45 research outputs found
Metabolic changes in response to varying whole-grain wheat and rye intake
Epidemiological studies have shown associations between whole-grain intake and lowered disease risk. A sufficient level of whole-grain intake to reach the health benefits has not been established, and there is limited knowledge about the impact of whole-grain intake on metabolite levels. In this clinical intervention study, we aimed to identify plasma and urine metabolites associated with two different intake levels of whole-grain wheat and rye and to correlate them with clinical plasma biomarkers. Healthy volunteers (N = 68) were divided into two groups receiving either whole-grain wheat or whole-grain rye in two four-week interventions with 48 and 96 g/d of whole grains consumed. The metabolomics of the plasma samples was performed with UPLC–QTOF-MS. Plasma alkylresorcinols were quantified with GC-MS and plasma and urinary mammalian lignans with HPLC-ECD. The high-dose intervention impacted the metabolite profile, including microbial metabolites, more in the rye-enriched diet compared with wheat. Among the increased metabolites were alkylresorcinol glucuronides, sinapyl alcohol, and pipecolic acid betaine, while the decreased metabolites included acylcarnitines and ether lipids. Plasma alkylresorcinols, urinary enterolactone, and total mammalian lignans reflected the study diets in a dose-dependent manner. Several key metabolites linked with whole-grain consumption and gut microbial metabolism increased in a linear manner between the two interventions. The results reveal that an increase in whole-grain intake, particularly rye, is strongly reflected in the metabolite profile, is correlated with clinical variables, and suggests that a diet rich in whole grains promotes the growth and/or metabolism of microbes producing potentially beneficial microbial metabolites.Similar content being viewed by other
Equity in health care financing: The case of Malaysia
Background: Equitable financing is a key objective of health care systems. Its importance is
evidenced in policy documents, policy statements, the work of health economists and policy
analysts. The conventional categorisations of finance sources for health care are taxation, social
health insurance, private health insurance and out-of-pocket payments. There are nonetheless
increasing variations in the finance sources used to fund health care. An understanding of the equity
implications would help policy makers in achieving equitable financing.
Objective: The primary purpose of this paper was to comprehensively assess the equity of health
care financing in Malaysia, which represents a new country context for the quantitative techniques
used. The paper evaluated each of the five financing sources (direct taxes, indirect taxes,
contributions to Employee Provident Fund and Social Security Organization, private insurance and
out-of-pocket payments) independently, and subsequently by combined the financing sources to
evaluate the whole financing system.
Methods: Cross-sectional analyses were performed on the Household Expenditure Survey
Malaysia 1998/99, using Stata statistical software package. In order to assess inequality,
progressivity of each finance sources and the whole financing system was measured by Kakwani's
progressivity index.
Results: Results showed that Malaysia's predominantly tax-financed system was slightly
progressive with a Kakwani's progressivity index of 0.186. The net progressive effect was produced
by four progressive finance sources (in the decreasing order of direct taxes, private insurance
premiums, out-of-pocket payments, contributions to EPF and SOCSO) and a regressive finance
source (indirect taxes).
Conclusion: Malaysia's two tier health system, of a heavily subsidised public sector and a user
charged private sector, has produced a progressive health financing system. The case of Malaysia
exemplifies that policy makers can gain an in depth understanding of the equity impact, in order to
help shape health financing strategies for the nation
LongITools: Dynamic longitudinal exposome trajectories in cardiovascular and metabolic noncommunicable diseases
The current epidemics of cardiovascular and metabolic noncommunicable diseases have emerged alongside dramatic modifications in lifestyle and living environments. These correspond to changes in our “modern” postwar societies globally characterized by rural-to-urban migration, modernization of agricultural practices, and transportation, climate change, and aging. Evidence suggests that these changes are related to each other, although the social and biological mechanisms as well as their interactions have yet to be uncovered. LongITools, as one of the 9 projects included in the European Human Exposome Network, will tackle this environmental health equation linking multidimensional environmental exposures to the occurrence of cardiovascular and metabolic noncommunicable diseases