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Dietary components and health

The availability of food in Europe has never been as good as in recent decades. Affluent though European countries are, sub-groups of populations experience the deficiency of minerals and micronutrients that play a vital role in health and development (Serra-Majem, 2001). A significant proportion of European infants and children are today experiencing a low dietary intake of iodine and iron (Trichopoulou and Lagiou, 1997a WHO, 1998). The iodine deficiency leads to several disorders collectively referred to as Iodine Deficiency Disorders (IDD), with goitre (hyperplasia of thyroid cells), cretinism (mental deficiency) and severe brain damage being the most common. It is estimated that IDD may affect approximately 16 of the European population. Furthermore, inadequate levels of folate have been implicated with a rise in the blood homocysteine levels, leading possibly to increased risk of cardiovascular disease (CVD). European policies address such deficiencies either by recommending the...

Dietary data in Europe national surveys

A number of European countries have carried out national dietary surveys. Table 2.1 summarises basic information on the various IDSs that have been undertaken in 20 European countries during the last 20 years. The surveys are often designed to document the dietary patterns of the general population or segments of it and possibly to identify groups at nutritional risk. In other instances, the primary aim is to address country-specific objectives. The selection of the dietary survey method depends on a number of different factors and investigators may frequently have to compromise according to the specific objectives of the survey and the inherent cost of setting it up. When the option of running international comparisons using these data is raised, a number of methodological constraints emerge. It can directly be noted that a variety of dietary assessment methods are used, making it difficult to accomplish comparability at the international level (Friedenreich, 1994). The differences...

Obesity and Physical Activity

Excess body weight appears to place Mexican Americans at higher risk than whites for certain diseases such as diabetes and cardiovascular disease. National data indicate that the proportion of the population that is considered overweight (defined as a body mass index 25) has grown for both Latinos and whites over the last 20 years (National Center for Health Statistics 2000). Among Mexican Americans aged 20-74 years, combined age-adjusted data for 1988-1994 showed that 67.0 of the men and 67.8 of the women were considered overweight (vs. 59.9 of white men and 45.7 of white women) (National Center for Health Statistics 2000). The same trend has been observed in children and adolescents aged 6-17 years. Approximately 15.8 and 14.8 of Mexican American girls and boys, respectively, were found to be overweight based on combined data for 1988-1994 (compared with 11.9 and 11.8 of white girls and boys, respectively) (National Center for Health Statistics 2000). An analysis of NHANES III data...

Reported Dietary Chromium Intakes Of Adults

Anderson and Kozlovsky 30 determined dietary chromium in self-selected diets for 10 males and 22 females. Each subject collected duplicate food and beverage composites for a 7-day period. Diets were collected in polyethylene containers and homogenized in a Waring blender with a low-chromium steel blade to minimize contamination. Samples were analyzed by graphite furnace atomic absorption spectroscopy. Bovine liver standard reference material, a low-chromium rat diet, and a composite human diet sample were also analyzed for quality control. The majority of diets contained between 10 and 40 g Cr day. Mean daily Cr intake for the 10 male subjects was 33 3 g day (range 13-89 g) and mean intake for the 22 women was 25 1 g day (range 8-72 g). Mean chromium intake for the males was 14 g 1000 kcal and for females was 16 g 1000 kcal. For all subjects together, the mean intake was 28 1 g day or 15 g 1000kcal 30 . In another study, freely chosen diets from eleven women and eight men were...

Obesity and fat distribution

As mentioned above, prevalence of obesity is an important factor in influencing prevalence of the metabolic syndrome. The association of central or general obesity and the metabolic syndrome varies with gender (Ho etal., 2001). Distribution of fat influences prevalence of the metabolic syndrome for a given BMI. The NHANES III study showed that prevalence of the metabolic syndrome (defined using the ATP-III criteria) increased from 0.9-3.0 per cent for people with a BMI in the range 18.5-20.9 kg m-2 to 9.6-22.5 per cent for people with a BMI in the range 25.0-26.9kgm-2, depending on gender and ethnicity (St Onge, Janssen and Heymsfield, 2004). The influence of obesity on prevalence of the metabolic syndrome also has been observed in children. A detailed study of 439 obese, 31 overweight and 20 non-obese children and adolescents in the USA found that prevalence of the metabolic syndrome increased with the severity of obesity and around half of the severely obese participants had the...

Dietary sources supplementation and fortification

The soil is deficient in a particular mineral, or where the diet is deliberately restricted to a limited number of food types, that problems of mineral deficiencies occur. Some food sources are better than others as sources of minerals. Plant foods are generally poor in iron and zinc, with the exception of certain dark green vegetables such as spinach. Dairy products are generally an excellent source of calcium. Red meat and offal, such as liver, are the best dietary sources of easily absorbed iron. Many of the trace elements are found in relatively high concentrations in fish and other seafoods. Table 4.3 lists some of the best food sources of a number of the essential minerals. As is indicated in the table, there are some unusually good sources of a number of these minerals. Milk, for example, is often an excellent source of iodine because of the presence of residual iodine-containing compounds used to sterilise dairy equipment. Tea is a major source of manganese in the UK diet. An...

Dietary copper requirements

Despite the known essentiality of copper in humans, dietary requirements are still uncertain. World-wide, a number of Dietary Reference Values are recommended for copper intake (see Table 5.2) but the variability between them is indicative of the lack of consensus between advisory bodies. Making dietary recommendations, even of Estimated Average Requirements (EAR), is difficult owing to a lack of adequate data. In the UK, the Department of Health considers the available data on human copper requirements to be insufficient to determine an EAR.12 In the US, an EAR of adults for copper was derived from a combination of biochemical indicators of copper requirement, as no single indicator was judged as sufficiently sensitive, specific and consistent to be used alone.

Supplementing Dietary Supplements Nutrient Boosts

Precisely how much of each vitamin or mineral should be in the human diet has long been a matter of research and discussion. In 1941, an official body of experts in the United States published a compendium of Recommended Dietary Allowances (RDAs) that has been updated periodically ever since. For each nutrient, this book lists the daily ingestion levels judged adequate to meet the standard nutritional requirements of a normal healthy person of given age, sex, and physical condition. The adult RDA for zinc is 15 mg, for example, and that for riboflavin (vitamin B2) is 1.7 mg. The lists were later expanded as a series of Dietary Reference Intakes (DRIs) that also include upper bounds on tolerable ingestion levels. These are important too, because there is circumstantial evidence that particular vitamins in large doses reduce the risk of cardiovascular disease and some cancers, or slow the aging process and, on the other hand, that high-dose levels may also have some toxic effects....

What About Dietary Cholesterol

I saved talking about dietary cholesterol levels to last because it's fairly obvious if you want to decrease your cholesterol levels, you should ingest less cholesterol The NCEP guidelines recommend less than 200 mg of dietary cholesterol per day. For reference, one large egg yolk has 200 mg. See Table 6.2 for the amount of cholesterol in some other foods. The Diet-Cholesterol Connection For some people let's call them responders blood cholesterol levels rise and fall pretty directly in relation to the amount of cholesterol and fat in their diets. In others, there's little connection. The same goes for dietary fat. A 1997 study done at the Human Nutrition Research Center on Aging at Tufts University looked at how 120 men and women responded to the same low-fat, low-cholesterol diet recommended by the NCEP. On average, LDL levels dropped. Yet though everyone ate the same thing the researchers provided the volunteers with all their food and drink the average result masked a wide range...

Dietary Sources Of Beneficial Chromium

Significant dietary sources of trivalent chromium are available in various food sources such as whole-grain products, high-bran breakfast cereals, egg yolks, coffee, nuts, green beans, broccoli, meat, Brewers' yeast, and selected brands of beer and wine. Chromium is also found in many mineral or multivitamin supplements. According to the National Research Council (NRC), the Estimated Safe and Adequate Daily Dietary Intake (ESADDI) for trivalent chromium is 50-200 g day, corresponding to 0.833.33 g kg day for an adult weighing 60 kg 6 . The Food and Drug Administration (FDA) has selected a Reference Daily Intake (RDI) of 120 g day for chromium. However, normal dietary intake of chromium for adults may be less than optimal. Recent reports demonstrate that the normal US adult chromium dietary intake is less than 50 g day, resulting in approximately 0.4 chromium absorption. Results from one study indicated that daily chromium intakes for men and women in the US were 33 and 25 g,...

Meditation Xxi Obesity

Were I a physician with a diploma, I would have written a whole book on obesity thus I would have acquired a domicil in the domain of science, and would have had the double satisfaction of having, as patients, persons who were perfectly well, and of being besieged by the fairer portion of humanity. To have exactly fat enough, not a bit too much, or too little, is the great study of women of every rank and grade. In the intereim, I intend to prepare the way for him. A chapter on obesity is a necessary concomitant of a book which relates so exclusively to eating. Obesity is that state of greasy congestion in which without the sufferer being sick, the limbs gradually increase in volume, and lose their form and harmony. One kind of obesity is restricted to the stomach, and I have never observed it in women. Their fibres are generally softer, and when attacked with obesity nothing is spared. I call this variety of obesity GASTROPHORIA. Those attacked by it, I call GASTROPHOROUS. I belong...

Inconvenience Of Obesity

Obesity has a lamentable influence on the two sexes, inasmuch as it is most injurious to strength and beauty. Obesity destroys beauty by annihilating the harmony of primitive proportions, for all the limbs do not proportionately fatten. Nothing is so common as to see faces, once very interesting, made common place by obesity. Obesity produces a distaste for dancing, walking, riding, and an inaptitude for those amusements which require skill or agility.

Obesity and malnutrition

Body mass Index (BMI) wt ht2 (kg m2) Surgical therapy for obesity Surgical therapy for obesity Obesity related disease Medical therapy for obesity and weight maintenance Appetite suppressants Amphetamines Adverse Amphetamine derivativesj effects 5HT re-uptake inhibitors 1 under (sibutramine) J evaluation Truncal obesity General obesity Truncal obesity General obesity

Prevention Of Obesity

Studies that aim to reduce obesity or prevent it from developing are relevant to the prevention of type 2 diabetes, since obesity is one of the major modifiable risk factors. Like diabetes, overweight and obesity have been the outcomes for a large number of clinical trials and observational studies exploring risk factors for their development and reduction. Comprehensive reviews of obesity prevention issues and approaches have been published13,163,262-264 and it is not possible to review them here. The interventions studied have been similar to those for type 2 diabetes, and have focused on lifestyle modification as well the use of selected pharmacological agents that may reduce weight. No large RCTs have investigated the prevention of obesity (in contrast to obesity reduction) as it relates to type 2 diabetes. Several community-based cardiovascular prevention studies have included obesity as one of several outcomes, often with limited success265-267. However, hypertension prevention...

Alleviating Dietary Deficiencies The Golden Rice Story

In addition to proteins, fats, and carbohydrates, a proper diet for the human body includes at least 17 inorganic minerals and 13 organic vitamins. Inadequate supplies of these essential substances can result in nutritional-deficiency diseases. For example, scurvy (the hallmarks of which include bleeding gums, fatigue, and eventual prostration) appears in people deprived of vitamin C for even a few weeks pellagra, a syndrome of skin lesions and sometimes mania, follows from a paucity of dietary niacin (vitamin B3) rickets, a disease of growing bones, ensues from inadequate supplies of vitamin D and anemia is among the early symptoms of iron starvation. Sadly, in much of the developing world, people subsist on simple diets of staple foods such as corn, wheat, or rice that are poor sources of some of the essential nutrients. Approximately 30 of the world population is at constant risk of iodine and iron deficiencies, for example. Such health challenges raise a compelling new question...

Effects Of Various Dietary Components On Chromium Absorption And Excretion

Apparently, a number of dietary components affect the absorption of chromium. Effects of simple versus complex dietary carbohydrate on urinary chromium excretion were investigated 40 . Thirty-seven healthy men and women volunteered for the 18-week study in which they ate breakfast and dinner in the research kitchen facility at the Beltsville Human Nutrition Research Center. Lunches and weekend meals also were provided to go . The reference diet was designed by nutritionists to meet known nutrient needs. This reference diet consumed for 12 weeks contained 35 of total kilocalories as complex carbohydrate and 15 of kilocalories as simple sugars. A simple sugar diet with 35 of kilocalories as simple sugar and 15 of kilocalories as complex carbohydrate was fed for 6 weeks. The chromium content of the reference diet contained 16.0 1.2 xg Cr 1000 kcal and of the simple sugar diet was 15.7 0.8 g Cr 1000 kcal. Urinary chromium excretion was significantly higher during the simple sugar diet...

Obesity and body fat distribution

A multitude of studies have shown that excess fat in the abdominal region (visceral adipose tissue) is strongly associated with metabolic alterations such as disturbed plasma lipoprotein profile, hyperinsulinaemia, insulin resistance and glucose intolerance. In comparative analyses, people of Black ancestry have the highest levels of generalized obesity (BMI 30kgm-2) and Mexican-Americans have the highest percentage body fat, but the highest levels of central obesity (as measured by waist hip ratio) are found among South Asians and Mexican-Americans compared with European White, Chinese and Black-origin groups (Misra and Vikram, 2004). Whether these differences are attributable to diet, lack of exercise, genetic factors or a combination of these has not yet been established. A recent study found that transgenic mice selectively overexpressing 11P-hydroxysteroid dehydrogenase type 1 (11BHSD-1) in adipose tissue developed abdominal obesity and exhibited insulin-resistant diabetes...

Dietary data in Europe European surveys

In Europe, there is a need for sources of dietary data that would provide a regular and comparable flow of information. A limited number of studies on documenting and monitoring the dietary intake in Europe have been conducted. The EPIC and SENECA projects are examples of studies that developed procedures to allow the collection of harmonised data across countries. DAFNE is an example of a European project that aimed at achieving post-harmonisation of data already collected. The development of a food classification system that would allow international comparisons of dietary patterns was a central element in the development of an HBS-based European food databank One of the intermediate results of the harmonisation procedure is the development of the DAFNE food classification system, which allows the categorisation of HBS-collected food data into 56 detailed subgroups. These subgroups can be aggregated at various levels ending up at 15 main food groups (Lagiou et al, 2001). The...

Obesity and type 2 diabetes mellitus

The incidence and prevalence of overweight and obesity have increased dramatically in the United States during the last generation (4). Figure 1 shows the prevalence of obesity among US adult men and women, based on representative samples of the population, from 1960 to 2000. The prevalence of obesity doubled during this time, although the figure makes it clear that the increases have been mainly attributable to the period since 1980. In 2000, it was estimated that approximately 65 of the US population could be classified as overweight (BMI 25.0-29.9kg m2) or obese (BMI 30kg m2). Obesity is the strongest risk factor for the development of type 2 diabetes mellitus, with the top decile of BMI in the population showing a 40-fold to 50fold increased risk compared with the lowest decile (4). Therefore, it is not surprising that the incidence of type 2 diabetes mellitus has been rising in concert with that of obesity. Data released by the National Institute of Diabetes and Digestive and...


Because obesity is so closely linked to high blood pressure, unfavorable cholesterol levels, lack of exercise, and diabetes, it took scientists a long time to figure out whether obesity itself is an independent cardiac risk factor. Experts now agree that it is. Excess weight increases your risk for heart disease regardless of these other conditions. All forms of obesity are bad for your health, but excessive upper-body fat (an apple-shaped body) is more dangerous to the heart than lower-body obesity (the pear shape). In other words, fat stored at or above your waistline is worse than fat in your hips and thighs. Your body mass index (BMI), which takes both height and weight into consideration, provides an accurate reflection of your body fat. (Use Table 4.3 to calculate your BMI.) You should aim for a BMI of between 18.5 and 24, the range that's considered normal. A BMI between 25 and 29 is considered overweight, and a value of 30 or higher is defined as obese. Unfortunately, it's...

Dietary Factors

A number of case-control studies have evaluated the association between diet and risk of pancreatic cancer. Because of the retrospective assessment of diet in case-control studies, and the high fatality rate for this cancer (and thus, the use of proxy exposure data in many of these studies), case-control studies of diet and pancreatic cancer are considered to have a strong likelihood of bias. To date, there have been seven prospective studies of diet and pancreatic cancer. However, the methods of dietary assessment and the specific nutrients analyzed have varied and few of these studies had more than 100 cases.16-19 We have separated several salient dietary factors for this review. However, it should be noted that dietary factors including specific foods consumed, macronu-trient and energy intake, and level of physical activity are interrelated and may be difficult to separate as independent pancreatic cancer risk factors in many epidemiological studies. High-fat diets promote...

Causes Of Obesity

From the preceding observation, the causes of which any one may verify, it is easy to ascertain the principle causes of obesity. Then there are beyond doubt persons predestined to obesity, the digestive powers of whom elaborate a great quantity of grease. The second of the causes of obesity, is the fact that farinacious and feculaferous matter is the basis of our daily food. We have already said that all animals that live on farinaceous substances become fat man obeys the common law.

Examples Of Obesity

The obesity of the King of Poland had nearly been fatal to him, for having stumbled on a squadron of Turkish cavalry, from which he had to fly, he would certainly have been massacred, if his aids had not sustained him, almost fainting from fatigue on his horse, while others generously sacrificed themselves to protect him. There are many instances of remarkable obesity. I will only speak, however, of my own observations. From the preceding, it appears that if obesity be not a disease, it is at least a very troublesome predisposition, into which we fall from our own fault.

Related titles from Woodheads food science technology and nutrition list

Functional foods are widely predicted to become one of the biggest dietary trends of the next twenty-five years. The editors of this book have gathered together leading experts in the field in order to provide the food industry with a single authoritative resource. This book first defines and classifies the field of functional foods, paying particular attention to the legislative aspects in both the USA and EU. It then summarises the key work on functional foods and the prevention of disease. Finally, there is a series of chapters on developing functional products.

Administration route of

Adhering to a treatment regimen is difficult under the best of circumstances. The triple combinations used with HIV disease can require that a person take a dozen or more antiviral pills per day, with specific timing and dietary requirements. Some HAART strategies have reduced the pill burden to one or two pills a day. When a person must also use preventive or maintenance doses of drugs for opportunistic infections, the total daily pill count can soar. Keeping track of one's medication becomes a major activity. Maintaining perfect adherence to today's complex treatment regimens is difficult. Studies have shown that there are many possible explanations for failure to adhere to treatment regimens, including forgetting to take a dose, sleeping through a dose, being away from home, changing one's therapy routine, being busy, sickness, experiencing side effects, or being depressed. The degree to which nonadherence is tolerable and the speed with which it contributes to drug failure is...

Three Hundred Is a Healthy Cholesterol Level

When Mary was sixty-five, her business set up an afternoon health-screening program in the company cafeteria. She got screened during her lunch break and found out that her total cholesterol level was higher than 300. The screeners told her to contact her physician and get advice on treatment. Her family practitioner repeated the test and confirmed the level, asking Mary to try a low-fat, low-cholesterol diet to see if that would improve her numbers. She tried the diet the nutritionist prescribed, faithfully eating the foods on the plan, though she found the meals bland and unappealing.

What Affects Food Safety Issues Today

Changes in populations' lifestyles make new demands on food producers. Producers now have to try to meet requirements for food products for diabetics or people with allergies (so called 'functional foods,' including foods for special dietary use, medical foods, and dietary supplements), as well as having to expand their offering of food products for people who prefer heat-and-serve food or so-called 'organic' (practically non-processed) food. New classes of food products are being developed constantly to fulfil specific demands of particular segments of the consumer market. These developments can, however, have an impact on food safety. In the example of meeting consumers' demands for refrigerated ready-to-eat products, one result has been an increase in intoxication caused by enterotoxins of opportunistic pathogens, such as Clostridium perfringens, the spores which may survive such drastic conditions as cooking at 100 C for one hour (Novak and Juneja, 2002).

Food Allergy Or Food Intolerance

Between 12 and 20 of Americans, British and Dutch people complain about food allergies. In fact, problems are more likely to be due to food intolerance rather than actual allergy. This has been confirmed by skin-prick tests, analysis of immunoglobulin E level in serum, and enzyme-linked immunosorbent assay (ELISA) tests which found food intolerance in 2 to 5 of adults and 6 to 13 of children (age 1 to 6) in Europe. Challenge-proved adverse reaction to food is one tenth of that perceived and allergic reactions to chemicals and additives in food are even more rare. A similar ratio occurs in Asia. The dietary habits in different countries determine the observed rates of food sensitivities. Sensitivity to fish occurs frequently in Scandinavia, to rice in Japan, to peanuts in the U.S. and the U.K., and to seafood and milk in Italy. It also means that communities not exposed to particular allergens are not affected as frequently by various forms of sensitivities, e.g., allergy to peanuts is...

Nutritional Background

Up to the 1970s, the issue of fat in the diet and its effect on health was hardly considered, except in cases of obesity where an overall reduction in energy was recommended. Reduced-calorie foods, therefore, were mainly a small niche market directed toward a minority of consumers who were obese or otherwise wished to lose body weight, and thus were interested in reducing their calorie intake. Moreover, the nutritional advice for weight loss at that time tended to focus more on carbohydrates than on fat, despite the fact that fat is the most dense source of calories (9 kcal g vs. 4 kcal g for carbohydrates and proteins). By the 1980s, a radical change had taken place in consumers' attitudes. This can be traced directly to developments in the science of nutrition, and to a better understanding of the relationships between diet and health, which, in the developed countries, led to significant changes in official nutritional recommendations. In the U.K., this reevaluation was brought to...

Diseases and disorders

The gastrointestinal system is essential to nutrition, and disordered nutrition is a major issue worldwide - both through undernutrition and starvation and through overnutrition, which causes obesity, possibly the single most important modern health problem in the affluent world.

The Race To Synthesize A Model Of

A number of studies have examined a material characterized as Cr(nicotinate)2 (OH)(H2O)3 (subsequently to be referred to as chromium nicotinate or chromium polyn-icotinate for consistency with the nutrition literature), which is the product of the reaction of two or three equivalents of nicotinic acid with chromic ions in aqueous solution at elevated temperatures 52, 60-63 . The complex has not yet been crystallized, and NMR studies suggest that the proposed formula would indicate it is more complex 60 . The original interest in the complex arose from its ability to stimulate CO2 production in Cr-deficient yeast 52, 54 . However, the problems with this assay were described above. Because this chromium-nicotinate material is absorbed better than dietary chromium by mammals 62, 64 , it has gained substantial use as a nutritional supplement, especially before the rise in the popularity of chromium picolinate.

Nutritional supplement

In addition to attempts to synthesize and characterize Cr(III)-nicotinate complexes, the products of reaction of Cr(III) sources and the related pyridinecarboxylic acids picolinic acid (2-carboxypyridine) and isonicotinic acid (4-carboxypyridine) 65 have also been studied in some detail. Chromium(III) picolinate, Cr(pic)3, has been the most thoroughly studied of these synthetic products and has become a very popular nutritional supplement products containing Cr(pic)3 generate over one hundred million dollars in sales annually as the supplement is available over-the-counter in numerous forms including pills, chewing gums, sports drinks, and nutrition bars. Cr(pic)3 is a relatively well absorbed form of chromium ( 2 efficiency compared to dietary chromium which is only absorbed with approximately 0.5 efficiency) 62, 64 . (This degree of absorption or bioavailability versus dietary chromium or inorganic chromic salts is not unique and is shared by other organic Cr(III) ligand-complexes...

American Society for Stereotactic and Functional

A total of 20 different amino acids make up all the proteins found in the human body 12 can be made within the body (known as nonessential amino acids). The other eight (called the essential amino acids) must be obtained from the diet and cannot be produced by the body. In addition, there are about 200 other amino acids not found in proteins but which play an important part in chemical reactions within cells.

Bioavailability of provitamin carotenoids

The RNI for children up to 5 years of age is 400 mg retinol equivalents (RE) day, which can easily be met from the diet if animal foods are available e.g. 1 egg (50g) contains about 100 mg RE, 25g chicken liver contains 3000 mg RE. Plants also contribute to vitamin A intake e.g. 1 raw carrot (20g) contains 400 mg -carotene, a 70 g portion of spinach contains 600 mg -carotene and with a bioefficacy of 100 would supply 400 and 600 mg RE respectively. But the pro-vitamin A carotenoids are absorbed less efficiently than retinol, that is, their bioefficacy is less than 100 . Therefore the effective supply of vitamin A from fruits and vegetables is much lower than that from retinol in animal foods (van Lieshout et al, 2001). If 1 mole -carotene (Fig. 3.1) yields 2 moles retinol then, using 100 bioefficacy, 1 mmol (0.537 mg) -carotene would be absorbed and converted totally to 2 mmol (0.572 mg) retinol, i.e. 0.537 0.572 0.94 mg -carotene is equivalent to 1 mg retinol. The results of the...

Healthrelated roles of Pcarotene

The ability of carotenoids to act as antioxidants can be measured in vitro, ex vivo, or in vivo. LDL isolated from an individual who has been supplemented with carotenoids and then evaluated for its antioxidant activity is an extension of an in vivo study, i.e. ex vivo. However, when carotenoids are added to plasma and then the oxidisable value of the LDL is measured it is more like an in vitro model (Krinsky, 2001). Many studies report using the ex vivo method of measuring the oxidisability of the LDL particles after feeding increased amounts of carotene-containing foods. However, when using fruits and vegetables the outcome is variable and difficult to interpret because they also contain vitamin C, polyphenols and flavonoids, which are also potential antioxidants. One study which gave additional dietary fruits and vegetables to subjects reported an increase in the resistance of LDL to oxidation (Hininger et al, 1997) while two other studies found no effect (Chopra et al, 1996 van...

Definition of the metabolic syndrome

The clustering of insulin resistance, dysglycaemia, dyslipidaemia and hypertension was originally defined as syndrome X in 1988 (Reaven, 1988). Definitions of the metabolic syndrome that also include a measure of central obesity have been developed between 1999 and 2001 by the World Health Organization (WHO Consultation, 1999), the European Group for the Study of Insulin Resistance (EGIR Balkau and Charles, 1999) and the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults abbreviated to Adult Treatment Panel (ATP-III) (NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Central obesity Abbreviations BMI, body mass index HDL, high-density lipoprotein WHR, waist hip ratio.

Liver as Target for Thyroid Hormone

The liver is a major target organ of thyroid hormone. It has been estimated that approx 8 of the hepatic genes are regulated by thyroid hormone in vivo (1). We have used a quantitative fluorescent cDNA microarray to identify hepatic genes regulated by thyroid hormone. We sampled 2225 genes on the cDNA microarray, which represents approx 10 of the expressed genes in liver, assuming that the liver transcriptosome contains 10,000-20,000 genes (25). cDNA microarray hybridization is a powerful tool to study hormone effects on cellular metabolism and gene regulation on a genomic scale, as it enables simultaneous measurement and comparison of the expression levels of thousands of genes (26,27). Recently, cDNA microarrays have been used to study the gene expression due to fibroblast differentiation, oncogenesis, aging and caloric restriction of mouse muscle, cell cycle in yeast, and differentiation in Drosophila (28,30-34). Microarray technology is based on an approach where cDNA clone...

Important Considerations In The Development Of Lowfat Foods

The positioning of a particular product in the diet should, in principle, determine the level of fat reduction required and the product quality that can be achieved at different fat levels should be balanced against that before making a marketing decision. This helps to explain why some of the fat-free variants, despite apparently different characteristics from the equivalent standard product, appear to be of greater appeal to consumers than others.

Bone mineral density and fractures

In the presence of adequate dietary calcium, 1,25-OHD increases bone formation and growth plate mineralisation by providing sufficient calcium to allow calcification to occur. In contrast, prolonged vitamin D deficiency results in a poorly mineralised skeleton. When calcium is limited the skeleton is sacrificed because appropriate concentrations of calcium are required for vital nerve and muscle activity. Seasonal increases in PTH may have an adverse effect on bone loss. It is known that accelerated bone loss occurs in hyperparathyroidism (Maxwell, 2001) and increased PTH activity is a determinant in vertebral osteoporosis. However, studies by Krall and Dawson-Hughes (1991) showed that serum concentrations of 25-OHD 95nmol L prevent a seasonal increase in PTH. This suggests that when vitamin D status is poor, PTH stimulates 1,25-OHD production, which acts primarily on the bone to release calcium for essential activities. When vitamin D status is good, sufficient 1,25-OHD is produced...

Vitamin D and other aspects of health 3121 Behaviour

Mortality rates from colon cancer are highest in those areas that receive the least amount of sunlight. A prospective study of 26000 volunteers investigated the association between 25-OHD and the risk of colon cancer. In those with 25-OHD concentrations of 50nmol L (20ng ml) or more, the risk of colon cancer was decreased threefold. However, confounding factors such as consumption of milk, meat or fat in the diet were not considered but these observations and previous epidemiological and laboratory studies suggest good vitamin D status in conjunction with calcium nutrition might lower the risk of colon cancer (Garland et al, 1989).

Intracellular calcium levels Decrease myocardial apoptosis post reperfusion

In contrast to the role of insulin therapy, the role of oral hypoglycemic agents in AMI has not been well-studied. Thiazolidinediones significantly reduced infarct size and contractile dysfunction and were beneficial in preventing left ventricular remodeling in experimental models of ischemia reperfusion 50-52 . Clinical studies in acute ischemia in humans are lacking, however. Chronically, thiazolidenediones improve insulin resistance and have a host of nonhypoglycemic effects that result in improved endothelial and fibrinolyt-ic function and diminished levels of proinflamma-tory cytokines, high sensitivity-C reactive protein and soluble CD-40 53-55 . Thiazolidinediones also have direct effects on vascular smooth muscle, may have potent antirestenotic effects 56-57 , and were associated with regression of atherosclerosis 58 . Metformin therapy also is associated with a host of salutary effects on CV risk factors 59-60 and may reduce CV events in obese patients who have type 2 DM 61 ....

Emotions in Organizational Teams

Without it, patients are patients, doctors are doctors, dietary aides are dietary aides, and administrators are administrators in the senseless world of poking, prodding, and speedy discharge that patients have come to know as the health care system. Without collaboration and team decision making, patients, nurses, aides, and even doctors may have no idea what the goals are or where they are in relation to their accomplishment.

Other roles of vitamin E

Strate improvements in both cellular and humoral responses from vitamin E supplements, others who used less vitamin E (67 mg aTE d) were unable to do so (de Waart et al, 1997). Meydani and colleagues suggested that a consumption of at least 147mg a-TE d (ie 5-10 times a normal dietary intake) was needed to benefit the immune response. Dose may play a critical role in the effects of vitamin E on immune function and high doses may enhance the immune system of the aged by suppression of prostaglandin E2 (PGE2) production and or decreasing free radical formation. An increase in oxidant stress associated with an inadequacy of vitamin E will stimulate nuclear factor kB (NFkB) formation, stimulating inflammation and the formation of PGE2 (Grimble, 1997). At low concentrations PGE2 is believed to be necessary for certain aspects of cellular immunity. However, at higher concentrations, it suppresses several indices of cellular and humoral immunity such as antibody formation, delayed-type...

Background And Significance

In Western societies, high consumption of dietary fat has been linked to obesity, coronary artery disease, and certain types of cancer, and it is regarded as the top dietary problem in America (Drewnowski, 1990). Currently, dietary fat comprises nearly 36 of the energy content of the American diet. The guidelines of a number of health organizations recommend that no more than 30 of daily energy be derived from dietary fat in order to reduce the incidence of related morbidity and mortality (National Resource Council, 1989 U.S. Department of Health and Human Services, 1989). An obvious method to decrease the percentage of energy from fat is to substitute low-fat foods for high-fat foods. However, it is difficult for many people to limit their food choices to the low-fat varieties. Controlled laboratory-based experiments indicate that high-fat foods are overeaten because they are highly palatable. When a considerable amount of fat is removed from the diet, the diet is often bland and...

Differences In Fat Preference

Just as Jack Sprat would eat no fat and his wife would eat no lean, differences in fat preferences between men and women have been noted anecdotally. Recent epidemiolog-ical surveys have provided evidence that there are indeed gender differences in regard to fat preferences. Although both men and women seem to find high-fat foods highly palatable, men seem to derive the bulk of their dietary fat from red meat, whereas women derive dietary fats mainly from margarine, whole milk, shortening, and mayonnaise (Block et al., 1985). Women are also more likely than men to express preferences for sweet fat desserts like cake and ice cream (Block et al., 1985). These gender differences persist among obese individuals as well. Drewnowski and colleagues (1992) surveyed the favorite foods of obese men and women and found that obese men listed predominantly fat-protein sources (meat dishes) among their favorite foods while obese women listed more carbohydrate fat sources and more sweet foods...

Amino acids building blocks of proteins

The 20 different naturally occurring amino acids are the building blocks of peptides and proteins. Amino acids are commonly represented by three-letter abbreviations, but one-letter abbreviations are also sometimes used. Although the human body needs all 20 amino acids, it cannot synthesize some amino acids, known as essential amino acids. Essential amino acids must be obtained from the diet. As the name implies, an amino acid contains an amino group and an acid group in the same molecule. Amino acids have a central carbon atom (a-carbon) to which are attached a carboxyl group, an amino group, a hydrogen atom, and a side chain. Different amino acids differ with respect to the side chain (R) only

Refractory Hyponatremia with Lung Cancer

A 59-year-old white female was admitted for evaluation of refractory chronic hyponatremia, an ongoing problem for the past 6 months. The patient reported an 11-lb weight gain and increased fluid intake over the past 10 days prior to admission. Family members also reported that the patient had become increasingly confused during this time. The patient was previously admitted to the hospital for hyponatremia approximately one month ago and had been discharged 10 days prior to this admission. Serum sodium on previous admission was 122 mol L and following treatment had risen to 136 mmol L on discharge.

Shortterm Fat Manipulations

Several studies have investigated the effects of manipulating the fat content in certain meals on energy intake on a short-term basis ( 5 days). Caputo and Mattes (1992) manipulated the energy and fat content of a midday meal for 5 days by using traditional low-fat foods and some commercially available reduced-fat foods. They found that both males and females compensated for energy dilutions in their diet however, compensation for a surfeit of energy was weaker, especially when the additional energy was derived from dietary fat. Firm conclusions cannot be drawn from this study because the data for fat intake were obtained via diet records, and such data should be interpreted cautiously due to the potential errors and biases in using self-reported measures. However, similar results were found in a well-controlled residential laboratory study (Foltin et al., 1988) that manipulated the carbohydrate and fat content in certain meals. In this study, subjects (lean males) compensated well...

Longerterm Fat Manipulations

The studies mentioned above (Caputo and Mattes, 1992 Foltin et al., 1988 Foltin et al., 1990) manipulated fat intake within specific meals or over the course of a day. These types of interventions provide useful information about short-term regulation of fat and energy intake when dilutions and surfeits are introduced into the diet however, they provide no information about long-term regulation or the ability to maintain compliance to a low-fat diet. A few naturalistic studies (Schlundt et al., 1993 Mattes, 1993 Gatenby et al., 1993 Sheppard et al., 1991) have been designed to reduce the overall intake of dietary fat in certain groups over longer periods of time. These studies used various strategies (nutritional counseling, behavioral therapy, or financial incentives) to aid subjects in reducing their dietary fat consumption. Results of these studies generally showed that the intervention groups consumed less dietary fat than control groups. Intervention periods in these studies...

Fat Replacers And Fat Preference

It may be that the most effective strategy for fat reduction would be to decrease the preference for dietary fat. Mattes (1993) has examined the effects of two different reduced-fat diets, one which allowed the use of fat mimetics (commercially available reduced-fat products such as salad dressings, table spreads, mayonnaise) and one which did not, on the preference for a limited number of high-fat foods. The results indicated that the group which did not experience fatty flavors showed a decrease in the preferred level of fat in test foods, whereas the group using fat replacers showed no such shift. Mattes (1993) concluded that the preference for fat in foods is governed more by exposure to fatty flavors than by the level of fat in foods. Mattes (1993) further suggested that the preference for fat can be lowered and that the best strategy for lowering fat preference is to avoid fat mimetics and fat replacers. However, due to methodological limitations firm conclusions...

Role of Insulin Secretagogues and Insulin Sensitizing Agents in the Prevention of Cardiovascular Disease in Patients

Few long-term studies that compared the effects of secretagogues with sensitizers on cardiovascular outcomes have been conducted. Of particular importance is the United Kingdom Prevention of Diabetes Study (UKPDS), which demonstrated that in obese patients, a weak sensitizer like metformin may be better than a secretagogue in preventing myocardial infarction and cardiovascular mortality. underwent a subsequent randomization to primary therapy with sulfonylurea or insulin. In addition, obese patients were randomized to metformin or placebo. When compared with conventional therapy, intensive treatment was associated with a decreased risk of predominantly microvascular complications, including a 12 reduction in any diabetes-related end point (P 0.03) and a 25 reduction in all microvascular end points (P 0.001). There was no significant effect on diabetes-related death or on all-cause mortality, however, and there only was a trend toward a small effect ( 16 ) on the risk of myocardial...

Body fat redistribution syndrome A set of

Body mass index (BMI) An index used to judge the relation between a person's height and weight. The BMI is a person's weight in kilograms divided by height in meters squared. The resulting number correlates strongly with total body fat in adults. The National Heart, Lung and Blood Institute has a quick BMI calculator at http bmi bmicalc.htm

The formation of callosal connectional maps

The production of transient projections, often topographically different from the adult ones, was found to be a very general phenomenon, not restricted to the callosal connections but applying also to intrahemispheric and corticosubcortical projections (reviewed in Innocenti, 1991). The overproduction of projections clearly provides the potential substrate for plastic changes in the developing brain. Indeed, neither the fate of normally maintained axons nor that of normally eliminated axons seemed rigidly predetermined. Instead, it was found to be modifiable by epigenetic events, including activity, integrity of the sensory periphery and of other brain regions, and hormonal and dietary influences (reviewed in Innocenti, 1991 Zufferey et al., 1999).

Diseasenutrient interactions

Disease and stress lower both plasma and leukocyte ascorbate concentrations (Thurnham, 1994, 1997). It has been recognised for many years that smokers have lower plasma ascorbate concentrations than non-smokers, even when dietary intake is taken into account. The effect is similar to that seen during surgical stress or infection but the stress of smoking is more easily studied (Thurnham, 2000). The need to lower circulating vitamin C concentrations in the presence of trauma may be linked to an increased risk of reaction between vitamin C and iron (Thurnham, 1994). During infection, the capacity to bind iron in plasma does not diminish and in fact several acute phase proteins with the capacity to bind iron increase (eg ferritin and lactoferrin). Nevertheless there is increased likelihood that iron and other transition metals are released in the immediate locality surrounding damaged tissues (Chevion et al, 1993), and therefore vitamin C concentrations may be reduced to minimise the...

Oral Glucose Tolerance Test

The oral glucose tolerance test (OGTT) has for many years been the accepted standard for the diagnosis of diabetes. It is, however, time consuming and inconvenient requiring considerable preparation. Many would therefore regard it as unsuitable for widespread use among people with risk factors for diabetes. Unless conducted in the inpatient setting, the recent dietary intake and duration of the pre-test fast cannot be standardised in the way the protocol demands, and these factors can affect the results54,55. Paired OGTTs performed two to six weeks apart have shown that among people who are diagnosed as having diabetes in an initial OGTT, 95 of values in the second OGTT lie within 20 of the initial fasting glucose and 36 of the initial 2 h glucose56.

Center for Hyperactive Child Information A

Central nervous system stimulants Drugs that cause anxiety, excitation, or nervousness or that otherwise stimulate the brain and central nervous system. These drugs include amantadine, amphetamines, anesthetics, appetite suppressants (except fenfluramine), bronchodilators (xanthine-derivative), caffeine, clophedianol, cocaine, doxapram, methylphenidate, pemoline and sympathomimet-ics.

Racial and Ethnic Disparities in Health

Rates of illness such as asthma are much higher among African Americans than among whites, as are levels of obesity, diabetes, and other cardiovascular risk factors that are often established in adolescence and young adulthood. For example, the prevalence of obesity among African Americans is 29.3 percent and that among Hispanics is 21.5 percent, whereas it is 18.5 percent among whites (CDC, 2002). In 2000, the rate of diabetes-related mortality in non-Hispanic African Americans was 49.4 (per 100,000), whereas it was 32.4 in Hispanics and 20.8 in non-Hispanic whites (CDC, 2001b). Rates of death due to HIV AIDS are 31.9 among African Americans and 3.7 among whites (CDC, 2000).

Data Limitations For Establishing An

Establishing an EAR requires identification of a level of dietary intake that meets the needs of half of the individuals being evaluated (as assessed by the selected indicator). There were no studies with chromium that systematically depleted individuals of chromium until a functional parameter was abnormal. Only one study fed subjects a low-chromium diet in that study urinary chromium decreased but with the relatively small sample size this numerical change was not significant 2 . Without the ability to define an EAR, the only choice available to the panel was to base their recommendation on available dietary data.

Consumer Attitudes To Diet And Health

In 1993, the Leatherhead Food Research Association (Leatherhead Food RA) in the U.K. undertook a program of qualitative and quantitative consumer research based on group discussions and in-home interviews, respectively, in order to gain a better insight into consumer issues affecting market developments in reduced-fat foods and, as a consequence, the potential market need for fat replacers (Cathro, 1993). In group discussions, respondents agreed that the high fat content of many foods was one of the most important health issues facing them today. Quantitatively, 58 of 509 respondents interviewed in the home rated dietary fat intake as the most important health issue. This was followed by additives (49 ) and sugar contained in foods (41 ), while salt and fiber were rated as the least important issues, cited by 24 and 16 of respondents, respectively. One of the most worrying aspects about fat intake and cholesterol from a consumer's point of view was that there were no outward signs of...

Reported Chromium Concentrations In Foods

Dietary chromium intakes reported before 1977 are at least three times higher than those reported more recently. Valid data on the chromium content of foods are very limited. This is primarily because of the difficulty in collecting and analyzing chromium accurately in food samples 6, 7, 18 . In earlier analyses, much of the reported chromium was acquired through contamination in sampling, sample homogenization, and analysis. Most staple foods apparently provide less than 10g kg chromium 7 . However, a number of developing countries have reported higher dietary intakes than those reported by trace element laboratories in Scandinavian countries and in the US raising questions of regional differences or contamination problems. Wine is also a potential source of small amounts of chromium. Although mean concentrations were similar for red and white wines tested in France, the red wine ranged from 7 to 90 g Cr L and the white wine ranged from 7 to 44 g Cr L. The chromium concentrations of...

Chlorpromazine Trade name Thorazine A

Choline A basic compound found in plant and animal tissue that is essential to the normal metabolism of fat. This dietary substance is the forerunner of acetylcholine (a neurotransmitter). choline has been implicated as a possible aid to improving memory by increasing the amount of acetylcholine in the brain. Other tests suggest choline may improve thinking ability, muscle control, and the nervous system. Still other studies have suggested that egg yolk (a dietary source of choline) may be useful to patients suffering from memory problems and seem to show an improvement in alcoholics and drug addicts. The major dietary source of choline is lecithin foods rich in lecithin include eggs (average size), salmon, and lean beef. While some researchers dismiss the idea that eating these foods can significantly improve memory, other scientists note at least that a normal level of lecithin in the diet may not be enough as people age.

Reported Chromium Intakes Of Exclusively Breastfed Infants

Chromium concentrations in breast milk were examined in 17 apparently healthy exclusively breast-feeding women at 60 days postpartum using a gas chromatograph-mass spectrophotometer with 50Cr as an internal standard 24 . The mass ratio of 50Cr to 52Cr isotope was measured and the natural chromium in the breast milk samples was calculated. Over the three-day collection period the mean value was 3.43 + 0.39nmolCr L. Breast milk chromium did not increase with dietary chromium intake (r 0.03). Based on an average breast milk consumption of 780 mL day at 2 months postpartum 25 , babies would have received 0.14 g Cr day. (This was in contrast to the previous ESADDI of 10-40 g day for infants aged

Phytoestrogen Metabolism

Metabolism of dietary isoflavones and possesses estrogenic activity, having affinity for both ERa and ERp. Equol appears to be superior to all other isoflavones for antioxidant activity. It is the end product of the biotransformation of the phytoestrogen daidzein, one of the two main isoflavones found in abundance in soybeans and most soy foods. Once formed, equol is relatively stable however, it is not produced in all healthy adults in response to dietary challenge with soy or daidzein. Several recent dietary intervention studies examining the health effects of soy isoflavones allude to the potential importance of equol for obtaining maximal clinical responses to soy protein diets (Setchell et al., 2002b).

DEXA dualenergy Xray absorptiometry

Diabetes mellitus An illness caused by decreased production of insulin or by decreased responsiveness of tissues to it. Insulin, produced by the pancreas, lowers blood glucose levels, and diabetes is characterized by high blood sugar levels. Type I diabetes, also called insulin-dependent diabetes or juvenile-onset diabetes, affects younger people who need insulin injections to control it. Type II diabetes, also called noninsulin-dependent diabetes or maturity-onset diabetes, usually affects middle-aged, overweight people and can often be controlled by a special diet and tablets to lower the blood sugar. Well-known complications of diabetes include blindness caused by damage to blood vessels of the retina, kidney failure caused by damage to the glomeruli that filter urine, and an increased chance of developing infections. Diabetes is also associated with less well-known complications that can affect muscles, joints, and soft tissues.

Memory Loss Following Heart Surgery

Memory problems are common among people with diabetes, as well as among people with mildly impaired glucose metabolism, whose blood sugar is slightly high. In 2003, researchers at New York University School of Medicine reported that people with suboptimal glucose metabolism achieved lower scores on short-term memory tests than people with normal blood sugar. What's more, the hippocampus was smaller in people with elevated blood sugar. Suboptimal glucose metabolism (also known as reduced glucose tolerance) is one of the five characteristics of Syndrome X, a collection of risk factors for heart disease that tend to aggregate in some people. The other factors are hypertension, elevated triglyceride, low HDL (good cholesterol), and abdominal obesity.

Lipoprotein metabolism regulation

In the nonpathologic state, consumed dietary fat provides necessary cholesterol for metabolic needs via the exogenous pathway, and in times of fasting, the endogenous pathway supplies cholesterol. The balance between cholesterol deficit and excess is maintained by key regulatory processes.

Arabinoglycanprotein See agp

Arachidonic acid 5,8,11,14 eicosatetraenoic acid An essential dietary component for mammals. The free acid is the precursor for biosynthesis of the signalling molecules prostaglandins, thromboxanes, hydroxyeicosatetraenoic acid derivatives including leukotrienes, and is thus of great biological significance. Within cells the acid is found in the esterified form as a major acyl component of membrane phospholipids (especially phosphatidyl inositol), and its release from phospholipids is thought to be the limiting step in the formation of its active metabolites.

Folate homocysteine and cardiovascular disease CVD

Be associated with lower incidence of CVD. The consumption of fruit and vegetables has traditionally been associated with increased antioxidant intake (see sections 3.6, 3.15, 3.25) but green vegetables are also one of the main sources of folate, contributing more than 30 of total dietary folate intake. A recent meta-analysis of 12 randomised controlled trials, which included 1114 subjects, demonstrated that folic acid in the range of 0.5-5mg day lowers plasma homocysteine by approximately 25 with 0.5mg day as effective as 5mg day (Clark and Homocysteine Lowering Trials Collaboration 1998). Furthermore, the greatest lowering was in those with the highest baseline homo-cysteine concentrations (Ward, 2001). Doses as high as 0.5mg day can only be achieved using supplementation. It was of interest, therefore, to investigate whether dietary modification or fortification with lower levels of folic acid could also be effective. Results indicated that homocysteine concentrations were...

Reported Chromium Intakes Of The Elderly

Chromium needs of elderly persons have been investigated in two studies. In one of these, dietary intake and excretion of 22 apparently healthy men and women aged 70-85 were measured for a 5-day period using duplicate diet techniques 31 . Chromium was analyzed by graphite furnace atomic absorption spectroscopy and National Bureau of Standards reference materials were monitored for quality control. Mean daily chromium intake for men was 29.8 g and for women was 20.1 g. Men were not statistically significantly different from women. The overall average intake was 24.5 g day or 12.8 g 1000kcal and the overall mean retention of chromium was 0.2 g day. The authors reported that 16 of the 22 subjects were in equilibrium for chromium. Three more were in positive balance. Two subjects were in slight negative balance and one was in severe negative balance. The subject in severe negative balance consumed a very

Causes of decreased folate status

Dietary folate deficiency has been previously associated with poor socio-economic groups but now is thought to exist in 5-10 of the population of most communities. Intestinal absorption is impaired in those with coeliac disease or tropical sprue which if left untreated can lead to folate deficiency (Scott, 2000) (see also section 3.33). Pregnancy is associated with increased folate catabolism, particularly in the second and third trimesters, when it exceeds intake. Women who enter pregnancy with adequate stores or receive prophylaxis during pregnancy will avoid deficiency. Haemolytic anaemia, a condition with increased cell division, can also lead to folate deficiency (Scott, 2000). Anticonvulsant drug therapy is associated with folate deficiency but the mechanism is not known (Scott, 2000). It was suggested that the drugs cause folate malabsorption or excretion of folate through hepatic enzyme induction but this theory has now been discarded. Chronic alcoholics usually have folate...

Definition of the Disease

The cause of hypothyroidism may be primary (thyroid dysfunction), secondary (pituitary dysfunction), or tertiary (hypothalamic dysfunction). Primary hypothyroidism is 1000-fold more common than secondary or tertiary causes.1 Hypothyroidism is associated with cold intolerance, weight gain, constipation, dry skin, bradycardia, hoarseness, and slow mental processing.1 In adults, the characteristic signs and symptoms of hypothyroidism may have an insidious onset. Chronic cutaneous changes include dry, puffy skin with a yellowish complexion as well as a thickening of the subcutaneous tissues due to accumulation of mucopolysaccharides. The hair becomes dry and brittle and is often sparse. The voice may deepen in pitch, and hypoventilation has been observed. Hypothyroid patients can show decreased pulse rate, decreased cardiac stroke volume, and decreased myocar-dial contractility that causes decreased cardiac output. Since peripheral metabolism is slowed, arteriovenous oxygen may not show a...

Cobalamin vitamin B12

Only microorganisms synthesise vitamin B12 and the vitamin gets into the food chain from the bacteria present in the digestive system of herbivores. Herbivores are then eaten by animals higher in the food chain. For humans, food sources of vitamin B12 include almost all animal products, certain algae and bacteria. Vitamin B12 is not present in vegetables or fruits. The dietary intake of vitamin B12 is about 5 mg day (Weir and Scott, 1998). The current RDA for B12 in most countries is between 1 and 20 mg day the British RNI are given in Table 3.1. Since food sources of vitamin B12 are limited to those of animal origin, vegetarians and especially vegans are at risk of becoming deficient and should take an oral supplement. Studies on these groups have shown evidence of biochemical deficiency such as raised concentrations of homocysteine and methylmalonic acid

Reported Chromium Intakes During Pregnancy And Lactation

Chromium may be depleted during pregnancy and particularly with multiple pregnancies 37 . Tissue chromium analysis conducted by Schroeder and colleagues 38 showed a decrease in tissue chromium concentrations with age in comparison to the concentrations in the fetus. Because of limitations to analytical techniques in the 1960s, there is a problem with the absolute chromium values, but the age distribution patterns are interesting. However, because of lack of data, the AI was determined by extrapolating from adolescent girls and adult women. The median weight gain during pregnancies with good outcomes was determined to be 16 kg 39 , and this additional weight was added for extrapolation. Depending on the age of the woman, the AI for pregnancy was set at 29 or 30 g day. The AI for lactation is based on the amount of chromium needed to replace chromium secreted in human milk plus the AI for women. To calculate an AI for chromium during lactation, if it is assumed that 1 of chromium is...

The Regulation Of Lifestyle

While clinical trials have shown the benefits of stopping cigarette smoking, many of the changes in lifestyle that are being promoted by Western governments are based on information lacking in solid evidence. It is unpardonable to try to alter the diet of an entire population without sufficient information. Nor can very much be changed by the trendy fashions in changing 'life-styles', all the magazine articles to the contrary dieting, jogging, and thinking different thoughts may make us feel better while we are in good health, but they will not change the incidence or outcome of most of our real calamities.

Aspartyl protease See aspartic peptidase

Astaxanthin 3, 3'-Dihydroxy-4,4'-diketo-b-carotene A naturally occurring red carotenoid pigment with antioxidant properties. Most crustaceans are tinted red by accumulated astaxanthin, and the pink flesh of a healthy salmon is due to accumulated astaxanthin. This is added to feed in fish farms to substitute for the astaxanthin in the diet of a wild salmon.

Assessment and other issues

Normal variations in dietary intake of MMA do not affect plasma levels. MMA is excreted in the urine and is closely correlated with plasma concentrations. Plasma MMA levels rise in renal failure and in cobalamin deficiency but not in folate deficiency. Plasma concentrations rise from normal values of 0.10.4 mmol L to 50-100 mmol L in vitamin B12 deficiency. MMA in urine or plasma is a sensitive measure of absolute and or functional vitamin B12 deficiency, and is especially useful in the diagnosis of sub-clinical vitamin B12 deficiency in the elderly. Plasma homocysteine comes predominantly from dietary methionine, although concentrations are sensitive to dietary vitamin B12, folate and pyridoxine, the vitamin co-factors associated with its metabolism (Fig. 3.3). Normal homo-cysteine concentrations are higher in men than in premenopausal women, but increase with age especially after age 60.

Effects Of Metabolic States On Chromium Needs

Chromium did relieve diabetic signs in a patient receiving TPN 46 and control of steroid-induced diabetes was improved by chromium supplementation 47 . In China, 180 subjects with type II diabetes were supplemented with placebo or with 200 or 1000 g chromium picolinate per day for 4 months. After 2 months, fasting and 2-hour insulin concentrations and glycosylated hemoglobin were decreased significantly. Unfortunately, there is no information available on the dietary chromium intake of these patients 48 .

Vitamin B6 pyridoxine

Of pyridoxine (Department of Health, 1991). Intestinal absorption takes place mainly in the jejunum by non-saturable, passive diffusion of the non-phosphorylated forms of the vitamin. Post-absorptive phosphorylation of all three forms is catalysed by pyridoxal kinase and the phosphorylation constitutes a form of cellular trapping in intestinal cells and other tissues (liver, muscles and brain) as the charge on the phosphate hinders efflux through the cell membrane. Pyridoxine exhibits greater stability than other forms of the vitamin. As the hydrochloride salt, it is used in dietary supplements and food fortification because of its stability, comparative ease of manufacture and low cost (Gregory, 2001).

Molecular Genetic Studies

Destruction of orexin neurons in human narcolepsy is accompanied not only by abnormal sleep wake regulation but also by metabolic alterations (22,23). The finding of decreased caloric intake (24) combined with an increased body mass index (23) in narcolepsy suggests that narcolepsy patients have a feeding abnormality with reduced energy expenditure or low metabolic rate. Because narcolepsy is caused by orexin deficiency, the altered energy home-ostasis in human narcolepsy patients suggests roles of orexin in regulation of energy home-ostasis (22,23). Consistently, orexin neuron-ablated mice show hypophagia and late-onset obesity (25). Complex disruptions of energy homeostasis in orexin ataxin-3 transgenic mice are indicated by hypophagia (Fig. 3), obesity, and inactivity relative to control litter mates (25,26). Orexin knockout mice were also showed to be hypophagic (27). The decreases in food intake observed in orexin knockout or orexin neuron-ablated mice suggest the physiological...

Sometimes requires discontinuation Contraindicated in active hepatic renal and coronary artery disease

In the UKPDS, treatment with metformin (another drug that decreases hyperinsulinemia and insulin resistance) produced greater reduction in cardiovascular disease events and mortality than sulfonylureas and insulin 8 . The latter drugs decreased blood glucose level to a similar degree as metformin but did not decrease plasma insulin concentrations. This effect may have been mediated through a decrease in insulin resistance, although other effects of metformin, such as improvement in lipid profile, improved fibrinoly-sis, and prevention of weight gain, may be important 8 . Metformin has a favorable, albeit modest, effect on plasma lipids, particularly in decreasing triglycerides and low-density lipopro-tein (LDL) cholesterol however, it had little, if any, effect on HDL cholesterol levels 78 . Met-formin use was associated with decreased plas-minogen activator inhibitor (PAI-1) activity which led to improved endothelial dysfunction (see Table 1). PPARs are members of the nuclear...

Diet and physical activity

The major effects of diet (discussed in more detail in Chapter 13) and levels of physical activity (discussed in more detail in Chapter 14) on prevalence of the metabolic syndrome are probably mediated through their effects on fat distribution and obesity, although not all studies adjust for these factors. A study of health, nutrition and physical activity (with the latter assessed by questionnaire) in Greece reported that the odds ratios for the metabolic syndrome adjusted for age, gender, smoking habits, educational status and measurements of inflammation and coagulation factors (but not BMI) were 0.81 (95 per cent CI 0.68-0.98) among people who consumed a Mediterranean diet compared with those who did not eat this diet and 0.75 (95 per cent CI 0.65-0.86) among people who reported little to moderate physical activity compared with people having a sedentary lifestyle (Panagiotakos etal., 2004). In a study of 7104 women the age- and smoking-adjusted prevalence of the metabolic...

Egas Moniz Antonio Caetano de Abreu Freire

Ecstasy was first synthesized and patented in 1914 by the German drug company Merck as an appetite suppressant in the 1970s, it was given to psychotherapy patients because it helped them talk about their feelings. This practice was stopped in 1986 when animal studies showed that Ecstasy caused brain damage.

Enigmas Posed by Malevolent Genes

Many genetic disorders typically are not discussed as disorders at all because their harmful expression is confined to environments viewed as aberrant. For example, our genetic inability to produce vitamin C is of no health consequence when ascorbic acid from fresh fruits and vegetables is available. However, scurvy results when dietary access to vitamin C is limited, as often was true for European sailors on prolonged voyages during the fifteenth to nineteenth centuries. Conversely, some genetic conditions such as

Menopausehormone replacement therapy

Limited data are available about the effects of menopause and HRT on prevalence of the metabolic syndrome. More data are available on the effects of menopause and HRT on various measures of central obesity but there are conflicting results. Menopause is associated with increased amounts of abdominal visceral fat and there appears to be an effect that is independent of ageing (Poehlman and Tchernof, 1998 Tchernof etal., 1998). Some cross-sectional studies have suggested that various measures of central obesity (and therefore presumably prevalence of the metabolic syndrome) may be lower in women using HRT but this study design cannot show that this is an effect of HRT (Sites etal., 2001 Green etal., 2004). Other cross-sectional studies have not shown a relationship between measures of central adiposity and HRT use (Kanaley etal., 2001 Ryan, Nicklas and Berman, 2002) Longitudinal study designs also have provided conflicting results. Women taking part in the in the HRT group of the...

Models For Toxicological Testing

Different factors are believed to influence the activity of drug-metabolizing enzymes, hampering meaningful comparisons between xenobiotic metabolism of animals and humans. These include age, sex, environmental exposure, diet, pathophysiological status, drug-drug interactions, and genetics (interindividual differences in the activity level of various isoforms, polymorphisms).2 Sex differences in the expression of CYPs within the same species have been shown for rat and mouse, whereas a sex specific human CYP isozyme has not yet been reported.3 Concerning environmental exposure, there is even little comparison between rats and mice (and between strains of the same species) with respect to chemical carcinoge-nicity and in the pathways for both activation and detoxification.2,4 Experimental models are kept in a controlled environment with a defined dose regimen and dietary restrictions, limiting the chance of drug-drug interactions whereas in humans, drug-metabolizing enzymes are...

Avoidable Risk Factors

Fortunately, most of the risk factors for coronary artery disease can be partially or totally addressed. Many are unhealthy habits, such as smoking and lack of exercise. Others, such as high blood cholesterol and obesity, can be partly or mostly due to poor diet choices, although genetic susceptibilities can dramatically influence the response to those choices. Some are treatable illnesses such as depression and high blood pressure. And still others are circumstances, such as social isolation and stress, that can be mitigated to some degree. By addressing the risk factors that you have some control over, it's possible to reduce your vulnerability to coronary artery disease by a third or more.

Other minerals iodine and selenium

The non-metallic element iodine is an essential nutrient that, apparently, has a single function in the body as a component of the thyroid hormones thyroxine (T4) and triiodotyronine (T3). These hormones are necessary for a range of body processes, the most important of which are the control of metabolic rate, cellular metabolism, growth and neural development. Production of T4 and T3 is controlled by tissue demands which are mediated by the secretions of the pituitary gland and by the supply of iodine in the diet. Seafood is the major natural source of iodine in the diet. Fish, crustaceans and seaweeds are rich in the element. Milk is another good, though adventitious, source of dietary iodine as a result of the use of iodine-containing chemicals to sterilise dairy equipment. This practice has now ceased in many countries, with the result that dairy products are decreasing in value as a source of the nutrient. Cereals, vegetables and meat are generally poor sources. Iodised salt...

Effects Of Chromium Supplementation On Human Body Composition And Physical Functions

The impetus for research to determine the effects of supplemental Cr(III) came from two studies of healthy men 7 . Ten men aged 18-21 years enrolled in a weight training class were randomized to receive either 200 g Cr(III) as Cr(pic)3 or placebo (calcium phosphate) for 40 days. Men were instructed to follow usual dietary and physical activity patterns while participating in two weight training sessions weekly. Body weight and composition, assessed by using skin-fold thicknesses and body circumferences, were measured before and after training. After completion of the resistance training, the body weight of the men supplemented with Cr(pic)3 increased 2.2 kg with a slight increase in body fatness ( fat). Lean body mass was reported to increase significantly by 1.6 kg. Placebo-treated men also increased body weight (1.25 kg), but body fatness increased significantly (1.1 ) with a negligible increase in lean body mass (0.4 kg). of either 200 gCr(III) as Cr(pic)3 or placebo. Analysis of...

The Role Of Cyp Enzymes In Other Diseases

Nijhoff et al.48 investigated the effect of the dietary, naturally occurring anticarcinogens flavone, coumarin, a-angelicalactone, and ellagic acid on the activity of GSTs in the esophagus, stomach, and pancreas of male Wistar rats. The treatment resulted in strong chemoprotective effects in the esophagus and stomach and, to a lesser extent, in the pancreas by enhancing the GST detoxification system. The lesser effect in the pancreas was explained with the shorter exposure time and intensity with the dietary substance.48 These findings are in line with reports of GST enzyme induction in the pancreas of rat after a diet rich in cruciferous vegetables.49

Fluent aphasia See Wernickes aphasia fluid balance See thirst

Folate also can be obtained from dietary supplements, such as folic acid tablets and multivitamins with folic acid, and from fortified breakfast cereals. An estimated 2,500 babies were born in the United States each year with this condition, and the FDA panel estimates that this number could be cut in half if women consumed the suggested daily allowance of folic acid (0.4 milligrams). The average women ingests only 0.2 milligrams of the substance each day the vitamin is found in green leafy vegetables, dried beans, liver, citrus juices, nuts, avocados, and cereals.

General limitations in assessing nutrient intake

As for any nutrient where deficiency and toxicity are issues, the reliable assessment of intake is paramount. The ultimate aim of defining optimal dietary intakes is hampered by difficulties in determining certain key facts, namely, individual copper intakes and status. Dietary intake can be assessed by a number of methods, involving either the recording of actual consumption (prospective) or the assessment by questionnaires of diet in the recent past (retrospective). At each stage in the application of any method, errors are introduced, producing as a result either a systematic bias or random deviations from the true values. Of the methods in common use, the weighed dietary record is widely accepted to be the most accurate, but it requires a considerable amount of co-operation from human subjects. This disadvantage may give rise to substantial bias, most likely toward underreporting habitual dietary intakes.48 In clinical practice the most frequently used method of dietary assessment...

Obstructive Sleep Apnea OSA

In people with significant OSA, these disruptions can occur hundreds of times throughout the night and result in fragmentation of normal brain electrical activity and sleep architecture. OSA is usually caused by changes in airway anatomy, frequently associated with weight gain. Loud snoring and occasional gasping are near universal.

Clinical Implications Of Exocrine And Endocrine Interactions

Exocrine-endocrine pancreatic functional interrelationships play a significant role in the development of endocrine and exocrine disorders of the pancreas. Disorders of the exocrine pancreas, such as chronic and acute pancreatitis and pancreatic adenocarcinoma, can induce endocrine pancreatic disorders such as diabetes mellitus and islet cancer.35 In turn, diabetes and glucose intolerance are often associated with exocrine pancreatic dysfunction, and may participate in pancreatic carcinogenesis. New epidemiological studies confirmed that glucose intolerance is a risk factor for pancreatic cancer, such that association cannot be accounted for by an adverse impact of early pancreatic cancer on p-cell function42 and that insulin may also act as a promoter for pancreatic carcinogenesis. Recently, the nutritional factor link to pancreatic carcinogenesis became a main focus of interest.43 These include dietary roles and interaction between various risk factors, including hyperinsulinemia,...

Functional copper status

Functional copper status, however, is not dependent only on the absolute copper content of the body. Utilisation of absorbed copper is also modulated by the interactions of copper with a number of other factors, deriving from the general status and requirements of the body. Furthermore, individual organs have the potential to modulate copper status by retaining copper in response to dietary restriction. This capacity is highly organ-specific, being stronger and or more sensitive in some tissues than in others. Depletion studies in animals have found plasma to possess almost no copper conservation mechanisms, whereas the heart and brain were shown to conserve most of their endogenous copper during periods of restriction.62 Liver copper conservation mechanisms, while induced only after levels had dropped to around 60 of normal, were thereafter found to operate so strictly that almost no copper was exported into the plasma, and biliary copper excretion was also significantly reduced.

Box 161 Birth Defects

Talk of the many mutations present in the DNA of any one individual should not strike fear in the hearts of those who are planning families. The vast majority of babies are born healthy. In populations in which the parents are not related to each other, more than 97 of the children can be expected to be born without birth defects, and more than 99 will be free of major birth defects. This reflects, at least in part, the rarity of dominant alleles that can cause birth defects, but it also reflects just how often the hidden genetic defects (the recessive alleles) in one person are different from the hidden genetic defects in another. So what happens when people who are related have children together They have an increased chance of sharing defective alleles, and the rate of birth defects may double. These numbers tell us that, even in the case of first-cousin marriages, most babies are born healthy. According to the March of Dimes, some of the most common birth defects include cerebral...

Colloid Predominant Lesions

The term goiter refers to any enlargement of the thyroid gland. However, most goiters are caused by a nonneoplastic, dynamic process in which there is hyperplasia and regression of the follicular epithelium and accumulation of colloid within the enlarged follicles. Grossly, this can lead to the development of multiple nodules of varying sizes within the gland, termed multinodular goiter. Often the largest or dominant nodule is the target of the fine needle aspiration (FNA). Iodine deficiency is a major cause of multinodular goiter in some countries however, in geographic areas where dietary iodine is sufficient, the etiology of multinodular goiter is unknown. It may involve abnormalities in thyroid hormone production and variable sensitivity of follicular cells to thyroid-stimulating hormone (TSH). For unclear reasons, multinodular goiters are more common in women and increase with age.

Diet Enriched With Omega3 Fatty Acids Alleviates Convulsion Symptoms in Epilepsy Patients

Summary Researchers investigated whether taking a dietary supplement that contained omega-3 polyunsaturated fatty acids (n-3 PUFA's) would alleviate and or reduce the frequency of epileptic seizures in people with central nervous system diseases who were taking anticonvulsant drugs. Participants were patients hospitalized in Israel, all of whom had profound mental retardation and epilepsy secondary to another primary central nervous system disease. Researchers developed a spread containing 65 percent n-3 PUFA's that was added to the daily diet. Of the 21 patients, only 5 were willing to eat the spread. They ate it at breakfast for 6 consecutive months. Researchers examined their medical features, drug therapy, and seizure frequency before and after the 6-month trial. All five patients showed significant improvement and alleviation in seizure frequency and strength. There were no adverse effects noted among any of the participants. The researchers conclude that n-3 PUFA's can alleviate...

Current research and future trends

In young women undertaking a standardised hand-grip exercise, the blood pressure response was exaggerated when dietary copper was restricted to 0.65mg d.34 This was observed in the absence of significant changes in copper balance or plasma copper, but with reduced caeruloplasmin activity. Good correlations were found, for individual subjects, between blood pressure response and caeru-loplasmin concentration, demonstrating a relationship between the biochemical and physiological indices of copper status. The application of performance-related indices in parallel with biochemical measurements allows potential novel indicators of copper status to be evaluated. There is clearly a need to identify more closely the role of copper in biological systems, both in health and in disease states. According to the WHO, there is a great need for standardised sampling and analytical procedures for the determination of dietary copper and copper in drinking water. There appears, also, to be a case for...

Emulsification and micelle formation

Most dietary fat is too hydrophobic to dissolve in water, so mixing in the alkaline intestinal lumen emulsifies it, creating tiny particles and increasing the surface area available for lipid-digesting enzymes. Amphiphilic bile salts, phospholipids and cholesterol esters secreted in bile form micelles, which are microscopic particles with a hydrophobic core and the hydrophilic parts of the molecules on the outside. Digested lipids, such as fatty acids, partition into the hydrophobic core and can be absorbed from the intestinal lumen.

Infant Feeding Problems

A breast-fed baby under six months of age who is always restless and failing to gain weight even when emptying the breast may not be getting enough calories. A pediatrician should examine the baby and make recommendations for possible changes in diet or feeding methods. A bottle-fed baby who turns away from the bottle, or who vomits after most feedings, may in fact be getting too much food. Babies who avoid the bottle usually are full persisting in trying to feed is not effective. However, if the infant vomits even after drinking less milk, a pediatrician should be consulted.

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