Nutritional status and growth of children on macrobiotic diets : a population-based study

This thesis reports on the relationship between diet, growth, blood chemistry, psychomotor development, and clinical findings in the Dutch population of children on macrobiotic diets.- The macrobiotic diet mainly consisted of cereals, pulses and vegetables with small additions of seaweeds, fermented foods, nuts and seeds. meat and dairy products were avoided, whereas fish was occasionally being eaten but not by young children. The total Dutch macrobiotic population was invited to join the study; the refusal rate was below 5 per cent. A cross- sectional anthropometric study in macrobiotic children between birth and 8 years of age (n = 243) revealed that the age curves declined from the P50 of the Dutch standard mainly between 6 and 18 months of age. A partial return towards the P50 was observed after 2 years of age for weight and arm circumference, but not for height. A subsequent mixedlongitudinal study in macrobiotic infants aged 4 - 18 months and a matched omnivorous control group showed that growth of the macrobiotic infants was slowest between 8 and 14 months. This was attributed to a lack of both energy and protein in the macrobiotic weaning diet. The observed growth retardation was associated with retardation in gross motor and language development. For calcium, vitamin D, vitamin B12 and riboflavin, a low intake in combination with biochemical evidence of deficiency was found. Rickets was present in 28 per cent of macrobiotic infants in summer and 55 per cent in winter. AS a favourable aspect, lower levels of contaminants were found in the breast-milk of macrobiotic mothers. It is concluded that nutritional deficiencies are present in a high proportion of macrobiotic infants. Continued marginal deficiencies in older macrobiotic children seem to prevent catch-up growth in height. It is advised to adapt the macrobiotic diet as to include fatty fish (100 - 150 g/week), oil (20 - 25 g/day) and dairy products (one serving per day)

Long-term strict raw food diet is associated with favourable plasma b-carotene and low plasma lycopene concentrations in Germans

Dietary carotenoids are associated with a reduced risk of chronic diseases. Raw food diets are predominantly plant-based diets that are practised with the intention of preventing chronic diseases by virtue of their high content of beneficial nutritive substances such as carotenoids. However, the benefit of a long-term adherence to these diets is controversial since little is known about their adequacy. Therefore, we investigated vitamin A and carotenoid status and related food sources in raw food diet adherents in Germany. Dietary vitamin A, carotenoid intake, plasma retinol and plasma carotenoids were determined in 198 (ninety-two male and 106 female) strict raw food diet adherents in a cross-sectional study. Raw food diet adherents consumed on average 95 weight% of their total food intake as raw food (approximately 1800 g/d), mainly fruits. Raw food diet adherents had an intake of 1301 retinol activity equivalents/d and 16·7 mg/d carotenoids. Plasma vitamin A status was normal in 82% of the subjects ($1·05mmol/l) and 63$0·88 mmol/l). In 77% of subjects the lycopene status was below the reference values for average healthy populations (,0·45mmol/l). Fat contained in fruits, vegetables and nuts and oil consumption was a significant dietary determinant of plasma carotenoid concentrations (b-carotene r 0·284; P,0·05; lycopene r 0·168; P¼0·024). Long-term raw food diet adherents showed normal vitamin A status and achieve favourable plasma b-carotene concentrations as recommended for chronic disease prevention, but showed low plasma lycopene levels. Plasma carotenoids in raw food adherents are predicted mainly by fat intake

Selecting informative food items for compiling food-frequency questionnaires: comparison of procedures

The authors automated the selection of foods in a computer system that compiles and processes tailored FFQ. For the selection of food items, several methods are available. The aim of the present study was to compare food lists made by MOM2, which identifies food items with highest between-person variance in intake of the nutrients of interest without taking other items into account, with food lists made by forward regression. The name MOM2 refers to the variance, which is the second moment of the nutrient intake distribution. Food items were selected for the nutrients of interest from 2 d of recorded intake in 3524 adults aged 25–65 years. Food lists by 80 % MOM2 were compared to those by 80 % explained variance for regression on differences between the number and type of food items, and were evaluated on (1) the percentage of explained variance and (2) percentage contribution to population intake computed for the selected items on the food list. MOM2 selected the same food items for Ca, a few more for fat and vitamin C, and a few less for carbohydrates and dietary fibre than forward regression. Food lists by MOM2 based on 80 % of variance in intake covered 75–87 % of explained variance for different nutrients by regression and contributed 53–75 % to total population intake. Concluding, for developing food lists of FFQ, it appears sufficient to select food items based on the contribution to variance in nutrient intake without taking covariance into accoun

Reproducibility, validity, and responsiveness to change of a short questionnaire for measuring fruit and vegetable intake

The reproducibility, relative validity, and responsiveness to change of an eight-item food frequency questionnaire designed to measure fruit and vegetable consumption was assessed among 157 women (mean age = 41 years) in the Netherlands from spring 2001 to spring 2002. Plasma concentrations of vitamin C and total and specific carotenoids served as biomarkers against which validity was assessed. The questionnaire was completed and biomarker concentrations were determined three times: immediately preceding and following a controlled intervention of 1 month aimed at increasing fruit and vegetable consumption and 1 year after the start of the intervention. The 1-month and 1-year reproducibility of total fruit and vegetable consumption assessed in the control group was 0.80 and 0.79 (Spearman's r ). Correlations between consumption and plasma carotenoids and vitamin C at baseline were 0.39 and 0.37, respectively, for fruits and 0.24 and 0.26, respectively, for vegetables. Correlations between changes in consumption and plasma carotenoids and vitamin C were 0.32 and 0.33, respectively, for fruits and 0.28 and 0.30, respectively, for vegetables. On the basis of similar correlations reported in the literature, the authors conclude that the questionnaire appears to be suitable for ranking individuals according to their consumption of fruits and vegetables and according to changes in their consumption. However, the validity of the questionnaire remains to be established in males, other age groups, and populations of lower educational levels

Deconjugation Kinetics of Glucuronidated Phase II Flavonoid Metabolites by B-glucuronidase from Neutrophils

Flavonoids are inactivated by phase II metabolism and occur in the body as glucuronides. Mammalian ß-glucuronidase released from neutrophils at inflammatory sites may be able to deconjugate and thus activate flavonoid glucuronides. We have studied deconjugation kinetics and pH optimum for four sources of ß-glucuronidase (human neutrophil, human recombinant, myeloid PLB-985 cells, Helix pomatia) with five flavonoid glucuronides (quercetin-3-glucuronide, quercetin-3'-glucuronide, quercetin-4'-glucuronide, quercetin-7-glucuronide, 3'-methylquercetin-3-glucuronide), 4-methylumbelliferyl-ß-D-glucuronide, and para-nitrophenol-glucuronide. All substrate-enzyme combinations tested exhibited first order kinetics. The optimum pH for hydrolysis was between 3.5-5, with appreciable hydrolysis activities up to pH 5.5. At pH 4, the Km ranged 44-fold from 22 µM for quercetin-4'-glucuronide with Helix pomatia ß-glucuronidase, to 981 µM for para-nitrophenol-glucuronide with recombinant ß-glucuronidase. Vmax (range: 0.735-24.012 µmol·min-1·unit-1 [1 unit is defined as the release of 1 µM 4-methylumbelliferyl-ß-D-glucuronide per min]) and the reaction rate constants at low substrate concentrations (k) (range: 0.002-0.062 min-1·(unit/L)-1 were similar for all substrates-enzyme combinations tested. In conclusion, we show that ß-glucuronidase from four different sources, including human neutrophils, is able to deconjugate flavonoid glucuronides and non-flavonoid substrates at fairly similar kinetic rates. At inflammatory sites in vivo the pH, neutrophil and flavonoid glucuronide concentrations seem favorable for deconjugation. However, it remains to be confirmed whether this is actually the case

Effect of dietary fish oil on blood levels of free fatty acids, ketone bodies and triacylglycerol in humans

Although the reduction of serum triacylglycerol concentrations by dietary fish oil is a well-known effect, the exact mechanism of this effect has not been previously studied in human subjects. Therefore, the aim of this study was (i) to examine the effect of short-term fish oil supplementation on blood concentrations of ketone bodies, free fatty acids and triacylglycerol in healthy humans and (ii) to verify whether the observed relationships between these variables would be consistent with reduced lipolysis and/or enhanced hepatic fatty acid oxidation after fish oil supplementation. Twenty subjects (21-23 years, normal liver function tests) were randomly divided into two groups to supplement their usual diet with either 30 g/d of fish oil (n=11) or olive oil (n=9). Venous blood samples were drawn after an overnight fast, before and after 1, 3 and 7 d of fish oil/olive oil supplementation. Blood concentrations of triacylglycerol and free fatty acids decreased consistently after fish oil supplementation; the reduction was already significant after one day of fish oil (P0.10). No significant changes in glucose, insulin or ketone body levels were observed in either group after supplementation. After fish oil, but not after olive oil supplementation, the ratio of blood ketone body levels to free fatty acid levels increased significantly (P<0.05). Furthermore, after fish oil supplementation only, free fatty acid levels were significantly correlated with levels of ketone bodies (day 7 of supplementation: r=0.90, P<0.001) and triacylglycerol (maximum value on day 3: r=0.77, P<0.01). These findings suggest that reduced lipolysis and increased hepatic β-oxidation/ketogenesis may contribute to reduced triacylglycerol levels after ω3 fatty acid supplementation in humans. Turnover studies are needed in order to further quantitate these processes

Gut colonization with methanobrevibacter smithii is associated with childhood weight development

OBJECTIVE: To prospectively investigate the presence and counts of archaea in feces of 472 children in association with weight development from 6 to 10 years of age. METHODS: Within the KOALA Birth Cohort Study, a single fecal sample from each child was analyzed by quantitative polymerase chain reaction to quantify archaea (Methanobrevibacter smithii, Methanosphera stadtmanae). Anthropometric outcomes (overweight [body mass index {BMI} >/= 85th percentile], age- and sex-standardized BMI, weight, and height z-scores) were repeatedly measured at ages (mean +/- SD) of 6.2 +/- 0.5, 6.8 +/- 0.5, 7.8 +/- 0.5, and 8.8 +/- 0.5 years. Generalized estimating equation was used for statistical analysis while controlling for confounders. RESULTS: Methanobrevibacter smithii colonization was associated with an increased risk of overweight (adjusted odds ratio [OR] = 2.69; 95% confidence interval [CI] 0.96-7.54) from 6 to 10 years of age. Children with high levels (>7 log10 copies/g feces) of this archaeon were at highest risk for overweight (OR = 3.27; 95% CI 1.09-9.83). Moreover, M. smithii colonization was associated with higher weight z-scores (adj. beta 0.18; 95% CI 0.00-0.36), but not with height. For BMI z-scores, the interaction (P = 0.008) between M. smithii and age was statistically significant, implying children colonized with M. smithii had increasing BMI z-scores with age. CONCLUSIONS: Presence and higher counts of M. smithii in the gut of children are associated with higher weight z-scores, higher BMI z-scores, and overweight

Randomized clinical trial of adenosine 5'-triphosphate in patients with advanced non-small-cell lung cancer

BACKGROUND: Extracellular adenosine 5'-triphosphate (ATP) is involved in the regulation of a variety of biologic processes, including neurotransmission, muscle contraction, and liver glucose metabolism, via purinergic receptors. In nonrandomized studies involving patients with different tumor types including non-small-cell lung cancer (NSCLC), ATP infusion appeared to inhibit loss of weight and deterioration of quality of life (QOL) and performance status. We conducted a randomized clinical trial to evaluate the effects of ATP in patients with advanced NSCLC (stage IIIB or IV). METHODS: Fifty-eight patients were randomly assigned to receive either 10 intravenous 30-hour ATP infusions, with the infusions given at 2- to 4-week intervals, or no ATP. Outcome parameters were assessed every 4 weeks until 28 weeks. Between-group differences were tested for statistical significance by use of repeated-measures analysis, and reported P values are two-sided. RESULTS: Twenty-eight patients were allocated to receive ATP treatment and 30 received no ATP. Mean weight changes per 4-week period were -1.0 kg (95% confidence interval [CI] = -1.5 to -0.5) in the control group and 0.2 kg (95% CI = -0.2 to +0.6) in the ATP group (P =.002). Serum albumin concentration declined by -1.2 g/L (95% CI= -2.0 to -0.4) per 4 weeks in the control group but remained stable (0.0 g/L; 95% CI = -0.3 to +0.3) in the ATP group (P =.006). Elbow flexor muscle strength declined by -5.5% (95% CI = -9.6% to -1. 4%) per 4 weeks in the control group but remained stable (0.0%; 95% CI= -1.4% to +1.4%) in the ATP group (P =.01). A similar pattern was observed for knee extensor muscles (P =.02). The effects of ATP on body weight, muscle strength, and albumin concentration were especially marked in cachectic patients (P =.0002, P =.0001, and P =. 0001, respectively, for ATP versus no ATP). QOL score changes per 4-week period in the ATP group showed overall less deterioration than in the control group-physical scores (-0.2% versus -2.4%; P =. 0002); functional scores (+0.4% versus -5.5%; P =.02); psychologic scores (-0.7% versus -2.4%; P =.11); overall QOL score (+0.1% versus -3.5%; P =.0001). CONCLUSIONS: This randomized trial demonstrates that ATP has beneficial effects on weight, muscle strength, and QOL in patients with advanced NSCLC

ALTERED PHOSPHORYLATION STATUS, PHOSPHOLIPID-METABOLISM AND GLUCONEOGENESIS IN THE HOST LIVER OF RATS WITH PROSTATE-CANCER - A P-31 MAGNETIC-RESONANCE SPECTROSCOPY STUDY

31P magnetic resonance spectroscopy (MRS) in vivo and in vitro was used to study modulation of host liver (HL) metabolism in rats bearing the MAT-LyLu variant of the Dunning prostate tumour. Animals were inoculated either with 10(6) or 10(7) MAT-LyLu cells, or with saline to serve as controls. Carcass weight in tumour-bearing (TB) animals decreased despite similar food and water intake in both groups. Absence of metastatic tumour cells from HL of all TB animals was confirmed by histological examination. Twenty-one days after inoculation, 31P MRS showed a 2.5-fold increase in [Pi]/[ATP] ratios in HL in vivo (P < 0.001) which was confirmed by 31P MRS of liver extracts in vitro (P < 0.005). Phosphodiester to ATP ratios were significantly increased (P < 0.05) in HL in vivo, but absolute PDE levels were similar in both groups. Phosphomonoester to ATP ratios did not change, although absolute phosphomonoester levels in HL were reduced by -41% (not significant). In HL extracts in vitro, sharp reductions in the levels of glucose-6-phosphate (P < 0.05), fructose-6-phosphate (P = 0.05), phosphocholine (P < 0.001), glycerophosphocholine (P < 0.001), and glycerophosphoethanolamine (P < 0.001) were observed. Electron microscopy revealed increased amounts and altered distribution of rough endoplasmic reticulum in HL. These findings show that experimental prostate cancer significantly affects hepatic phosphorylation status, phospholipid metabolism, and gluconeogenesis in the host animal, and demonstrate the value of combined MRS in vivo and in vitro in monitoring HL metabolism in cancer

Severity of Diabetes Mellitus and Total Hip or Knee Replacement: A Population-Based Case-Control Study

Contains fulltext : 171491.pdf (publisher's version ) (Open Access)It is generally thought that people with diabetes mellitus (DM) are more likely to suffer from osteoarthritis (OA) due to an increased body mass index (BMI), resulting in mechanical destruction of cartilage. However, previous studies have suggested a coexisting metabolic causality.To evaluate the risk of hip or knee replacement, as a proxy for severe OA, in patients with DM. We additionally evaluated the risk of total joint replacement (TJR) with various proxies for increased DM severity.A population-based case-control study was performed, using the Clinical Practice Research Datalink (CPRD). Cases (n = 94,609) were defined as patients >18 years who had undergone TJR between 2000 and 2012. Controls were matched by age, gender, and general practice. Conditional logistic regression was used to estimate the risk of total knee (TKR) and total hip replacement (THR) surgery associated with use of antidiabetic drugs (ADs). We additionally stratified current AD users by proxies for DM severity.Current AD use was significantly associated with a lower risk of TKR (OR = 0.86 (95% CI = 0.78-0.94)) and THR (OR = 0.90 (95% CI = 0.82-0.99)) compared to patients not using ADs. Moreover, risk of TKR and THR was decreased with increasing HbA1c.This study does not support the theory that DM patients are more likely to suffer from severe OA as compared to patients without diabetes. Moreover, risk of severe OA necessitating TJR decreases with increasing DM severity. This is possibly due to dissimilarities in methodology, a decrease in eligibility for surgery, or variability of OA phenotypes