Allergiezusammenhänge im Überblick: Milchfettqualität als schützende Maßnahme gegen Allergien

Allergy in human populations is increasing due to modern lifestyle. Farm children and children with an anthroposophic lifestyle showed less allergic symptoms. This article describes the modern insights about nowadays nutrition and lifestyle factors impacting on the development of allergies and the research done in the 1920s about the health status of indigenous people and their eating behaviour. Many epidemiological studies mention the quality of farm milk, raw milk and milk fat as important factors to reduce the risk of allergies. It is explained why and how a high-quality milk fat in terms of conjugated linolenic acid and omega-3 long-chain fatty acids are influencing the cell physiology. These new insights will affect future strategies of organic dairy production and marketing in organic agriculture

Auswirkung von Kuhrasse und Melksaison auf die Fettsäurekomposition in Juchowo farm

At the biodynamic farm Juchowo, 7 pairs of dairy cows from 2 breeds (Holstein (HF) and Brown Swiss (BS)) were milk sampled in summer and in winter. Cows are grazed in summer and fed hay in winter. Differences in the milk fatty acid profile were evaluated for effects of month (fodder), breed and individual cows. The most important way to improve the FA quality is through grazing of fresh grass. Therefor milk from grass based systems should be preferred. Overall breed effects were small, but there are still possibilities present to select individual cows to get an improved FA quality profile in terms of CLA, n-3 FA and delta-9-desaturase activity

Sonographische Evaluation des gastralen Volumens im Rahmen der enteralen Ernährung kritisch kranker Patienten auf der Intensivstation mittels eines miniaturisierten Ultraschallgerätes

Hintergrund: Zur Einschätzung des Aspirationsrisikos, der Nährstofftoleranz und der Magenentleerung [59] von Patienten auf Intensivstationen kann die Magensonographie quantitative und qualitative Informationen über den Mageninhalt liefern [45]. Durch etablierte Formeln von Perlas et al. [62] und Bouvet et al. [12] kann durch Vermessung des Magenantrums das gastrale Volumen standardisiert berechnet werden. In dieser Studie sollte mittels eines miniaturisierten Ultraschallgerätes an einer Kohorte enteral ernährter Patienten das Magenvolumen bestimmt werden, um Erkenntnisse über die Durchführbarkeit und das gastrale Volumen im zeitlichen Verlauf des Aufenthaltes auf der Intensivstation zu erlangen. Die Ergebnisse könnten zur Optimierung der enteralen Ernährungstherapie beitragen. Methodik: Es wurden insgesamt 217 Ultraschalluntersuchungen mit je 3 Messungen (insgesamt 651 Messungen) in einer longitudinalen Beobachtungsstudie an 18 enteral ernährten Patienten der interdisziplinären operativen Intensivstation des Universitätsklinikums des Saarlandes zweimal täglich (morgens und abends) mit einem miniaturisierten Ultraschallgerät durchgeführt. Die Messwerte der Magenvolumina wurden in Abhängigkeit des klinischen Verlaufs, der Ernährungstherapie sowie weiterer demographischer sowie klinischer Parameter betrachtet. Ergebnisse: Die Durchführung der Messungen war ohne Unterbrechung der Abläufe der klinischen Versorgung sowie ohne Pausierung der enteralen Ernährung möglich. Das Magenvolumen zeigte sich bei spärlich auskultierten Darmgeräuschen signifikant größer als bei normalen und regen Darmgeräuschen (p < 0,01). Weiterhin lag bei Verwendung des Ernährungsproduktes Fresubin® energy fibre ein signifikant größeres Magenvolumen im Vergleich zu Fresubin® original fibre vor (p = 0,02). Das Magenvolumen bei Morgen- und Abendmessungen zeigte keine zirkadiane Rhythmik. Beim Vergleich der ersten und letzten Ultraschalluntersuchung der einzelnen Patienten bestand eine Tendenz zum vergrößerten Magenvolumen (p = 0,07). Bei BiPAP-Beatmung lag ein signifikant größeres Magenvolumen als bei CPAP/ASB-Beatmung und Spontanatmung vor (p < 0,01). Weiterhin konnte eine positive Korrelation zwischen dem Magenvolumen und dem Tidalvolumen festgestellt werden (Pearson r = 0,582, p < 0,01). Schlussfolgerung: Das gastrale Residualvolumen gemessen mittels eines miniaturisierten Ultraschallgeräts kann wichtige Informationen über Intensivpatienten liefern, ohne dass Behandlungsabläufe auf der Intensivstation eingeschränkt werden. Die Messungen sind bei laufender enteraler Ernährungstherapie möglich. Es sind weitere Studien nötig, um den gastralen Ultraschall als Steuerungsmöglichkeit in der Ernährungstherapie zu etablieren.Background: To assess the risk of aspiration, nutrient tolerance, and gastric emptying [59] of patients in intensive care units, gastric ultrasound can provide quantitative and qualitative information about the gastric contents [45]. Using established formulas by Perlas et al. [62] and Bouvet et al. [12], gastric volume can be calculated in a standardized way by measuring the gastric antrum. The purpose of this study was to determine gastric volume in a cohort of enteral-fed patients using a miniaturized ultrasound device to achieve knowledge about feasibility and gastric volume over time during the ICU stay. The findings could contribute to the optimization of enteral nutrition therapy. Methods: A total of 217 ultrasound examinations with 3 measurements each (651 measurements in total) were performed twice daily (morning and evening) in a longitudinal observational study on 18 patients with enteral nutrition in the interdisciplinary surgical intensive care unit of Saarland University Hospital. The measured values of the gastric volumes were analyzed in relation to the clinical course, the nutrition therapy, and other demographic and clinical parameters. Results: Measurements could be performed without interrupting the flow of clinical care and without pausing enteral nutrition. The gastric volume was significantly larger with sparsely auscultated bowel sounds than with normal and excited bowel sounds (p < 0.01). Furthermore, a significantly larger gastric volume was present when using the nutritional product Fresubin® energy fibre compared to Fresubin® original fibre (p = 0.02). Gastric volume at morning and evening measurements showed no circadian rhythm. When comparing the first and last ultrasound examination of each patient, there was a tendency towards increased gastric volume (p = 0.07). There was significantly greater gastric volume with BiPAP ventilation than with CPAP/ASB ventilation and spontaneous breathing (p < 0.01). In addition, a positive correlation between gastric volume and tidal volume was observed (Pearson r = 0.582, p < 0.01). Conclusion: Gastric residual volume measured by miniaturized ultrasound devices can provide important information about ICU patients without restricting treatment procedures in the ICU. Measurements are possible while enteral nutrition therapy is ongoing. Further studies are needed to establish gastric ultrasound as a monitoring tool in nutrition therapy

Work and diet-related risk factors of cardiovascular diseases: comparison of two occupational groups

<p>Abstract</p> <p>Background</p> <p>Although work related risk factors associated with Cardiovascular Diseases (CD) have been well researched, there is no detailed knowledge regarding disparate occupational groups each with a different risk exposition. Therefore, two occupational groups (chefs and office workers) were compared with a focus on nutritional and psychosocial factors.</p> <p>Methods</p> <p>Two groups of subjects were tested for work and diet-related risks of CD (45 chefs and 48 office workers). The groups matched both for gender (male) and age (30 to 45 years). The study included a medical check-up, bioelectrical impedance analysis as well as an evaluation of questionnaires on health, nutritional behaviour and coping capacity. In addition, volunteers were required to compile a 7-day-dietary-record and collect their urine 24 h prior to their check-up. Blood samples drawn were analysed for glucose and lipid metabolism, homocysteine, vitamin B₁₂, folic acid; C-reactive protein, uric acid, red blood cell fatty acids, plant sterols, antioxidative capacity and oxidative stress.</p> <p>Results</p> <p>On average, the chefs showed one risk factor more compared to the office workers. The most frequent risk factors in both groups included overweight/obesity (chef group [CG]: 62.2%; office group [OG]: 58.3%) and elevated TC (CG: 62.2%; OG: 43.8%]. Moreover, although the chefs often had higher CRP-concentrations (40.0%), more office workers suffered from hypertension (37.5%).</p> <p>Chefs showed significant higher concentrations of saturated fatty acids and oleic acid, whereas docosahexaenoic acid, Omega-6- and <it>trans </it>fatty acids were found more frequently in the red blood cell membranes of office workers. While there were no significant differences in analysed plant sterols between the two occupational groups, 7,8-dihydro-8-oxo-2'-deoxyguanosine was significantly increased in office workers.</p> <p>Concerning the work-related psychosocial factors, the chefs were characterised by a stronger subjective importance of work, a greater degree of professional aspiration and enhanced efforts at perfectionism at their workplace.</p> <p>Conclusions</p> <p>The chefs in the study bear a higher risk of CD compared to the office-workers. Although, CD is not exclusively a result of workplace-conditions, study results show that work-related influences can not be ignored. Thus, prevention of CD may be an important task attributable to occupational physicians.</p

Effect of calcium phosphate and vitamin D3supplementation on bone remodelling and metabolism of calcium, phosphorus, magnesium and iron

BACKGROUND: The aim of the present study was to determine the effect of calcium phosphate and/or vitamin D(3) on bone and mineral metabolism. METHODS: Sixty omnivorous healthy subjects participated in the double-blind, placebo-controlled parallel designed study. Supplements were tricalcium phosphate (CaP) and cholecalciferol (vitamin D(3)). At the beginning of the study (baseline), all subjects documented their normal nutritional habits in a dietary record for three successive days. After baseline, subjects were allocated to three intervention groups: CaP (additional 1 g calcium/d), vitamin D(3) (additional 10 μg/d) and CaP + vitamin D(3). In the first two weeks, all groups consumed placebo bread, and afterwards, for eight weeks, the test bread according to the intervention group. In the last week of each study period (baseline, placebo, after four and eight weeks of intervention), a faecal (three days) and a urine (24 h) collection and a fasting blood sampling took place. Calcium, phosphorus, magnesium and iron were determined in faeces, urine and blood. Bone formation and resorption markers were analysed in blood and urine. RESULTS: After four and eight weeks, CaP and CaP + vitamin D(3) supplementations increased faecal excretion of calcium and phosphorus significantly compared to placebo. Due to the vitamin D(3) supplementations (vitamin D(3), CaP + vitamin D(3)), the plasma 25-(OH)D concentration significantly increased after eight weeks compared to placebo. The additional application of CaP led to a significant increase of the 25-(OH)D concentration already after four weeks. Bone resorption and bone formation markers were not influenced by any intervention. CONCLUSIONS: Supplementation with daily 10 μg vitamin D(3) significantly increases plasma 25-(OH)D concentration. The combination with daily 1 g calcium (as CaP) has a further increasing effect on the 25-(OH)D concentration. Both CaP alone and in combination with vitamin D(3) have no beneficial effect on bone remodelling markers and on the metabolism of calcium, phosphorus, magnesium and iron. TRIAL REGISTRATION: NCT0129702

Incorporation of n-3 PUFA and γ-linolenic acid in blood lipids and red blood cell lipids together with their influence on disease activity in patients with chronic inflammatory arthritis - a randomized controlled human intervention trial

<p>Abstract</p> <p>Background and aim</p> <p>Marine n-3 fatty acids and γ-linolenic acid both have anti-inflammatory effects and may be useful to help treat inflammatory diseases. The effects of these alone or combined were examined in patients with arthritis in a randomized controlled trial.</p> <p>Design</p> <p>Patients with rheumatoid arthritis or psoriatic arthritis were randomized into four groups in a double-blind, placebo-controlled parallel designed study. Patients received the respective capsules (1: 3.0 g n-3 LC-PUFA/d; 2: 3.2 g γ-linolenic acid/d; 3: 1.6 g n-3 LC-PUFA + 1.8 g γ-linolenic acid/d; 4: 3.0 g olive oil) for a twelve week period. Clinical status was evaluated and blood samples were taken at the beginning and at the end of the period. Differences before and after intervention were tested with paired t-test or with Wilcoxon test for non-normal data distribution.</p> <p>Results</p> <p>60 patients (54 rheumatoid arthritis, 6 psoriatic arthritis) were randomised, 47 finished per protocol. In group 1, the ratio of arachidonic acid (AA)/eicosapentaenoic acid (EPA) decreased from 6.5 ± 3.7 to 2.7 ± 2.1 in plasma lipids and from 25.1 ± 10.1 to 7.2 ± 4.7 in erythrocyte membranes (p ≤ 0.001). There was no significant influence on AA/EPA ratio due to interventions in group 2-4. In group 2, the intake of γ-linolenic acid resulted in a strong rise of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte membranes. The combination of n-3 LC-PUFA and γ-linolenic acid (group 3) led to an increase of γ-linolenic acid and dihomo-γ-linolenic acid concentrations in plasma lipids, cholesteryl esters, and erythrocyte mem-branes. This increase was only half of that in group 2.</p> <p>Conclusions</p> <p>Incorporation of eicosanoid precursor FAs was influenced by an intake of n-3 LC-PUFA and γ-linolenic acid suggesting a possible benefit for therapy of chronic inflammatory diseases.</p> <p>Trial Registration</p> <p>ClinicalTrials <a href="http://www.clinicaltrials.gov/ct2/show/NCT01179971">NCT01179971</a></p

Fatty acid distribution of cord and maternal blood in human pregnancy: special focus on individual trans fatty acids and conjugated linoleic acids

<p>Abstract</p> <p>Background</p> <p>Maternal nutrition in pregnancy has a crucial impact on the development of the fetus. Dietary <it>trans </it>fatty acids (<it>t</it>FA) are known to have adverse health effects, especially during pregnancy. However, the distribution of <it>t</it>FA produced via partial hydrogenation of vegetable oils (mainly elaidic acid; <it>t</it>9) differs compared to ruminant-derived <it>t</it>FA (mainly vaccenic acid; <it>t</it>11). Recent findings indicate that they may have different impact on human health.</p> <p>Therefore, in this study, plasma and erythrocytes of mother-child pairs (n = 55) were sampled to investigate the distribution of <it>t</it>FA, including individual <it>trans </it>C18:1 fatty acids and conjugated linoleic acids (CLA) in fetal related to maternal lipids; with additional consideration of maternal dairy fat intake.</p> <p>Results</p> <p>Portion of <it>t</it>9 and <it>t</it>11, but also of <it>c</it>9,<it>t</it>11 CLA was higher in maternal than in fetal blood lipids. The portion of <it>t</it>9 in maternal and fetal lipids differed only slightly. In contrast, the portion of fetal <it>t</it>11 was only half of that in maternal blood. This led to a fetal <it>t</it>9/<it>t</it>11-index in plasma and erythrocytes being twice as high compared to the maternal values. A high dairy fat intake resulted in elevated portions of <it>t</it>11 and its Δ9-desaturation product <it>c</it>9,<it>t</it>11 CLA in maternal blood. In contrast, in the respective fetal blood lipids only <it>c</it>9,<it>t</it>11 CLA, but not <it>t</it>11 was increased. Nevertheless, a positive association between maternal and fetal plasma exists for both <it>t</it>11 and <it>c</it>9,<it>t</it>11 CLA. Furthermore, in contrast to <it>t</it>9, <it>t</it>11 was not negatively associated with n-3 LC-PUFA in fetal blood lipids.</p> <p>Conclusions</p> <p>Fetal blood fatty acid composition essentially depends on and is altered by the maternal fatty acid supply. However, in addition to dietary factors, other aspects also contribute to the individual fatty acid distribution (oxidation, conversion, incorporation). The lower portion of fetal <it>t</it>11 compared to maternal <it>t</it>11, possibly results from Δ9-desaturation to <it>c</it>9,<it>t</it>11 CLA and/or oxidation. Based on the fatty acid distribution, it can be concluded that <it>t</it>11 differs from <it>t</it>9 regarding its metabolism and their impact on fetal LC-PUFA.</p