Consumption of plant food supplements in the Netherlands.

The use of food supplements containing herbs or other botanical ingredients (plant food supplements, PFS) is on the rise. In some cases, PFS can contain compounds that are toxic and may pose a health risk. To assess the potential health risks, information on the consumption of PFS is required, however, this was lacking for the Netherlands. In the current study, the consumption of PFS was investigated for several subgroups in the Dutch population, including children. Data from the Dutch National Food Consumption Surveys were used to get a first impression on the consumption of PFS. To obtain more detailed information, a specific PFS consumption survey was performed using online questionnaires. First, a screening survey was performed among a representative sample of 75 100 adults and children of the Dutch population, followed by a main survey among 739 selected PFS users in eight different age and gender subgroups. The prevalence of PFS users in the Dutch population was approximately 10% for men, 17% for women and 13% for children. A wide variety of PFS was used, with around 600 different PFS reported, containing 345 different botanicals. The most frequently used botanicals were echinacea (Echinacea purpurea), ginkgo (Ginkgo biloba), cranberry (Vaccinium macrocarpon), ginseng (Panax ginseng) and algae (such as species belonging to the genus Spirulina or Chlorella). Because PFS are widely used in the Dutch population, it is important to evaluate the potential risks associated with PFS consumption in the Netherlands, including potential herb-drug interactions. The data collected in this study are of great value to assess these risks

Evaluation of Outcomes following Focal Ablative Therapy for Treatment of Localised Clinically Significant Prostate Cancer in Patients >70 Years: A Multi-institute, Multi-energy 15-year Experience

PURPOSE: In older patients who do not wish to undergo watchful waiting, focal therapy could be an alternative to the more morbid radical treatment. We evaluated the role of focal therapy (FT) in patients 70 years and older as an alternative management modality. MATERIALS AND METHODS: 649 patients across 11 UK sites receiving focal high intensity focused ultrasound (HIFU) or cryotherapy between June 2006 - July 2020 reported within the UK based HIFU Evaluation and Assessment of Treatment and the International Cryotherapy Evaluation (ICE) registries were evaluated. Primary outcome was failure free survival (FFS) defined by need for more than 1 focal re-ablation, progression onto radical treatment, development of metastases, need for systemic treatment or prostate cancer specific death. This was compared to the FFS in patients undergoing radical treatment via a propensity score weighted analysis. RESULTS: Median age was 74 years (IQR: 72, 77) and median follow-up 24 months (IQR: 12, 41). 60% had intermediate risk disease and 35% high risk disease. 113 patients (17%) required further treatment. 16 had radical treatment and 44 required systemic treatment. FFS was 82% (95% CI: 76-87%) at 5 years. Comparing patients who had radical therapy to those who had focal therapy, 5-year FFS was 96%, (95% CI: 93-100%) and 82% (95% CI: 75-91%) respectively, P < .001. 93% of those in the radical treatment arm had received Radiotherapy as their primary treatment with its associated use of Androgen Deprivation Therapy (ADT) thereby leading to potential over estimation of treatment success in the radical treatment arm, especially given the similar metastases free and overall survival rates seen. CONCLUSIONS: We propose FT to be an effective management option for the older or comorbid patient who is unsuitable for or not willing to undergo radical treatment

The Rotterdam Study: 2012 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch

Dietary Changes among Adults in The Netherlands in the Period 2007-2010 and 2012-2016. Results from Two Cross-Sectional National Food Consumption Surveys.

Insight into dietary trends is important for the development and evaluation of dietary policies. The aim of this study is to describe changes in dietary intakes of Dutch adults and to evaluate these changes by age, gender, and education. In 2007-2010 and 2012-2016, two national food consumption surveys were conducted including 2106 and 1540 adults, respectively. Data collection included two non-consecutive 24 h dietary recalls. Mean habitual intakes of foods and nutrients relevant for a healthy diet of both surveys were estimated. Between the two periods the mean consumption of red or processed meat, dairy, sodium and alcohol and the ratio of whole-grain to cereal products decreased by 4-30% and the consumption of fibre and unsaturated fatty acids increased by about 3% and 6%, respectively. For most food groups, changes in consumption were comparable for both sexes and in all age groups. A healthier consumption pattern and several favorable changes were observed among higher-educated people. Most, but not all, changes in food consumption are favorable from a public health point of view. However, there is still a large potential for further improvements. A healthier consumption pattern was observed in adults with a higher educational level which calls for attention to social disparities when developing dietary policies.</p

Decreased, but still sufficient, iodine intake of children and adults in the Netherlands.

Sufficient I intake is important for the synthesis of thyroid hormones, which play an important role in normal growth and development. Our aim was to estimate habitual I intake for the Dutch population and the risk of inadequate or excessive intakes. Further, we aimed to provide an insight into the dietary sources of I and the association with socio-demographic factors. Data from the Dutch National Food Consumption Survey 2007-2010 (n 3819; 7-69 years), and from the Dutch food and supplement composition tables were used to estimate habitual I intake with a calculation model. Contribution of food groups to I intake were computed and multiple linear regression was used to examine associations of intakes with socio-demographic factors. A total of ≤2 % of the population had an intake below the estimated average requirement or above the upper level. The main sources of I were bread containing iodised salt (39 %), dairy products (14 %) and non-alcoholic drinks (6 %). I intake (natural sources only, excluding iodised salt and supplements) was positively associated with (parental) education, which could at least partly be attributed to a higher consumption of dairy products. Among children, the consumption of bread, often containing iodised bakery salt, was positively associated with parental education. The I intake of the Dutch population (7-69 years) seems adequate, although it has decreased since the period before 2008. With the current effort to reduce salt intake and changing dietary patterns (i.e. less bread, more organic foods) it is important to keep a close track on the I status, important sources and potential risk groups

Reproducibility and relative validity of a FFQ to estimate the intake of fatty acids

We investigated the validity and reproducibility of the FFQ used in the Dutch European Investigation of Cancer and Nutrition cohort, in order to rank subjects according to intakes of fatty acid classes and individual fatty acids. In total, 121 men and women (23-72 years) filled out three FFQ at 6-month intervals between 1991 and 1992. As a reference method, they filled out twelve monthly 24-h dietary recalls (24HDR) during the same year. Intra-class correlation coefficients for the FFQ showed moderate to good reproducibility across all fatty acids (classes and individual) in men (0·56-0·81) and women (0·57-0·83). In men, Spearman's correlation coefficients (r s) for the FFQ compared with the 24HDR indicated moderate to good relative validity (r s=0·45-0·71) for all fatty acids, except for arachidonic acid and marine PUFA (r s<0·40). In women, relative validity was moderate to good for MUFA and trans-fatty acids (TFA) and the majority of SFA (r s=0·40-0·66), was fair for the short-chain SFA and lauric acid (r s=0·30-0·33) and was fair to moderate for PUFA (r s=0·22-0·47). Bland-Altman plots showed good agreement between the FFQ and 24HDR, and proportional bias for fatty acids with very low intakes. In conclusion, the FFQ showed good reproducibility for subject ranking based on intakes of fatty acids (classes and individual). The relative validity measures indicated that the FFQ is an adequate tool to rank subjects according to intakes of high-abundant fatty acids, but less for low-abundant fatty acids