Endemic cryptosporidiosis and exposure to municipal tap water in persons with acquired immunodeficiency syndrome (AIDS): A case-control study

BACKGROUND: In persons with acquired immunodeficiency syndrome (AIDS), Cryptosporidium parvum causes a prolonged, severe diarrheal illness to which there is no effective treatment, and the risk of developing cryptosporidiosis from drinking tap water in non-outbreak settings remains uncertain. To test the hypothesis that drinking tap water was associated with developing cryptosporidiosis, we conducted a matched case-control study among persons with AIDS in San Francisco. METHODS: Among patients reported to the San Francisco AIDS Registry from May 1996 through September 1998, we compared patients who developed cryptosporidiosis to those who did not. Cases were individually matched to controls based on age, sex, race/ethnicity, CD4(+ )T lymphocyte count, date of CD4(+ )count, and date of case diagnosis. Population attributable fractions (PAFs) were calculated. RESULTS: The study consisted of 49 cases and 99 matched controls. In the multivariable analysis with adjustments for confounders, tap water consumption inside and outside the home at the highest exposure categories was associated with the occurrence of cryptosporidiosis (inside the home: odds ratio (OR), 6.76; 95% CI 1.37–33.5, and outside the home: OR 3.16; 95% CI 1.23–8.13). The PAF was 85%; that is, the proportion of cases of cryptosporidiosis in San Francisco AIDS patients attributable to tap water consumption could have been as high as 85%. CONCLUSIONS: Although the results from this observational study cannot be considered definitive, until there is more data, we recommend persons with AIDS, especially those with compromised immune systems, consider avoiding tap water

ISSN exercise & sport nutrition review: research & recommendations

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients

Indication of the Maillard reaction during storage of protein isolates

In a previous study, feeding an isolated soy protein (ISP)-based diet to rats was found to reduce colon cancer risk as assessed by a reduced number of colonic precancerous lesions. However, this same ISP, after storage at room temperature for >2 years, increased the number of precancerous lesions (Gallaher et al., 1996). We hypothesize that this increase was due to the development of Maillard reaction products in the ISP during storage. Thus, the objective of this study was monitor development of the Maillard reaction during storage of ISP and delactosed whey protein concentrate. Proteins were stored at different water activities (0.22, 0.33, 0.55) and temperatures (22, 30, 45 degrees C) with and without glucose (5% w/w) and increases in browning (A = 420 nm) and fluorescence (lambda(ex) 365 nm/lambda(em) 475 nm) determined. In the absence of glucose, only soy protein underwent browning; otherwise the rate of browning and fluorescence increased with increasing temperature and water activity. To investigate why ISP underwent browning in the absence of glucose while whey protein concentrate did not, the reaction of genistein was investigated. Genistein is an isoflavone with putative chemoprotective properties found in ISP but not in whey. Genistein(2 mM) was incubated alone or with lysine (2 mM) in buffer. The absorbance (A = 420 nm) of the reaction mixtures and genistein concentration was measured over time. It was found that genistein underwent reaction both alone and in the presence of lysine. The rate of browning was found to parallel the rate of genistein loss, suggesting that genistein plays a role as a reactant in nonenzymatic browning reactions. This suggests that long-term storage of ISP will lead to the loss of genistein and potentially result in the development of carcinogens.4672485248