Articles in Press

Nanotechnology Research: Applications in Nutritional Sciences [Symposium-Nanotechnology Research: Applications in Nutritional Sciences]

Wed, 25 Nov 2009 07:27:34 PST

The tantalizing potential of nanotechnology is to fabricate and combine nanoscale approaches and building blocks to make useful tools and, ultimately, interventions for medical science, including nutritional science, at the scale of ~1–100 nm. In the past few years, tools and techniques that facilitate studies and interventions in the nanoscale range have become widely available and have drawn widespread attention. Recently, investigators in the food and nutrition sciences have been applying the tools of nanotechnology in their research. The Experimental Biology 2009 symposium entitled "Nanotechnology Research: Applications in Nutritional Sciences" was organized to highlight emerging applications of nanotechnology to the food and nutrition sciences, as well as to suggest ways for further integration of these emerging technologies into nutrition research. Speakers focused on topics that included the problems and possibilities of introducing nanoparticles in clinical or nutrition settings, nanotechnology applications for increasing bioavailability of bioactive food components in new food products, nanotechnology opportunities in food science, as well as emerging safety and regulatory issues in this area, and the basic research applications such as the use of quantum dots to visualize cellular processes and protein-protein interactions. The session highlighted several emerging areas of potential utility in nutrition research. Nutrition scientists are encouraged to leverage ongoing efforts in nanomedicine through collaborations. These efforts could facilitate exploration of previously inaccessible cellular compartments and intracellular pathways and thus uncover strategies for new prevention and therapeutic modalities.

Vitamin A Intake and Status in Populations Facing Economic Stress [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

West, K. P., Mehra, S. — Wed, 25 Nov 2009 07:27:34 PST

Dietary quality and diversity reflect adequacy of vitamin A. Both can deteriorate in response to economic crises. Although the nutritional consequences of the 2008 world food price crisis remain unclear, past studies of diet, status, and socioeconomic standing under usual (deprived) and unusually disruptive times suggest dietary quality and vitamin A status decline in mothers and young children. This is presumably the result of shifting diets to include less preformed vitamin A–rich animal source foods and, to a lesser extent, vegetables and fruits. Cross-sectional assessments of diet, deficiency, and socioeconomic status in a number of countries and surveillance data collected during the Indonesian economic crisis of 1997–8 indicate that the prevalence of vitamin A deficiency, night blindness, and other related disorders (e.g., anemia) may have increased during the 2008 crisis, and that it might not have necessarily recovered once food prices waned later in 2008. Lost employment may be a factor in slow nutritional recovery, despite some easing of food prices. Vitamin A deficiency should still be preventable amid economic instabilities through breast feeding promotion, vitamin A supplementation, fortification of foods targeted to the poor, and homestead food production that can bolster income and diversify the diet.

Editorial Comment: Helping the Vulnerable [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Nabarro, D. — Wed, 25 Nov 2009 07:27:33 PST

How to Ensure Nutrition Security in the Global Economic Crisis to Protect and Enhance Development of Young Children and Our Common Future [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Wed, 25 Nov 2009 07:27:33 PST

The global economic crisis, commodity price hikes, and climate change have worsened the position of the poorest and most vulnerable people. These crises are compromising the diet and health of up to 80% of the population in most developing countries and threaten the development of almost an entire generation of children (~250 million), because the period from conception until 24 mo of age irreversibly shapes people's health and intellectual ability. High food prices reduce diversity and nutritional quality of the diet and for many also reduce food quantity. Poor households are hit hardest, because they already spend 50–80% of expenditures on food, little on medicines, education, transport, or cooking fuel, and cannot afford to pay more. Reduced public spending, declining incomes, increased food and fuel prices, and reduced remittance thus impede and reverse progress made toward Millenium Development Goals 1, 4, and 5. Investments in nutrition are among the most cost-effective development interventions because of very high benefit:cost ratios, for individuals and for sustainable growth of countries, because they protect health, prevent disability, boost economic productivity, and save lives. To bridge the gap between nutrient requirements, particularly for groups with high needs, and the realistic dietary intake under the prevailing circumstances, the use of complementary food supplements to increase a meal’s nutrient content is recommended. This can be in the form of, e.g., micronutrient powder or low-dose lipid-based nutrient supplements, which can be provided for free, in return for vouchers, at subsidized, or at commercial prices.

Maternal and Young Child Nutrition Adversely Affected by External Shocks Such As Increasing Global Food Prices [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Darnton-Hill, I., Cogill, B. — Wed, 25 Nov 2009 07:27:32 PST

Rising food prices, resulting from the ongoing global economic crisis, fuel price volatility, and climate change, have an adverse impact upon the poor, especially those in food-importing, resource-limited countries. The conventional approach by large organizations has been to advocate for increased staple crop yields of mainly cereals. High food prices are predicted to continue to at least 2015. Past shocks and their known impacts upon nutrition were reviewed. Price instability and increases have long been an existing global problem, which has been exacerbated by recent macroeconomic shocks such as acute emergencies due to war and civil strife, acute climatic events, increase in food prices, fuel price volatility, dysfunction of the global financial systems, long-term climate change, and the emergence of failed states. The FAO estimated that there were 815 million "hungry" people in 2006, with a now additional 75–135 million with increased vulnerability, and currently it is estimated that there are one billion people at risk of food insecurity. The shocks initially compromise maternal and child nutrition, mainly through a reduction in dietary quality and an increase in micronutrient deficiencies and concomitant increases in infectious disease morbidity and mortality. A further reduction in the quantity of diet may follow with greater underweight and wasting. Recent macroeconomic shocks have greatly increased the number of people who are vulnerable to hunger in developing countries. Nutritional surveillance systems need to be strengthened and expanded to inform policy decisions.

Higher Household Expenditure on Animal-Source and Nongrain Foods Lowers the Risk of Stunting among Children 0-59 Months Old in Indonesia: Implications of Rising Food Prices [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Wed, 25 Nov 2009 07:27:32 PST

Because the global financial crisis and high food prices affect food consumption, we characterized the relationship between stunting and nongrain food expenditure at the household level among children 0–59 mo old in Indonesia's rural and urban poor population. Expenditure and height-for-age data were obtained from a population-based sample of 446,473 children in rural and 143,807 in urban poor areas in Indonesia. Expenditure on food was grouped into categories: animal, plant, total nongrain, and grain. The prevalence of stunting in rural and urban poor areas was 33.8 and 31.2%, respectively. In rural areas, the odds ratios (OR) (5th vs. first quintile) for stunting were similar for proportion of household expenditure on animal (0.87; 95% CI = 0.85–0.90; P < 0.0001), plant (0.86; 95% CI = 0.84–0.88; P < 0.0001), and total nongrain (0.85; 95% CI = 0.83–0.87; P < 0.0001). In urban poor areas, the relationship between stunting and proportion of household expenditure on animal sources was stronger than in rural areas (OR 0.78; 95% CI = 0.74–0.81; P < 0.0001), whereas the relationship with nongrain was similar to rural areas (OR 0.88; 95% CI = 0.85–0.92; P < 0.0001) and no relationship was observed with plant sources (OR 0.97; 95% CI = 0.93–1.01; P = 0.13). For grain expenditure, OR for stunting in highest vs. lowest quintile was 1.21 (95% CI = 1.18–1.24; P < 0.0001) in rural and 1.09 (95%CI = 1.04–1.13; P < 0.0001) in urban poor areas. Thus, households that spent a greater proportion on nongrain foods, in particular animal source foods, had a lower prevalence of child stunting. This suggests potential increased risk of malnutrition associated with reductions of household expenditure due to the current global crises.

The Food, Fuel, and Financial Crises Affect the Urban and Rural Poor Disproportionately: A Review of the Evidence [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Ruel, M. T., Garrett, J. L., Hawkes, C., Cohen, M. J. — Wed, 25 Nov 2009 07:27:31 PST

The vulnerability of the urban poor to the recent food and fuel price crisis has been widely acknowledged. The unfolding global financial crisis, which brings higher unemployment and underemployment, is likely to further intensify this vulnerability. This paper reviews the evidence concerning the disproportionate vulnerability of the urban compared with the rural poor to these types of shocks. It reviews some of the unique characteristics of urban life that could make the urban poor particularly susceptible to price and financial shocks and summarizes the evidence regarding the disproportionate vulnerability of the urban poor. The focus is on impacts on poverty, food insecurity, and malnutrition. The review shows that although the urban poor are clearly one of the population groups most affected by the current (and previous) crises, the rural poor, landless, and net buyers are in no better position to confront the crisis without significant suffering. The poorest of the poor are the ones who will be most affected, irrespective of the continent, country, or urban or rural area where they live. The magnitude and severity of their suffering depends on their ability to adapt and on the specific nature, extent, and duration of the coping strategies they adopt. A better understanding of how these coping strategies are used and staggered is critical to help design triggers for action that can prevent households from moving to more desperate measures. Using these early coping strategies as early warning indicators could help prevent dramatic losses in welfare.

High Food Prices and the Global Financial Crisis Have Reduced Access to Nutritious Food and Worsened Nutritional Status and Health [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Brinkman, H.-J., de Pee, S., Sanogo, I., Subran, L., Bloem, M. W. — Wed, 25 Nov 2009 07:27:31 PST

A global economic and financial crisis is engulfing the developing world, coming on top of high food and fuel prices. This paper assesses the impact of the crises on food consumption, nutrition, and health. Several methods were applied, including risk analysis using the cost of the food basket, assessment surveys, simulations, regression analysis using a food consumption score (FCS), reflecting diet frequency and diversity, and a review of the impact of such dietary changes on nutritional status and health. The cost of the food basket increased in several countries, forcing households to reduce quality and quantity of food consumed. The FCS, which is a measure of diet diversity, is negatively correlated with food prices. Simulations show that energy consumption declined during 2006–2010 in nearly all developing regions, resulting potentially in an additional 457 million people (of 4.5 billion) at risk of being hungry and many more unable to afford the dietary quality required to perform, develop, and grow well. As a result of the crises, large numbers of vulnerable households have reduced the quality and quantity of foods they consume and are at risk of increased malnutrition. Population groups most affected are those with the highest requirements, including young children, pregnant and lactating women, and the chronically ill (particularly people with HIV/AIDS and tuberculosis). Because undernutrition during the first 2 y of life has life-long consequences, even short-term price rises will have long-term effects. Thus, measures to mitigate the impact of the crises are urgently required.

Household Rice Expenditure and Maternal and Child Nutritional Status in Bangladesh [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Wed, 25 Nov 2009 07:27:31 PST

In Bangladesh, poor rural families often deal with high food costs by purchasing primarily rice. Our objective was to characterize the relationship between household expenditure on rice and nonrice foods with maternal and child malnutrition. Food expenditure data and anthropometry were obtained in a population-based sample of 304,856 households in the Bangladesh Nutrition Surveillance Project, 2000–2005. Food expenditures were categorized as rice and nonrice foods and expressed as quintiles of proportional food expenditure. Of children aged 6–11, 12–23, and 24–59 mo, the prevalence of stunting was 33.5, 56.3, and 53.1%, respectively. The prevalence of maternal underweight (BMI < 18.5 kg/m²) was 37.3%. Among children aged 6–11, 12–23, and 24–59 mo, rice expenditures were associated with stunting [odds ratio (OR) 1.11, 95% CI 1.02–1.20, P = 0.01; OR 1.09, 95% CI 1.04–1.13, P < 0.0001; OR 1.13, 95% CI 1.08–1.18, P < 0.0001), respectively, among families in the highest compared with the lowest quintile, adjusting for potential confounders, and nonrice food expenditures were associated with stunting (OR 0.87, 95% CI 0.80–0.95, P = 0.002; OR 0.86, 95% CI 0.83–0.90, P < 0.0001; OR 0.89, 95% CI 0.85–0.94, P < 0.0001) among families in the highest compared with the lowest quintile, adjusting for potential confounders. In the highest compared with the lowest quintile, rice expenditures (OR 1.12, 95% CI 1.08–1.15, P < 0.0001) and nonrice food expenditures (OR 0.93, 95% CI 0.90–0.96, P < 0.0001) were associated with maternal underweight. Households that spent a greater proportion on nonrice foods and less on rice had a lower prevalence of maternal and child malnutrition.

The Role of Expanded Coverage of the National Vitamin A Program in Preventing Morbidity and Mortality among Preschool Children in India [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Semba, R. D., de Pee, S., Sun, K., Bloem, M. W., Raju, V. K. — Wed, 25 Nov 2009 07:27:29 PST

Higher food prices increase the risk of vitamin A deficiency among preschool children in poor families, because a larger part of the household food budget is spent on grain foods and less on vitamin A-rich foods. Vitamin A supplementation is an important source of vitamin A for children. Our objective was to characterize coverage of the India national vitamin A program for preschool children and identify risk factors for not receiving vitamin A. Anthropometric and demographic data were examined in 23,008 children aged 12–59 mo in the India National Family Health Survey, 2005–2006. Within the last 6 mo, 20.2% of children received vitamin A supplementation. The prevalence of stunting, severe stunting, underweight, and severe underweight was higher among children who did not receive vitamin A compared with those who received vitamin A (P < 0.0001). In families with a child who did and did not receive vitamin A, respectively, the proportion with a history of under-5 child mortality was 8.4 vs. 11.4% (P < 0.0001). By state, vitamin A program coverage was inversely proportional to the under-5 child mortality rate (r = –0.51; P = 0.004). Maternal education of ≥10 y [odds ratio (OR) 2.22; 95% CI 1.69–2.91], 7–9 y (OR 1.99; 95% CI 1.57–2.53), or 1–6 y (OR 1.65; 95% CI 1.28–2.13) compared with no education was an important factor related to receipt of vitamin A. Poor coverage of the vitamin A supplementation program in India has serious implications in the face of rising food prices. Expanded coverage of the vitamin A program in India will help protect children from morbidity, mortality, and blindness.

Macronutrient Supplementation and Food Prices in HIV Treatment [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Sztam, K. A., Fawzi, W. W., Duggan, C. — Wed, 25 Nov 2009 07:27:29 PST

Infection caused by HIV and malnutrition have a complex interaction and often coexist geographically. Malnutrition has synergistic immune effects and HIV affects nutritional status. HIV care and treatment programs are compelled to confront this dual burden to optimize HIV outcomes. In this article, we review the published literature concerning intervention studies in adults and children and the effect of food prices on HIV treatment programs. While the evidence base is relatively incomplete for specific macronutrient interventions in the context of HIV treatment, it is clear that a new standard of care is needed, guided by experience, rationale, and existing data, in which malnourished patients may easily access nutritional therapies within HIV treatment. From this clinical foundation, we may both treat patients and evaluate novel therapies. Some HIV care and treatment programs provide food-based supplements; however, rising food costs and economic instability may jeopardize the success of these programs. HIV treatment programs may struggle to meet the needs of patients with potential increased rates of malnutrition and food insecurity in the setting of high food prices.

CORRECTION [Correction]

Boland, C. R., Ricciardiello, L. — Wed, 18 Nov 2009 11:27:38 PST

Low Total and Nonheme Iron Intakes Are Associated with a Greater Risk of Hypertension [Nutritional Epidemiology]

Wed, 18 Nov 2009 11:27:38 PST

The relationship between iron intake and blood pressure (BP) status has not been well established. Only 1 cross-sectional study has suggested an inverse association of dietary total iron intake and nonheme iron intake with BP. We investigated the relationship between total, heme, and nonheme iron intakes, markers of iron status, 5.4-y changes in BP, and the incidence of hypertension. A total of 2895 participants included in the Supplémentation en Vitamines et Minéraux Antioxydants cohort were followed up for 5.4 y. At least 3 repeated 24-h dietary records were performed at baseline and 5.4 y later. Hemoglobin and serum ferritin concentrations were assessed at baseline. Low nonheme iron intake at baseline was associated with a greater increase in systolic BP (SBP) and pulse pressure over time after adjustment for multiple possible confounding factors (P-trend = 0.002 and 0.0005, respectively). Conversely, participants in the 3rd tertile of nonheme iron intake at baseline had a 37% lower risk of hypertension after 5.4 y of follow-up compared with those in the first tertile (P-trend = 0.04). Heme iron intake was not associated with BP changes or risk of hypertension. Meat intake was positively associated with an increase in SBP (P-trend = 0.04). However, that relation became nonsignificant after adjusting for dietary pattern scores. Baseline hemoglobin and ferritin concentrations were not associated with changes in BP or incidental hypertension. Our data support a possible role of low nonheme iron intake, independent of heme iron intake, in the development of hypertension.

Diet Quality in Childhood Is Prospectively Associated with the Timing of Puberty but Not with Body Composition at Puberty Onset [Nutritional Epidemiology]

Wed, 18 Nov 2009 11:27:37 PST

We examined whether the diet quality of healthy children prior to the pubertal growth spurt was associated with age and body composition at puberty onset. Multivariate regression analyses were performed using data from 222 Dortmund Nutritional and Anthropometric Longitudinally Designed Study participants (mean age ± SD at baseline: 7.4 ± 1.3 y) with 3-d weighed dietary records and anthropometric data at baseline, i.e. the visits 2 and 3 y before the onset of pubertal growth spurt [defined as age at take-off (ATO)]. Diet quality at baseline was determined using the nutrient density-based Nutritional Quality Index (NQI) and the food group and nutrient-based Revised Children's Diet Quality Index (RC-DQI). Based on their distribution, 3 NQI or RC-DQI categories were created to indicate lower, moderate, and higher diet quality. Parameters describing body composition at ATO were age- and gender-specific Z-scores of BMI, fat mass/height², and fat-free mass/height². Children with lower diet quality indicated by lower NQI scores entered puberty ~0.4 y earlier than children with higher NQI scores {ATO in lower and higher NQI categories were [mean (95% CI)] 9.2 y (9.0–9.4), and 9.6 y (9.4–9.9), adjusted for sex, maternal overweight, baseline energy intake, and baseline BMI Z-score} (P-value = 0.02). A similar association of the RC-DQI with ATO was largely explained by baseline energy intakes. Our data suggest that diet quality was not independently associated with body composition at ATO. Children with lower diet quality according to a nutrient density-based index appear to enter puberty at an earlier age, independently of prepubertal body composition.

Lysine Requirement of Healthy, School-Aged Indian Children Determined by the Indicator Amino Acid Oxidation Technique [Nutrient Requirements and Optimal Nutrition]

Wed, 18 Nov 2009 11:27:36 PST

We recently reported the lysine requirement of school-aged children living in Canada consuming a mixed diet to be 35 mg·kg^–1·d^–1. Because the majority of children in the world live on cereal-based diets in developing countries, we measured the daily lysine requirement in healthy children living in India and consuming a mostly cereal-based diet. Our objective in this study was to determine the lysine requirement in healthy, school-aged children in the developing world by using the indicator amino acid oxidation method with l-[1-¹³C] phenylalanine. Six healthy, school-aged children consumed 7 levels of lysine (5, 15, 25, 35, 50, 65, and 80 mg·kg^–1·d^–1) each in a random order along with an amino acid mixture providing energy and protein intakes of 1.7 x resting energy expenditure and 1.5 g·kg^–1·d^–1, respectively. The mean lysine requirement was determined by applying a 2-phase linear regression crossover analysis on tracer oxidation (F¹³CO₂) data, which identified a breakpoint (requirement) at minimal F¹³CO₂ in response to the graded lysine intakes. The mean lysine requirements with the upper 95% CI for children were determined to be 33.5 and 46.6 mg·kg^–1·d^–1, respectively, by breakpoint analysis of the F¹³CO₂ data. The mean lysine requirements of Indian children were almost identical to that of Canadian children (35 mg·kg^–1·d^–1). There is no evidence for any adaptation in lysine requirements in children from developing countries such as India.

Dietary Plasma Protein Supplements Prevent the Release of Mucosal Proinflammatory Mediators in Intestinal Inflammation in Rats [Nutrition and Disease]

Wed, 18 Nov 2009 11:27:36 PST

Spray-dried plasma (SDP) is a complex mixture of active proteins that modulates the immune response of gut-associated lymphoid tissue. We examined whether SDP and Ig concentrate (IC) supplementation could modulate cytokine expression and inflammatory mediators in rats challenged with Staphylococcus aureus enterotoxin B (SEB). Wistar-Lewis rats were fed diets supplemented with SDP (8% wt:wt), IC (1.5% wt:wt), or milk proteins (control diet) from weaning (d 21) to d 34 after birth. On d 32 and 35, the rats were given SEB (0.5 mg/kg; intraperitoneal). Six hours after the second SEB dose, jejunal mucosa and Peyer's patches (PP) from the small intestine were collected. Cytokines interferon- (IFN), tumor necrosis factor- (TNF), interleukin (IL)-6, IL-10, transforming growth factor-β (TGFβ), and leukotrienne B₄ (LTB₄) were analyzed using commercial kits. SEB increased the release of proinflammatory mediators (IFN, TNF, IL-6, and LTB₄) in PP (P < 0.05) and in the mucosa (P < 0.05). In both tissues, SDP prevented the increase in IFN, IL-6, and LTB₄ induced by SEB (P < 0.05). IC reduced the expression of TNF and LTB₄ in PP and mucosa (P < 0.05). SDP supplementation increased IL-10 and mature TGFβ concentrations in intestinal mucosa from both inflamed and noninflamed rats. Both SDP and IC increased the mature:total TGFβ ratio (all P < 0.05). Both supplements were effective at preventing the SEB-induced increase in proinflammatory:antiinflammatory cytokine ratios in PP and mucosa and in serum. The preventive effects of plasma supplements on intestinal inflammation involve modulation of intestinal cytokines, characterized by an increased expression of antiinflammatory cytokines.

Castel Gandolfo Workshop: An Introduction to the Impact of Climate Change, the Economic Crisis, and the Increase in the Food Prices on Malnutrition [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Bloem, M. W., Semba, R. D., Kraemer, K. — Wed, 18 Nov 2009 11:27:35 PST

The global food supply system is facing serious new challenges from economic and related crises and climate change, which directly affect the nutritional well-being of the poor by reducing their access to nutritious food. To cope, vulnerable populations prioritize consumption of calorie-rich but nutrient-poor food. Consequently, dietary quality and eventually quantity decline, increasing micronutrient malnutrition (or hidden hunger) and exacerbating preexisting vulnerabilities that lead to poorer health, lower incomes, and reduced physical and intellectual capabilities. This article introduces the series of papers in this supplement, which explore the relationships between crises and their cumulative impacts among vulnerable populations, particularly through hidden hunger.

Impact of the Economic Crisis and Increase in Food Prices on Child Mortality: Exploring Nutritional Pathways [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Christian, P. — Wed, 18 Nov 2009 11:27:35 PST

The current economic crisis and food price increase may have a widespread impact on the nutritional and health status of populations, especially in the developing world. Gains in child survival over the past few decades are likely to be threatened and millennium development goals will be harder to achieve. Beyond starvation, which is one of the causes of death in famine situations, there are numerous nutritional pathways by which childhood mortality can increase. These include increases in childhood wasting and stunting, intrauterine growth restriction, and micronutrient deficiencies such as that of vitamin A, iron, and zinc when faced with a food crisis and decreased food availability. These pathways are elucidated and described. Although estimates of the impact of the current crisis on child mortality are yet to be made, data from previous economic crises provide evidence of an increase in childhood mortality that we review. The current situation also emphasizes that there are vast segments of the world's population living in a situation of chronic food insecurity that are likely to be disproportionately affected by an economic crisis. Nutritional and health surveillance data are urgently needed in such populations to monitor both the impacts of a crisis and of interventions. Addressing the nutritional needs of children and women in response to the present crisis is urgent. But, ensuring that vulnerable populations are also targeted with known nutritional interventions at all times is likely to have a substantial impact on child mortality.

World Food Crisis: A Wake-Up Call to Save a Generation of Children. Participants Statement: Castel Gondolfo, Italy, 25 January, 2009 [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Badham, J. — Wed, 18 Nov 2009 11:27:34 PST

Energy Restriction Is Associated with Lower Bone Mineral Density of the Tibia and Femur in Lean but Not Obese Female Rats [Nutrition and Disease]

Hawkins, J., Cifuentes, M., Pleshko, N. L., Ambia-Sobhan, H., Shapses, S. A. — Wed, 18 Nov 2009 11:27:34 PST

Energy restriction decreases bone mineral density (BMD), and epidemiological studies suggest that the risk of weight loss-induced bone loss is greater in lean than in heavier individuals. Our goal in this study was to determine how bone density and geometry respond to energy restriction in mature obese rats compared with lean rats. At 6 mo of age, 36 diet-induced obese and lean female Sprague-Dawley rats were allocated to control (CTL; ad libitum; n = 18) and energy-restricted (EnR; 40% restriction; n = 18) diets. After 10 wk of dietary intervention, obese EnR rats lost more weight (–61 ± 14 g) than lean EnR rats (–91 ± 34 g) (P < 0.02), whereas body weight did not change significantly in the 2 CTL groups (14 ± 23 g). Only the lean EnR (and not obese EnR) rats showed lower BMD compared with CTL rats at the tibia, distal, and proximal femur and femoral neck, and trabecular bone volume (P < 0.05). Serum estradiol declined in lean EnR rats compared with baseline (P < 0.05) but not in the obese EnR rats. In addition, the final serum 25-hydroxyvitamin D (25OHD) concentration was higher (P < 0.05) in obese than in lean EnR rats. Serum parathyroid hormone decreased (P < 0.05) from baseline to final in lean and obese CTL, but not EnR rats. These data support the hypothesis that energy restriction in lean rats compared with obese rats is more detrimental to bone, and it is possible that the greater decline in estrogen and lower levels of 25OHD contribute to this effect.

Soybean Isoflavonoid Equol Blocks Ritonavir-Induced Endothelial Dysfunction in Porcine Pulmonary Arteries and Human Pulmonary Artery Endothelial Cells [Nutrition and Disease]

Cheng, C., Wang, X., Weakley, S. M., Kougias, P., Lin, P. H., Yao, Q., Chen, C. — Wed, 18 Nov 2009 11:27:33 PST

HIV protease inhibitor (PI) ritonavir (RTV) may cause vascular injury through oxidative stress. Our purpose in this study was to determine whether equol, a soy isoflavone, could prevent RTV-induced endothelial dysfunction in porcine pulmonary arteries and in human pulmonary artery endothelial cells (HPAEC). Fresh porcine pulmonary artery rings were treated with 15 µmol/L of RTV and/or equol in concentrations of 0.1, 1, and 10 µmol/L for 24 h. A control was set with no amount of equol or RTV administered. Based on myograph tension analysis, RTV significantly reduced endothelium-dependent relaxation in response to bradykinin in the artery rings compared with untreated vessels, whereas the antioxidant equol effectively reversed the RTV effect in a concentration-dependent manner. RTV also reduced the contraction of artery rings in response to thromboxane A(2) analogue U46619 and this reduction was blocked by equol. In addition, RTV treatment significantly reduced endothelial nitric oxide synthase (eNOS) expression in both porcine pulmonary arteries and HPAEC, whereas equol effectively blocked RTV-induced eNOS downregulation. Furthermore, RTV significantly increased superoxide anion production, whereas equol reversed this effect of RTV in porcine pulmonary arteries. Thus, the antioxidant equol effectively protects vascular function from the detrimental effects of HIV PI RTV in both porcine pulmonary arteries and HPAEC via a reduction in the vasomotor dysfunction, eNOS downregulation, and oxidative stress induced by RTV. These novel data suggest that equol may have a clinical application in preventing HIV-associated cardiovascular complications.

Safety Nets Can Help Address the Risks to Nutrition from Increasing Climate Variability [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Alderman, H. — Wed, 18 Nov 2009 11:27:33 PST

Models of climate change predict increased variability of weather as well as changes in agro-ecology. The increased variability will pose special challenges for nutrition. This study reviews evidence on climate shocks and nutrition and estimates the economic consequences in terms of reduced schooling and economic productivity stemming from nutritional insults in childhood. Panel data covering up to 20 y indicate that that short-term climate shocks have long-term impacts on children that persist, often into their adult lives. Other studies document the potential for relief programs to offset these shocks providing that the programs can be implemented with flexible financing, rapid identification of those affected by the shock, and timely scale-up. The last of these presumes that programs are already in place with contingency plans drawn up. Arguably, direct food distribution, including that of ready-to-use therapeutic food, may be part of the overall strategy. Even if such programs are too expensive for sustainable widespread use in the prevention of malnutrition, scalable food distribution programs may be cost effective to address the heightened risk of malnutrition following weather-related shocks.

Household Dietary Diversity and Food Expenditures Are Closely Linked in Rural Bangladesh, Increasing the Risk of Malnutrition Due to the Financial Crisis [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Wed, 18 Nov 2009 11:27:32 PST

In Bangladesh, rice prices are known to be positively associated with the prevalence of child underweight and inversely associated with household nongrain food expenditures, an indicator of dietary quality. The collection of reliable data on household expenditures is relatively time consuming and requires extensive training. Simple dietary diversity scores are increasingly used as measures of food security and as proxies for nutrient adequacy. This study examines associations between a simple dietary diversity score and commonly used indicators of socioeconomic status in Bangladesh. Data representative of rural Bangladesh was collected from 188,835 households over 18 rounds of bi-monthly data collection from 2003–2005. A simple household dietary diversity score was developed by summing the number of days each household consumed an item from each of 7 food groups over a 7-d period. The dietary diversity score was associated with per capita nongrain food expenditures (r = 0.415), total food expenditures (r = 0.327), and total household expenditures (r = 0.332) using Spearman correlations (all P < 0.0001). The frequency of meat and egg consumption showed greater variation across quintiles of total monthly expenditure than other items contributing to the dietary diversity score. After controlling for other measures of socioeconomic status in multiple linear regression models, the dietary diversity score was significantly associated with monthly per capita food and total expenditures. Low dietary diversity during the period prior to major food price increases indicates potential risk for worsening of micronutrient deficiencies and child malnutrition in Bangladesh.

Medium- to Long-Run Implications of High Food Prices for Global Nutrition [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Webb, P. — Wed, 18 Nov 2009 11:27:32 PST

The combined food, fuel, and financial crises of 2007–2009 had severe and widespread negative impacts around the world. Two key questions challenging governments were: how long would the high prices last and with what effects on food security and nutrition over the longer run? This paper considers the drivers of the crisis and explores if, unlike past shocks, the recent price increases reflect structural changes in food price formation that will have lasting global implications. New cross-commodity relationships allowed prices to spike, although there was no shortage of food at the global level nor indeed a significant downturn in recent yields. Yet recent record levels of farm production were also mirrored by growing numbers of people chronically undernourished and/or micronutrient deficient. The gap between supply and need was underpinned by growing urban demand, consumption of processed and higher-value foods (including meat), biofuel policy, and purchasing power erosion, but also by short-term market-distorting policies implemented by governments responding to perceived shortages of food. Thus, the impact of future food price crises will depend largely on what policymakers chose to do in response to the peaks and what they do not do during the troughs. Appropriate investments are urgently needed not just in smallholder developing country agriculture, but in effective food policies and targeted programming that can reverse the recent negative trends in nutrition and that support access globally to improved diet quality as well as food quantity.

Modifications in Dietary Fat Quality Are Associated with Changes in Serum Lipids of Older Adults Independently of Lipid Medication [Nutritional Epidemiology]

Wed, 18 Nov 2009 11:27:31 PST

Prospective evidence on the extent to which serum lipid concentrations in older persons respond to dietary modification is scarce. It is not clear whether such behavioral changes are relevant in the context of more commonly initiated treatments with lipid-lowering drugs. We therefore examined whether individual changes in the consumption of dietary fatty acids or main food sources were associated with changes in the serum lipid profile of older Australians. A total of 903 participants (≥49 y) in the Blue Mountains Eye Study had complete data on fasting lipids and dietary intake from a validated FFQ at baseline (1992–1994) and 5- and 10-y follow-up examinations. Decreasing consumption of SFA and butter during the 10-y period were associated with moderate decreases in serum total cholesterol independently of initiation of lipid-lowering drug treatment [adjusted estimates were 0.018 ± 0.007 mmol/(L x % energy (%en) from SFA (P = 0.01) and 0.055 ± 0.015 mmol/(L x 5 g butter) (P = 0.0003), respectively]. Increased consumption of (n-3) fatty acids and fish was independently related to modest increases in serum HDL-cholesterol [0.067 ± 0.026 mmol/(L x %en from (n-3) fatty acids) (P = 0.01) and 0.010 ± 0.004 mmol/(L x 20 g fish) (P = 0.02)] and decreases in log-transformed serum triglyceride concentrations [P = 0.02 for (n-3) fatty acids and P = 0.02 for fish intake]. Hence, 10-y changes in the intake of dietary fatty acids and their food sources appear to have contributed to concurrent improvements in the serum lipid profile of older Australians, independent of concomitantly initiated lipid-lowering drug treatment.

Preventing Food Crises Using a Food Policy Approach [The Impact of Climate Change, the Economic Crisis, and the Increase in Food Prices on Malnutrition]

Timmer, C. P. — Wed, 18 Nov 2009 11:27:31 PST

A food crisis occurs when rates of hunger and malnutrition rise sharply at local, national, or global levels. This definition distinguishes a food crisis from chronic hunger, although food crises are far more likely among populations already suffering from prolonged hunger and malnutrition. A food crisis is usually set off by a shock to either supply or demand for food and often involves a sudden spike in food prices. It is important to remember that in a market economy, food prices measure the scarcity of food, not its value in any nutritional sense. Except in rare circumstances, the straightforward way to prevent a food crisis is to have rapidly rising labor productivity through economic growth and keep food prices stable while maintaining access by the poor. The formula is easier to state than to implement, especially on a global scale, but it is good to have both the objective, reducing short-run spikes in hunger, and the deep mechanisms, pro-poor economic growth and stable food prices, clearly in mind. A coherent food policy seeks to use these mechanisms, and others, to achieve a sustained reduction in chronic hunger over the long run while preventing spikes in hunger in the short run.

The Population Distribution of Ratios of Usual Intakes of Dietary Components That Are Consumed Every Day Can Be Estimated from Repeated 24-Hour Recalls [Methodology and Mathematical Modeling]

Freedman, L. S., Guenther, P. M., Dodd, K. W., Krebs-Smith, S. M., Midthune, D. — Wed, 18 Nov 2009 11:27:30 PST

Estimating the population distribution of the usual intake of a nutrient relative to that of another nutrient requires determination of individual-level ratios. If intake data are available on a per-day basis, as with 24-h dietary recalls, those ratios can be determined in 1 of 2 ways: as the usual ratio of intakes or the ratio of usual intakes. Each of these ratios has its own meaning and determination; the ratio of usual intakes is conceptually consistent with determinations obtained from FFQ data. We present a method for estimating the ratio of usual intakes that uses bivariate modeling of the 2 nutrient intakes in question. Application of the method to the NHANES data for the years 2001–2004 yielded estimated distributions for percent of usual energy intake from total fat, percent of usual energy intake from saturated fat, and usual sodium intake per 1000 kcal (4184 kJ) of usual energy intake. Distributions for both the total population and for age-gender subgroups were estimated. Approximately 60% of adults (>19 y) had a usual total fat intake that was within the recommended range of 20–35% of total energy, but only ~34% had a usual saturated fat intake <10% of total energy. The results changed only minimally when the other definition of usual intake, the usual ratio of intakes, was adopted.

Dietary Vaccenic Acid Has Antiatherogenic Effects in LDLr Mice [Nutrition and Disease]

Wed, 18 Nov 2009 11:27:29 PST

Epidemiological evidence has associated dietary trans fatty acids (TFA) with heart disease. TFA are primarily from hydrogenated fats rich in elaidic acid, but dairy products also contain naturally occurring TFA such as vaccenic acid. Our purpose in this study was to compare the effects of consuming a commercially hydrogenated vegetable shortening rich in elaidic TFA (18:1t9) or a butter rich in vaccenic TFA (18:1t11) in the absence and presence of dietary cholesterol on atherosclerosis. LDL receptor deficient (LDLr^–/–) mice were fed 1 of 8 experimental diets for 14 wk with the fat content replaced by: regular (pork/soy) fat (RG), elaidic shortening (ES), regular butter (RB), vaccenic butter (VB), or an atherogenic diet containing 2% cholesterol with RG (CH+RG), ES (CH+ES), RB (CH+RB), or VB (CH+VB). Serum cholesterol levels were elevated with cholesterol feeding (P < 0.001), whereas serum triglyceride levels were higher only in the CH+RB (P < 0.001) and CH+VB (P < 0.001) groups compared with 6 other groups. Serum cholesterol and triglyceride levels were significantly lower in the CH+VB group than in the CH+RB group (P < 0.001). Atherosclerosis was stimulated by dietary ES compared with RG (P = 0.021), but CH+ES did not stimulate atherosclerosis beyond CH+RG alone. In contrast, VB did not induce an increase in atherosclerotic plaque formation compared with the RG and RB diets and the CH+VB diet reduced atherosclerosis compared with the other diets containing cholesterol (P < 0.01). In summary, consuming a hydrogenated elaidic acid-rich diet stimulates atherosclerosis, whereas a vaccenic acid-rich butter protects against atherosclerosis in this animal model.

Current In Vitro Testing of Bioactive Peptides Is Not Valuable [Issues and Opinions]

Foltz, M., van der Pijl, P. C., Duchateau, G. S. M. J. E. — Wed, 11 Nov 2009 06:30:34 PST

Dietary peptides have been suggested to possess biological activity in vivo and could affect cardiovascular disease parameters, based on data derived from in vitro experiments. Isolated peptides are often tested in in vitro cellular assays or on heterologously expressed molecular target proteins. The stimulatory or inhibitory effect on target proteins in vitro has often been used as the justification to test these compounds directly in vivo. Unfortunately, this research approach has an inherent flaw. It neglects the poor absorption, distribution, metabolism, and excretion (ADME) properties of peptides resulting in low peptide bioavailability. Because peptides are prone to extensive hydrolysis in the gastrointestinal tract by stomach, small intestinal, and brush border peptidases, most of them do not reach the absorption stage in the duodenum and jejunum. Therefore, a valid research approach should include the demonstration of stability of the peptide toward luminal and brush border peptidases and evaluate its ADME properties. Surprisingly, only very few animal and human studies determined absolute concentrations and kinetics of bioactive peptides. These studies have shown the presence of selected peptides in plasma samples at pico- and nanomolar concentrations with fast elimination kinetics in the minute range. For the correct interpretation of results, it is advised that researchers refer to the data currently available concerning bioavailability and ADME properties in humans. Two mandatory criteria for future in vitro studies investigating potential biological activities of peptides should be using physiologically relevant concentrations and times.

Vitamin B-6 Intake Is Inversely Related to, and the Requirement Is Affected by, Inflammation Status [Community and International Nutrition]

Morris, M. S., Sakakeeny, L., Jacques, P. F., Picciano, M. F., Selhub, J. — Wed, 11 Nov 2009 06:30:33 PST

Low circulating pyridoxal 5'-phosphate (PLP) concentrations have been linked to inflammatory markers and the occurrence of inflammatory diseases. However, the implications of these findings are unclear. The measurement of PLP and C-reactive protein (CRP) in blood samples collected from participants in the 2003–2004 NHANES afforded us the opportunity to investigate this relationship in the general U.S. population. Dietary and laboratory data were available for 3864 of 5041 interviewed adults, 2686 of whom were eligible (i.e. provided reliable dietary data and were not diabetic, pregnant, lactating, or taking hormones or steroidal antiinflammatory drugs). Vitamin B-6 intake was assessed using 2 24-h diet recalls and supplement use data. After multivariate adjustment for demographics, smoking, BMI, alcohol use, antioxidant vitamin status, intakes of protein and energy, and serum concentrations of creatinine and albumin, high vitamin B-6 intake was associated with protection against serum CRP concentrations >10 mg/L compared with ≤3 mg/L. However, plasma PLP ≥20 nmol/L compared with <20 nmol/L was inversely related to serum CRP independently of vitamin B-6 intake (P < 0.001). Among participants with vitamin B-6 intakes from 2 to 3 mg/d, the multivariate-adjusted prevalence of vitamin B-6 inadequacy was <10% in participants with serum CRP ≤3 mg/L but close to 50% in those with serum CRP > 10 mg/L (P < 0.001). In conclusion, higher vitamin B-6 intakes were linked to protection against inflammation and the vitamin B-6 intake associated with maximum protection against vitamin B-6 inadequacy was increased in the presence compared to absence of inflammation.

Higher Selenium Status is Associated with Adverse Blood Lipid Profile in British Adults [Nutritional Epidemiology]

Wed, 11 Nov 2009 06:30:33 PST

Recent findings have raised concern about possible associations of high selenium exposure with diabetes and hyperlipidemia in the US, a population with high selenium status. In the UK, a population with lower selenium status, there is little data on the association of selenium status with cardio-metabolic risk factors in the general population. We examined the association of plasma selenium concentration with blood lipids in a nationally representative sample of British adults. A cross-sectional study was conducted among 1042 white participants (aged 19–64 y) in the 2000–2001 UK National Diet and Nutrition Survey. Plasma selenium was measured by inductively coupled-plasma mass spectrometry. Total and HDL cholesterol were measured in nonfasting plasma samples. Mean plasma selenium concentration was 1.10 ± 0.19 µmol/L. The multivariate adjusted differences between the highest (≥1.20 µmol/L) and lowest (<0.98 µmol/L) quartiles of plasma selenium were 0.39 (95% CI 0.18, 0.60) mmol/L for total cholesterol, 0.38 (0.17, 0.59) for non-HDL cholesterol, and 0.01 (–0.05, 0.07) for HDL cholesterol. Higher plasma selenium (i.e., ≥1.20 µmol/L) was associated with increased total and non-HDL cholesterol levels but not with HDL in the UK adult population. These findings raise additional concern about potential adverse cardio-metabolic effects of high selenium status. Randomized and mechanistic evidence is necessary to assess causality and to evaluate the impact of this association on cardiovascular risk.

A Bifidobacterium Probiotic Strain and Its Soluble Factors Alleviate Chloride Secretion by Human Intestinal Epithelial Cells [Biochemical, Molecular, and Genetic Mechanisms]

Heuvelin, E., Lebreton, C., Bichara, M., Cerf-Bensussan, N., Heyman, M. — Wed, 04 Nov 2009 06:35:20 PST

Previous studies indicate that certain probiotic bacterial strains or their soluble products can alleviate proinflammatory cytokine secretion by intestinal epithelial cells (IEC), but their impact on epithelial chloride (Cl^–) secretion remains elusive. To further decipher the mechanisms of the cross-talk between bacteria/soluble factors and epithelial cells, we analyzed the capacity of the probiotic strain Bifidobacterium breve C50 (Bb C50), its conditioned medium, and other commensal Gram (+) bacteria to modulate epithelial Cl^– secretion. The effect of Bb C50 on carbachol- (CCh) or forskolin (Fsk)-induced Cl^– secretion was measured in an IEC line in Ussing chambers. The mechanisms involved in the regulation of Cl^– secretion were assessed by measuring intracellular Ca²⁺ concentration, phosphatase activity, protein kinase (PK) C and PKA activation, and cystic fibrosis transmembrane conductance regulator (CFTR) expression. CCh- or Fsk-induced Cl^– secretion [short-circuit current (Isc): 151 ± 28 and 98 ± 14 µA/cm², respectively] was inhibited dose-dependently by Bb C50 (Isc 33 ± 12 and 49 ± 7 µA/cm² at multiplicity of infection 100; P < 0.02). Fsk-induced Cl^– secretion was also inhibited by Lactobacillus rhamnosus 10893. No other inhibitory effect was recorded with the other Gram (+) bacteria tested. The inhibitory effect of Bb C50 on CCh-induced Cl^– secretion targeted a step downstream of epithelial Ca²⁺ mobilization and was associated with decreased PKC activity. Thus, Bb C50 and secreted soluble factors, by inhibiting phosphorylation processes, may promote intestinal homeostasis by controlling Cl^– secretion.

Consumption of a Legume-Enriched, Low-Glycemic Index Diet Is Associated with Biomarkers of Insulin Resistance and Inflammation among Men at Risk for Colorectal Cancer [Nutritional Epidemiology]

Wed, 04 Nov 2009 06:35:20 PST

The Legume Inflammation Feeding Experiment is, to our knowledge, the first randomized crossover feeding trial testing the effects of a legume-enriched, low-glycemic index (GI) diet among men characterized for colorectal adenomas and insulin resistance (IR) status. This study was designed to test the effects of a legume-enriched diet compared with a healthy American (HA) diet under weight-stable conditions. The primary objective was to assess effects on C-reactive protein (CRP) and C-peptide levels. The secondary objective was to assess changes by IR status or history of adenomas. A total of 64 men who completed a colonoscopy within the previous 2 y consumed 2 diets in random order each for 4 wk separated by a washout period. The diets were a legume-enriched (250 g/d), low-GI (GI 38) diet and a high-GI (GI 69) HA diet. We measured fasting glucose, insulin, C-peptide, CRP, and soluble tumor necrosis factor- receptors I and II (sTNFRI/II) at the beginning and end of the diet periods. Participants who consumed both the legume and HA diets had favorably improved CRP (–20.2 and –18.3%) and sTNFRI (–3.7 and –4.4%) concentrations, respectively. The sTNFRII concentrations declined marginally during the legume diet period (–3.8%; P = 0.060) and significantly during the HA diet period (–5.1%; P < 0.001). Fasting glucose increased significantly during both the legume (+1.8%) and HA (–2.2%) diet periods. Only the changes in glucose differed between the diet periods. Serum C-peptide and plasma insulin levels did not change in participants consuming either diet. Healthful dietary changes can improve biomarkers of IR and inflammation.

Oral Glutamine Protects against Acute Doxorubicin-Induced Cardiotoxicity of Tumor-Bearing Rats [Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions]

Todorova, V. K., Kaufmann, Y., Hennings, L., Klimberg, V. S. — Wed, 04 Nov 2009 06:35:20 PST

Doxorubicin (DOX), a widely used anticancer drug, has a dose-dependent cardiotoxicity, attributed mainly to free radical formation. The cardiomyocyte oxidative stress occurs rapidly after DOX treatment, resulting in harmful modifications to proteins, lipids, and DNA. Previous data showed that oral l-glutamine (Gln) prevented cardiac lipid peroxidation and maintained normal cardiac glutathione (GSH) levels in DOX-treated rats. Our aim in this study was to examine the effect of Gln on DOX-induced cardiac oxidative stress in a tumor-bearing host. Female Fisher344 rats with implanted MatBIII mammary tumors were randomized into 2 groups: a Gln group that received l-Gln (1 g·kg^–1·d^–1) (n = 10) via a Gln-enriched diet and/or gavage with 50% Gln suspension during the whole experiment and a control group that was fed the same diet formulation without Gln and/or were gavaged with water. All rats received a single injection of 12 mg/kg DOX and were killed 3 d later. GSH levels of hearts, livers, tumors, and blood, as well as cardiac histological alterations, lipid peroxidation, peroxinitrite levels, and caspase-3 activation were determined. Cardiac physiologic alterations were assessed by ultrasound imaging before and 3 d after DOX administration. The Gln supplementation resulted in lower cardiac lipid peroxidation and peroxintrite levels and elevated cardiac catalase enzyme activity and GSH compared with the controls, without affecting those of the tumors. DOX-induced alterations of the echocardiographic parameters were significantly reduced in the Gln-supplemented rats. These data indicate that Gln is able to reduce the oxidative damage of cardiomyocytes that occurs soon after DOX administration and thus protects the heart of a tumor-bearing host from DOX-induced cardiomyopathy.

Iron-Fortified Rice Is As Efficacious As Supplemental Iron Drops in Infants and Young Children [Nutrient Requirements and Optimal Nutrition]

Beinner, M. A., Velasquez-Melendez, G., Pessoa, M. C., Greiner, T. — Wed, 04 Nov 2009 06:35:19 PST

How to improve iron status among infants and young children is of continued concern in low- to middle-income countries, including Brazil. In a double blind, 5-mo, home-based, randomized trial in Brazil, we gave one group of mildly anemic 6- to 24-mo-old children (n = 175) rice fortified with micronized ferric pyrophosphate using the Ultra Rice technology and a placebo solution (URG) and another group identical nonfortified rice and iron drops. We instructed parents on the correct dosage of iron drops and to feed their children rice as they normally would. We measured serum ferritin (SF) and hemoglobin (Hb) concentrations at baseline and at 5 mo. At baseline, the prevalences of iron deficiency and anemia in the total sample were 73.1 and 100%, respectively. At 5 mo, SF and Hb increased in both groups, although the change in the URG was larger (P < 0.01). Adult participants were unable to distinguish cooked fortified rice from unfortified rice in terms of smell, color, or taste. As rice is normally consumed at home, MPF-fortified rice increased iron stores and reduced anemia in a group of mildly anemic children 6–24 mo old. In populations where young children are routinely fed ~100 g of cooked rice daily, fortifying it with iron may improve iron status at least as well as providing free iron drops.

Dietary Fiber, Magnesium, and Glycemic Load Alter Risk of Type 2 Diabetes in a Multiethnic Cohort in Hawaii [Nutritional Epidemiology]

Wed, 04 Nov 2009 06:35:19 PST

The influence of dietary fiber, magnesium (Mg), and glycemic load (GL) on diabetes was examined in the Hawaii component of the Multiethnic Cohort. The 75,512 Caucasian, Japanese American, and Native Hawaiian participants aged 45–75 y at baseline completed a FFQ. After 14 y of follow-up, 8587 incident diabetes cases were identified through self-reports and health plans. We applied Cox regression stratified for age at cohort entry and adjusted for ethnicity, BMI, physical activity, education, and total energy with further stratifications by sex and ethnicity. When comparing extreme quintiles, total fiber intake was associated with reduced diabetes risk among all men [hazard ratio (HR): 0.75; 95% CI: 0.67, 0.84; P-trend < 0.001) and women (HR: 0.95; 95% CI: 0.85, 1.06; P-trend = 0.05). High intake of grain fiber reduced diabetes risk significantly by 10% in men and women. High vegetable fiber intake lowered risk by 22% in all men but not women. Mg intake reduced risk (HR = 0.77 and 0.84 for men and women, respectively) and, due to its strong correlation with fiber (r = 0.83; P < 0.001), may explain the protective effect of fiber. The top GL quintile was associated with a significantly elevated diabetes incidence in Caucasian men and in all women except Japanese Americans. Overall, several associations were more pronounced in Caucasians than in the other groups. These findings suggest that protection against diabetes can be achieved through food choices after taking into account body weight, but, due to differences in commonly consumed foods, risk estimates may differ by ethnic group.

Antiangiogenic Effects of Indole-3-Carbinol and 3,3'-Diindolylmethane Are Associated with Their Differential Regulation of ERK1/2 and Akt in Tube-Forming HUVEC [Biochemical, Molecular, and Genetic Mechanisms]

Kunimasa, K., Kobayashi, T., Kaji, K., Ohta, T. — Wed, 04 Nov 2009 06:35:18 PST

We previously reported that indole-3-carbinol (I3C), found in cruciferous vegetables, suppresses angiogenesis in vivo and in vitro. However, the underlying molecular mechanisms still remain unclear. Antiangiogenic effects of its major metabolite, 3,3'-diindolylmethane (DIM), also have not been fully elucidated. In this study, we investigated the effects of these indoles on angiogenesis and tested a hypothesis that I3C and DIM inhibit angiogenesis and induce apoptosis by affecting angiogenic signal transduction in human umbilical vein endothelial cells (HUVEC). We found that I3C and DIM at 25 µmol/L significantly inhibited tube formation and only DIM induced a significant increase in apoptosis in tube-forming HUVEC. DIM showed a stronger antiangiogenic activity than I3C. At the molecular level, I3C and DIM markedly inactivated extracellular signal-regulated kinase 1/2 (ERK1/2) and the inhibitory effect of DIM was significantly greater than that of I3C. DIM treatment also resulted in activation of the caspase pathway and inactivation of Akt, whereas I3C did not affect them. These results indicate that I3C and DIM had a differential potential in the regulation of the 2 principal survival signals, ERK1/2 and Akt, in endothelial cells. We also demonstrated that pharmacological inhibition of ERK1/2 and/or Akt was enough to inhibit tube formation and induce \caspase-dependent apoptosis in tube-forming HUVEC. We conclude that both I3C and DIM inhibit angiogenesis at least in part via inactivation of ERK1/2 and that inactivation of Akt by DIM is responsible for its stronger antiangiogenic effects than those of I3C.

Acute Ingestion of Long-Chain (n-3) Polyunsaturated Fatty Acids Decreases Fibrinolysis in Men with Metabolic Syndrome [Nutrient Physiology, Metabolism, and Nutrient-Nutrient Interactions]

Montegaard, C., Tulk, H. M. F., Lauritzen, L., Tholstrup, T., Robinson, L. E. — Wed, 04 Nov 2009 06:35:17 PST

Individuals with metabolic syndrome (MetS) often have elevated plasma plasminogen activator inhibitor-1 (PAI-1) and tissue plasminogen activator (t-PA), contributing to an increased risk of cardiovascular disease. PAI-1 and t-PA may be affected by chronic (n-3) long-chain PUFA [(n-3)LCPUFA] supplementation; however, the acute impact of fat ingestion on these risk factors has not been established. Our objective was to investigate the acute effect of (n-3)LCPUFA on plasma PAI-1, t-PA, and platelet aggregation. We conducted a randomized crossover study in which men (n = 8, ≥45 y) with MetS consumed water or a high-saturated fat beverage (1 g fat/kg body weight) with either a high or low content of (n-3)LCPUFA. Blood samples were collected over 8 h to measure triacylglycerol (TAG), PAI-1, t-PA, and platelet aggregation. Both fat loads resulted in a significant increase in whole blood TAG concentration, plasma PAI-1 and t-PA concentrations, and PAI-1 activity, as well as a significant decrease in t-PA activity during the postprandial period. Interestingly, PAI-1 concentration and activity increased more following the high (n-3)LCPUFA compared with the low (n-3)LCPUFA beverage (P < 0.05). Furthermore, the high (n-3)LCPUFA beverage resulted in a lower t-PA activity (P < 0.05), whereas the effects of the 2 fat loads on the plasma t-PA concentration and platelet aggregation did not differ. Overall, acute intake of a high (n-3)LCPUFA beverage shifted the balance between plasma PAI-1 and t-PA, which might indicate a lower capacity for fibrinolysis.