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Metabolic syndrome is defined by a cluster of inter-related cardiovascular risk factors
(hyperglycemia, hypertension, dyslipidemia, insulin resistance, and central adiposity) linked to
chronic, systemic, and low-grade inflammation, which severely increases the risk of type II diabetes
and cardiovascular disease. Before, within, and hopefully after the COVID pandemics, metabolic
diseases are still one of the major silent pandemics worldwide, causing at least more than 2.5 million
deaths annually. A growing body of evidence generated in recent decades has shown that not
only the energy balance but also the macro-, micro-, and non-nutrient composition of the diet may
influence the onset and progression of metabolic syndrome. However, further research is required
to increase our understanding of the contribution of diet to the prevention of metabolic syndrome.
We propose this Special Issue, entitled “Dietary Intakes and Metabolic Syndrome”, with the aim of
gathering original research manuscripts and reviews dealing with the relationships between diet as
a whole and metabolic-syndrome-related diseases, as well as with the effects of specific nutrients
or non-nutritional bioactive compounds on this metabolic condition and related pathologic features.
In the end, the Special Issue covers important issues such as nutrition and bioenergetics, the legacy
effect in nutrition, the effects of specific foods and dietary patterns on type II diabetes mellitus, or
the always-controversial omega 3 fatty acids. We hope that this Special Issue will be helpful for
healthcare providers and researchers in nutrition and/or cardio- and metabolic diseases, to reflect
on, in more depth, the complex system of nutrition and metabolic syndrome. Finally, we would like
to thank all of the authors and reviewers for their contributions, in addition to the MDPI staff and
the Editors-in-Chief of Nutrients for their kind assistance in the process. We sincerely hope that you
enjoy reading this Special Issue.
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Our purpose in creating this text is to provide a compila-
tion of current knowledge in clinical nutrition and an
overview of the rationale and science base of its applica-
tion to practice in the prevention and treatment of
disease.
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Food is a complex and heterogeneous system. It often consists of a
protein and/or polysaccharide matrix surrounding, sustaining a typically
aqueous continuous phase containing soluble hydrophilic compounds
(carbohydrates, salts, vitamins, etc.) and some dispersed elements (cells, fat
globules, gas bubbles, crystals, etc.) (Figure I.1). Such a system is
thermodynamically, biologically and chemically very unstable.
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Clearly, these determinants involve a number of variables that are com-
monly studied as contextual factors, e.g., physical context, social and cultural
context, economic context, eating alone versus with others, eating inside ver-
sus outside the home, and the interaction of the food within a meal or snack
context.
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Approximately 415 million adults worldwide are suffering from the dreadful
consequences of the metabolic syndrome, an entity that includes among many
common chronic malfunctions diabetes mellitus, obesity, and a variety of cardiovascular maladies to name but a few. The number of unfortunate individuals
involved in these chronic perturbations is estimated to soar as high as 642 million
by 2040 [1]. According to the National Diabetes Statistics Report of 2014, nearly
30.3 million people in the United States, representing about 9.4% of the US
population suffer from diabetes [13]. To compound the difficulties, persistent
hyperglycemia in Type 2 Diabetes Mellitus cases can cause development of
serious secondary complications including diabetic neuropathy, nephropathy,
retinopathy, peripheral vascular diseases, and numerous cerebrovascular afflictions [13]. All the above individual health difficulties can be intricately correlated with poor choices in diet—particularly overindulgence of dietary fat, sugar,
and salt often in a setting of a sedentary lifestyle. To give substance to the last
statements, information concerning the previously described practices have been
detailed in this book Influence of Dietary Sugar, Salt and Fat on Human Health.
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The first concern of primitive people was to find food in their immediate
environment to meet their physiological needs to survive; with no
knowledge of either their requirements or the properties of food products,
whether they were of plant or animal origin, these food choices were based
on very empirical observations. The development of agriculture and
livestock farming gradually gave people greater control in procuring food
compared to the randomness of gathering, hunting and fishing. However, the
supply of agricultural and livestock products has long been highly irregular
for reasons of climate, diseases or simply the seasonal nature of certain
products. Due to this irregularity, and in order to meet the needs of people
located far from production areas, man has always been in search of ways to
preserve food, thereby creating the possibility of varying the time and place
of consumption of agricultural products
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This Handbook is a companion volume to the recently published new and
enlarged second edition of the Handbook of hydrocolloids. In the main
those ‘hydrocolloids’ are complex carbohydrates, but quite often with some
protein attachment within or associated with the primary structure. Their
function is to impart special texture to food, replace fat, introduce special
functionality such as emulsifi cation and more recently to improve the nutritional quality of the food. While the traditional role of proteins was to
provide nutrition, their ability to form gels and stabilise emulsions and
foams is now well recognised and more and more specialised protein
sources are now being introduced into a range of food products. This volume
has uniquely drawn these together to provide another ready reference to a
subject which extends over a wide range of sources and processing practices.
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This modular textbook Nutrition, Immunity and Infection has had a long gestation! For someone who has
barely made any significant contribution to this specific field, accepting the invitation to develop a module
on ‘Nutrition and Infection’ for the new Masters Course in Infectious Diseases at the London School of
Hygiene & Tropical Medicine for London University’s Distance Learning Pro gramme, required some consid-
erable arm twisting.
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The Strategic Plan of the United States’ National Institute of Health stresses the
pursuit of mechanistic studies as an overarching priority. Among the basic mechanisms
identified as needing exploration are immune-focused studies. Many dietary components are believed to exert their activities by modulating immune function. These are
highly sought by patients in the absence of an effective standard pharmaceutical therapy.
Numerous botanical extracts as well as high dose vitamin supplements are used by the
public with the expectation that they will boost and/or modulate immune responses.
As the number of seniors grows interest in their loss of immune defenses (immunosenescence) increases and is linked to longevity or lack thereof. The desire to maintain
wellness by preventing and treating infectious diseases are among the key reasons for
responses. Normal functioning of the immune system is critical to health. One new
tumor cell appears about every day and is eliminated by the immune system. Aging,
stress, diseases like AIDS, autoimmune reactions, chemical treatments to suppress
immune responses in arthritis, and transplants can facilitate the survival of a cancer,
leading to clinical disease. Can dietary modulation thereafter help treat cancer? Putative
immune-modulating agents and practices are also being used with the belief that they
will maintain wellness by reversing the immune decline-associated aging and the immunosuppression associated with cancer, its treatment, and with HIV/AIDS. Thus, an
increased focus on understanding the efficacy of botanicals and other dietary supplements on immune function is warranted.
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obesity measures, differences by study design, and lack of consideration for participant
weight history) and variation by subgroup (age, sex, comorbidities) were brought to light.
Key issues to resolve in this review will therefore include different metabolic syndrome com-
ponents; discrepancies in cross-sectional vs longitudinal research; issues in measurement of
sleep parameters and abdominal obesity; and changes in sleep with new onset obesity and
cardiometabolic risk. In the following sections, we address these questions by highlighting
variations in relationships in younger vs older adults, male vs females, and in healthy vs
nonhealthy free-living populations following a pragmatic data integration perspective
proposed by Fedak et al.25
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Research and development (R&D) not only represent a vast area of topics and heated debate but
it also is a playground for much controversy of the most different kind. In academia, such
controversy is often based on interpretations of data and subsequent conclusions and often
debates the question of who was first to discover a particular finding and whether or not the said
finding is of any value to the scientific community. R&D in corporate environments follows
different rules and judgment patterns and is mostly defined and driven by costs and consumer
relevant targets, or so one may believe. There is, however common ground among these two
worlds: both strive to maximize knowledge, although for different reasons and in different
ways. Equipment and scientific rigor may be similar or identical, however their usage, approach,
and interpretation are different. This book discusses history and background of today’s food
industry as seen by consumers, academia, and the industry itself, and several chapters are
especially dedicated to new and disruptive approaches to R&D. Is your company presently
restructuring its R&D organization? I bet it is! Then this book is definitely a must‐read for all
professionals in the packaged goods industry as well as students who aspire to contribute to this
new type of industry forcefully driven by R&D!
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Food engineering is a multidisciplinary field of applied physical sciences combined with the knowledge of product properties. Food engineers provide the technological knowledge transfer essential
for the cost-effective production and commercialization of food products and services. In particular,
food engineers develop and design processes and equipment to convert raw agricultural materials
and ingredients into safe, convenient, and nutritious consumer food products. However, food engineering topics are continuously undergoing changes to meet diverse consumer demands, and the
subject is being rapidly developed to reflect market needs.
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I decided to submit the proposal for this book in 2002 after writing a short commissioned
article on dietary supplements for a nursing journal. This was the first time that I had given
concentrated thought to the use of supplements as a whole. The low word limit of the article
forced me to identify general concepts and principles relating to dietary supplements.
Previously, I had only considered the use of individual supplements such as fish oils or
evening primrose oil, or the use of supplements in particular circumstances such as during
pregnancy or in housebound elderly people
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For women, a diet adequate in the right nutrients is important throughout her child-
bearing years. Poor quality diets can not only affect women’s health and nutrition
status but can also influence the health of the next generation. Even though in the
developed world we now have access to more foods than ever before, making the
right food choices is no easy task. In addition, confusing and sometimes conflicting
health messages can complicate this matter further.
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When my former Nestlé colleague and one of the authors of this book, Helmut Traitler,
had asked me to read Food Industry Design, Technology and Innovation, I was hesitant.
Every year I receive dozens of unsolicited management books—with catchy titles and
bold theses—and after skimming a few pages they wind up in a cupboard behind my
desk, unread. But this one is different. The book’s premise that the role of design is
under-appreciated and marginalized in industry, and in particular the food industry (in
which I have worked for over 30 years), hits home from page one. But what makes this
text unique is its ability to analyze and synthesize complex concepts, and spark thoughts
and actions through real-world examples. Design is clearly one of the most important
factors of our lives: professionally and personally. Food Industry Design, Technology and
Innovation may not have a catchy title, but the content is thought provoking and practical.
This book does not sit on my cupboard with the others, but near my desk, with its pages
dog-eared and notes written in the margins. Enjoy and design
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Understanding consumers’ attitudes, perception, and behavior is of vital importance
for food choice research and new product development but also for policy making,
to support various current societal challenges. The consumer science field emerged
in the early half of the 20th century, mainly as a support to product development
and to identify the main drivers of preferences. Over the last two decades, the com-
plexity of consumer behavior has been increasingly acknowledged, and researchers
have become interested in studying other aspects of product consumption that also
play a relevant role in consumers’ decision-making process.
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Public health nutrition is a complex, multifaceted set
of programs dedicated to improving the health of the
population through improved nutrition. In more detail,
public health nutrition primarily exists to:
• Improve the health of the whole population and
teach high-risk subgroups within the population
improved nutrition;
• Emphasize health promotion and disease prevention
through improved nutrition; and
• Provide integrated community efforts for improved
nutrition with leadership demonstrated by government
offices.1
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This fifth edition of Nutrition in Pediatrics: Basic Science and
Clinical Applications is our continuing effort to establish a
comprehensive and accessible approach to pediatric nutrition for a
wide range of clinicians, scientists, and—most importantly—trainees.
An important addition to the textbook has been the inclusion of
Professor Berthold Koletzko to our Editorial Board. As Professor of
Pediatrics at the University of Munich and Head of the Division of
Metabolic and Nutritional Medicine at Hauner Children’s Hospital,
Dr. Koletzko brings a wealth of clinical and research expertise to this
text. In addition, his global collaborations have allowed us to
substantially broaden our team of authors, making this version of the
text a truly international one.
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Generally, a process is defi ned as a sequence of events that transforms the biological
materials of food products, via biochemical changes, into stable forms with added
value. This can create new products or modify existing ones. Process design refers to
the design of food processes and manufacturing methods, while plant design refers to
the design of the whole processing plant. The processing of food is no longer as simple
or straightforward as in the past. Food process design is an interdisciplinary science
that is highly regarded by the food industry. The architecture of food process engineering is based on the solid foundations of chemical and mechanical engineering, together
with the basics of microbiology, chemistry, nutrition, and economics. Other related
disciplines, including instrumentation, computer science and mathematics, complete
the discipline. Process design is the core of food engineering, and frequently begins
with a concept and eventually ends in fabrication. Many types of documentation are
involved in the process to test theories, display results, and organize data.
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The exposure of the fetus to adverse nutritional conditions has long-term effects, which can then extend
into adulthood. These include increased rates of cardiovascular disease, diabetes, and metabolic
syndrome. Some cancer rates are also reported to increase, and there is evidence that neurological
deficiencies occur in adults who were previously exposed to nutritional inadequacies in utero.
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Food safety is a multidisciplinary scientifi c discipline that is specifi cally designed to
prevent foodborne illness to consumers. It is generally assumed to be an axiom by
both nonprofessionals and professionals alike that the most developed countries,
through their intricate and complex standards, formal trainings and inspections, are
always capable of providing much safer food items and beverages to consumers as
opposed to the lesser developed countries and regions of the world. Clearly, the
available data regarding the morbidity and the mortality in different areas of the
world confi rms that in developing countries, the prevalence and the incidence of
presumptive foodborne illness are much greater. However, other factors need to be
taken into consideration in this overall picture: First of all, one of the key issues in
developing countries appears to be the availability of safe drinking water, a key element in any food safety strategy. Second, the different availability of healthcare
facilities, care providers, and medicines in different parts of the world makes the
consequences of foodborne illness much more important and life threatening in
lesser developed countries than in most developed countries. It would be therefore
ethnocentric and rather simplistic to state that the margin of improvement in food
safety is only directly proportional to the level of development of the society or to
the level of complexity of any given national or international standard. Besides standards and regulations, humans as a whole have evolved and adapted different strategies to provide and to insure food and water safety according to their cultural and
historical backgrounds. Our goal is to discuss and to compare these strategies in a
cross- cultural and technical approach , according to the realities of different socioeconomic, ethnical, and social heritages.
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François-Pierre Martin , Ph.D., Eng., is Senior Scientist and Research Program
Manager in the Department of Molecular Biomarkers, at the Nestlé Institute of
Health Sciences, Lausanne, Switzerland. He received his Ph.D. in Biochemistry
and Metabonomics from Imperial College London, UK, in 2006, and has a back-
ground in biotechnology and microbiology from the engineering school Polytech-
Marseille, France. From 2006 to 2012, François-Pierre has developed and expanded
metabonomics applications to nutrition and gut microbiota research for health and
disease management, at the Nestlé Research Center, Switzerland. Emphasis was
given to investigate transgenomic interactions between the mammalian and the gut
microbial metabolic space using systems biology. Dr. Martin has developed a
strong expertise in investigating gut microbial effects on diverse mammalian
processes and their impact upon the etiology of several conditions (gastrointestinal
health, diabetes, obesity). In July 2012,
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This manual addresses food habits and consumption patterns in developing and emerging
countries to better understand the nutritional situation of their populations. It comprises
practical information on conducting field studies.
Part One of the manual provides insight into the dynamics of food habits and consumption
and the accompanying socio-economic and cultural dimensions. Part Two gives practical
information on conducting small-scale studies to be carried out within the framework of
a nutrition issue, including the collection of data on food habits and the measurement of
food intake. This manual on food habits and consumption is intended for professionals
with practical or academic training and who are involved in various types of food and
nutrition programmes and related activities. It can also be used as a handbook in food
and nutrition training courses at professional and academic levels.
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In this book the Editors aim to disseminate important material pertaining to the forti fi cation of foods
from strategic initiatives to public health applications. It covers (in two volumes) policy, preclinical
studies, clinical investigations, and the impact of forti fi cation on the individual and whole communities. The importance of food forti fi cation relates to the fact that optimal nutritional intake is an essential component of health and well-being. Unfortunately, situations arise on a local or national scale
when nutrient supply or intake is deemed to be suboptimal. As a consequence, ill health occurs, for
example, neural tube defects in the developing fetus, organ damage in adults, or increased rates of
premature deaths. In terms of public health, malnutrition due to micronutrient de fi ciency can be quite
profound, imposing economic and social burdens on individuals and whole communities. The complex inter-relationship between poor health outcomes and nutrient delivery can, however, be modulated by appropriate food forti fi cation. Thereafter issues arise as to the ef fi cacy of food forti fi cation,
what strategies should be employed and what nutrients to add. The food carrier is also important, as
well as its stability. Ethical issues also arise, and the concept of potential harm also needs to be
addressed in terms of cost-bene fi ts. All of these aspects, and many others, are covered in The Handbook
of Food Forti fi cation : From Concepts to Public Health Applications
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This book is the culmination of observations, experience, knowledge, and
ideas generated over many years and involving numerous people. It has been
enriched through the generous support, encouragement, and expert advice of
many colleagues and friends including: Martin Caraher, John Coveney,
Sharon Friel, Roger Hughes, Tim Lang, Anita Lawrence, Amanda Lee, Barrie
Margetts, Kerin O’Dea, Christina Pollard, Mike Rayner, Rosemary Stanton,
Boyd Swinburn, Mark Wahlqvist, Tony Worsley, Heather Yeatman, and my
friend and mentor, Barbara Smith.
