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Title:
Meeting nutritional needs on a vegetarian diet
Authors:
Marsh, Kate; Zeuschner, Carol; Saunders, Angela; Reid, Michelle
Abstract:
A vegetarian is a person who consumes a diet consisting mostly of plant based foods including fruit, vegetables, legumes, nuts, seeds and grains. Some vegetarians also consume eggs and dairy foods. Individuals choose to follow a vegetarian diet for a range of reasons, including animal rights and religion, but two common reasons are the health and environmental benefits of plant based eating.
Published:
2009-08
Title:
Metabolite profiling of hydroxycinnamate derivatives in plasma and urine after the ingestion of coffee by humans: identification of biomarkers of coffee consumption
Authors:
Stalmach, Angélique; Mullen, William; Barron, Denis; Uchida, Kenichi; Yokota, Takao; Cavin, Christophe; Steiling, Heike; Williamson, Gary; Crozier, Alan
Abstract:
Human subjects drank coffee containing 412 mumol of chlorogenic acids, and plasma and urine were collected 0 to 24 h after ingestion and were analyzed by high-performance liquid chromatography-mass spectrometry. Within 1 h, some of the components in the coffee reached nanomole peak plasma concentrations (C(max)), whereas chlorogenic acid metabolites, including caffeic acid-3-O-sulfate and ferulic acid-4-O-sulfate and sulfates of 3- and 4-caffeoylquinic acid lactones, had higher C(max) values. The short time to reach C(max) (T(max)) indicates absorption of these compounds in the small intestine. In contrast, dihydroferulic acid, its 4-O-sulfate, and dihydrocaffeic acid-3-O-sulfate exhibited much higher C(max) values (145-385 nM) with T(max) values in excess of 4 h, indicating absorption in the large intestine and the probable involvement of catabolism by colonic bacteria. These three compounds, along with ferulic acid-4-O-sulfate and dihydroferulic acid-4-O-glucuronide, were also major components to be excreted in urine (8.4-37.1 mumol) after coffee intake. Feruloylglycine, which is not detected in plasma, was also a major urinary component (20.7 mumol excreted). Other compounds, not accumulating in plasma but excreted in smaller quantities, included the 3-O-sulfate and 3-O-glucuronide of isoferulic acid, dihydro(iso)ferulic acid-3-O-glucuronide, and dihydrocaffeic acid-3-O-glucuronide. Overall, the 119.9 mumol excretion of the chlorogenic acid metabolites corresponded to 29.1% of intake, indicating that as well as being subject to extensive metabolism, chlorogenic acids in coffee are well absorbed. Pathways for the formation of the various metabolites within the body are proposed. Urinary dihydrocaffeic acid-3-O-sulfate and feruloylglycine are potentially very sensitive biomarkers for the consumption of relatively small amounts of coffee.
Published:
2009-08
Title:
The influence of concurrent anticonvulsants on the efficacy of the ketogenic diet
Authors:
Morrison, Peter F.; Pyzik, Paula L.; Hamdy, Rana; Hartman, Adam L.; Kossoff, Eric H.
Abstract:
It is unknown if any particular anticonvulsants modify the likelihood of seizure reduction when used in combination with the ketogenic diet (KD). A retrospective study was performed of 217 consecutive children who started the KD from 2000-2007. Patients included did not have any changes to their anticonvulsant dose. Efficacy data at 3 months on the KD were analyzed with respect to the six most frequently used anticonvulsants in this cohort. A total of 115 patients were included. Children receiving phenobarbital in combination with the KD were significantly less likely to have a >50% seizure reduction (p = 0.003). Conversely, those receiving zonisamide in combination with the KD at onset were more likely to have a >50% reduction (p = 0.04). These results provide practical information to clinicians who are treating children receiving both the KD and anticonvulsants.
Published:
2009-08
Title:
The negative effects of hydrogenated trans fats and what to do about them
Authors:
Kummerow, Fred A.
Abstract:
Partially hydrogenated vegetable oils have been in the American diet since 1900. More than 50 years ago they were found to contain trans fatty acids that were different from natural fatty acids in plant oils and in animal fat. There was growing evidence that the consumption of trans fats have negative health effects, including increasing plasma lipid levels. In 2003, the Food and Drug Administration (FDA) ruled that the amount of trans fat in a food item must be stated on the label after January 1, 2006; food items could be labeled 0% trans if they contain less than 0.5g/serving. Since the initial ruling, it is now known that the fatty acids in partially hydrogenated vegetable oil are 14 cis and trans isomers of octadecenoic and octadecadienoic acids that are formed during hydrogenation. They cause inflammation and calcification of arterial cells: known risk factors for coronary heart disease (CHD). They inhibit cyclooxygenase, an enzyme required for the conversion of arachidonic acid to prostacyclin, necessary for the regulation of blood flow. There have been several reformulations of hydrogenated fat containing varying amounts of trans fatty acids and linoleic acid, an essential fatty acid that is converted to arachidonic acid. Epidemiological data suggest that when trans fat percentages go up and linoleic acid percentages go down, death rates rise; when trans goes down, death rates go down. In spite of the harmful effects of trans fats, the FDA allows it in the food supply as long as the amount in a food item is declared on the label. Trans fat should be banned from the food supply.
Published:
2009-08
Title:
Challenging homeostasis to define biomarkers for nutrition related health
Authors:
van Ommen, Ben; Keijer, Jaap; Heil, Sandra G.; Kaput, Jim
Abstract:
A primary goal of nutrition research is to optimize health and prevent or delay disease. Biomarkers to quantify health optimization are needed since many if not most biomarkers are developed for diseases. Quantifying "normal homeostasis" and developing validated biomarkers are formidable tasks because of the robustness of homeostasis and of inter-individual diversity. In this paper, we discuss the science, strategies, and technologies for measuring parameters that define individual health. The following concepts are central to define the physiology of the healthy individual: (i) responses to a challenge of homeostasis will be more informative than static homeostatic measures; (ii) processes involved in maintaining homeostasis usually are multi-factorial and require quantitative analyses of the many individual components involved; (iii) health includes a large variation in "normality" and the effects of nutritional interventions may remain hidden in this "diversity of robustness," if incompletely analyzed. Specifically, comprehensive multi-parameter ("omics") analysis may identify key parameters (biomarkers) and lead to a greater understanding of health supporting processes. Perturbation tests that accurately target aspects of the overarching drivers of health (metabolism, oxidation, inflammation, and psychological stress) may be instrumental in creating knowledge for maintaining health and preventing disease through nutrition.
Published:
2009-07
Title:
Platelet aggregation, eicosanoid production and thrombogenic ratio in individuals at high cardiovascular risk consuming meat enriched in walnut paste. A crossover, placebo-controlled study
Authors:
Canales, Amaia; Bastida, Sara; Librelottto, Josana; Nus, Meritxell; Sánchez-Muniz, Francisco J.; Benedi, Juana
Abstract:
Walnut consumption produces beneficial cardiovascular effects. The aim of the present study is to compare the effects of meat enriched in walnut paste (WM) and low-fat meat (LM) consumptions on platelet aggregation, plasma thromboxane A2 (TXA2, measured as TXB2), prostacyclin I2 (PGI2, as 6-keto-PGF1alpha) and the thrombogenic ratio (TXB2/6-keto-PGF1alpha) in volunteers at high CVD risk. Twenty-two adults were placed on a random, non-blinded crossover study involving two test periods (five portions WM/week for 5 week; five portions LM/week for 5 week) separated by a 4- to 6-week washout period. The participants were asked to complete a diet record throughout the study. Platelet aggregation, plasma TXB2, 6-keto-PGF1alpha production and the TXB2/6-keto-PGF1alpha ratio were determined at baseline and at weeks 3 and 5 for the two dietary periods. The WM diet contains a lower SFA content, a higher concentration of PUFA and a more favourable n-6/n-3 ratio than the LM diet. Significant time x treatment interactions were observed for TXB2 (P = 0.048) and the TXB2/6-keto-PGF1alpha ratio (P = 0.028). The WM diet significantly increased the level of 6-keto-PGF1alpha (P = 0.037) and decreased the TXB2/6-keto-PGF1alpha ratio (P = 0.048). At week 5, significant differences (P or = 2200 mg/l. The WM diet should be considered a functional meat because it improves the thrombogenic status mainly in individuals with high-cholesterol levels or high BMI.
Published:
2009-07
Title:
Position of the American Dietetic Association: vegetarian diets
Authors:
Craig, Winston J.; Mangels, Ann Reed; American Dietetic Association
Abstract:
It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes. A vegetarian diet is defined as one that does not include meat (including fowl) or seafood, or products containing those foods. This article reviews the current data related to key nutrients for vegetarians including protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B-12. A vegetarian diet can meet current recommendations for all of these nutrients. In some cases, supplements or fortified foods can provide useful amounts of important nutrients. An evidence- based review showed that vegetarian diets can be nutritionally adequate in pregnancy and result in positive maternal and infant health outcomes. The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals. The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating vegetarians about sources of specific nutrients, food purchase and preparation, and dietary modifications to meet their needs.
Published:
2009-07
Title:
The effects of dietary fibre type on satiety-related hormones and voluntary food intake in dogs
Authors:
Bosch, Guido; Verbrugghe, Adronie; Hesta, Myriam; Holst, Jens J.; van der Poel, Antonius F. B.; Janssens, Geert P. J.; Hendriks, Wouter H.
Abstract:
Depending on type and inclusion level, dietary fibre may increase and maintain satiety and postpone the onset of hunger. This 7-week study evaluated the effect of fibre fermentability on physiological satiety-related metabolites and voluntary food intake (VFI) in dogs. Sixteen healthy adult dogs were fed a low-fermentable fibre (LFF) diet containing 8.5 % cellulose or a high-fermentable fibre (HFF) diet containing 8.5 % sugarbeet pulp and 2 % inulin. Large intestinal fibre degradation was evaluated by apparent faecal digestibility of nutrients and faecal SCFA and NH3 concentrations. Postprandial blood samples were obtained to determine postprandial plasma glucose, insulin, total peptide tyrosine-tyrosine (PYY), total glucagon-like peptide-1 (GLP-1) and total ghrelin concentrations. At the end of the study, the dogs were given a single meal of a dry dog food to determine VFI. Dogs fed the HFF diet had a significantly higher large intestinal fibre degradation and production of SCFA compared with the dogs fed the LFF diet. The HFF-fed dogs tended (P = 0.058) to show a lower VFI at the end of the study. No treatment effects were found for postprandial plasma glucose, PYY, GLP-1 and ghrelin responses. The concentrations of these metabolites could not be related to the observed difference in VFI. The inclusion of fermentable fibre in canine diets may contribute to the prevention or mitigation of obesity through its effects on satiety. The underlying mechanisms require further investigation.
Published:
2009-07
Title:
The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review
Authors:
Heizer, William D.; Southern, Susannah; McGovern, Susan
Abstract:
This review summarizes what is known about the effect of diet on irritable bowel syndrome (IBS) symptoms emphasizing data from randomized, controlled clinical trials. Studies suggest that IBS symptoms in one quarter of patients may be caused or exacerbated by one or more dietary components. Recent studies indicate that a diet restricted in fermentable, poorly absorbed carbohydrates, including fructose, fructans (present in wheat and onions), sorbitol, and other sugar alcohols is beneficial, but confirmatory studies are needed. Despite a long history of enthusiastic use, fiber is marginally beneficial. Insoluble fiber may worsen symptoms. Some patients with IBS, especially those with constipation, will improve with increased intake of soluble fiber. Prebiotic fibers have not been adequately tested. Daily use of peppermint oil is effective in relieving IBS symptoms. The usefulness of probiotics in the form of foods such as live-culture yogurt and buttermilk for IBS symptoms is not established. In clinical practice, it is very difficult to establish that a patient's symptoms result from an adverse reaction to food. A double blind placebo-controlled food challenge is the most reliable method, but it is not suitable for routine clinical use. A modified exclusion diet and stepwise reintroduction of foods or trials of eliminating classes of food may be useful.
Published:
2009-07
Title:
Androgen therapy for delayed male puberty
Authors:
Ambler, Geoffrey R
Abstract:
PURPOSE OF REVIEW Delayed puberty in men is a commonly presenting problem to paediatricians and an understanding of the available evidence on cause, treatments and outcomes is important to guide practice. RECENT FINDINGS Understanding of the regulation of the onset of puberty is gradually unfolding, although the genetic factors that dictate the timing of puberty in individuals and families remain poorly elucidated. Mutations and polymorphisms in candidate genes are being actively studied and it is likely that there is significant overlap between traditional diagnostic categories. Also, environmental endocrine disruptors may interact with the genetic regulation of puberty. Delayed puberty may not always be a benign condition, with increased risks of failing to achieve target height, adverse psychological and educational consequences, delayed sexual and psychosocial integration into society and effects on skeletal proportions and bone mass reported. Appropriate evaluation and follow-up is needed to guide clinical practice, particularly to distinguish constitutional delay in growth and puberty from that associated with other medical disease or permanent disorders. SUMMARY In milder cases of delayed puberty, treatment is often not required; however, considerable evidence exists for the efficacy and safety of short courses of low-dose testosterone therapy for appropriately selected individuals. This treatment is associated with high levels of patient satisfaction. There is not yet sufficient evidence for the routine use of other therapies (e.g. growth hormone, aromatase inhibitors) for constitutional delay in growth and puberty and better characterization of cause may lead to more targeted individual therapy.
Published:
2009-06
Title:
Binding of S100 proteins to RAGE: an update
Authors:
Leclerc, Estelle; Fritz, Günter; Vetter, Stefan W.; Heizmann, Claus W.
Abstract:
The Receptor for Advanced Glycation Endproducts (RAGE) is a multi-ligand receptor of the immunoglobulin family. RAGE interacts with structurally different ligands probably through the oligomerization of the receptor on the cell surface. However, the exact mechanism is unknown. Among RAGE ligands are members of the S100 protein family. S100 proteins are small calcium binding proteins with high structural homology. Several members of the family have been shown to interact with RAGE in vitro or in cell-based assays. Interestingly, many RAGE ligands appear to interact with distinct domains of the extracellular portion of RAGE and to trigger various cellular effects. In this review, we summarize the modes of S100 protein-RAGE interaction with regard to their cellular functions.
Published:
2009-06
Title:
Conjugated oral versus transdermal estrogen replacement in girls with Turner syndrome: a pilot comparative study
Authors:
Nabhan, Zeina M; Dimeglio, Linda A; Qi, Rong; Perkins, Susan M; Eugster, Erica A
Abstract:
BACKGROUND The optimal route of estrogen replacement in Turner syndrome (TS) is unknown. OBJECTIVE The objective of the study was to compare conjugated oral vs. transdermal estrogen (TD E2) on bone accrual, uterine growth, pubertal development, IGF-I, and lipids in girls with TS. Methods: Prepubertal GH-treated girls aged 10 yr or older with TS were eligible. Subjects were randomized to conjugated oral estrogen or TD E2 for 1 yr. Assessments included dual-emission x-ray absorptiometry, pelvic ultrasound, Tanner staging, growth velocity, IGF-I, and lipid profile. RESULTS Twelve girls (14.0 +/- 1.7 yr) were enrolled. TD E2 resulted in a significantly greater change in spine bone density at 12 months compared with conjugated oral estrogen (bone mineral content 9.0 +/- 0.9 vs. 5.8 +/- 0.9 g, P = 0.04; bone mineral density 0.12 +/- 0.01 vs. 0.06 +/- 0.01 g/cm2, P = 0.004; Z-score 0.7 +/- 0.1 vs. 0.3 +/- 0.1, P = 0.03). Greater increases in uterine length (4.13 +/- 0.39 vs. 1.98 +/- 0.39 cm, P = 0.003) and volume (22.2 +/- 4.4 vs. 4.0 +/- 4.4 ml, P = 0.02) were also found in the TD vs. the oral group at 1 yr. At study end, 66% of subjects in the TD group had a mature uterus vs. 0% in the oral group. No significant differences in other parameters examined were seen. CONCLUSION In girls with TS, TD E2 resulted in faster bone accrual at the spine and increased uterine growth compared with conjugated oral estrogen. This pilot study provides preliminary information for optimizing estrogen replacement in this population.
Published:
2009-06
Title:
Experimental animal models of hypertension
Authors:
Sarikonda, Kiran V.; Watson, Ralph E.; Opara, Oluchi C.; Dipette, Donald J.
Abstract:
Hypertension (HTN) and cardiovascular disease are the most common causes of death in developed countries. The use of experimental animal models of HTN has provided valuable information regarding many aspects of HTN, including etiology, pathophysiology, complications, and treatment. Because the etiology of HTN is heterogeneous, many experimental animal models have been developed to mimic the many facets of human HTN. The choice of animal model will be determined by the research question, monetary limitations, and technical expertise. The categories of models of HTN are: renovascular, renal parenchymal, pharmacologically induced, environmentally induced, and genetic. There are considerable differences between HTN in animals and humans, including differences in homeostatic mechanisms and pathophysiology; therefore, a thorough understanding of the animal models and rigorous analysis is required before extrapolating the finding in animals to humans.
Published:
2009-06
Title:
Iron status biomarkers in iron deficient women consuming oily fish versus red meat diet
Authors:
Navas-Carretero, S.; Pérez-Granados, A. M.; Schoppen, S.; Sarria, B.; Carbajal, A.; Vaquero, M. P.
Abstract:
Specific recommendations for anemic individuals consist in increasing red meat intake, but the population at large is advised to reduce consumption of red meat and increase that of fish, in order to prevent the risk of developing cardiovascular disease. This study aimed to determine the effects of consuming an oily fish compared to a red meat diet on iron status in women with low iron stores. The study was designed attending the Consolidated Standards of Reporting Trials (CONSORT) statement guidelines. It was a randomised crossover dietary intervention study of two 8-week periods. Twenty-five young women with low iron stores completed the study. Two diets containing a total of 8 portions of fish, meat and poultry per week were designed differing only in their oily fish or red meat content (5 portions per week). At the beginning and the end of each period blood samples were taken and hemoglobin, hematocrit, serum ferritin, serum iron, serum transferrin, serum transferrin receptor-2 and the Zn-protoporphyrin/free-protoporphyrin ratio were determined. Food intake and body weight were monitored. During the oily fish diet, PUFA intake was significantly higher (p=0.010) and iron intake lower (mean+/-SD, 11.5+/-3.4 mg/day vs. 13.9+/-0.1 mg/day, p=0.008), both diets providing lower mean daily iron intake than recommended for menstruating women. Although there were no significant differences after 16 weeks, serum ferritin moderately decreased and soluble transferrin receptor increased with the oily fish, while changes with the red meat diet were the opposite. In conclusion, an oily fish diet compared to a red meat diet does not decrease iron status after 8 weeks in iron deficient women.
Published:
2009-06
Title:
Lifestyle intervention in obese children with non-alcoholic fatty liver disease: 2-year follow-up study
Authors:
Reinehr, T; Schmidt, C; Toschke, A M; Andler, W
Abstract:
OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in obese youth. Lifestyle intervention was demonstrated to improve NAFLD but follow-up studies after end of intervention are lacking. Furthermore the necessary degree of overweight reduction for improvement of NAFLD remains unknown. METHODS: We examined standard deviation score of body mass index (SDS-BMI) and transaminases in 152 obese children with NAFLD diagnosed by ultrasound at baseline, at the end of a 1-year intervention and 2 years after baseline. Within-subject changes of these parameters were compared by participation in the intervention based on physical activity, nutrition education and behaviour therapy. RESULTS: In contrast to 43 children without lifestyle intervention, participation in lifestyle intervention (n = 109) was associated with a significant decrease of transaminases and overweight 1 and 2 years after baseline (1 year: alanine transaminase (ALT) -10 U/l (-14 to -6); aspartate transaminase (AST) -5 U/l (-7 to -3); SDS-BMI -0.23 (-0.30 to -0.16); 2 years: ALT -9 U/l (-12 to -6); AST -6 U/l (-7 to -4); SDS-BMI -0.30 (-0.37 to -0.22); data as mean changes and 95% confidence interval compared to baseline). Any degree of overweight reduction was associated with a significant decrease of NAFLD prevalence. The greatest decrease of NAFLD prevalence (1 year: -89% (95% CI -72% to -100%); 2 years: -94% (95% CI -83% to -100%)) was observed in children with the greatest overweight reduction (SDS-BMI decrease >0.5). CONCLUSIONS: Multidisciplinary lifestyle intervention is effective to improve NAFLD even in the 1-year follow-up after the end of intervention. A minimal reduction of overweight led to an improvement of NAFLD. Trial registration number: NCT00435734.
Published:
2009-06
Title:
Measurement of dietary exposure: a challenging problem which may be overcome thanks to metabolomics?
Authors:
Favé, Gaëlle; Beckmann, M. E.; Draper, J. H.; Mathers, J. C.
Abstract:
The diet is an important environmental exposure, and its measurement is an essential component of much health-related research. However, conventional tools for measuring dietary exposure have significant limitations being subject to an unknown degree of misreporting and dependent upon food composition tables to allow estimation of intakes of energy, nutrients and non-nutrient food constituents. In addition, such tools may be inappropriate for use with certain groups of people. As an alternative approach, the recent techniques of metabolite profiling or fingerprinting, which allows simultaneous monitoring of multiple and dynamic components of biological fluids, may provide metabolic signals indicative of food intake. Samples can be analysed through numerous analytical platforms, followed by multivariate data analysis. In humans, metabolomics has been applied successfully in pharmacology, toxicology and medical screening, but nutritional metabolomics is still in its infancy. Biomarkers of a small number of specific foods and nutrients have been developed successfully but less targeted and more high-throughput methods, that do not need prior knowledge of which signals might be discriminatory, and which may allow a more global characterisation of dietary intake, remain to be tested. A proof a principle project (the MEDE Study) is currently underway in our laboratories to test the hypothesis that high-throughput, non-targeted metabolite fingerprinting using flow injection electrospray mass spectrometry can be applied to human biofluids (blood and urine) to characterise dietary exposure in humans.
Published:
2009-06
Title:
Origins of dental crowding and malocclusions: an anthropological perspective
Authors:
Rose, Jerome C.; Roblee, Richard D.
Abstract:
The study of ancient Egyptian skeletons from Amarna, Egypt reveals extensive tooth wear but very little dental crowding, unlike in modern Americans. In the early 20th century, Percy Raymond Begg focused his research on extreme tooth wear coincident with traditional diets to justify teeth removal during orthodontic treatment. Anthropologists studying skeletons that were excavated along the Nile Valley in Egypt and the Sudan have demonstrated reductions in tooth size and changes in the face, including decreased robustness associated with the development of agriculture, but without any increase in the frequency of dental crowding and malocclusion. For thousands of years, facial and dental reduction stayed in step, more or less. These analyses suggest it was not the reduction in tooth wear that increased crowding and malocclusion, but rather the tremendous reduction in the forces of mastication, which produced this extreme tooth wear and the subsequent reduced jaw involvement. Thus, as modern food preparation techniques spread throughout the world during the 19th century, so did dental crowding. This research provides support for the development of orthodontic therapies that increase jaw dimensions rather than the use of tooth removal to relieve crowding.
Published:
2009-06
Title:
The PI3-K/AKT-pathway and radiation resistance mechanisms in non-small cell lung cancer
Authors:
Schuurbiers, Olga C. J.; Kaanders, Johannes H. A. M.; van der Heijden, Henricus F. M.; Dekhuijzen, Richard P. N.; Oyen, Wim J. G.; Bussink, Johan
Abstract:
The phosphatidylinositol-3-kinase (PI3-K)/protein kinase B (AKT) pathway is associated with all three major radiation resistance mechanisms: intrinsic radiosensitivity, tumor cell proliferation, and hypoxia. In cell signaling cascades, the PI3-K/AKT signaling pathway is a key regulator of normal and cancerous growth and cell fate decisions by processes such as proliferation, invasion, apoptosis, and induction of hypoxia-related proteins. Activation of this pathway can be the result of stimulation of receptor tyrosine kinases such as epidermal growth factor receptor or vascular endothelial growth factor receptor or from mutations or amplification of PI3-K or AKT itself which are frequently found in non-small cell lung cancer (NSCLC). Furthermore, several treatment modalities such as radiotherapy can stimulate this survival pathway. Monitoring and manipulation of this signal transduction pathway may have important implications for the management of NSCLC. Strong and independent associations were found between expression of activated AKT (pAKT) and treatment outcome in clinical trials. Direct targeting and inhibition of this pathway may increase radiosensitivity by antagonizing the radiation induced cellular defense mechanisms especially in tumors that have activated the PI3-K/AKT cascade. To successfully implement these treatments in daily practice, there is a need for molecular predictors of sensitivity to inhibitors of PI3-K/AKT activation. In conclusion, the PI3-K/AKT pathway plays a crucial role in cellular defense mechanisms. Therefore, quantification of the activation status is a potential parameter for predicting treatment outcome. More importantly, specific targeting of this pathway in combination with radiotherapy or chemotherapy may enhance tumor control in NSCLC by antagonizing cellular defense in response to treatment.
Published:
2009-06
Title:
[ADHD and attachment processes: are they related?]
Authors:
Franc, N.; Maury, M.; Purper-Ouakil, D.
Abstract:
Attention-deficit/hyperactivity disorder (ADHD) is defined on the basis of developmentally inappropriate inattention, motor activity and impulsivity that emerges early in development and causes impairment in social and academic functioning. ADHD is described as a multifactorial disease, with a well studied genetic vulnerability, and early environmental factors also playing an important role in the development and course of the disorder. Current aetiological models emphasize interaction between genes and environment. The concept of attachment, as proposed by John Bowlby, reflects quality of early interactions, and should therefore be considered as an early developmental factor. First, clinical findings emphasize similitude between both disorders; emotional dysregulation is an important feature in reactive attachment disorder as well as in ADHD. Emotion regulation is highly related to attachment security in young children and could play a part in the development of early attention processes. Moreover, difficult temperament is associated with higher risk for ADHD on the one hand, and can disturb the process of attachment on the other. Parental caregiving - including maternal sensitivity, positive parenting practices - is a main factor involved in the development of attachment, and has shown to be associated with better outcomes in ADHD children, especially with less oppositional/conduct disorders. Second, the aim of our review is to present clinical studies that have looked for a link between ADHD and attachment: the type of attachment could play a part in the course of the disorder: insecure and disorganised attachment types tend to be associated with a higher risk of externalised behaviors in children. For ADHD, this effect seems to be weaker than for other externalised disorders, and has been shown only in populations of at-risk children. Clinical studies also raise the question of possible links between reactive attachment disorder and ADHD. In children suffering severe early deprivon such as institution-rearing, inattention/hyperactivity symptoms were shown to be high, but these findings may not be valid in less severely deprived children. Third, another link could depend on a common vulnerability for ADHD and attachment disorder. Some perinatal factors, such as smoking during pregnancy or prematurity, have been shown to increase the risk of hyperactive symptoms in children. These variables may also be associated with a higher risk of impaired early interactions. Recent animal studies have raised interest in the role of prenatal stress in the emotional and behavioral development of the offspring, particularly as regards vulnerability to stress. Epigenetic mechanisms may be involved in durable alterations of the hypothalamo-pituitary-adrenergic axis. Preliminary findings in humans show that prenatal stress or maternal depression may also influence the development of the child. The understanding of the relationship between attachment and ADHD may help to better target prevention and intervention efforts. As the perinatal period seems to be particularly involved in both ADHD and attachment disorders, early guidance and possibly prenatal interventions should be developed and assessed for mothers and caregivers with risk-factors.
Published:
2009-06
Title:
A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial
Authors:
Barnard, Neal D.; Cohen, Joshua; Jenkins, David J. A.; Turner-McGrievy, Gabrielle; Gloede, Lise; Green, Amber; Ferdowsian, Hope
Abstract:
BACKGROUND: Low-fat vegetarian and vegan diets are associated with weight loss, increased insulin sensitivity, and improved cardiovascular health. OBJECTIVE: We compared the effects of a low-fat vegan diet and conventional diabetes diet recommendations on glycemia, weight, and plasma lipids. DESIGN: Free-living individuals with type 2 diabetes were randomly assigned to a low-fat vegan diet (n = 49) or a diet following 2003 American Diabetes Association guidelines (conventional, n = 50) for 74 wk. Glycated hemoglobin (Hb A(1c)) and plasma lipids were assessed at weeks 0, 11, 22, 35, 48, 61, and 74. Weight was measured at weeks 0, 22, and 74. RESULTS: Weight loss was significant within each diet group but not significantly different between groups (-4.4 kg in the vegan group and -3.0 kg in the conventional diet group, P = 0.25) and related significantly to Hb A(1c) changes (r = 0.50, P = 0.001). Hb A(1c) changes from baseline to 74 wk or last available values were -0.34 and -0.14 for vegan and conventional diets, respectively (P = 0.43). Hb A(1c) changes from baseline to last available value or last value before any medication adjustment were -0.40 and 0.01 for vegan and conventional diets, respectively (P = 0.03). In analyses before alterations in lipid-lowering medications, total cholesterol decreased by 20.4 and 6.8 mg/dL in the vegan and conventional diet groups, respectively (P = 0.01); LDL cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan and conventional groups, respectively (P = 0.03). CONCLUSIONS: Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations. Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established. This trial was registered at clinicaltrials.gov as NCT00276939.
Published:
2009-05
Title:
Adults with type 1 diabetes eat a high-fat atherogenic diet that is associated with coronary artery calcium
Authors:
Snell-Bergeon, J. K.; Chartier-Logan, C.; Maahs, D. M.; Ogden, L. G.; Hokanson, J. E.; Kinney, G. L.; Eckel, R. H.; Ehrlich, J.; Rewers, M.
Abstract:
CONCLUSIONS/INTERPRETATION: Adults with type 1 diabetes reported consuming higher than recommended levels of fat and saturated fat. High fat intake was associated with increased CHD risk factors, worse glycaemic control and CAC. An atherogenic diet may contribute to the risk of CHD in adults with type 1 diabetes.
Published:
2009-05
Title:
Best practice updates for pediatric/adolescent weight loss surgery
Authors:
Pratt, Janey S A; Lenders, Carine M; Dionne, Emily A; Hoppin, Alison G; Hsu, George L K; Inge, Thomas H; Lawlor, David F; Marino, Margaret F; Meyers, Alan F; Rosenblum, Jennifer L; Sanchez, Vivian M
Abstract:
The objective of this study is to update evidence-based best practice guidelines for pediatric/adolescent weight loss surgery (WLS). We performed a systematic search of English-language literature on WLS and pediatric, adolescent, gastric bypass, laparoscopic gastric banding, and extreme obesity published between April 2004 and May 2007 in PubMed, MEDLINE, and the Cochrane Library. Keywords were used to narrow the search for a selective review of abstracts, retrieval of full articles, and grading of evidence according to systems used in established evidence-based models. In light of evidence on the natural history of obesity and on outcomes of WLS in adolescents, guidelines for surgical treatment of obesity in this age group need to be updated. We recommend modification of selection criteria to include adolescents with BMI >or= 35 and specific obesity-related comorbidities for which there is clear evidence of important short-term morbidity (i.e., type 2 diabetes, severe steatohepatitis, pseudotumor cerebri, and moderate-to-severe obstructive sleep apnea). In addition, WLS should be considered for adolescents with extreme obesity (BMI >or= 40) and other comorbidities associated with long-term risks. We identified >1,085 papers; 186 of the most relevant were reviewed in detail. Regular updates of evidence-based recommendations for best practices in pediatric/adolescent WLS are required to address advances in technology and the growing evidence base in pediatric WLS. Key considerations in patient safety include carefully designed criteria for patient selection, multidisciplinary evaluation, choice of appropriate procedure, thorough screening and management of comorbidities, optimization of long-term compliance, and age-appropriate fully informed consent.
Published:
2009-05
Title:
Consequences of a plant-based diet with low dairy consumption on intake of bone-relevant nutrients
Authors:
Merrill, Ray M.; Aldana, Steven G.
Abstract:
OBJECTIVE: This study examines the extent to which a plant-based dietary intervention that discourages consumption of dairy products and meat influences bone-relevant nutrients. METHODS: A randomized controlled study design was used to evaluate the Coronary Health Improvement Project. The Project is a heart disease prevention intervention administered in an intensive 40-hour educational course delivered over a 4-week period. Participants were evaluated at baseline, 6 weeks, and 6 months. RESULTS: After 6 weeks, participants in the intervention group compared with the control group experienced significant increases in magnesium and daily intake of fruit, vegetables, and grains but significant decreases in dairy servings per day and calcium and vitamin D from food. After 6 months, those in the intervention group showed significant increases in daily intake of fruit, vegetables, and grains and significant decreases in dairy servings per day, daily meat consumption, and protein, phosphorous, calcium, total calcium, and vitamin D from food. Serum calcium levels are the primary determinant of parathyroid hormone (PTH) release, and within 6 weeks, the intervention group's PTH levels were elevated from baseline and significantly different from the control group's PTH levels. At 6 months, urinary type I collagen N-telopeptide (NTx) levels were significantly greater in the intervention group compared with the control group. CONCLUSIONS: The Coronary Health Improvement Project increases the intake of important food items but decreases calcium and vitamin D consumption. There is also some evidence of an increase in NTx biomarkers, consistent with increased bone resorption.
Published:
2009-05
Title:
Consequences of a plant-based diet with low dairy consumption on intake of bone-relevant nutrients
Authors:
Merrill RM; Aldana SG
Abstract:
OBJECTIVE: This study examines the extent to which a plant-based dietary intervention that discourages consumption of dairy products and meat influences bone-relevant nutrients. METHODS: A randomized controlled study design was used to evaluate the Coronary Health Improvement Project. The Project is a heart disease prevention intervention administered in an intensive 40-hour educational course delivered over a 4-week period. Participants were evaluated at baseline, 6 weeks, and 6 months. RESULTS: After 6 weeks, participants in the intervention group compared with the control group experienced significant increases in magnesium and daily intake of fruit, vegetables, and grains but significant decreases in dairy servings per day and calcium and vitamin D from food. After 6 months, those in the intervention group showed significant increases in daily intake of fruit, vegetables, and grains and significant decreases in dairy servings per day, daily meat consumption, and protein, phosphorous, calcium, total calcium, and vitamin D from food. Serum calcium levels are the primary determinant of parathyroid hormone (PTH) release, and within 6 weeks, the intervention group's PTH levels were elevated from baseline and significantly different from the control group's PTH levels. At 6 months, urinary type I collagen N-telopeptide (NTx) levels were significantly greater in the intervention group compared with the control group. CONCLUSIONS: The Coronary Health Improvement Project increases the intake of important food items but decreases calcium and vitamin D consumption. There is also some evidence of an increase in NTx biomarkers, consistent with increased bone resorption.
Published:
2009-05
Title:
Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans
Authors:
Stanhope, Kimber L.; Schwarz, Jean Marc; Keim, Nancy L.; Griffen, Steven C.; Bremer, Andrew A.; Graham, James L.; Hatcher, Bonnie; Cox, Chad L.; Dyachenko, Artem; Zhang, Wei; McGahan, John P.; Seibert, Anthony; Krauss, Ronald M.; Chiu, Sally; Schaefer, Ernst J.; Ai, Masumi; Otokozawa, Seiko; Nakajima, Katsuyuki; Nakano, Takamitsu; Beysen, Carine; Hellerstein, Marc K.; Berglund, Lars; Havel, Peter J.
Abstract:
Studies in animals have documented that, compared with glucose, dietary fructose induces dyslipidemia and insulin resistance. To assess the relative effects of these dietary sugars during sustained consumption in humans, overweight and obese subjects consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Although both groups exhibited similar weight gain during the intervention, visceral adipose volume was significantly increased only in subjects consuming fructose. Fasting plasma triglyceride concentrations increased by approximately 10% during 10 weeks of glucose consumption but not after fructose consumption. In contrast, hepatic de novo lipogenesis (DNL) and the 23-hour postprandial triglyceride AUC were increased specifically during fructose consumption. Similarly, markers of altered lipid metabolism and lipoprotein remodeling, including fasting apoB, LDL, small dense LDL, oxidized LDL, and postprandial concentrations of remnant-like particle-triglyceride and -cholesterol significantly increased during fructose but not glucose consumption. In addition, fasting plasma glucose and insulin levels increased and insulin sensitivity decreased in subjects consuming fructose but not in those consuming glucose. These data suggest that dietary fructose specifically increases DNL, promotes dyslipidemia, decreases insulin sensitivity, and increases visceral adiposity in overweight/obese adults.
Published:
2009-05
Title:
Dietary fat and carbohydrates differentially alter insulin sensitivity during caloric restriction
Authors:
Kirk, Erik; Reeds, Dominic N.; Finck, Brian N.; Mayurranjan, S. Mitra; Mayurranjan, Mitra S.; Patterson, Bruce W.; Klein, Samuel
Abstract:
BACKGROUND & AIMS: We determined the effects of acute and chronic calorie restriction with either a low-fat, high-carbohydrate (HC) diet or a low-carbohydrate (LC) diet on hepatic and skeletal muscle insulin sensitivity. METHODS: Twenty-two obese subjects (body mass index, 36.5 +/- 0.8 kg/m2) were randomized to an HC (>180 g/day) or LC (<50 g/day) energy-deficit diet. A euglycemic-hyperinsulinemic clamp, muscle biopsy specimens, and magnetic resonance spectroscopy were used to determine insulin action, cellular insulin signaling, and intrahepatic triglyceride (IHTG) content before, after 48 hours, and after approximately 11 weeks (7% weight loss) of diet therapy. RESULTS: At 48 hours, IHTG content decreased more in the LC than the HC diet group (29.6% +/- 4.8% vs 8.9% +/- 1.4%; P < .05) but was similar in both groups after 7% weight loss (LC diet, 38.0% +/- 4.5%; HC diet, 44.5% +/- 13.5%). Basal glucose production rate decreased more in the LC than the HC diet group at 48 hours (23.4% +/- 2.2% vs 7.2% +/- 1.4%; P < .05) and after 7% weight loss (20.0% +/- 2.4% vs 7.9% +/- 1.2%; P < .05). Insulin-mediated glucose uptake did not change at 48 hours but increased similarly in both groups after 7% weight loss (48.4% +/- 14.3%; P < .05). In both groups, insulin-stimulated phosphorylation of c-Jun-N-terminal kinase decreased by 29% +/- 13% and phosphorylation of Akt and insulin receptor substrate 1 increased by 35% +/- 9% and 36% +/- 9%, respectively, after 7% weight loss (all P
Published:
2009-05
Title:
Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel
Authors:
Jacobs, David R.; Haddad, Ella H.; Lanou, Amy Joy; Messina, Mark J.
Abstract:
We summarize conclusions drawn from a panel discussion at the "Fifth International Congress on Vegetarian Nutrition" about the roles of and emphasis on food, plant food, and vegetarianism in current and future US dietary guidelines. The most general recommendation of the panel was that future dietary guidelines, following the lead of the 2005 Dietary Guidelines Advisory Committee, should emphasize food-based recommendations and thinking to the full extent that evidence allows. Although nutrient-based thinking and Dietary Reference Intakes (DRIs) may help ensure an adequate diet in the sense that deficiency states are avoided, the emphasis on DRIs may not capture many important nutritional issues and may inhibit a focus on foods. More generally, in the context of the conference on vegetarian nutrition, this report focuses on the history and structure of the Dietary Guidelines Advisory Committee, on various plant food-oriented recommendations that are supported by literature evidence, and on mechanisms for participating in the process of forming dietary guidelines. Among recommendations that likely would improve health and the environment, some are oriented toward increased plant food consumption and some toward vegetarianism. The literature on health effects of individual foods and whole lifestyle diets is insufficient and justifies a call for future food-oriented research, including expanding the evidence base for plant-based and vegetarian diets. The Dietary Guidelines Advisory Committee's role should be carried forward to creation of a publicly accessible icon (eg, the current pyramid) and related materials to ensure that the science base is fully translated for the public.
Published:
2009-05
Title:
Health effects of vegan diets
Authors:
Craig, Winston J.
Abstract:
Recently, vegetarian diets have experienced an increase in popularity. A vegetarian diet is associated with many health benefits because of its higher content of fiber, folic acid, vitamins C and E, potassium, magnesium, and many phytochemicals and a fat content that is more unsaturated. Compared with other vegetarian diets, vegan diets tend to contain less saturated fat and cholesterol and more dietary fiber. Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart disease. However, eliminating all animal products from the diet increases the risk of certain nutritional deficiencies. Micronutrients of special concern for the vegan include vitamins B-12 and D, calcium, and long-chain n-3 (omega-3) fatty acids. Unless vegans regularly consume foods that are fortified with these nutrients, appropriate supplements should be consumed. In some cases, iron and zinc status of vegans may also be of concern because of the limited bioavailability of these minerals.
Published:
2009-05
Title:
Potential contributions of food consumption patterns to climate change
Authors:
Carlsson-Kanyama, Annika; González, Alejandro D.
Abstract:
Anthropogenic warming is caused mainly by emissions of greenhouse gases (GHGs), such as carbon dioxide, methane, and nitrous oxide, with agriculture as a main contributor for the latter 2 gases. Other parts of the food system contribute carbon dioxide emissions that emanate from the use of fossil fuels in transportation, processing, retailing, storage, and preparation. Food items differ substantially when GHG emissions are calculated from farm to table. A recent study of approximately 20 items sold in Sweden showed a span of 0.4 to 30 kg CO(2) equivalents/kg edible product. For protein-rich food, such as legumes, meat, fish, cheese, and eggs, the difference is a factor of 30 with the lowest emissions per kilogram for legumes, poultry, and eggs and the highest for beef, cheese, and pork. Large emissions for ruminants are explained mainly by methane emissions from enteric fermentation. For vegetables and fruits, emissions usually are </=2.5 kg CO(2) equivalents/kg product, even if there is a high degree of processing and substantial transportation. Products transported by plane are an exception because emissions may be as large as for certain meats. Emissions from foods rich in carbohydrates, such as potatoes, pasta, and wheat, are
Published:
2009-05
Title:
Should dairy be recommended as part of a healthy vegetarian diet? Counterpoint
Authors:
Lanou, Amy Joy
Abstract:
Although cow milk has been widely recommended in Western countries as necessary for growth and bone health, evidence collected during the past 20 y shows the need to rethink strategies for building and maintaining strong bones. Osteoporotic bone fracture rates are highest in countries that consume the most dairy, calcium, and animal protein. Most studies of fracture risk provide little or no evidence that milk or other dairy products benefit bone. Accumulating evidence shows that consuming milk or dairy products may contribute to the risk of prostate and ovarian cancers, autoimmune diseases, and some childhood ailments. Because milk is not necessary for humans after weaning and the nutrients it contains are readily available in foods without animal protein, saturated fat, and cholesterol, vegetarians may have healthier outcomes for chronic disease if they limit or avoid milk and other dairy products. Bones are better served by attending to calcium balance and focusing efforts on increasing fruit and vegetable intakes, limiting animal protein, exercising regularly, getting adequate sunshine or supplemental vitamin D, and getting approximately 500 mg Ca/d from plant sources. Therefore, dairy products should not be recommended in a healthy vegetarian diet.
Published:
2009-05
Title:
Type of vegetarian diet, body weight, and prevalence of type 2 diabetes
Authors:
Tonstad, Serena; Butler, Terry; Yan, Ru; Fraser, Gary E.
Abstract:
OBJECTIVE: We assessed the prevalence of type 2 diabetes in people following different types of vegetarian diets compared with that in nonvegetarians. RESEARCH DESIGN AND METHODS: The study population comprised 22,434 men and 38,469 women who participated in the Adventist Health Study-2 conducted in 2002-2006. We collected self-reported demographic, anthropometric, medical history, and lifestyle data from Seventh-Day Adventist church members across North America. The type of vegetarian diet was categorized based on a food-frequency questionnaire. We calculated odds ratios (ORs) and 95% CIs using multivariate-adjusted logistic regression. RESULTS: Mean BMI was lowest in vegans (23.6 kg/m(2)) and incrementally higher in lacto-ovo vegetarians (25.7 kg/m(2)), pesco-vegetarians (26.3 kg/m(2)), semi-vegetarians (27.3 kg/m(2)), and nonvegetarians (28.8 kg/m(2)). Prevalence of type 2 diabetes increased from 2.9% in vegans to 7.6% in nonvegetarians; the prevalence was intermediate in participants consuming lacto-ovo (3.2%), pesco (4.8%), or semi-vegetarian (6.1%) diets. After adjustment for age, sex, ethnicity, education, income, physical activity, television watching, sleep habits, alcohol use, and BMI, vegans (OR 0.51 [95% CI 0.40-0.66]), lacto-ovo vegetarians (0.54 [0.49-0.60]), pesco-vegetarians (0.70 [0.61-0.80]), and semi-vegetarians (0.76 [0.65-0.90]) had a lower risk of type 2 diabetes than nonvegetarians. CONCLUSIONS: The 5-unit BMI difference between vegans and nonvegetarians indicates a substantial potential of vegetarianism to protect against obesity. Increased conformity to vegetarian diets protected against risk of type 2 diabetes after lifestyle characteristics and BMI were taken into account. Pesco- and semi-vegetarian diets afforded intermediate protection.
Published:
2009-05
Title:
Vegetarian and vegan diets in type 2 diabetes management
Authors:
Barnard, Neal D.; Katcher, Heather I.; Jenkins, David J. A.; Cohen, Joshua; Turner-McGrievy, Gabrielle
Abstract:
Vegetarian and vegan diets offer significant benefits for diabetes management. In observational studies, individuals following vegetarian diets are about half as likely to develop diabetes, compared with non-vegetarians. In clinical trials in individuals with type 2 diabetes, low-fat vegan diets improve glycemic control to a greater extent than conventional diabetes diets. Although this effect is primarily attributable to greater weight loss, evidence also suggests that reduced intake of saturated fats and high-glycemic-index foods, increased intake of dietary fiber and vegetable protein, reduced intramyocellular lipid concentrations, and decreased iron stores mediate the influence of plant-based diets on glycemia. Vegetarian and vegan diets also improve plasma lipid concentrations and have been shown to reverse atherosclerosis progression. In clinical studies, the reported acceptability of vegetarian and vegan diets is comparable to other therapeutic regimens. The presently available literature indicates that vegetarian and vegan diets present potential advantages for the management of type 2 diabetes.
Published:
2009-05
Title:
Vegetarian diets: what do we know of their effects on common chronic diseases?
Authors:
Fraser, Gary E.
Abstract:
A number of studies have evaluated the health of vegetarians. Others have studied the health effects of foods that are preferred or avoided by vegetarians. The purpose of this review is to look critically at the evidence on the health effects of vegetarian diets and to seek possible explanations where results appear to conflict. There is convincing evidence that vegetarians have lower rates of coronary heart disease, largely explained by low LDL cholesterol, probable lower rates of hypertension and diabetes mellitus, and lower prevalence of obesity. Overall, their cancer rates appear to be moderately lower than others living in the same communities, and life expectancy appears to be greater. However, results for specific cancers are much less convincing and require more study. There is evidence that risk of colorectal cancer is lower in vegetarians and in those who eat less meat; however, results from British vegetarians presently disagree, and this needs explanation. It is probable that using the label "vegetarian" as a dietary category is too broad and that our understanding will be served well by dividing vegetarians into more descriptive subtypes. Although vegetarian diets are healthful and are associated with lower risk of several chronic diseases, different types of vegetarians may not experience the same effects on health.
Published:
2009-05
Title:
[Megaloblastic-vitamin B12 Deficiency Anemia in Childhood]
Authors:
Zg, Mtvarelidze; An, Kvezereli-Kopadze; Ma, Kvezereli-Kopadze
Abstract:
Megaloblastic anemias are basically caused by vitamin B(12) and/or folic acid deficiency. Childhood vitamin B(12) deficiency is extremely rare. There are congenital and acquired forms of vitamin B(12)-deficiency anemias. The article captures findings of 10 year observation of 3 patients with Imerslu …
Published:
2009-05
Title:
A new Japanese vegetarian food guide
Authors:
Nakamoto, Keiko; Arashi, Masako; Noparatanawong, Somboon; Kamohara, Seika; Radak, Tim; Tuchida, Mitsuru; Miyazaki, Kyoichi; Watanabe, Sanae; Kudo, Hideki; Tanaka, Akira
Abstract:
Vegetarianism continues to gain popularity in Japan and the Westernized world, in part from decades of science supporting the health advantages of properly planned vegetarian-based diets. Although there are Asian nutritional tools, one specific to a Japanese vegetarian diet is lacking. Thus, the Japanese vegetarian food guide (JVFG) was developed and based in part on the American Dietetic Association position paper for vegetarian diets and the Japanese Food Guide Spinning Top. The JVFG was developed by collecting dietary information from 3 different institutes in Japan that specialize in regularly offering vegetarian meals. The JVFG was divided into 6 groups with respective recommended servings: vegetables (7.5), grains (4.5), protein foods (4), milk (3), fruits (2), and fats, sugar, and seasonings (
Published:
2009-04
Title:
Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet
Authors:
Volek, Jeff S.; Phinney, Stephen D.; Forsythe, Cassandra E.; Quann, Erin E.; Wood, Richard J.; Puglisi, Michael J.; Kraemer, William J.; Bibus, Doug M.; Fernandez, Maria Luz; Feinman, Richard D.
Abstract:
We recently proposed that the biological markers improved by carbohydrate restriction were precisely those that define the metabolic syndrome (MetS), and that the common thread was regulation of insulin as a control element. We specifically tested the idea with a 12-week study comparing two hypocaloric diets (approximately 1,500 kcal): a carbohydrate-restricted diet (CRD) (%carbohydrate:fat:protein = 12:59:28) and a low-fat diet (LFD) (56:24:20) in 40 subjects with atherogenic dyslipidemia. Both interventions led to improvements in several metabolic markers, but subjects following the CRD had consistently reduced glucose (-12%) and insulin (-50%) concentrations, insulin sensitivity (-55%), weight loss (-10%), decreased adiposity (-14%), and more favorable triacylglycerol (TAG) (-51%), HDL-C (13%) and total cholesterol/HDL-C ratio (-14%) responses. In addition to these markers for MetS, the CRD subjects showed more favorable responses to alternative indicators of cardiovascular risk: postprandial lipemia (-47%), the Apo B/Apo A-1 ratio (-16%), and LDL particle distribution. Despite a threefold higher intake of dietary saturated fat during the CRD, saturated fatty acids in TAG and cholesteryl ester were significantly decreased, as was palmitoleic acid (16:1n-7), an endogenous marker of lipogenesis, compared to subjects consuming the LFD. Serum retinol binding protein 4 has been linked to insulin-resistant states, and only the CRD decreased this marker (-20%). The findings provide support for unifying the disparate markers of MetS and for the proposed intimate connection with dietary carbohydrate. The results support the use of dietary carbohydrate restriction as an effective approach to improve features of MetS and cardiovascular risk.
Published:
2009-04
Title:
Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet
Authors:
Volek, Jeff S.; Phinney, Stephen D.; Forsythe, Cassandra E.; Quann, Erin E.; Wood, Richard J.; Puglisi, Michael J.; Kraemer, William J.; Bibus, Doug M.; Fernandez, Maria Luz; Feinman, Richard D.
Abstract:
We recently proposed that the biological markers improved by carbohydrate restriction were precisely those that define the metabolic syndrome (MetS), and that the common thread was regulation of insulin as a control element. We specifically tested the idea with a 12-week study comparing two hypocaloric diets (approximately 1,500 kcal): a carbohydrate-restricted diet (CRD) (%carbohydrate:fat:protein = 12:59:28) and a low-fat diet (LFD) (56:24:20) in 40 subjects with atherogenic dyslipidemia. Both interventions led to improvements in several metabolic markers, but subjects following the CRD had consistently reduced glucose (-12%) and insulin (-50%) concentrations, insulin sensitivity (-55%), weight loss (-10%), decreased adiposity (-14%), and more favorable triacylglycerol (TAG) (-51%), HDL-C (13%) and total cholesterol/HDL-C ratio (-14%) responses. In addition to these markers for MetS, the CRD subjects showed more favorable responses to alternative indicators of cardiovascular risk: postprandial lipemia (-47%), the Apo B/Apo A-1 ratio (-16%), and LDL particle distribution. Despite a threefold higher intake of dietary saturated fat during the CRD, saturated fatty acids in TAG and cholesteryl ester were significantly decreased, as was palmitoleic acid (16:1n-7), an endogenous marker of lipogenesis, compared to subjects consuming the LFD. Serum retinol binding protein 4 has been linked to insulin-resistant states, and only the CRD decreased this marker (-20%). The findings provide support for unifying the disparate markers of MetS and for the proposed intimate connection with dietary carbohydrate. The results support the use of dietary carbohydrate restriction as an effective approach to improve features of MetS and cardiovascular risk.
Published:
2009-04
Title:
Consensus statement on the use of gonadotropin-releasing hormone analogs in children
Authors:
Carel, Jean-Claude; Eugster, Erica A; Rogol, Alan; Ghizzoni, Lucia; Palmert, Mark R; Antoniazzi, Franco; Berenbaum, Sheri; Bourguignon, Jean-Pierre; Chrousos, George P; Coste, Joël; Deal, Sheri; de Vries, Liat; Foster, Carol; Heger, Sabine; Holland, Jack; Jahnukainen, Kirsi; Juul, Anders; Kaplowitz, Paul; Lahlou, Najiba; Lee, Mary M; Lee, Peter; Merke, Deborah P; Neely, E Kirk; Oostdijk, Wilma; Phillip, Moshe; Rosenfield, Robert L; Shulman, Dorothy; Styne, Dennis; Tauber, Maïthé; Wit, Jan M
Abstract:
OBJECTIVE: Gonadotropin-releasing hormone analogs revolutionized the treatment of central precocious puberty. However, questions remain regarding their optimal use in central precocious puberty and other conditions. The Lawson Wilkins Pediatric Endocrine Society and the European Society for Pediatric Endocrinology convened a consensus conference to review the clinical use of gonadotropin-releasing hormone analogs in children and adolescents. PARTICIPANTS: When selecting the 30 participants, consideration was given to equal representation from North America (United States and Canada) and Europe, an equal male/female ratio, and a balanced spectrum of professional seniority and expertise. EVIDENCE: Preference was given to articles written in English with long-term outcome data. The US Public Health grading system was used to grade evidence and rate the strength of conclusions. When evidence was insufficient, conclusions were based on expert opinion. CONSENSUS PROCESS: Participants were put into working groups with assigned topics and specific questions. Written materials were prepared and distributed before the conference, revised on the basis of input during the meeting, and presented to the full assembly for final review. If consensus could not be reached, conclusions were based on majority vote. All participants approved the final statement. CONCLUSIONS: The efficacy of gonadotropin-releasing hormone analogs in increasing adult height is undisputed only in early-onset (girls
Published:
2009-04
Title:
Dietary sources of vitamin B-12 and their association with plasma vitamin B-12 concentrations in the general population: the Hordaland Homocysteine Study
Authors:
Vogiatzoglou, Anna; Smith, A. David; Nurk, Eha; Berstad, Paula; Drevon, Christian A.; Ueland, Per M.; Vollset, Stein E.; Tell, Grethe S.; Refsum, Helga
Abstract:
BACKGROUND: Limited information is available on the association between vitamin B-12 status and intake from different dietary sources. OBJECTIVE: We investigated the relation of dietary intake of different food items with plasma vitamin B-12 concentrations in the general population. DESIGN: A cross-sectional, population-based study of 5937 subjects in 2 age groups (47-49 and 71-74 y) from the Hordaland Homocysteine Study in Norway was conducted by using a food-frequency questionnaire and measurements of plasma vitamin B-12 concentrations. RESULTS: A significant difference in plasma vitamin B-12 concentrations was observed with increasing total vitamin B-12 intake. A plateau was reached at an intake of approximately 10 microg/d. Plasma vitamin B-12 was associated with intakes of increasing amounts of vitamin B-12 from dairy products or fish (P for trend <0.001 for both) but not with intakes of vitamin B-12 from meat or eggs. For the same content of vitamin B-12, intake from dairy products led to the greatest increase in plasma vitamin B-12. Total intake of vitamin B-12, particularly from milk and fish, decreased the risk of vitamin B-12 concentrations <200 pmol/L and impaired vitamin B-12 function (vitamin B-12 0.27 micromol/L) in the total group and in 71-74-y-old subjects. CONCLUSIONS: Dietary intake of dairy products and fish are significant contributors to plasma vitamin B-12 and may improve plasma vitamin B-12 status. Vitamin B-12 appears to be more bioavailable from dairy products; guidelines for improving vitamin B-12 status should take this into consideration.
Published:
2009-04
Title:
Effects of two weight-loss diets on health-related quality of life
Authors:
Yancy, William S.; Almirall, Daniel; Maciejewski, Matthew L.; Kolotkin, Ronette L.; McDuffie, Jennifer R.; Westman, Eric C.
Abstract:
PURPOSE: To compare the effects of two diets on health-related quality of life (HRQOL). METHODS: Overweight volunteers (n = 119) were randomized to follow a low-carbohydrate, ketogenic diet (LCKD) or a low-fat diet (LFD) for 24 weeks. HRQOL was measured every 4 weeks using the Short Form-36 and analyzed using linear mixed-effects models. RESULTS: The mean age was 45 years and mean baseline body mass index was 34 kg/m(2); 76% were women. At 24 weeks, five subscales (Physical Functioning, Role-Physical, General Health, Vitality, Social Functioning) and the Physical Component Summary score improved similarly in both diet groups. Bodily Pain improved in the LFD group only, whereas the Role-Emotional and Mental Health subscales and the Mental Component Summary (MCS) score improved in the LCKD group only. In comparison with the LFD group, the LCKD group had a statistically significant greater improvement in MCS score (3.1; 95%CI 0.2-6.0; effect size = 0.44) and a borderline significant greater improvement in the Mental Health subscale (5.0; 95%CI -0.3-10.4; effect size = 0.37). CONCLUSIONS: Mental aspects of HRQOL improved more in participants following an LCKD than an LFD, possibly resulting from the LCKD's composition, lack of explicit energy restriction, higher levels of satiety or metabolic effects.
Published:
2009-04
Title:
Excess thyroid hormone and carbohydrate metabolism
Authors:
Potenza, Matthew; Via, Michael A.; Yanagisawa, Robert T.
Abstract:
OBJECTIVE: To review the pertinent basic and clinical research describing the complex effects of excess thyroid hormone on carbohydrate metabolism. METHODS: We performed a MEDLINE search of the English-language literature using a combination of words (ie, "thyrotoxicosis and diabetes," "diabetic ketoacidosis and thyroid storm," "carbohydrate metabolism and hyperthyroid," "glucose homeostasis and thyrotoxicosis") to identify key articles addressing various aspects of the thyroid's influence on carbohydrate metabolism. RESULTS: Thyroid hormone affects glucose homeostasis via its actions on a variety of organs including increased hepatic glucose output, increased futile cycling of glucose degradation products between the skeletal muscle and the liver, decreased glycogen stores in the liver and skeletal muscle, altered oxidative and non-oxidative glucose metabolism, decreased active insulin output from the pancreas, and increased renal insulin clearance. Thyroid hormone also affects adipokines and adipose tissue, further predisposing the patient to ketosis. CONCLUSIONS: Thyrotoxicosis can alter carbohydrate metabolism in a type 2 diabetic patient to such an extent that diabetic ketoacidosis develops if untreated. Based on the current understanding of this relationship, all diabetic patients should be screened for thyroid dysfunction because correcting hyperthyroidism can profoundly affect glucose homeostasis. Similarly, patients presenting in diabetic ketoacidosis should undergo a thyroid function assessment.
Published:
2009-04
Title:
Ketogenic Diets: Evidence for Short- and Long-term Efficacy
Authors:
Kossoff, Eric H.; Rho, Jong M.
Abstract:
The use of dietary treatments for epilepsy (ketogenic, modified Atkins, and low glycemic index diets) has been in continuous use since 1921. These treatments have been well studied in the short term, with approximately half of children having at least a 50% reduction in seizures after 6 months. Approximately one third will attain \textgreater90% reduction in their seizures. Animal studies confirm these findings, with broad evidence demonstrating acute anticonvulsant effects of the diet. Furthermore, the diet appears to maintain its efficacy in humans when provided continuously for several years. Interestingly, benefits may be seen long term even when the diet is discontinued after only a few months of use, suggesting neuroprotective effects. This potential antiepileptogenic activity has been recently demonstrated in some animal studies as well. This review discusses the animal and human evidence for both short- and long-term benefits of dietary therapies. © 2009 The American Society for Experimental NeuroTherapeutics, Inc.
Published:
2009-04
Title:
Metabolic response to a ketogenic breakfast in the healthy elderly
Authors:
Freemantle, E.; Vandal, M.; Tremblay Mercier, J.; Plourde, M.; Poirier, J.; Cunnane, S. C.
Abstract:
OBJECTIVE: To determine whether the metabolism of glucose or ketones differs in the healthy elderly compared to young or middle-aged adults during mild, short-term ketosis induced by a ketogenic breakfast. DESIGN AND PARTICIPANTS: Healthy subjects in three age groups (23 +/- 1, 50 +/- 1 and 76 +/- 2 y old) were given a ketogenic meal and plasma beta -hydroxybutyrate, glucose, insulin, triacylglycerols, total cholesterol, non-esterified fatty acids and breath acetone were measured over the subsequent 6 h. Each subject completed the protocol twice in order to determine the oxidation of a tracer dose of both carbon-13 (13C) glucose and 13C-beta-hydroxybutyrate. The tracers were given separately in random order. Apolipoprotein E genotype was also determined in all subjects. RESULTS: Plasma glucose decreased and beta-hydroxybutyrate, acetone and insulin increased similarly over 6 h in all three groups after the ketogenic meal. There was no significant change in cholesterol, triacylglycerols or non-esterified fatty acids over the 6 h. 13C-glucose and 13C-beta-hydroxybutyrate oxidation peaked at 2-3 h postdose for all age groups. Cumulative 13C-glucose oxidation over 24 h was significantly higher in the elderly but only versus the middle-aged group. There was no difference in cumulative 13C-beta-hydroxybutyrate oxidation between the three groups. Apolipoprotein E (epsilon 4) was associated with elevated fasting cholesterol but was unrelated to the other plasma metabolites. CONCLUSION: Elderly people in relatively good health have a similar capacity to produce ketones and to oxidize 13C-beta-hydroxybutyrate as middle-aged or young adults, but oxidize 13C-glucose a little more rapidly than healthy middle-aged adults.
Published:
2009-04
Title:
Monitoring of pesticide residues in vegetarian diet
Authors:
Kumari, Beena; Kathpal, T. S.
Abstract:
Samples (28) of complete vegetarian diet consumed from morning till night i.e. tea, milk, breakfast, lunch, snacks, dinner, sweet dish etc. were collected from homes, hostels and hotels periodically from Hisar and analysed for detecting the residues of organochlorine, synthetic pyrethriod, organophosphate and carbamate insecticides. The estimation was carried out by using multi-residue analytical technique employing gas chromatograph (GC)-electron capture detector and GC-nitrogen phosphorous detector systems equipped with capillary columns. The whole diet sample was macerated in a mixer grinder and a representative sample in duplicate was analyzed for residues keeping the average daily diet of an adult to be 1,300 g. On comparing the data, it was found that actual daily intake (microgram/person/day) of lindane in two and endosulfan in four samples exceeded the acceptable daily intake. Residues of other pesticides in all the diet samples were lower than the acceptable daily intake (ADI) of the respective pesticides. The study concluded that although all the diet samples were found contaminated with one or the other pesticide, the actual daily intake of only a few pesticides was higher than their respective ADI. More extensive study covering other localities of Haryana has been suggested to know the overall scenario of contamination of vegetarian diet.
Published:
2009-04
Title:
Preliminary validation of the Yale Food Addiction Scale
Authors:
Gearhardt, Ashley N.; Corbin, William R.; Brownell, Kelly D.
Abstract:
The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p \textless 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation., $\backslash$n $\backslash$n $\backslash$n Key Points$\backslash$n $\backslash$n $\backslash$n $\backslash$n Compared with standard push-ups on the floor, suspended push-ups increase core muscle activation.$\backslash$n $\backslash$n $\backslash$n A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity.$\backslash$n $\backslash$n $\backslash$n More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation.$\backslash$n $\backslash$n $\backslash$n A suspended push-up is an effective method to achieve high muscle activity levels in the ABS.
Published:
2009-04
Title:
The effect of fruit in different forms on energy intake and satiety at a meal
Authors:
Flood-Obbagy, Julie E.; Rolls, Barbara J.
Abstract:
Consuming whole fruit reduces ratings of satiety more than fruit juice, but little is known about the effects of different forms of fruit on subsequent energy intake. This study tested how consuming preloads of apples in different forms prior to a meal (apple, applesauce, and apple juice with and without added fiber) influences satiety and energy intake at meal. Preloads were matched for weight, energy content, energy density, and ingestion rate. Once a week for 5 weeks, 58 adults consumed one of four preloads (266 g; 125 kcal [523 kJ]), or no preload (control), followed by a test meal consumed ad libitum 15 min later. Results showed that eating apple reduced lunch energy intake (preload+test meal) by 15% (187+/-36 kcal [782+/-151 kJ]) compared to control (papplesauce>both juices>control). Overall, whole apple increased satiety more than applesauce or apple juice. Adding naturally occurring levels of fiber to juice did not enhance satiety. These results suggest that solid fruit affects satiety more than pureed fruit or juice, and that eating fruit at the start of a meal can reduce energy intake.
Published:
2009-04
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