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Some countries have introduced mandatory folic acid fortification, whereas others support periconceptional supplementation of women in childbearing age. Several European countries are considering whether to adopt a fortification policy. Projections of the possible beneficial effects of increased folic acid intake assume that the measure will result in a considerable reduction in neural-tube defects (NTD) in the target population. Therefore, the objective of the present study is to evaluate the beneficial effects of different levels of folic acid administration on the prevalence of NTD. Countries with mandatory fortification achieved a significant increase in folate intake and a significant decline in the prevalence of NTD. This was also true for supplementation trials. However, the prevalence of NTD at birth declined to approximately five cases at birth per 10 000 births and seven to eight cases at birth or abortion per 10 000 births. This decline was independent of the amount of folic acid administered and apparently reveals a ‘floor effect’ for folic acid-preventable NTD. This clearly shows that not all cases of NTD are preventable by increasing the folate intake. The relative decline depends on the initial NTD rate. Countries with NTD prevalence close to the observed floor may have much smaller reductions in NTD rates with folic acid fortification. Additionally, potential adverse effects of fortification on other vulnerable population groups have to be seriously considered. Policy decisions concerning national mandatory fortification programmes must take into account realistically projected benefits as well as the evidence of risks to all vulnerable groups.
Colorectal cancer screening forms part of Scotland's cancer reduction strategy. Screened participants, who had undergone colonoscopy and had adenoma(s) removed, were invited to participate in the bowel health to better health (BHBH) programme. BHBH tested the hypothesis that a minimal contact lifestyle intervention could prove effective in promoting changes in diet and activity. Baseline and follow-up questionnaires on lifestyle and psycho-social measures were undertaken in adults randomised to BHBH or a comparison group (CG). The 3-month intervention comprised personalised lifestyle advice, goal-setting and social support to promote increases in physical activity, fibre, fruit and vegetables. Response rate to BHBH was 51 %. BHBH participants (n 32) increased their intake of fibre (DINE FFQ scores 30 (sd 11)–41 (sd 13)) significantly (P < 0·001) more than the CG (n 30; 31 (sd 8)–30 (sd 11). No significant differences between the groups were detected for changes in fruits, vegetables and moderate activity. At baseline, only one participant from each study arm, met the target recommendations for fibre, fruit and vegetable intakes and physical activity. At follow up a significant number of BHBH participants, 15 (47 %) compared to 4 (13 %) of the CG were achieving all three lifestyle recommendations (χ2 (1, n 62) = 8·196, P = 0·006). If sustained, the positive behaviour change achieved through this intervention has the potential to impact on the progression of chronic disease risk including CVD.
In recent years, l-carnitine has been used increasingly as a supplement in livestock animals. The present review gives an overview of the effects of dietary l-carnitine supplementation on the reproductive performance of sows. Results concerning the effect of l-carnitine supplementation during pregnancy on litter sizes are controversial. There are some studies reporting an increased number of piglets born alive per litter, while others could not find such an effect. In contrast, most studies performed show consistently that l-carnitine supplementation to a sow diet low in native carnitine during gestation increases piglet and litter weights at birth and enhances growth of litters during the suckling period. Biochemical mechanisms underlying the favourable effect of carnitine on intra-uterine growth have not been fully elucidated. There is, however, some evidence that carnitine influences the insulin-like growth factor-axis in sows and leads to greater placentae, which in turn improves intra-uterine nutrition, and stimulates oxidation of glucose in the fetuses. These effects may, at least in part, be responsible for higher birth weights of piglets. The stimulating effect of carnitine on growth of the litters might be due to an improved suckling behaviour of piglets born to l-carnitine-supplemented sows, causing the sows' milk production to rise. In conclusion, recent studies have clearly shown that dietary l-carnitine supplementation increases the reproductive performance of sows. These findings suggest that endogenous de novo synthesis of carnitine is insufficient to meet the metabolic requirement of sows during gestation.
It has been estimated that up to one-third of patients with diabetes mellitus use some form of complementary and alternative medicine. Momordica charantia (bitter melon) is a popular fruit used for the treatment of diabetes and related conditions amongst the indigenous populations of Asia, South America, India and East Africa. Abundant pre-clinical studies have documented the anti-diabetic and hypoglycaemic effects of M. charantia through various postulated mechanisms. However, clinical trial data with human subjects are limited and flawed by poor study design and low statistical power. The present article reviews the clinical data regarding the anti-diabetic potentials of M. charantia and calls for better-designed clinical trials to further elucidate its possible therapeutic effects.
Conjugated linoleic acids (CLA) are biologically highly active lipid compounds that inhibit the development of atherosclerotic plaques in experimental animals. The underlying mechanisms of action, however, are only poorly understood. Since cell-culture experiments are appropriate to provide a detailed view into the mechanisms of action of a compound, the present review summarises results from in vitro studies dealing with the effects of CLA isomers and CLA mixtures on functional properties of cells of the vascular wall, such as endothelial cells, smooth muscle cells and monocyte-derived macrophages, which are amongst the major cells contributing to atherosclerotic lesion development. Based on these studies, it can be concluded that CLA exert several beneficial actions in cells of the vascular wall through the activation of nuclear PPAR. These actions of CLA, which may, at least partially, explain the inhibition of atherogenesis by dietary CLA, include modulation of vasoactive mediator release from endothelial cells, inhibition of inflammatory and fibrotic processes in activated smooth muscle cells, abrogation of inflammatory responses in activated macrophages, and reduction of cholesterol accumulation in macrophage-derived foam cells.
Isoflavone intake is associated with various properties beneficial to human health which
are related to their antioxidant activity, for example, to their ability to increase LDL
oxidation resistance. However, the distribution of isoflavones among plasma lipoproteins
has not yet been elucidated in vivo. Therefore, the objective of the
present study was to investigate the association between daidzein (DAI) and lipoproteins
in human plasma upon administration of the aglycone and glucoside form. Five men aged
22–30 years participated in a randomised, double-blind study in cross-over
design. After ingestion of DAI and
daidzein-7-O-β-d-glucoside (DG) (1 mg DAI
aglycone equivalents/kg body weight) blood samples were drawn before isoflavone
administration as well as 1, 2, 3, 4·5, 6, 8, 10, 12, 24 and 48 h
post-dose. Concentrations of DAI in the different lipoprotein fractions (chylomicrons,
VLDL, LDL, HDL) and in the non-lipoprotein fraction were analysed using isotope dilution
capillary GC/MS. The lipoprotein fraction profiles were similar for all subjects and
resembled those obtained for plasma in our previously published study. The lipoprotein
distribution based on the area under the concentration–time profiles from
0 h to infinity in the different fractions were irrespective of the administered
form: non-lipoprotein fraction (53 %) > LDL (20 %) > HDL
(14 %) > VLDL (9·5 %) > chylomicrons
(2·5 %). Of DAI present in plasma, 47 % was associated to
lipoproteins. Concentrations in the different lipoprotein fractions as well as in the
non-lipoprotein fraction were always higher after the ingestion of DG than of DAI. Taken
together, these results demonstrate an association between isoflavones and plasma
lipoproteins in vivo.
Meta-analysis was applied to quantify the effect of replacement of fish meal by soyabean products in diets on fish growth. Measurement of growth in different units among studies required the use of a standardised effect size (Hedges' d). From a total of ninety-nine studies concentrating on fish meal replacement by defatted soyabean meal, 53 % were eliminated due to, among others, absence of a fish meal control diet (n 18), or no statistical differences or measurement of dispersion (n 6) indicated. Replacement of 4 to 40 % fish meal by soyabean meal (inclusion levels of 71–366 g/kg) resulted in a mean effect size of − 0·1142 (95 % CI − 0·4665, 0·2382) obtained in forty-eight comparisons evaluated with seventeen different fish species. However, at higher fish meal replacement levels the 95 % CI calculated for combined effect sizes did not overlap with zero. With soya protein concentrate replacing 25 to 100 % of fish meal in diets for seven fish species, methionine supplementation (mean − 2·4373 (95 % CI − 3·9004, − 0·9742); n 10) did not have a substantial influence on the magnitude of cumulative effect sizes relative to no supplementation (mean − 2·7306 (95 % CI − 3·7991, − 1·6620); n 16). Information on other soyabean products (full-fat soyabeans, soya flour) used as protein sources in fish diets was found as too limited for analysis and definite conclusions. The present study contributes by putting a numerical value to the magnitude of growth differences in fish when replacing dietary fish meal by soyabean products.
Being the metabolic syndrome a multifactorial condition, it is difficult to find adequate experimental models to study this pathology. The obese Zucker rats, which are homozygous for the fa allele, present abnormalities similar to those seen in human metabolic syndrome and are a widely extended model of insulin resistance. The usefulness of these rats as a model of non-insulin-dependent diabetes mellitus is nevertheless questionable, and they neither can be considered a clear experimental model of hypertension. Some experimental models different from the obese Zucker rats have also been used to study the metabolic syndrome. Some derive from the spontaneously hypertensive rats (SHR). In this context, the most important are the obese SHR, usually named Koletsky rats. Hyperinsulinism, associated with either normal or slightly elevated levels of blood glucose, is present in these animals, but SHR/N-corpulent rats are a more appropriated model of non-insulin-dependent diabetes mellitus. The SHR/NDmc corpulent rats, a subline of SHR/N-corpulent rats, also exhibit metabolic and histopathologic characteristics associated with human metabolic disorders. A new animal model of the metabolic syndrome, stroke-prone–SHR (SHRSP) fatty rats, was obtained by introducing a segment of the mutant leptin receptor gene from the Zucker line heterozygous for the fa gene mutation into the genetic background of the SHRSP. Very recently, it has been developed as a non-obese rat model with hypertension, fatty liver and characteristics of the metabolic syndrome by transgenic overexpression of a sterol-regulatory element-binding protein in the SHR rats. The Wistar Ottawa Karlsburg W rats are also a new strain that develops a nearly complete metabolic syndrome. Moreover, a new experimental model of low-capacity runner rats has also been developed with elevated blood pressure levels together with the other hallmarks of the metabolic syndrome.
The objective of the present study was to assess the effects of Enterococcus sp. strain TN-3 isolated from deep seawater on inhibition of eosinophil accumulation, IgE production and active cutaneous anaphylaxis (ACA). We investigated the effects of viable and non-viable TN-3 on allergen-induced peritoneal eosinophil accumulation in mice. Viable (5·4 × 1010 colony-forming units per 60 mg) or non-viable TN-3 (60 mg) was orally administered to BALB/c mice that had been sensitised with the cedar pollen (Cryptomeria japonica) allergen. Oral administration of non-viable TN-3 was effective in suppressing eosinophil accumulation while viable TN-3 was ineffective. We also examined the dose–response relationship for non-viable TN-3 in regard to eosinophil accumulation, IgE production and ACA in allergen-primed mice. Non-viable TN-3 was orally administered at doses of 15 mg (low dose), 30 mg (medium dose) and 60 mg (high dose) to BALB/c mice that had been sensitised with cedar pollen allergen. The anti-allergic effects expressed as inhibition of eosinophil accumulation, IgE production and ACA were found at the low and high doses, but not at the medium dose. These results suggest that non-viable TN-3 exhibited anti-allergic effects at doses of 15 and 60 mg.
Within the EURopean micronutrient RECommendations Aligned Network of Excellence (EURRECA), a scoring system was developed to assess the quality of dietary intake validation studies. The scoring system included three steps. The first step was to give each study a quality score, which included five components: sample size, statistics used, data collection procedure, consideration of seasonality and supplement use. Scores ranged from 0 to 7, and validation studies classified as very good ( ≥ 5), good (5–3·5), acceptable/reasonable (3·5–2·5) and poor ( < 2·5). The second and third steps included an adjustment/weighting of the correlation coefficient according to the quality score and moreover a rating of the adjusted/weighted correlation. The scoring system was tested in 124 validation studies that included at least one vitamin. Only 5·6 % of the 124 studies were judged to be of very good quality according to the quality score, 41·9 % of good quality and 16·9 % had a poor rating. When adjusting for the study quality scores, crude and adjusted mean correlations of vitamins A, C, D and E intakes were similar, but the percentage of correlation values classified as poor or very good was higher after adjustment. These results show the importance of considering the quality of studies validating dietary assessment methods and the correlations obtained for the micronutrient of interest when interpreting effects observed in epidemiological studies using dietary assessment methods. Without a doubt, this subject constitutes a key topic for research in nutritional epidemiology.
Low intakes of fruit and vegetables have previously been reported in the older population of Great Britain, particularly among certain socio-demographic groups. Levels and patterns of consumption in the older population of Northern Ireland, however, remain unknown. A representative sample of 1000 members of the older population of Northern Ireland were contacted by telephone to assess average intake of all fruits and vegetables and various demographic details. Data from 426 individuals (representative of the whole population) reported a mean consumption of 4·0 (sd 1·3) and 4·1 (sd 1·3) portions of fruit and vegetables per weekday and per weekend day respectively. Regression analyses revealed greater consumption on weekdays by females (B 0·53; P < 0·01), younger individuals (B − 0·02; P = 0·01) and those living in less deprived areas (B − 0·01; P = 0·04), and greater consumption at weekends by females (B 0·54; P < 0·01) and younger individuals (B − 0·03; P = 0·01). The amount of fruit and vegetables consumed is slightly higher than that reported in older populations in Great Britain, possibly as a result of differences in farming practices and rural activities, although levels of consumption remain below current recommendations for health. Patterns of consumption are similar across the UK, and suggest that strategies to increase fruit and vegetable consumption should target males, older individuals and those living in more deprived areas.
The infant born small size for gestational age (SGA) has low bone mass. Since dietary arachidonic acid (AA) and DHA enhance bone mass in normal-birth-weight piglets the objective of the present study was to test for such benefits in the SGA piglet. In the present 15 d study, two levels of dietary AA and DHA (6:1 ratio of AA:DHA diets, 0·6:0·1 or 1·2:0·2 g/100 g dietary fat) v. a control diet were tested for effects on growth, fatty acid status, whole-body and regional bone mineral content (BMC) and metabolism in SGA piglets categorised as either very low birth weight (VLBW; ≤ 1·0 kg; n 12) or low birth weight (LBW; 1·1 to 1·2 kg; n 18). Differences in outcomes for each body weight category were detected using ANOVA with post hoc Bonferroni tests. Growth was not influenced by diet, yet the LBW piglets fed 0·6:0·1 AA and DHA as g/100 g fat had elevated BMC in the spine, whereas the VLBW piglets had higher BMC of the spine if fed the higher intake of AA and DHA. In both weight categories, the higher intake of AA and DHA lowered bone resorption relative to controls, whereas bone formation was unchanged. Tissue fatty acid concentrations reflected dietary AA and DHA, especially trabecular bone of VLBW piglets. Whether the enhanced lumbar spine BMC is due to enhanced Ca absorption and thus suppression of bone resorption remains to be established.