Review Article Socio-economic determinants of micronutrient intake and status in Europe: a systematic review

Objective To provide the evidence base for targeted nutrition policies to reduce the risk of micronutrient/diet-related diseases among disadvantaged populations in Europe, by focusing on: folate, vitamin B-12, Fe, Zn and iodine for intake and status; and vitamin C, vitamin D, Ca, Se and Cu for intake. Design MEDLINE and Embase databases were searched to collect original studies that: (i) were published from 1990 to 2011; (ii) involved gt 100 subjects; (iii) had assessed dietary intake at the individual level; and/or (iv) included best practice biomarkers reflecting micronutrient status. We estimated relative differences in mean micronutrient intake and/or status between the lowest and highest socio-economic groups to: (i) evaluate variation in intake and status between socio-economic groups; and (ii) report on data availability. Setting Europe. Subjects Children, adults and elderly. Results Data from eighteen publications originating primarily from Western Europe showed that there is a positive association between indicators of socio-economic status and micronutrient intake and/or status. The largest differences were observed for intake of vitamin C in eleven out of twelve studies (5-47 %) and for vitamin D in total of four studies (4-31 %). Conclusions The positive association observed between micronutrient intake and socio-economic status should complement existing evidence on socio-economic inequalities in diet-related diseases among disadvantaged populations in Europe. These findings could provide clues for further research and have implications for public health policy aimed at improving the intake of micronutrients and diet-related diseases

Effect of maternal and paternal nutrition on DNAmethylation in the offspring: asystematic review of human and animal studies

Maternal or paternal diet may influence health throughout life. This is a systematic review of studies in humans and animals specifically investigating DNA methylation in progeny in relation to diet of the mother or father, or previous generations. There is an overview of the type of diet studied and themetabolic paths affected. Food deprivation in humans and animal models, studies on imprinted genes, hypothalamic pituitary adrenal axis and influence of paternal dietare discussed.status: publishe

Maternal obesity is associated with a lower dietary quality and increased incidence of pregnancy complications

status: publishe

Coronary heart disease risk factors and LDL cholesterol-lowering efficacy of fibrates and simvastatin

The objective of this study was to assess the low-density lipoprotein cholesterol (LDL-C) lowering efficacy of fibric acid derivatives (fibrates) and simvastatin as a function of coronary heart disease (CHD) risk status, stratified according to National Cholesterol Education Program guidelines. Two independent databases were analysed retrospectively. The first data set originated from a consecutive sample of 6340 patients with primary hypercholesterolaemia who completed the diet plus fibrate treatment phase of the Belgian General Practitioners Trial, an open-label, prospective study conducted in a primary care setting. The second data set was derived from 782 participants in five randomised, double-blind studies that each compared a specific fibrate with simvastatin. The main outcome measures were percentage of subjects reaching LDL-C treatment goal, and mean percentage reduction in LDL-C across 5 (first data set) or 3 (second data set) CHD risk strata. In the Belgian General Practitioners Trial, LDL-C lowering efficacy of fibrates was inversely related to CHD risk status as 15.0% of patients with prior CHD reached the LDL-C goal < 4.13 mmol/L (< 160 mg/dl) vs 30.2% of those without CHD and no other risk factor (p < 0.0001 after adjustment for baseline LDL-C acid triglycerides). Adjusted mean percentage reductions in LDL-C were 15.1 and 18.2, in these strata, respectively (p < 0.05). Younger age, male gender, high blood pressure, low high-density lipoprotein cholesterol, and history of prior CHD were significant (p < 0.05) negative determinants of both outcome measures in multivariate analyses that adjusted for other risk factors. In the pooled analysis of five randomised trials, the percentage of fibrate-treated patients with prior atherosclerotic disease reaching LDL-C goal < 4.20 mmol/L (< 162 mg/dl) was significantly lower when compared with those without CHD and no risk factor other than LDL-C (adjusted odds ratio = 0.46; p = 0.009), while simvastatin efficacy was similar across CHD risk strata. In conclusion, our results, derived from two independent databases, suggest that the LDL-C lowering efficacy of fibrates, but not of simvastatin, is inversely related to CHD risk status. This exploratory analysis must be confirmed by future prospective studies.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

A prospective study analysing fat-soluble vitamin levels of women with bariatric surgery: first trimester results

status: publishe

Ontbijtfrequentie van Belgische mannelijke en vrouwelijke adolescenten tussen 12 en 15 jaar

A daily breakfast plays a paramount role in the contribution of essential elements to the human body, especially for adolescents. During this period the growing body needs supplementary and essential micro- and macronutrients. Our study was performed during the school year 1999-2000 and discribes the breakfast rates in 5.000 male and female adolescents aged between 12 and 15 years and living in Belgium. It is remarkable that for both sexes breakfast rate is statistical significantly higher in Flanders as compared to Wallonia. One female adolescent out of three in Wallonia takes four or less breakfasts a week. Daily breakfast decreases for both sexes between the ages of 13 and 14 years (respectively from 66,5% to 54,5% for boys and from 61,0% to 47,2% for girls). The habit of a daily breakfast is influenced by the adolescents' perception of their own body: 50% of the adolescents who consider themselves as being fat do not breakfast every day. The percentage of adolescents who breakfast every day is also lower in technical and professional schools compared to schools for general education (respectively for boys 49,3%, 47,8 and 67,6%, and for girls 42,2%,39,2% and 60,0%).SCOPUS: re.jinfo:eu-repo/semantics/publishe

Fruit- en groenteconsumptie bij belgische adolescenten tussen 12 en 15 jaar: Essentiële factoren om doeltreffende campagnes in te richten ter promotie van fruit en groenten bij de jeugd

During the school year 1999-2000, three nurses visited a number of Belgian schools to procure free information about female hygiene to girls 12 to 15 old. Using self-administered questionnaires, a sample of 5000 young male and female adolescents were at the same time interviewed about their food practices, way of life, living situation and the image they had of themselves. One out of four male teenagers in Wallonia and almost one out of five teenagers in Flanders declared to take one, or less than one portion of fruit and/or vegetables a day. In female teenagers, these figures amounted to 19,5% in Wallonia and 16,0% in Flanders. One out of ten male adolescents ate enough fruit and vegetable each day, 10.0% in Flanders and 13.2% in Wallonia. In female teenagers, these amounted to 15,0% in Flanders and to 14.6% for Wallonia. Our study noted a decline from 15.7% to 12.2% for the highest intake of fruits and vegetables by female adolescents between 14 and 15 years old. Once 15 years old, almost one adolescent out of three (28.4% in males and 28.9% in females) declared to take one or less than one portion of fruits and/or vegetables a day. No aliments except fruit and vegetables have ever proved to exert a more beneficial effect on health as regards a reduction of morbidity and mortality. These facts are established since more than 20 years, but are still largely overlooked by the lay public. Most Belgian citizens believe that many food products are unhealthy because of their contamination with dioxins, addition of antibiotics and hormones, and presence of pesticides. However, intake of unsaturated fatty acids, fruits and vegetables exercise a much greater influence on mortality and morbidity.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Boter als smeervet bij cardiovasculaire risicofactoren en in functie van dieetinterventies

Between September 1998 and February 2000, Belgian general practitioners (GPs) who graduated since 1965 were contacted by mail to participate in an epidemiological study on cardiovascular and behavioural risk factors (the Coronary Heart Disease Monitor or CHD-Monitor). In this article, we present data from the CHD-Monitor related to the consumption of butter on bread slices. In Wallonia 751 persons (35,7%) smear regularly butter on their daily slices of bread, in Flanders 380 (13,4%) and in Brussels 190 (32,7%) (p<0,0001 for the difference between Flanders and Wallonia and for Flanders and Brussels). In Wallonia one third of the patients with a coronary pathology and/or with diabetes mellitus declared using butter on a regular basis, in contrast to Flanders where only 1 per ten persons with the same disease(s) declared himself a consumer. The use of butter decreases with age for men in the Flanders, in contrast to Wallonia. Smokers have a spontaneously increased risk for coronary disease and mortality; moreover, they use as well in Flanders as in Wallonia more frequently than non-smokers butter on their bread slices (more than four out of 10 smokers use butter) (difference between smokers and nonsmokers is significant p<0,001 for Flanders and Wallonia). These data confirm the regional differences in butterconsumption which were demonstrated in the Belgian epidemiologic studies of the sixties and seventies. Considering the content of saturated fatty acids in butter, the regular use of butter does not make it possible to respect the norm for saturated fatty acids.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

EMG IN SYMPTOMATIC LUMBOSACRAL TARLOV CYST PATIENTS WITH UNEXPLAINED CHRONIC COMPLEX PERINEAL, PELVIC AND/OR SACROISCHIALGIC PAIN SYNDROMES

Introduction Tarlov cysts (TC) are usually considered asymptomatic and therefore overlooked as a possible cause of sacral and sciatic pain, urogenital and bowel problems. This is especially true for smaller cysts. Controversy remains regarding their clinical importance. Because of this underdiagnosed condition, patients often suffer for several years from unrecognized chronic neuropathic pain and neurological disorders. Purpose To report on the presence of lumbosacral TC cysts in unexplained complex chronic pain syndromes (CCPS) and to document the TC as the cause of nerve damage in these patients, using EMG of the lumbosacral myotomes. Methods In an outpatient clinic of physical medicine, for patients consulting for musculoskeletal disorders, 17 patients with longstanding unexplained and intractable CCPS of the perineum, pelvis, sacrum, coccyx, lower back and/or the legs were found to harbor Tarlov cysts on MRI. Other causes of chronic pain were ruled out. EMG of the lumbosacral myotomes was performed by an expert senior neurophysiologist in order to document nerve damage in these patients, including L5, S1, and S2 (tibial nerve innervated intrinsic foot muscles) and S3S4 (external anal sphincter). Results All of the patients harbored more than one TC. Nerve conduction studies showed sural nerve abnormalities in 33.3%, delayed S1 Hoffmann-reflex latencies in 12% and ano-anal reflex abnormalities in 60%. Needle EMG showed neurogenic abnormalities in myotomes L5 (87.5%), S1 (18.8%), S2 (64.3%) and S3S4 (81.3%). All patients had abnormalities in the S2 or S3,S4 myotomes, or in both. Discussion and conclusion In patients with CCPS, the presence of TC should be taken into consideration. A needle-EMG of both the tibial nerve innervated intrinsic foot muscles and the external anal sphincter was able to document sacral nerve root damage in all of these patients. EMG for pelvic, perineal or radicular pain should include a needle EMG of these myotomes.status: publishe