Breastfeeding woman are at higher risk of vitamin D deficiency than non-breastfeeding women - insights from the German VitaMinFemin study

Background: Despite increased awareness of the adverse health effects of vitamin D deficiency, only a few studies have evaluated the vitamin D status (25-hydroxyvitamin D [25(OHD)]) of breastfeeding women and up to now, no information exits for German breastfeeding women. Therefore, the aim of study was to determine the vitamin D status of breastfeeding women compared to non-pregnant and non-breastfeeding (NPNB) women. Methods: This cross-sectional study investigated 124 breastfeeding women and 124 age and season matched NPNB women from the German "Vitamin and mineral status among German women" study. The study participants were recruited from April 2013 to March 2015 and did not take vitamin D supplements. Serum 25(OH)D was analyzed by chemiluminescent immunoassay. Results: Vitamin D deficiency (<25.0 nmol/L) was prevalent in 26.6% of the breastfeeding women. The majority of women (49.2%) showed 25(OH)D concentration between 25.0 and 49.9 nmol/L. In multiple binary logistic regression analysis, breastfeeding women had a 4.0-fold higher odds ratio (OR) (95% confidence interval [CI] 1.8, 8.7) for vitamin D deficiency than NPNB women. For breastfeeding women, the risk of vitamin D deficiency was higher in the winter and spring months (OR: 2.6, 95% CI 1.1, 6.3) and increased with lower longitude per one unit (OR 0.7, 95% CI 0.6, 0.9). Conclusion: Breastfeeding women in Germany had a higher risk of deficient vitamin D levels than NPNB women. In further studies, the optimal vitamin D status for breastfeeding women should be investigated and also the required vitamin D doses to ensure this vitamin D status. Trial registration: German Clinical Trial Register (identification number: DRKS00004789 ).Rottapharm Madaus GmbHMeda A

Sub specie evolutionis : eine Studie zur evolutionären Ernährungswissenschaft

[no abstract

Effects of mineral waters on acid–base status in healthy adults

Background: The ‘Western diet’ typically consumed in industrialized countries is characterized by high amounts of processed cereal grains and animal products while being low in vegetables, tubers, and fruits. This dietary behavior leads to imbalances of acid–base status in favor of the acids and may cause low-grade metabolic acidosis (LGMA) that is associated with negative effects on health in the long run, including urolithiasis, bone loss, and even cardiometabolic diseases. Therefore, it has become of great interest to find dietary strategies that can be used to neutralize the acid load associated with Western diets. Objective: The aim of this study was to investigate whether the diet-dependent net acid load can be reduced by the daily consumption of mineral waters with different bicarbonate content and different potential renal acid load (PRAL). Methods: A single-centered, randomized trial including 129 healthy men and women aged from 18 to 75 years was conducted. Participants consumed 1,500–2,000 mL of one of four mineral waters with different bicarbonate content and different PRAL values daily for 4 weeks: low bicarbonate, high PRAL (LBHP, HCO3 −: 403.0 mg/L, PRAL: 10.7); medium-high bicarbonate, medium PRAL (MBMP, HCO3 − : 1816.0 mg/L, PRAL: −10.8); high bicarbonate, low PRAL (HBLP, HCO3 −: 2451.0 mg/L, PRAL: −19.3); medium-high bicarbonate, low PRAL (MBLP, HCO3 −: 1846.0 mg/L, PRAL: −22.1). Throughout the study, participants were asked to maintain their usual dietary habits. The primary outcome was the net acid excretion (NAE) measured in the 24-h urine output. Results: Consumption of the three mineral waters: MBMP, HBLP, and MBLP led to a significant decrease in NAE values. Within the MBMP group, the NAE could be reduced by 48% (P = 0.001), while consumption of HBLP led to a reduction of 68% (P < 0.001) and MBLP to a reduction of 53% (P = 0.001). Moreover, a slight increase in serum bicarbonate could also be observed in the groups that drank HBLP (P = 0.057) and MBLP (P = 0.001). Conclusion: Daily consumption of at least 1,500–2,000 mL of mineral water rich in bicarbonate (>1800.0 mg/L) with medium or low PRAL (<−11 mEq/L) can effectively reduce the NAE level by reducing the dietary acid load under free-living conditions in healthy adults

Support Vector Machine Analysis of Functional Magnetic Resonance Imaging of Interoception Does Not Reliably Predict Individual Outcomes of Cognitive Behavioral Therapy in Panic Disorder with Agoraphobia

Background: The approach to apply multivariate pattern analyses based on neuro imaging data for outcome prediction holds out the prospect to improve therapeutic decisions in mental disorders. Patients suffering from panic disorder with agoraphobia (PD/AG) often exhibit an increased perception of bodily sensations. The purpose of this investigation was to assess whether multivariate classification applied to a functional magnetic resonance imaging (fMRI) interoception paradigm can predict individual responses to cognitive behavioral therapy (CBT) in PD/AG. Methods: This analysis is based on pretreatment fMRI data during an interoceptive challenge from a multicenter trial of the German PANIC-NET. Patients with DSM-IV PD/AG were dichotomized as responders (n = 30) or non-responders (n = 29) based on the primary outcome (Hamilton Anxiety Scale Reduction ≥50%) after 6 weeks of CBT (2 h/week). fMRI parametric maps were used as features for response classification with linear support vector machines (SVM) with or without automated feature selection. Predictive accuracies were assessed using cross validation and permutation testing. The influence of methodological parameters and the predictive ability for specific interoception-related symptom reduction were further evaluated. Results: SVM did not reach sufficient overall predictive accuracies (38.0–54.2%) for anxiety reduction in the primary outcome. In the exploratory analyses, better accuracies (66.7%) were achieved for predicting interoception-specific symptom relief as an alternative outcome domain. Subtle information regarding this alternative response criterion but not the primary outcome was revealed by post hoc univariate comparisons. Conclusion: In contrast to reports on other neurofunctional probes, SVM based on an interoception paradigm was not able to reliably predict individual response to CBT. Results speak against the clinical applicability of this technique

The Revised D-A-CH-Reference Values for the Intake of Vitamin B 12 : Prevention of Deficiency and Beyond

Scope: The nutrition societies of Germany, Austria, and Switzerland are the joint editors of the “D-A-CH reference values for nutrient intake”, which are revised regularly. Methods and Results: By reviewing vitamin-B 12 -related biomarker studies, the reference values for vitamin B 12 were revised in 2018. For adults, the estimated intake is based on the adequate serum concentrations of holotranscobalamin and methylmalonic acid. The estimated values for children and adolescents are extrapolated from the adult reference value by considering differences in body mass, an allometric exponent, and growth factors. For infants below 4 months of age, an estimated value is set based on the vitamin B 12 intake via breast milk. The reference values for pregnant and lactating women consider the requirements for the fetus and for loss via breast milk. The estimated values for vitamin B 12 intake for infants, children, and adolescents range from 0.5 to 4.0 µg d −1 . For adults, the estimated values are set at 4.0 µg d −1 , and for pregnant and lactating women, they are set at 4.5 and 5.5 µg d −1 , respectively. Conclusion: Based on the data of several vitamin B 12 status biomarkers studies, the reference value for vitamin B 12 intake for adults is raised from 3.0 to 4.0 µg d −1

Diet-dependent net endogenous acid load of vegan diets in relation to food groups and bone health-related nutrients: Results from the German Vegan Study

Background/Aims:Dietary composition has been shown to affect acid-base homeostasis and bone health in humans. We investigated the potential renal acid load (PRAL) and the estimated diet-dependent net acid load (net endogenous acid production, NEAP) in adult vegans and evaluated the relationships between NEAP, food groups and intake of bone health-related nutrients. Methods: The German Vegan Study (GVS) is a cross-sectional study. Data from healthy men (n = 67) and women (n = 87), aged 21–75 years, who fulfilled the study criteria (vegan diet for ≧1 year prior to study start; age ≧18 years, and no pregnancy/childbirth during the last 12 months) were included in the analysis. NEAP values were calculated from diet composition using two models: one based on the protein/potassium quotient and another taking into account an anthropometry-based loss of urinary organic anions. Results:Mean daily intakes of phosphorus, potassium, sodium, magnesium and vitamin C were above, and vitamin D and calcium below Dietary Reference Intake (DRI). Regardless of the model used, the diet in the GVS was characterized by a nearly neutral NEAP. A strong correlation was observed between the NEAP values of the two models (rs = 0.873, p < 0.001). Only the consumption of fruits decreased constantly across the increasing quartiles of NEAP. Conclusions: It can be hypothesized that vegan diets do not affect acid-base homeostasis. With respect to bone health, the significance of this finding needs further investigation

Overall glycemic index and glycemic load of vegan diets in relation to plasma lipoproteins and triacylglycerols

Background: To investigate the overall glycemic index (GI), glycemic load (GL), and intake of dietary fiber, and to examine the associations between these factors and plasma lipoproteins and triacylglycerols in adult vegans in the German Vegan Study (GVS). Methods: Cross-sectional study, Germany. Healthy men (n = 67) and women (n = 87), who fulfilled the study criteria (vegan diet for ≧1 year prior to study start; minimum age of 18 years; no pregnancy/childbirth during the last 12 months) and who participated in all study segments. Results: The average dietary GL of the GVS population was 144, and the average GI was 51.4. The adjusted geometric mean total, HDL, and LDL cholesterol concentrations decreased across the increasing quartiles of GL, carbohydrate and dietary fiber intake. The associations between total cholesterol, HDL cholesterol, LDL cholesterol and GL density and GI were inconsistent. Also, associations between GI, GL, the intake of carbohydrates, and triacylglycerol concentration were not observed. Conclusions: Fiber-rich vegan diets are characterized by a low GI and a low to moderate GL. The data do not support the hypothesis that a carbohydrate-rich diet per se is associated with unfavorable effects on triaclyglycerols that would be predicted to increase the risk of coronary heart disease

Dimensional structure of bodily panic attack symptoms and their specific connections to panic cognitions, anxiety sensitivity and claustrophobic fears

This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.Background. Previous studies of the dimensional structure of panic attack symptoms have mostly identified a respiratory and a vestibular/mixed somatic dimension. Evidence for additional dimensions such as a cardiac dimension and the allocation of several of the panic attack symptom criteria is less consistent. Clarifying the dimensional structure of the panic attack symptoms should help to specify the relationship of potential risk factors like anxiety sensitivity and fear of suffocation to the experience of panic attacks and the development of panic disorder. Method. In an outpatient multicentre study 350 panic patients with agoraphobia rated the intensity of each of the ten DSM-IV bodily symptoms during a typical panic attack. The factor structure of these data was investigated with nonlinear confirmatory factor analysis (CFA). The identified bodily symptom dimensions were related to panic cognitions, anxiety sensitivity and fear of suffocation by means of nonlinear structural equation modelling (SEM). Results. CFA indicated a respiratory, a vestibular/mixed somatic and a cardiac dimension of the bodily symptom criteria. These three factors were differentially associated with specific panic cognitions, different anxiety sensitivity facets and suffocation fear. Conclusions. Taking into account the dimensional structure of panic attack symptoms may help to increase the specificity of the associations between the experience of panic attack symptoms and various panic related constructs.Peer Reviewe

Прецеденты снижения распространенности немецкого языка в Бразилии во второй половине XX вв. (на примере опроса учащихся школ штата Санта-Катарина)

Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n = 89 patients and n = 90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research