significantly higher compared to their commercial counterparts. Median protein contents were highest in savoury and cereal–milk meals (>2.5 g 100 g–1) and dairy–fruit meals (2–4 g 100 g–1). Added sugars were found in less than a quarter of meals. Highest median sodium contents were found not only in commercial savoury meals (median 38 mg 100 g–1) and vegetable meals (32 mg 100 g–1), but also in home-made cereal–milk meals (36 mg 100 g–1). Both median fat and iron contents were higher in home-made meals compared to commercial savoury and cereal–fruit meals.


With the exception of the higher sodium content in commercial savoury meals for older infants, the lower fat content in commercial savoury and cereal–fruit meals, and the added sugar content in some commercial dairy–fruit meals, a comparison of commercial and home-made complementary meals did not reveal any serious inadequacy.

Issue 28(4) – coming soon!

The July/August issue of JHND will be published soon. The contents for this issue are:

Wandrag et al., Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other wasting disease: systematic review.

Huynh et al., Effects of oral nutritional supplementation in the management of malnutrition in hospital and post-hospital discharge in India- a randomised, open-label, controlled trial.

Karam et al., Cardiovascular disease biomarkers in patients with inborn errors of protein metabolism: a pilot study.

Mokhtari et al., Relationship between dietary approaches to stop hypertension score and Alternative Healthy Eating Index score with plasma asymmetrical dimethylarginine levels in patients referring coronary angiography.

Roberts et al., Nutrition care related practices and factors affecting nutritional intakes in hospital patients at risk of pressure ulcers.

Bandara et al., Current infant feeding practices and impact on growth of babies during second half of infancy.

Amezdroz et al., Transition from milks to the introduction of solid foods across the first two years of life: findings from an Australian birth cohort study.

Gaba et al., Comparison of multi- and single-frequeancy bioelectrical impedance analysis with dual x ray absorptiometry for assessment of body composition in post-menopausal women: effects of body mass index and accelerometer-determined physical activity.

Hebden et al., ‘You are what you choose to eat’. Factors influencing young adults’ food selection behaviour.

Georgioulis et al., Associations between dietary intake and the presence of metabolic syndrome in patients with non-alcoholic fatty liver disease.