Lead, Diabetes, Hypertension, and Renal Function: The Normative Aging Study

In this prospective study, we examined changes in renal function during 6 years of follow-up in relation to baseline lead levels, diabetes, and hypertension among 448 middle-age and elderly men, a subsample of the Normative Aging Study. Lead levels were generally low at baseline, with mean blood lead, patella lead, and tibia lead values of 6.5 μg/dL, 32.4 μg/g, and 21.5 μg/g, respectively. Six percent and 26% of subjects had diabetes and hypertension at baseline, respectively. In multivariate-adjusted regression analyses, longitudinal increases in serum creatinine (SCr) were associated with higher baseline lead levels but these associations were not statistically significant. However, we observed significant interactions of blood lead and tibia lead with diabetes in predicting annual change in SCr. For example, increasing the tibia lead level from the midpoints of the lowest to the highest quartiles (9–34 μg/g) was associated with an increase in the rate of rise in SCr that was 17.6-fold greater in diabetics than in nondiabetics (1.08 mg/dL/10 years vs. 0.062 mg/dL/10 years; p < 0.01). We also observed significant interactions of blood lead and tibia lead with diabetes in relation to baseline SCr levels (tibia lead only) and follow-up SCr levels. A significant interaction of tibia lead with hypertensive status in predicting annual change in SCr was also observed. We conclude that longitudinal decline of renal function among middle-age and elderly individuals appears to depend on both long-term lead stores and circulating lead, with an effect that is most pronounced among diabetics and hypertensives, subjects who likely represent particularly susceptible groups

Cognitive deficits and magnetic resonance spectroscopy in adult monozygotic twins with lead poisoning.

Seventy-one-year-old identical twin brothers with chronic lead poisoning were identified from an occupational medicine clinic roster. Both were retired painters, but one brother (J.G.) primarily removed paint and had a history of higher chronic lead exposure. Patella and tibia bone lead concentrations measured by K-X-ray fluorescence in each brother were 5-10 times those of the general population and about 2.5 times higher in J.G. than in his brother (E.G.). Magnetic resonance spectroscopy (MRS) studies examined N-acetylaspartate:creatine ratios, a marker of neuronal density. Ratios were lower in J.G. than in his brother. Scores on neurocognitive tests that assess working memory/executive function were below expectation in both twins. Short-term memory function was dramatically worse in J.G. than in his brother. These results demonstrate some of the more subtle long-term neurologic effects of chronic lead poisoning in adults. In particular, they suggest the presence of frontal lobe dysfunction in both twins, but more dramatic hippocampal dysfunction in the brother with higher lead exposure. The MRS findings are consistent with the hypothesis that chronic lead exposure caused neuronal loss, which may contribute to the impairment in cognitive function. Although a causal relation cannot be inferred, the brothers were genetically identical, with similar life experiences. Although these results are promising, further study is necessary to determine whether MRS findings correlate both with markers of lead exposure and tests of cognitive function. Nevertheless, the results point to the potential utility of MRS in determining mechanisms of neurotoxicity not only for lead but also for other neurotoxicants as well

Association between hemochromatosis genotype and lead exposure among elderly men: the normative aging study.

Because body iron burden is inversely associated with lead absorption, genes associated with hemochromatosis may modify body lead burden. Our objective was to determine whether the C282Y and/or H63D hemochromatosis gene (HFE) is associated with body lead burden. Patella and tibia lead levels were measured by K X-ray fluorescence in subjects from the Normative Aging Study. DNA samples were genotyped for C282Y and H63D using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP). A series of multivariate linear regression models were constructed with bone or blood lead as dependent variables; age, smoking, and education as independent variables; and C282Y or H63D as independent risk factors and/or effect modifiers. Of 730 subjects, 94 (13%) carried the C282Y variant and 183 (25%) carried the H63D variant. In the crude analysis, mean tibia, patella, and blood lead levels were consistently lower in carriers of either HFE variant compared with levels in subjects with wild-type genotypes. In multivariate analyses that adjusted for age, smoking, and education, having an HFE variant allele was an independent predictor of significantly lower patella lead levels (p < 0.05). These data suggest that HFE variants have altered kinetics of lead accumulation after exposure. Among elderly men, subjects with HFE variants had lower patella lead levels. These effects may be mediated by alterations in lead toxicokinetics via iron metabolic pathways regulated by the HFE gene product and body iron stores

Levels of Lead in Breast Milk and Their Relation to Maternal Blood and Bone Lead Levels at One Month Postpartum.

Despite the many well-recognized benefits of breast-feeding for both mothers and infants, detectable levels of lead in breast milk have been documented in population studies of women with no current environmental or occupational exposures. Mobilization of maternal bone lead stores has been suggested as a potential endogenous source of lead in breast milk. We measured lead in breast milk to quantify the relation between maternal blood and bone lead levels and breast-feeding status (exclusive vs. partial) among 310 lactating women in Mexico City, Mexico, at 1 month postpartum. Umbilical cord and maternal blood samples were collected at delivery. Maternal breast milk, blood, and bone lead levels were obtained at 1 month postpartum. Levels of lead in breast milk ranged from 0.21 to 8.02 microg/L (ppb), with a geometric mean (GM) of 1.1 microg/L; blood lead ranged from 1.8 to 29.9 microg/dL (GM = 8.4 microg/dL); bone lead ranged from less than 1 to 67.2 microg/g bone mineral (patella) and from less than 1 to 76.6 microg/g bone mineral (tibia) at 1 month postpartum. Breast milk lead was significantly correlated with umbilical cord lead [Spearman correlation coefficient (r$_S$) = 0.36, p less than 0.0001] and maternal blood lead (r$_S$= 0.38, p less than 0.0001) at delivery and with maternal blood lead (r$_S$ = 0.42, p less than 0.0001) and patella lead (r$_S$= 0.15, p less than 0.01) at 1 month postpartum. Mother's age, years living in Mexico City, and use of lead-glazed ceramics, all predictive of cumulative lead exposure, were not significant predictors of breast milk lead levels. Adjusting for parity, daily dietary calcium intake (milligrams), infant weight change (grams), and breast-feeding status (exclusive or partial lactation), the estimated effect of an interquartile range (IQR) increase in blood lead (5.0 microg/dL) was associated with a 33% increase in breast milk lead [95% confidence interval (CI), 24 to 43%], whereas an IQR increase in patella lead (20 microg/g) was associated with a 14% increase in breast milk lead (95% CI, 5 to 25%). An IQR increase in tibia lead (12.0 microg/g) was associated with a 5% increase in breast milk lead (95% CI, -3% to 14%). Our results indicate that even among a population of women with relatively high lifetime exposure to lead, levels of lead in breast milk are low, influenced both by current lead exposure and by redistribution of bone lead accumulated from past environmental exposures

Carbon and nitrogen isotopic composition of commercial dog food in Brazil

Background Brazil is a low- to medium-income country and has the second largest pet food market in the world with 8% of world pet food consumption. The lowest-income social class spends around 17% of their domestic budget on pet food and other items related to pets. Consumers are frequently misled by advertising as there is no precise information about the main sources of protein, carbohydrates and fat in the labels, and the Brazilian pet food industry can legally claim that their products contain certain items like salmon or beef even if they use just a flavoring compound. Methods The stable isotope methodology compares the stable isotope ratios of carbon (13C/12C) and nitrogen (15N/14N) between source and product. The 13C/12C ratio of a specific product (e.g., dog food) reveals the proportions of C4 (maize) and C3 (soybean, rice and wheat) plants in that product and the 15N/14N ratio reveals the proportion of the compounds derived from animals. With this isotopic data, we used MixSIAR, a Bayesian stable isotope-mixing model, to estimate the proportion of maize, grains, poultry and beef in dog food. Results The δ13C values of dry dog food ranged from −24.2‰ to −12.8‰, with an average (± standard-deviation) of −17.1‰ ± 2.8‰. The δ13C values of wet pet food ranged from −25.4‰ to −16.9‰, with an average (± standard-deviation) of −21.2‰ ± 2.4‰, which was significantly lower (p 0.01). The output of the MixSIAR showed a low proportion of bovine products in dry dog food samples. On the other hand, poultry was obviously the dominant ingredient present in most of the samples. Maize was the second dominant ingredient. Wet and dry dog food showed similar isotopic analysis results. The only difference was a lower proportion of maize and higher proportion of grains in wet dog food. Discussion The main finding is that dog food in Brazil is mostly made of approximately 60% (ranging from 32% to 86%) animal-based and 40% (ranging from 14% to 67%) plant-based products. Poultry and maize are the main ingredients. Poultry is added as a by-product or meal, which avoids competition between dogs and humans for meat products, while they can compete for maize. On the other hand, a large proportion of plant-based products in dog food decreases the energy and environmental footprint, since plant-based food products tend to be less harmful compared to animal-based products. Labels can mislead consumers by showing pictures of items that are not necessarily part of the product composition and by not showing the detailed information on the proportion of each ingredient. This information would allow customers to make their own choices considering their pet’s nutrition, the competition between animals and humans for resources and environmental sustainability

Capacitações em Assentamentos Rurais e Comunidades Quilombolas: Críticas às Idealizações, Propostas de Educação Continuada

This paper addresses the issue of extension on agrarian reform in the State of São Paulo, based on the proposed construction and completion of training established by the contract of service between INCRA – SP and UNIARA in year 2011. As a result of this experience, there were 31 training, totaling 280 hours of courses, covering 717 seated regions Andradina, Araraquara, Itapeva, Promised, Ribeirão Preto, São Paulo and Pontal do Paranapanema. In this article we discuss extension, the criteria for the proposed construction, describes the courses taken, and finally, the evaluation of those involved as to the limits and potential of the proposal. Refers also to the specific demands and workshops done in quilombolas communities.Keywords: University Extension, Rural Communities, Education, Learning.O presente trabalho aborda a temática da extensão rural em assentamentos de reforma agrária no Estado de São Paulo, tendo como base a proposta de construção e realização de capacitações estabelecidas através do contrato de prestação de serviços entre a Superintendência Regional do INCRA – SP e a UNIARA no ano de 2011. Como fruto desta experiência, foram realizadas 31 capacitações, perfazendo 280 horas de cursos, abrangendo 717 assentados nas regiões de Andradina, Araraquara, Itapeva, Promissão, Ribeirão Preto, grande São Paulo e Pontal do Paranapanema. Neste artigo discute-se extensão rural, os critérios estabelecidos para construção da proposta, descrevese os cursos realizados e, por fim, a avaliação dos envolvidos quanto aos limites e potencialidades da proposta. Refere-se, também, às especificidades das demandas e oficinas feitas nas comunidades quilombolas