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Dietary supplements of plant origin

Epidemiology suggests that cancer is largely an unavoidable disease and that more than two-thirds of cancers might be prevented through lifestyle modification (Ferguson, 1999). According to some authors the four main causes of cancer deaths are smoking, diet, chronic infections (especially in developing countries) and hormonal factors (Ames and Gold, 1998). One of the major influences on cancer risk appears to be diet. Dietary imbalances are important especially the lack of sufficient amounts of dietary fruits and vegetables (Ames and Gold, 1997). Despite disagreement between different authors on details, there is agreement on the considerable number of modifying factors in the carcinogenic process and that there are very good prospects for dietary interventions (Ferguson, 1999). Epidemiological studies, supported by preclinical data from animal and in vitro experiments and by clinical findings, have contributed immensely in providing insights into links between diet and cancer...

Definitions of dietary supplements

The DSHEA defines dietary supplements for regulatory purpose within the United States. The Office of Dietary Supplements at the NIH needed to implement research priorities using this definition and yet in some manner group the wide array of supplement ingredients available in the marketplace into more manageable categories. A definition was needed that also could be interpreted more readily in terms of research projects. An operating definition was requested in meetings with the NIH Institute Directors and other agencies who expressed difficulty in understating whether or not specific ingredients would be supported in the research and education programmes developed by the ODS. The resulting operating definition and categorization of dietary supplement ingredients was developed in collaboration with the staff of the Office of Special Nutritionals at the Food and Drug Administration (FDA), who had oversight for dietary supplement regulatory affairs, and a large group of ad hoc advisers...

Dietary Lna And Dha As Substrates For Brain And Retina Dha Compositional Studies

Kliauea Graph

In nontracer experiments, relative contribution of dietary LNA and DHA to CNS DHA accretion have been examined in various species, including chicks, rat pups, newborn piglets, and guinea pigs. Anderson and colleagues studied the relative efficacy of LNA and DHA in restoring neural DHA levels in newly hatched chicks, as presented in Fig. 1 (Anderson, Connor, & Corliss, 1990). Laying hens were fed a n-3-deficient diet for 2 mo, and their hatched chicks were then fed a control diet or n-3-deficient diets supplemented with LNA (+LNA) or DHA (+DHA) at 3.6 wt (0.44 kcal) for 3 wk. After 3 wk, the DHA group showed brain DHA levels similar to that of controls (12.3 vs 8.3 ), whereas dietary LNA alone brought the level to only 25 of the controls. Similar results were observed for retinal DHA accretion. It was concluded that dietary DHA exerts a fourfold greater potency compared to LNA as a substrates for brain and retina DHA accretion. group. It was thus concluded that dietary LNA is 24 as...

The Dietary Reference Intakes DRIs

We all need the same nutrients, but the amounts we need depend on our age, sex, and a few other factors. For example, women who are pregnant or breastfeeding need more of most nutrients. The Food and Nutrition Board of the Institute of Medicine, National Academy of Sciences, a group of nutritional scientists from the United States and Canada, has established the Dietary Reference Intakes (DRIs), a set of recommendations for nutrient intake. The DRIs are age- and sex-specific. With the exception of fats and carbohydrates (whose requirements depend only on our calorie needs), a separate DRI is set for each of the known nutrients for each of10 different age groups. From the age of 9 years, males and females have separate DRIs, and additional DRIs are set for women who are pregnant or breastfeeding. How did the nutrient recommendations originate Concerned with the need to provide proper nutrition for newly drafted World War II soldiers, many of whom were undernourished, the Department of...

Dietary Protein and Body Protein

The grains and cereals group of foods, which form the base of the Food Guide Pyramid, are excellent sources of protein, but because these proteins often lack one or more essential amino acids, they are called incomplete proteins. For example, the proteins in corn are low in the essential amino acids lysine and tryptophan, and wheat is low in lysine. In contrast, legumes tend to be rich in lysine but a bit low in methionine. Among the legumes, soybeans contain the most complete protein. Contrary to popular belief, simply eating more dietary protein, in excess of recommended amounts, will not result in bigger muscles. Our bodies do not store excess protein. If we eat more protein than our bodies need to replenish the amino acids we have used during the day, the excess amino acids are converted to, and stored as, fat. Dietary protein, like carbohydrates, supplies about 4 calories of energy per gram. Because our requirements for protein mainly depend on our body's size, our need for...

Dietary Fat and Weight Gain

Dietary restriction of cholesterol and saturated fatty acid can mitigate and in some cases prevent increases in LDL-cholesterol, VLDL-cholesterol, and hypertriglyceridemia during thiazide therapy. In addition, increases in body weight during long-term treatment with diuretics tends to increase plasma cholesterol, whereas weight loss is associated with improvement in plasma lipids. Whether the changes in weight reflect attendant alterations in insulin resistance or dietary effects on lipid synthesis is not known. However, the observations suggest that dietary fat and caloric intake are important in the pathogenesis of hyper-lipidemia during thiazide treatment.

Effect Of Dietary n3 Fatty Acids On Cognitive Function

Brain, and most other parameters remain approximately unchanged, these are not confounding factors and the effects of n-3 deficiency are generally assumed to be the result of the change in fatty acid composition of organs such as the brain. Table 2 lists oils commonly used in dietary depletion studies according to whether they are rich or poor sources of n-3 fatty acids.

Dietary Modulation of Retinal Fatty Acid Composition and Function

The effect of maternal diet on the modulation of n-3 fatty acid in the retina of offspring has been studied in newly hatched chicks (Anderson et al., 1989), juvenile felines (Pawlosky et al., 1997) and piglets (Arbuckle & Innis, 1993). Docosahexaenoic acid appears to be the preferred fatty acid for raising the level of 22 6n-3 in the retina and brain among different sources of n-3 fatty acids (Anderson et al., 1990). Feeding corn oil supplemented with 22 6n-3 is able to restore the 22 6n-3 level in n-3-deficient chicks (Anderson & Connor, 1994) and felines (Pawlosky et al., 1997) probably through replacement of dipolyunsaturated molecular species (22 6n-3 - 22 6n-3) (Lin et al., 1994). These observations imply that 18 3n-3 alone in the diet as the n-3 fatty acid source may not be adequate for meeting the 22 6n-3 requirement for brain and retinal development, because 18 3n-3 is a less efficient precursor for 22 6n-3 when there is low A6desaturase activity (Anderson et al., 1990 Kohn et...

Effect of Dietary Fat on Very Long Chain Fatty Acids and Rhodopsin Content

Retina membrane phospholipids, particularly phosphatidylethanolamine, contain a high level of 22 6n-3 (Birch et al., 1992 Suh et al., 1994). In the rod outer segment of the retina, significant amounts of 22 6n-3 in phosphatidylserine and phosphatidylcholine also occur (Suh et al., 1994). Increased dietary intake of n-3 fatty acids increases the n-3 Fig. 2. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on 20 4n-6 or 22 6n-3 in phosphatidylethanolamine of photoreceptors. Fig. 2. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on 20 4n-6 or 22 6n-3 in phosphatidylethanolamine of photoreceptors. Fig. 3. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on very long chain fatty acids in phosphatidylcholine of photoreceptors. Fig. 3. Developmental profiles and effect of dietary 20 4n-6 and 22 6n-3 on very long chain fatty acids in phosphatidylcholine of photoreceptors. fatty acid content of the rod outer segment (Suh et al., 1994, 1996 Lin...

Dietary n3 Deficiency in the Mouse 721 Mouse Visual Acuity and n3 Deficiency

In contrast, Bourre's group (Frances, et al., 1996a) compared OF1 mice fed a peanut-oil-based diet containing trace amounts of LNA with a group receiving 200 mg of LNA 100 g of feed from rape seed oil and found significant performance differences. Both groups had the same total fat and LA content in the diet and had been reared by dams receiving the same diet as their pups. There were 10 female mice in each group. The LNA-deficient group improved its performance over time, but in the Morris water maze (place-test version), it took them significantly longer to find the platform after 16 practice trials. The difference was not significant in the cued version of the test. When mice raised by the same scheme were tested (Frances, et al., 1996b) it was found that the n-3-sufficient mice but not n-3-deficient mice showed reduced exploration in a photocell Actimeter. In the forced swimming test, the n-3-sufficient mice were significantly less active, and the same was found (p 0.061,...

Dietary n3 Deficiency in the

Perhaps the most consistent effect of n-3 deficiency is found on vision. For instance, when Wistar rats that had been fed sunflower-oil-based chow for three generations were compared to a similar soybean-oil-fed group, there were striking and highly significant differences in their electroretinograms (Bourre, et al., 1989). In 4-wk-old rats, the amplitudes of the a- and b-waves in the LNA-rich group were 39 and 80 higher, respectively, compared to the deficient group. Furthermore, for the a- and b-waves to reach the detection limit, the intensity of the light stimulus had to be 10 times higher in the LNA-deficient group than in the sufficient group. This effect diminished with time, but even between adult rats, a statistically significant difference of 20 between the a-wave amplitudes of the two dietary groups remained. Dietary Sources of Dietary Fat Commonly Used in Animal Experiments Good dietary sources of n-3 Poor dietary sources of n-3 Three generations of Wistar rats were fed...

The Office of Dietary Supplements at the National Institutes of Health

The Office of Dietary Supplements (ODS) was authorized at the NIH as part of the DSHEA legislation. This office was formally started in late 1995 with the mandate to serve as a source of research support, inter-government advice, and science-based information on dietary supplements. The ODS has worked extensively with the other NIH institutes, centres and offices to partner in identifying the most fruitful areas for research in dietary supplements and to serve as a source of information for scientists, industry and the public. While the Congressional mandate for the ODS was specified broadly, the office staff needed to take this mandate and transform it into specific achievable goals and objectives. In order to do this, the office assembled over 125 scientists and professionals from academia, government, industry and public-interest groups and held a series of seven strategic planning meetings in autumn and winter 1996 1997. Different individuals were involved in each of the seven...

Childhood Obesity

As is the case in adults, increase in energy intake and decrease in physical activity are the primary environmental influences on childhood obesity. A number of studies have documented that the increase in obesity prevalence has paralleled the increased consumption of junk foods snacks and decreased physical activity in this age group (85-87). Incidentally, children are especially vulnerable since most decisions regarding diet and physical activity are beyond their control. For example, parental concerns over safety have tended to limit time for recreational activity and to limit activities such as walking or bicycling to school. One obvious consequence is longer periods of television viewing, which leads to prolonged unsupervised exposure to direct advertisement of foods and drinks, most of which are high in fat and or simple sugars.

Cell Signaling Molecules As Targets Of Selected Dietary Chemopreventive Phytochemicals

The National Cancer Institute (NCI) of the United States has identified about 40 plant-based foods that possess chemopreventive properties. Attention has recently been focused on a vast reservoir of nonnutri-tive phytochemicals present in fruits, vegetables, spices, and beverages as potential chemopreventive agents. It is now estimated that more than 1000 different phytochemicals possess chemopreventive activities 5 . Examples of chemopre-ventive dietary phytochemicals are epigallocatechin gallate (EGCG) from green tea, curcumin from turmeric, genistein from soybeans, sulforaphane from broccoli, proanthocyanidins from grape seeds, indole-3-carbinol from cabbage, res-veratrol from grapes, lycopene from tomatoes, organosulfur compounds from garlic, gingerol from ginger, and caffeic acid phenethyl ester (CAPE) from honey bee propolis 5 . The following section will focus on an overview of the modulation of cell signaling molecules by selected dietary...

Genetic And Dietary Factors Which Influence N3 Fatty Acid Metabolism

Because of the inability to synthesize n-3 fatty acids de novo, all animals require these fatty acids in their diet to meet their demand for maintaining a high concentration of DHA in the brain. Although little direct evidence exists in any species concerning the quantitative conversion of n-3 fatty acid precursors to DHA, it has been estimated based on rodent studies that an n-3 fatty acid intake of 0.5 of energy as a-linolenic acid (LNA) is needed in order to maintain an adequate level of DHA in the brain (Bourre et al., 1989). However, it must be recognized that the ability to biosynthesize DHA from LNA or other n-3 fatty acids varies among different animal species (Rivers et al., 1975 Hassam et al., 1977 Sinclair et al., 1979 Clandinin et al., 1985 Scott & Bazan, 1989 Salem & Pawlosky, 1994 Pawlosky et al., 1994 Fu & Sinclair, 2000). Moreover, the composition of fat in the diet has a significant influence on the liver production of long-chain PUFAs (Salem & Pawlosky, 1994 Pawlosky...

Retroperitoneoscopy in Obese Patients

Although the excessive retroperitoneal fat increases the degree of technical difficulty, adherence to a standardized stepwise anatomical approach (14) allows retroperitone-oscopy to be performed effectively in markedly obese or morbidly obese patients. In fact, the retroperitoneal flank approach allows the gravitational pull to shift much of the weight of the pannus anteriorly, away from the ipsilateral flank (Fig. 11). In our series, 35 of the patients had body mass index (BMI) equal or greater than 30. However, the reader should be cautioned that these challenging procedures should be performed by surgeons facile with the laparoscopic technique.

Recommended Dietary Allowances For Folate And Vitamin B12 Based On Genomic Stability

There is now increasing interest to redefine recommended dietary allowances (RDAs) of minerals and vitamins not only to prevent diseases of extreme deficiency but also to prevent developmental abnormalities and degenerative diseases of old age as well as optimizing cognition (75). Prevention of chromosome breakage and aneuploidy is an important parameter for the definition of new RDAs for micronutrients (9) such as folic acid and vitamin B12 because increased rates of DNA damage have been shown to be associated with increased cancer risk (76-78) and accelerated aging (79). Table 1 summarizes the information from in vitro and in vivo controlled experiments in human cells and human subjects with a view to defining, based on current knowledge, the optimal concentration and dietary intake of folic acid for minimizing genomic instability. The results from a variety of DNA damage biomarkers suggest that above RDA levels of folic acid intake are required to minimize DNA damage furthermore,...

Absorption Transport And Metabolism Of Dietary Folates

If one takes into account all folyl oligo-y-glutamyl forms of the various one-carbon and unsubstituted oxidation states of the vitamin, folate metabolism becomes complex. However, it is generally agreed that food folate exists largely in 5CH3-H4folate and formyltetrahydrofolate (formyl-H4folate) forms (27). (Figure 1 gives the structure of all reduced folate derivatives.) The predominant natural dietary folate is 5CH3-H4folate (28,29), which is readily oxidized to 5-methyl-5,6-dihydrofolate (5CH3-5,6-H2folate) (27). In this oxidized form, it may add up to 50 of the total food folate (30). relatively stable. Fortunately, ascorbate secreted into the stomach lumen can salvage acid-labile 5CH3-5,6-H2folate by reducing it back to acid-stable 5CH3-H4folate and, thus, may be critical for optimizing the bioavailability of food folate (31). It has recently been shown that dietary formyl-H4folates may also utilize the natural pH of the gastrointestinal tract to isomerize and yield biologically...

Major Molecular Targets of Selected Dietary Chemopreventive Phytochemicals to Induce Apoptosis

Mechanisms underlying the elevated expression of HIF and HIF-regulated inflammatory and angiogenic gene products in tumors includes control of mRNA expression, protein stability, and activity of HIF 79 . Under hypoxic conditions, HIF-1a protein escapes prolylhydroxylase von Hippel Lindau (VHL)-dependent proteasomal degradation, thus, forming a heterodimer with HIF-1 P and subsequent binding to the hypoxia response elements (HRE) located in the promoter of target genes 79 . Under normoxic conditions, the transcriptional activity of HIF-1a is regulated by factor inhibiting HIF-1a (FIH), which prevents the binding of HIF-1a with transcriptional coactivator p300 CBP by hydroxylation of an asparagene residue located in the C-terminal domain of HIF-1a 89,90 . The activation of extracellular signal-regulated protein kinase (ERK) enhances transcrip-tional activity of HIF-1a by promoting phosphorylation and subsequent nuclear localization of HIF-1a 91,92 . Moreover, loss-of-function of tumor...

The role of the dietitian

Dietary history A careful dietary history should reveal the patient's dietary habits, their intake of the suspected food and the extent to which they have to modify their diet to comply with the dietary avoidance. It can also help to identify a situation where accidental exposure is likely to occur. Likes, dislikes and cravings for foods are noted. There may be preconceived ideas about various foods and some foods may already be excluded at the patient's own initiative or following advice from other medical or non-medical practitioners. A food diary completed over a week could be analysed by a computer program to give an indication of the patient's dietary intake. An assessment is also made of the patient's ability to understand and comply with a possibly difficult avoidance diet. This information would help in the diagnosis and assessment of risk to the patient and is also valuable when an avoidance diet is suggested. The dietitian should give an explanation and provide a list of...

Obesity and Nutritional Intake

Obesity, in general, is associated with decreased adiponectin expression in adipose tissue and plasma levels (7,13). In both men and women, overall obesity, assessed by parameters such as body mass index (BMI) and fat mass, is negatively correlated to adiponectin, although prolonged weight reduction leads to increased adiponectin levels (7,14-17). Nutritional intake does not seem to explain this relationship. Although fasting decreases adiponectin messenger ribonucleic acid (mRNA) levels in mice, serum levels remain unchanged (18). In humans, short-term fasting also does not change plasma levels of adiponectin, although prolonged caloric restriction does result in weight loss and increased adiponectin levels (14,19). Additionally, daily caloric intake, macronutrient intake, or a high-fat meal is not related to any immediate change in circulating adiponectin levels in humans except possibly in obese individuals (20-22).

Impact Of Dietary Essential Fatty Acids On Neuronal Cell Composition And Function

Brain membranes were generally viewed as resistant to structural change by both endogenous and exogenous factors. Data have shown that brain membranes are much more sensitive to changes in composition induced by dietary fat than previously thought (Bourre et al., 1989a Foot et al., 1982 Jope & Jenden, 1979 Lee, 1985 Wurtman et al., 1981). Moreover, the extent of the changes in brain membrane composition by dietary fat varies among brain regions, cell types, and organelles (reviewed by Clandinin et al., 1997 Clandinin et al., 1991 Hargreaves & Clandinin, 1990). Earlier studies examining the role of dietary fat on brain membrane composition have used rodents that were fed 18 2n-6-deficient diets for several weeks to a few generations. Results from these studies demonstrate qualitative changes in brain membrane fatty acid composition associated with essential fatty acid deficiency (i.e., increase in 20 3n-9 and decrease in 20 4n-6 Koblin et al., 1980 Paoletti & Galli, 1972 Sun & Sun,...

Your Diet for Type 2 Diabetes

People with type 2 diabetes are frequently overweight, so advice about nutrition is directed not only at controlling carbohydrate intake, but also at limiting calories. (I discuss caloric restriction and weight loss in Chapter 10.) If you have type 2 diabetes, there are several reasons why you still need to estimate the carbohydrate content of your food

High Fat Diets and Obesity Possible Influence of n3 PUFAs

Obesity is one of the major health risks for a number of diseases, particularly heart disease and diabetes. It is well known that ingestion of a diet high in saturated fats is one of the major causes of obesity. There are two explanations for this observation. First, diets high in saturated fats do not seem to be as satiating as either high-carbohydrate or highprotein diets (Doucet et al., 1998), even when the high-fat diet is less palatable (Warwick, 1996). Second, whereas increased intake of either carbohydrate or protein causes a concomitant increase in energy expenditure (e.g., nonshivering thermogenesis), increased intake of saturated fat does not cause a similar increase in energy expenditure. Individuals maintained for 1 wk on a high-carbohydrate or high-protein diet have, whereas individuals maintained on a diet high in saturated fat did not have, increased body temperature and ingested fat was mostly sequestered to adipose tissue that is, increased intake of saturated fat...

The Power of the Food Guide Pyramid

The Food Guide Pyramid, the triangular symbol you see on many food packages, was developed by nutrition experts at the U.S. Department ofAgriculture (USDA) (see below). The Pyramid is an educational tool that translates nutrient requirements into the foods you need to eat and helps you put into action the advice offered by the Dietary Guidelines. In graphic form, the Pyramid displays the variety of food choices and the correct proportions needed to attain the recommended amounts of all the nutrients you need without consuming an excess of calories. The Pyramid divides all foods into six categories, based on the nutrients they contain. The Food Guide Pyramid The Food Guide Pyramid was developed by the U.S. Department ofAgriculture. The pyramid incorporates many principles that emphasize a plant-based diet that is low in fat, high in fiber, and rich in important vitamins, minerals, and other nutrients. All of these factors contribute to optimal health and help you to control your weight...

A brief overview of dietary supplement ingredient regulation in the United States

In 1994 the United States Congress passed the Dietary Supplement Health and Education Act (DSHEA, Public law 103-417, October 25, 1994, 103rd Congress). This law modified the Food, Drug, and Cosmetic Act and expanded the definition of dietary supplements to include botanical ingredients, hormones, and a diverse array of related products in addition to vitamins and minerals. The DSHEA also specified the role of the United States Food and Drug Administration (FDA) in regulating dietary supplements, mandated the creation of a Presidential Commission on Dietary Supplement Labeling, and authorized the establishment of the Office of Dietary Supplements at the National Institutes of Health (NIH). The main elements of the definition of dietary supplements from the DSHEA are listed in Box 1.1. For products that are regulated by the FDA, the 'intended use' of a product or ingredient is the turnkey that determines whether an item is broadly classified as a food or a drug. Dietary supplements, no...

Sales and use of dietary supplements in the United States

The sale and use of dietary supplements in the United States initially grew dramatically after the passage of the DSHEA. Figures of individual and mixtures of botanical supplements drove the market. The growth and demand led to a consolidation of manufacturing and retail corporations as well as new growth in botanical supplements produced by the major pharmaceutical corporations in the US. It is estimated that from 30 53 per cent of Americans or 100 million people use dietary supplements on a regular basis (several times each week) (Aarts, 1998). In 1996 sales of dietary supplements totalled 9.8 billion and represented 51 per cent of the total sales in the nutrition industry in the United States. Sales of dietary supplements in natural food stores comprised 44 per cent of the total, and mass-market retail accounted for 26 per cent of the total with the remainder in direct marketing through the mail or Internet. Overall sales for dietary supplements grew 9 per cent in 1996 (Aarts,...


Obesity is an increasing health issue and a burden for the public health system. Recent studies reported an age-adjusted prevalence of approximately 20-25 in the German population 4 . Almost 2 of people are is morbidly obese, i.e. have a BMI of at least 40 kg m2 4 . Among the best-known obesity-linked diseases are diabetes mellitus, hypertension and cancer, especially breast cancer. In the latter, obesity is a well-known risk factor linked with poorer prognosis. However, the relationship between obesity and prostate cancer is not completely clear. A growing number of studies suggest that the risk of developing prostate cancer as well as the probability of higher-grade disease and disease progression after radical prostatectomy increases with increased BMI. In contrast, an equal number of studies propose a weak association or none at all 5, 6 . Only few reports are available on radical prostatectomy in obese patients 7-10 . In a recent study from our center (unpublished data) we...

Obesity In Children

Childhood obesity is a serious problem in the United States because of its association with detrimental social and physical outcomes and its rising prevalence in recent years. Although several proposed methods for determining childhood obesity exist, the most widely used is to define childhood obesity as equal to or above the 95th percentile on the body mass index (BMI). Epidemiological studies employing the BMI method suggest that approximately 11 to 15 of children in the United States are obese. Estimates suggest that the prevalence of childhood obesity has risen by 4 over the previous decade (Centers for Disease Control and Prevention, 2004). Although obesity rates have increased for both sexes and all racial-ethnic groups studied, it appears that rates of obesity may be higher among minority groups, including African Americans and Mexican Americans, when compared to whites. Childhood obesity has multiple possible causes, which can be best understood by considering the combined...

Ideal Body Weight

To determine your ideal body weight, use the following formula If you are large-framed you can add 10 percent to the calculated weight. For example, if you are a male who is 5 feet 8 inches tall, your ideal body weight is 106 + 48 154 pounds. If you are large-framed, you might weigh as much as 169 pounds.

Healthy Weight

However, your health care provider does want you to be at a reasonable and healthy weight. Before you become pregnant, you should try to be at a healthy weight. Being at a healthy weight makes it easier for you to conceive, because your metabolism and hormones are more likely to be in the proper balance. So what defines a healthy weight Most health care professionals use the body mass index (BMI) as a reliable indicator of body fat. The BMI is a way of correlating your body weight to your height. (A mathematical formula divides your weight in kilograms by your height in meters squared.) Table 5.1 summarizes what you need to know about BMI. Find your height along the left column, and then find your current weight in that same row. Then look up at the top of Table 5.1 to determine your BMI category. Table 5.1. Body Mass Index Table Table 5.1. Body Mass Index Table

Concluding remarks

Our diet contains a host of secondary metabolites which can interact with important pharmacological targets, and for which biological activity can be demonstrated in in vitro and in vivo assays. The role of these interactions for human homeostasis is unknown, and the translation of dietary constituents into pharmaceutical leads is undoubtedly fraught with difficulties. Nevertheless, it is not unconceivable that in the near future progress in biomedical sciences will put us in the position to better evaluate the physiological role and pharmacological potential of the multitude of dietary chemicals which have challenged our homeostasis over the course of evolution. People in developed countries are expecting food to make them healthier, fending off the chronic diseases of ageing. This trend has led to the explosion of the functional food market, which is expected to constitute 10 per cent of the total food market in the USA (and presumably of other developed countries as well) by 2010...

Transgenic crops for improved medicinal plants and pharmaceutical products

As discussed earlier, secondary metabolite pathways are complicated, since they require multiple enzymatic steps to the desired end-product used as therapeutic substance or dietary supplement and since these enzymatic pathways are under the control of multifactorial regulatory processes.

The example of St Johns wort

Increasing numbers of people are seeking symptomatic relief of psychiatric disorders by using dietary supplements. Since this is generally without medical supervision (Fugh-Berman and Cott, 1999 Wong et al., 1998), it is essential that clinicians avail themselves of the extensive literature available on natural products so that potential problems can be avoided. Herb drug interactions can be of two primary types pharmacokinetic and pharmacodynamic. Dynamic interactions are those having to do with the mechanism of action, e.g. where the drug's pharmacologic actions may be in opposition to or in addition to one another. Pharmacokinetic interactions are the result of alterations in the absorption, distribution, metabolism or excretion of medications when given together with specific drugs, foods or supplements. Interactions between botanical products and prescribed medications could increase or decrease the action of the drug, though the majority of interactions are likely to go...

Druglike compounds from food plants and spices

Since nutritional research has traditionally focused on macronutrients (proteins, lipids, sugars) and essential micronutrients (vitamins, minerals), food plants have long been assumed to contain few if any secondary metabolites apart from those revealed by our senses and responsible for their taste and flavour. Over the past few decades, evidence has, however, been mounting that food plants also contain a host of secondary metabolites which, though generally undetected by our senses, can nevertheless contribute to human well-being and play a role in the maintenance of health (Pisha and Pezzuto, 1994). Evidence for the dietary intake of biologically active small molecules can be traced to two distinct lines of research, namely the study of the detrimental effects of the inordinately large consumption of single food plants, and the recognition that food and medicines can interact, sometimes with dramatic consequences. Research in these areas has always been intense, and recent...

Main techniques employed by plant biotechnology

Plant secondary metabolism is very important in determining flower colour, flavour of food, and plant resistance against pests and diseases. Moreover, it is the source of many useful chemicals such as drugs, dyes, flavours and fragrances (Verpoorte et al., 1999, 2000), which are the main active constituents or at least simple components of most medicinal plants and herbal dietary supplements. Therefore, it is of interest to be able to engineer the secondary metabolite production of the plant cell factory, e.g. to produce more of a useful chemical, to produce less of a toxic compound, or even to make new compounds or valuable herbal products. Our limited knowledge of secondary metabolite pathways and the genes involved is one of the main bottlenecks (Verpoorte et al, 2000).

The situation in Europe

In Europe, dietary supplements account for 15 20 per cent of the herbal market. Although regulations vary from country to country, in Europe, herbal products are generally considered as medicines. Therefore, full registration with a full dossier on quality, safety and efficacy has to be submitted for pre-market approval. Bibliographic documentation can be based on clinical trials, and the monographs of the European Pharmacopoeia (EP), World Health Organization (WHO), German Commission E and the European Scientific Cooperative on Phytotherapy (ESCOP). There is a simplified way of registering a herbal product as medicine with proof of efficacy based on long-term traditional use in countries like Germany, Austria, Belgium and France. In such a case, the medicine has to carry a disclaimer on the label stating that it is 'traditionally used' (Lawson and Bauer, 1998 Stott, 1998 Grunwald, 1999 Steinhoff, 2001). In short, the EU has, at present, no legislation like in the USA to regulate...

Official information resources

The section on official sources of information includes reviews (monographs) by officially recognized experts on botanicals such as the United States Pharmacopoeia, World Health Organization Traditional Medicine Programme and the European Scientific Cooperative on Phytotherapy. It also includes information resources from governmental organizations such as the Office of Dietary Supplements at the National Institute of Health.

Mainstream drugs from edible plants

The background 'pharmaceutical noise' of dietary origin Certain active pharmaceutical ingredients occur naturally in food plants and spices. With a few notable exceptions (statins, xanthines, capsaicinoids), the concentrations are very low and unlikely to exert any direct significant pharmacological activity. This background dietary 'pharmaceutical noise' can, however, become significant under particular conditions, especially in the realm of exposure to recreational drugs like tobacco and opioids. The interference of dietary nicotine (3a) in studies of exposure to environmental tobacco smoke has long been debated. Nicotine is widely distributed, and has been found in twelve plant families, with detectable amounts in many food plants. Thus, levels up to 100 (xg kg have been measured in aubergines, and also non-solanaceous vegetables like cauliflower can accumulate nicotine (Domino et al, 1993). The dietary intake of nicotine is unlikely to produce any direct pharmacological or...

The chapters that follow

In 1994 or the establishment of the European Scientific Cooperative on Phytotherapy (ESCOP) in 1989. These scientists present a comprehensive view of the earlier and current approaches to studying plant-derived compounds that are used as dietary supplements. They also have placed their research into the worldwide perspective of plant biodiversity, ecology and the increasingly politically fraught arena of genetically modified foods. Dr Can Baser approaches dietary supplements of plant origin from the perspective of the plant industry in Chapter 4. He discusses the active compounds with potential health benefits in a number of food products such as soybeans, tomatoes, etc. In Chapter 5 Giovanni Appendino and Orazio Taglialatela-Scafati take what they describe as a 'pharmaceutical point of view' towards diet. In this carefully organized chapter Drs Appendino and Taglialetela-Scafati walk the reader through major developments in the scientific understanding of active pharmaceutical...


Soybeans are a unique dietary source of the isoflavone genistein, which possesses weak oestrogenic activity and has been shown to act in animal models as an anti-oestrogen. Genistein is also a specific inhibitor of protein tyrosine kinases it also inhibits DNA topoisomerases and other critical enzymes involved in signal transduc-tion (Messina et al, 1994). Genistein is highly bioavailable in rats because its enterohepatic circulation may accumulate within the gastrointestinal tract (Sfakianos et al, 1997). The branch pathway for the formation of isoflavonoids shares several mechanistic features with the anthocyanin pathway. However, the first reaction specific for isoflavonoid biosynthesis is unique. It comprises 2-hydroxylation coupled to aryl migration of the B-ring of a flavanone (naringenin or daidzein) to yield, after a dehydration reaction that might be spontaneous or enzyme-catalysed (Hakamatsuka et al, 1998), the corresponding isoflavone (genistein or daidzein, respectively)....

The European market

Due to the uncertain interpretation of rules and the lack of a harmonized legislation, anyone who has ever tried to market food supplements containing herbs, having in mind to sell the same product in the majority of EU countries, will experience the range of complications and practical difficulties which may arise. For instance, the first problem may be the legal status of the herbal product in certain countries it will be deemed as a medicine, in others as a food or a food ingredient. Talking about dietary supplements in Europe means considering both the above-mentioned categories because of the different legal basis that a single product can have in different states. As a matter of fact, we must not limit our discussion to food products. From the description of a herbal product as a medicine or as a food can derive the practical feasibility of marketing it in a number of countries. A good example of this can be marketing a Ginkgo biloba product, claiming its capability to improve...


Dietary supplements in the United States include a wide array of ingredients and products that are broadly available in the marketplace. While these products are presented in formats that give the appearance of standard over-the-counter (OTC) medications such as aspirin, their manufacturers are not required to provide the same level of pre-market safety data as manufacturers of OTC products. Botanical supplements, in particular, are directly derived from wild, or in some cases, commercially grown plants and therefore are more subject to product variability due to plant contamination, and manufacturing and post-manufacturing variables that are currently not regulated. The United States and countries within Europe have widely differing approaches to regulation and marketing of dietary supplements of plant origin. While these aspects may differ, scientists worldwide share concern with the need for careful hypothesis-driven research on the efficacy and safety of dietary supplements, and,...

New terminology

The expanding world of dietary supplements especially in the USA, has learned new terminology such as 'functional foods', 'novel foods', 'nutraceuticals', 'designer foods', 'pharmafood', 'phytoceuticals'. These terms are used to describe At present, in the USA, there is no legislation governing the use of nutraceuticals or functional foods. The FDA states that existing regulations for foods are sufficient and that companies must decide on intended use (conventional food or dietary supplement) early in product development (Anon., 2000).

Primary Nursing Diagnosis

A dietary consultation can provide the patient with a plan to supplement needed nutrients and bulk-forming foods based on the patient's symptoms. Unless the patient requires fluid restriction, he or she needs to drink at least 2 L of fluid per day. A referral to a speech therapist may be necessary if the patient's tongue prevents clear communication.

Discharge And Home Healthcare Guidelines

Instruct the patient to increase fluid intake to enhance the passage of the stone. Instruct the patient to strain all urine, and, if a stone is obtained, emphasize the importance of returning the stone to the physician for analysis. If the patient has passed the stone and it has been analyzed, teach the necessary dietary changes, fluid intake requirements, and exercise regimen to prevent future stone formation. Patient should drink at least 2.5 L a day of fluid to prevent recurrences.

Pathology and Pathogenesis

The signs of ascovirus disease are very subtle, and this probably accounts for why ascoviruses were discovered only recently. The most obvious sign of disease within 24 h of infection is a decrease in the normal rate of feeding. The feeding rate continues to slow as the disease progresses, and as a result larvae fail to gain weight or advance in development. Healthy larvae, particularly in the early stages of development, will easily quadruple their weight and size in a period of 3 or 4 days, whereas ascovirus-infected larvae cease to grow and may actually lose weight. This feature of ascovirus disease is almost impossible to detect in infected larvae in the field. However, it is easily noticed under laboratory conditions when infected and healthy larvae are reared side by side over a period of a few days. A second feature easily noted in the laboratory is that ascovirus diseases are chronic, though usually fatal. When infected during early stages of development, ascovirus-diseased...

Summary And Conclusion

It would seem that modulation of lipid intake and exercise training may mediate and reverse some of the age-associated depression in the immune system. As human aging generally is accompanied by a reduction in the level of physical activity and impaired responsiveness of the immune system, there may be a relationship between these concurrent changes and the increased incidence of, and mortality from, cancer, autoimmune disorders, and chronic infectious diseases with age. The studies on the immune system of centenarians suggest that the immune system in this population may not be declining with age, instead it is being constantly remodeled and reshaped as required. Appropriate fat and protein intake may improve immune function. Lipids modulate immune function by several factors and mediators. Both the quantity and type of dietary lipids are known to have modulatory effects on the cellular immune system at biochemical and molecular levels. The mechanisms by which lipids modulate the...

Purification and Characterization of Recombinant Produced Human APC

This similarity to plasma-derived material was not seen in rHPC produced from other cell lines, for example, BHK-21 cells 30 . The respective N-terminal sequences of the heavy and light chains of rHPC were identical to those previously reported for plasma-derived HPC 31 . Thus, the HEK293 cell line, unlike others such as the C127 and CHO cell lines 16 , was capable of proper proteolytic processing of the propeptide, even at high expression levels. There was no significant difference in the amount of P-OH-Asp in the rHPC and plasma-derived HPC. Thus, with respect to the posttranslational modifications of proteolytic processing and the two types of amino acid modification, the rHPC from the HEK293 cell line appears to be processed in a manner similar to plasma-derived material, but more completely in the case of y-carboxylation of the nine glutamate residues. y-Carboxylation of glutamates is dependent on an adequate supplement of vitamin K in the...

Perinatal N3 And N6 Fatty Acid Metabolism And Neural Development

The polyunsaturated fatty acids (PUFA), a-linolenic acid (LNA, 18 3n-3) and linoleic acid (LA, 18 2n-6) are indispensable dietary components in mammals. It is thought that the primary metabolic role of LA and LNA are as essential precursors for conversion to their respective long-chain metabolites. Of these long-chain PUFA (LCP, C 20) docosahexaenoic acid (DHA, 22 6n-3) and arachidonic acid (AA, 20 4n-6), have received the most attention, because of their distinct functional roles in fetal and infant health. They are present in human breast milk at small but significant amounts, ranging from 0.1 to 0.6 and 0.5 to 1 , respectively (Jensen, 1996). DHA and AA are the most abundant n-3 and n-6 LCP found in the lipids of humans and are concentrated in the brain and central nervous system (CNS), which is second only to adipose tissue in containing the greatest percentage of lipid. The brain is comprised of 50-60 lipids (dry wt) serving mostly structural roles, as opposed to storage of...

Considerations For Animal Studies

Equally important to brain nutrition is the relative brain-weight percentage. For nonprimates, the percentage of total body weight represented by the brain is less than 5 at birth (Brody, 1945). For instance, the rat brain is about 2 of body weight at birth. In contrast, the brain weight of rhesus monkeys, baboons, and other primates is greater than 10 at birth, whereas the brain weight of term human infants is about 14 at birth. Because nutrient requirements are best expressed in terms of a fraction of dietary energy, it stands to reason that requirements for an animal supporting the growth of a brain of 10 body weight are more applicable to humans than an animal with a brain of 2 body weight.

Neonatal Conversion in Rodents

Sinclair's results in suckling rats were consistent with these findings (Sinclair, 1975). He provided an oral dose of 14C-LNA or 14C-DHA at 2 wk of life and measured radioactivity in specific fatty acids at 22 and 48 h postdose. As a percent of dose, 14C-LNA uptake was relatively low compared to 14C-DHA (brain 0.29 vs 2.71 liver 3.29 vs 19.8 ). Here, the relative efficacy of LNA and DHA for brain DHA could be estimated, and at 22 h postdose was measured to be 59 1 in favor of DHA. A similar trend was found for 14C-LA and 14C-AA at 22 and 48 hr postdose, consistent with later data Hassam and Crawford obtained for orally fed labeled AA versus LA (Hassma & Crawford, 1976). Diet control was not well described in these two tracer studies (Anderson & Connor, 1988 Sinclair, 1975), and data reported in primates, to be discussed below, indicates that the timing of sampling is not sufficiently long for all brain DHA derived from labeled LNA or DHA to reach a constant level. Thus, no overall...

Perinatal Conversion in Primates

Several considerations suggest that quantitative requirements for brain growth should be modeled in primates. The human brain constitutes about 14 of body weight at birth, and the brains of most primates constitute more than 10 of body weight at birth. In contrast, most non-primate brains are less than 4 of body weight at birth. The relative anatomy of the brains and neural tissues of primates is much more similar to one another to that of non-primates. Dietary recommendations for essential fatty acids are usually cast in terms of the relative fraction of dietary energy required to support tissue growth and maintenance. Because the fraction of body weight occupied by the primate brain is twofold to fourfold greater than that of common laboratory species, it is a priori expected that dietary requirements for laboratory species cannot be directly translated into recommendations for humans. For this reason, nonhuman primates represent the only realistic model of quantitative human brain...

Protocol Section 58120

(7) A description and or identification of the diet used in the study as well as solvents, emulsifiers, and or other materials used to solubilize or suspend the test or control articles before mixing with the carrier. The description will include specifications for acceptable levels of contaminants that are reasonably expected to be present in the dietary materials and are

Expression And Function Of Agat Gamt And Ct1 In The Mammalian Brain

Abstract In mammals, creatine is taken up from the diet and can be synthesized endogenously by a two-step mechanism involving the enzymes arginine glycine amidinotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT). Creatine (Cr) is taken up by cells through a specific transporter, CT1. While the major part of endogenous synthesis of Cr is thought to occur in kidney, pancreas and liver, the brain widely expresses AGAT, GAMT and CT1 , both during development and in adulthood. The adult central nervous system (CNS) has a limited capacity to take up Cr from periphery, and seems to rely more on its endogenous Cr synthesis. In contrast, the embryonic CNS might be more dependent on Cr supply from periphery than on endogenous synthesis. This review will focus on the expression and function of AGAT, GAMT and CT1 in the mammalian CNS, both during development and in adulthood. Emphasis will also be placed on their specific roles in the different cell types of the brain, to analyze...

Disorders of Urea Formation

The urea cycle is a series of enzyme reactions that removes waste nitrogen from the body, allowing it to be excreted in the urine as urea. Disorders of the enzymes of the urea cycle disrupt this pathway, increasing blood ammonia (hyperammonemia). Hyperammonemia results in mental retardation, and acute episodes can progress to seizures, coma, and death. These conditions are inherited in an autosomal recessive pattern, except for ornithine trans-carbamylase deficiency, which is X-linked, affecting males more severely than females. Treatment for these disorders includes limiting dietary protein (the major source of nitrogen intake) and using agents (such as phenylacetate) that provide an alternate mechanism to remove waste nitrogen (through excretion of phenylacetyl-glutamine in urine). Liver transplantation may also be effective in controlling blood ammonia in these conditions.

Epidemiologic Studies

Data from epidemiologic studies, clinical trials, and in vitro studies of BC cell lines all provide support of the hypothesis that ER-negative cancers can arise from ER-positive cells. A vast amount of data from these epidemiologic studies suggest that the most important risk factor for BC development is the cumulative exposure to estrogen and possibly also P hormones (52). Such studies demonstrate that BC risk is increased with early menarche (53-56), late menopause (57,58), obesity in postmenopausal women (59, 60), hormone replacement therapy (meta-analysis performed in refs. 61-63), all of which lead to increased exposure to estrogen or progesterone. In addition, studies have shown that factors that decrease exposure to estrogen or progesterone reduce BC risk. Well-established factors associated with reduced incidence of BC include early first-term pregnancy (64), lactation (65,66), and increased physical activity (67,68). In addition, premenopausal women who have had bilateral...

Neonatal Conversion in Primates

It has been known for several years through in vivo tracer studies that human term and preterm infants are capable of synthesizing C20 and C22 LCP from the C18 precursors (Carnielli et al., 1996 Salem et al., 1996 Sauerwald et al., 1997). These and more recent studies suggest that this capability is highly variable from individual to individual (Uauy et al., 2000). However, all studies to date have sampled blood compartments, and estimates of relative conversion based on such measurements are tenuous at best. We recently reported the bioequivalence of dietary LNA and DHA as precursors for primate neonate brain DHA accretion based on direct measurements of brain DHA accretion (Su et al., 1999a). Neonate baboons were fed a commercial infant formula with 18 of total fatty acids by weight as LA and 1.8 as LNA, which gives an LA LNA ratio of 10 for 6 wk. Doses of LNA* or DHA* were administered orally at 4 wk and animals were sacrificed at 6 wk. The term bioequivalence, as used here, is...

Gene Environment Interaction in Phenylketonuria

The treatment of PKU by removing foods containing phenylalanine from the diet (and thus reducing the accumulation of phenylalanine) demonstrated that mutations in the phenylalanine hydroxylase gene cause mental retardation only in the presence of dietary phenylalanine. Since phenylalanine is very common in the diet, this gene-environment interaction was not detected at first. PKU serves as an illustration that phenotypes that are apparently Mendelian in nature may have complex interactions with other genes and with the environment. Removing the exposure to dietary phenylalanine prevents mental retardation, and phenylalanine does not cause mental retardation in the absence of mutations in the phenylalanine hydroxylase gene. Therefore, both factors are needed to cause mental retardation due to PKU.

Supplying Dha To The Brain Rodent And Feline Models Of Dha Synthesis

Although much of our understanding concerning the regulation of DHA biosynthesis has been ascertained from studies in rodents, it does not appear that either rats or mice are the most appropriate model for understanding n-3 metabolism in humans. Rodents seem to be more adept at synthesizing long-chain PUFAs than either felines or rhesus monkeys and are less influenced by dietary alterations (Salem & Pawlosky, 1994b). Rodents maintain a capacity to synthesize DHA in their livers (Scott & Bazan, 1989) as well as in the CNS (Pawlosky et al., 1996b) and have more active desaturases than several other species when measured in vitro (Willis, 1981). Using stable isotopically labeled substrates, Pawlosky and Salem demonstrated that DHA precursors could be taken up into the brain of developing rats and mice at a time when the brain is rapidly growing (Pawlosky et al, 1996b). The uptake of labeled-DPAn-3 into the brain appeared to be appreciable, as there was a ratio of approximately 1 5 of...

System Reconstructive Procedures

The primary cause of cystoceles and rectoceles is a weakened vaginal wall. Factors that contribute to this loss of pelvic muscle tone are repeated pregnancies, especially those spaced close together, congenital weaknesses, and unrepaired childbirth lacerations. Obesity, advanced age, chronic cough, constipation, forceps deliveries, and occupations that involve much standing and lifting are also contributing factors. Lack of estrogen after menopause frequently aggravates the condition.

Important illustrative studies

In a second study, the Pima Indians who settled in Arizona were compared with the Pimas who settled in Mexico (100). The Mexican Pimas had less obesity, expended more energy, and had a strikingly lower incidence of IGT and type 2 diabetes (101,102). This report emphasized that individuals of the same genetic background can have markedly different rates of IGT and type 2 diabetes depending on their diet and exercise pattern (103). Finally, in a fourth report published in September, 2001 (30), a large number (84,941) of nurses was followed from 1980 to 1996. During the 16-yr of follow-up, 3300 new cases of type 2 diabetes were found. Being overweight or obese was the single most important predictor of developing type 2 diabetes. Lack of exercise and a poor diet were also found in those who developed type 2 diabetes. These last four studies strikingly illustrate the important treatment concepts (1) diet and exercise can rapidly slow the progression of IGT to diabetes and can also improve...

Gastrointestinal biopsy

Gluten-sensitive enteropathy (coeliac disease) should be diagnosed with serial small bowel biopsies (duodenum or jejunum), demonstrating typical histo-pathological abnormalities on a normal diet and resolution following a gluten-free diet.6 It has been argued that as this diagnosis has such significant lifelong dietary implications, it should then be followed by a further biopsy demonstrating relapse upon a gluten challenge. Few clinicians carry out this third biopsy.

Polycystic Ovarian Syndrome

Of obesity or a family history of type 2 diabetes. Screening patients with PCOS, especially in the presence of other risk factors for IGT (Table 1), should clearly be done. Again, screening should include fasting glucose with the diagnosis of IGT confirmed by 2-h glucose after ingestion of 75 g glucola.

Silk Production By B Mori

B. mori larvae have a unique metabolic system for producing a large amount of cocoon protein and efficiently using dietary nitrogen. Both male and female silkworms digest and absorb about two-thirds of the nitrogen in the mulberry leaves they consume, and high percentages of the digested and absorbed nitrogen (66 in females and 70 in males) are utilized in the production of cocoon protein.

Factors Associated With Eating Disorders

An eating disorder are five times more likely to have an eating disorder. Davison and Neale (1998) found a 47 concordance rate for monozygotic (identical) twins after combing data from several studies. The sociocultural factors surrounding eating disorders include the ideal of thinness shared by most Western nations and the negative view that societies have toward obesity. The media often relay the value that beauty equals thinness (Davison & Neale, 1998).

Multidisciplinary treatment teams

In an attempt to stem the rising tide of type 2 diabetes, multidisciplinary teams have been formed in a few areas of the country. One such program has been ongoing at the University of Iowa since 1999. Led by a physical therapist exercise therapist (Rhonda Barr), the team is composed of a psychologist, a certified diabetes nurse educator, a nutritionist, and a diabetologist. All persons on the team had a strong interest in disease prevention and IGT in particular. All had read extensively about IGT and clearly were aware of the difficulties in establishing such a team (Table 3). The team, called REACH (Reaching Euglycemia and Comprehensive Health), designed an 8-wk program that incorporated requisite lifestyle changes for healthier daily living patterns in individuals with IGT (Table 4). These included dietary counseling with group and individual dietary

Hypolipidemic 3thia Fatty Acids

High serum levels of triglyceride (TG)-rich lipoproteins, i.e. very low density lipoproteins (VLDL) and its remnants are important risk factors for coronary artery disease.1 Serum TGs can be lowered either by dietary treatment with fish oils or by pharmacological treatment with drugs of the fibrate class. Classically, the decrease in plasma TG concentrations upon fibrate treatment (Table 1) are thought to be the result of a decreased hepatic secretion of VLDL accompanied by an enhanced plasma TG clearance, possibly due to the induction of lipoprotein lipase (LPL) activity in peripheral tissues.2

Serological Relationship and Variability

It remains to be seen whether inapparent infections in horses and sheep might be due to variant strains. All virus strains used for infection of experimental animals originate from brain tissue of naturally infected diseased horses. These isolates mostly underwent serial passages in rabbits and were adapted thereafter to different animals. Different biological properties of virus isolated at various times after infection from rats could also point to the existence of variants. In this context it should be emphasized that virus isolates exist that cause extreme obesity syndrome or behavioral alterations in infected rats. Sequence analyses confirmed the general view of highly conserved regions in the BDV genome.

Immediate Adaptations

About 25 mol of sodium are filtered every day by the kidneys in a normal human. Because dietary salt intake on a Western diet is typically 130-260 mmol daily, approximately 3 pounds of salt (17 mol 1 kg NaCl) must be reabsorbed every day by the renal tubules to maintain salt balance. All sodium chloride reabsorption along the mammalian nephron is driven by the action of Na K ATPase, which is present along the basolateral cell membrane of most renal epithelial cells. Transepithelial sodium transport occurs because apical transport pathways permit Na to move down its electrochemical gradient from tubule lumen to cell, often coupled to the movement of other ions across the same membrane. Most diuretic drugs act by inhibiting apical Na transport pathways. Because apical Na transport pathways are nephron segment specific, each class of diuretic inhibits Na transport predominantly along a single segment of the nephron. As an example, loop diuretics inhibit Na K 2C1 cotransport at the apical...

Exploiters of large food parcels

In the food-poor deep sea, prey are rare, so the time between encounters with prey will be long compared to that needed to subdue and ingest a prey item once encountered. Under these circumstances, optimal-foraging theory predicts that diets should be generalized to shorten the time between prey encounters, increasing the food-acquisition rate (MacArthur, 1972). The step from feeding on live prey to including carrion in the diet is a small one, so organisms that might be predators in shallow water are likely to consume both

Conjugated Linoleic Acid

Source of cis-9, cis-12 linoleic acid such as safflower oil to the diet (Herbel et al., 1998). Therefore, foods appear to be the principal sources of CLA. On GLC, they elute a little later than other C18 fatty acid esters (Figure 3.8). Overheating of homemade standards in alkali can produce many additional isomers (Mounts et al., 1970 Christie et al., 1997 Ackman, 1998), and careless saponification of lipids can also produce extra peaks of CLA (Ast, 1963). Special care is needed for methyl ester preparation from lipid samples if CLAs are suspected (Shantha et al., 1993 Kramer et al., 1997). In general, the analysis of CLA is difficult and should not be taken lightly (Sehat et al., 1998). This almost automatically includes all dairy products and human milks (McGuire et al., 1997 Jensen et al., 1998 Lavillonniere et al., 1998 Lin et al., 1998).

As An Adjunct To Dialysis

Loop diuretics have also been administered to patients with end-stage renal disease on maintenance dialysis in an attempt to reduce interdialytic weight gains, prevent heart failure or pulmonary congestion, and control blood pressure without unpalatable limitations in fluid or sodium intake. It has also been suggested that this strategy could reduce the number of hypotensive episodes which occurred during hemodialysis during removal of excess fluid. The ma jority of these studies have been performed in patients on chronic hemodialysis. Most individuals on dialysis who have residual renal function respond to loop diuretics, although very large doses are frequently required. However, the effect of diuretics on weight gain and blood pressure in this population have been inconsistent. In a double blind study of hemodialysis patients with residual creatinine clearances of less than 4 ml min, 200 mg per day of torasemide or 250 mg of furosemide increased fractional sodium excretion compared...

Bioavailability Of aLinolenate

Primarily through enzyme assays, dietary supplementation trials and in vivo tracer studies, much has been learned about the metabolic steps involved in the desaturation-chain elongation pathway converting a-linolenate through the main intermediates, eicosapentaenoate and docosapentaenoate (22 5n-3), to docosahexaenoate. The desaturation-chain elongation steps occur in the endoplasmic reticulum and are part of the electron transport chain. In addition to desaturation-chain elongation, it now appears that peroxisomal chain shortening of 24 carbon n-3 LC-PUFA is required to form docosahexaenoate in mammalian cells. The desaturases, in particular, are dependent on several mineral cofactors (iron, zinc, copper), whereas chain elongation appears to depend on pyridoxine. Hence, beyond the need for an adequate dietary supply of a-linolenate, normal fat absorption, and competition from n-6 PUFA at many levels, adequate dietary availability of all these cofactor nutrients plays an important...

Environmental Factors

SAM levels are also dependent on folic acid, and the enzymes involved in one-carbon metabolism use vitamin B cofactors. As folic acid and vitamin B are provided by nutrition, it should not be surprising that epigenetic states can be influenced by the diet. Changes in DNA methylation by folate have been observed in various types of cancers as well as in animal models (Garfinkel and Ruden 2004).

Whole Body Fatty AcidBalance Methodology

Whole-body fatty-acid-balance methodology exploits the fact that in the absence of other n-3 PUFA, the diet is the only source of a-linolenate besides what is already present in the body. By comparing a-linolenate intake to accumulation of the sum of all n-3 PUFA determined over a balance period of several days to several weeks (deducting excretion and conversion to n-3 LC-PUFA), one can calculate a-linolenate disappearance or p-oxidation by difference. The advantages of the whole-body balance method are that (1) it reflects metabolism in the whole body rather than in an isolated tissue or subcellular compartment and (2) during energy deficit, this method alone can provide an estimate of a-linolenate oxidation derived from existing body stores as well as from the diet. These tracer and whole-body balance p-oxidation studies demonstrate three important points. First, several very different models show that relative to the other 16-20 carbon fatty acids commonly present in the human...

Income and urbanization levels affect the mix of foods consumed in different countries

According to a study on global consumers by Regmi and Pompelli of USDA's Economic Research Service (2002), income is the factor that has the greatest influence on dietary changes. The analysis below updates the framework used by Regmi and Pompelli (2002) with more recent and expanded data on the food available for consumption in different countries from the United Nations Food and Agriculture Organization. The World Bank's country classifications (2005) are used to help illustrate that the demand for particular food groups depends on a country's income level. The analysis below also extends Regmi and Pompelli's framework by discussing how global differences in consumption may be associated with global differences in microbial foodborne disease risks.

Oxidation During Energy Deficit

Large proportions of the world's population do not have sufficient energy intake. Among those that usually have access to adequate food, many transiently but repetitively choose to restrict food intake through dieting. Our whole-body fatty-acid-balance studies in rats show that both short- and long-term dietary energy deficits rapidly and significantly increase P-oxidation of a-linolenate (Table 3). Collectively, these studies demonstrate several important points about the p-oxidation of a-linolenate. First, like other long-chain dietary fatty acids, a-linolenate is readily used as a fuel. Second, acute or chronic undernutrition depletes body stores of a-linolenate regardless of the adequacy of a-linolenate intake. Third, when fasting or chronic undernutrition accompanies a condition of higher energy and nutrient demand such as pregnancy, P-oxidation of a-linolenate can exceed intake by twofold to fourfold in rats, thereby eliminating all a-linolenate consumed and also significantly...

Carbon Recycling Of aLinolenate 51 Radiotracer Studies in the Suckling

These radiotracer studies used a very low mass of tracer therefore, it is likely that the tracer represented the normal metabolism of a-linolenate and would probably not have overloaded any steps leading to docosahexaenoate synthesis, thereby potentially skewing the tracer's metabolism toward P-oxidation or carbon recycling. Furthermore, these were healthy, suckling rat pups thus, nutritional circumstances were also likely to reflect normal a-linolenate metabolism. The influence of dietary docosahexaenoate (present in the milk) in these studies may well have increased carbon recycling from a-linolenate, but this was not assessed in these studies. Thus, under normal circumstances, carbon recycling appears to consume the majority of a-linolenate appearing in lipids of the suckling rodent brain. Apart from these two reports, this topic received little or no attention until the 1990s.

Africa and the Middle East

In contrast to most industrialized nations, the emphasis in this region has been on undernutrition and food security, resulting in the paucity of data on the current prevalence of obesity. However, some regional studies indicate a growing prevalence of obesity in certain socioeconomic groups. This is illustrated by the high prevalence of obesity (44 and 33 ) found in black women in the Cape Peninsula of the Republic of South Africa and among urban women 35 years or older in Obesity Prevalence (BMI 30 kg m ) in Selected Countries in Africa and the Middle East Prevalence of obesity ( ) BMI, body mass index. aData from ref. 34. Adapted from ref. 4. BMI, body mass index. aData from ref. 34. Adapted from ref. 4. Gambia, respectively (34). Furthermore, as shown in Table 3, there was a dramatic increase in obesity prevalence in Mauritius over a 5-yr period in both men and women aged 25-74. With the exception of Saudi Arabia, nationally representative data have not been well documented in...

The Americas and Europe

Not surprisingly, the most comprehensive data in this region come from the United States, and these are based on data from the National Health Examination Survey (NHES 1960-62), the National Health and Nutrition Examination Survey I (NHANES I, 1971-74), NHANES II (1976-1980), and NHANES III (1988-94). More than half of U.S. adults are overweight (55 with BMI 25 kg m2) and nearly one-fourth are obese (22 with BMI 30 kg m2). It should be noted that detailed analysis of the data reveals that black women and other racial ethnic minorities have particularly high rates of obesity compared with Caucasians. For example in the 20+ age group, the prevalence of overweight (BMI 25 kg m2) is 65.8, 65.9, and 49.2 for black, Mexican, and white women, respectively. As depicted in Table 4, Canada also has a worsening obesity problem, although it is not as bad as the situation in the United States. In the 1980s, there was a dramatic increase in the prevalence of obesity in the United States, which is...

Analytical strategies

Cross-sectional studies are often referred to as surveys. For example, one might conduct a survey involving a random sample of individuals of a city to study the relationship of viral infection level with their dietary habits, lifestyle, age, and socioeconomic status. Such information may be obtained from a questionnaire and by examining databases from the local health agency. The correlations measured from such data can give an estimate of the proportion of people infected with the virus at a particular point in time, which is termed as prevalence.

Prediction of fetal growth restriction

The epidemiological factors described above might be used to identify fetuses which are likely to have growth abnormalities allowing an increased level of surveillance. However, although many statistical associations are described, few of these are particularly strong. Therefore, although a study may show that a woman with a body mass index of 17 has an increased risk of delivering an SGA infant, the majority of these women would deliver an AGA infant. Most adverse pregnancy outcomes occur to women with no identified risk factors. These statements can be expressed in terms of screening maternal history has low sensitivity and low positive predictive value in detecting fetal growth disorder. Biochemical prediction of IUGR has been investigated primarily using analytes measured in the first or second trimesters in the context of Down's screening programmes. While low first trimester PAPP-A levels are associated with low birthweight, studies of first and second trimester AFP, hCG and...

Essential Fatty Acid Synthesis and Metabolism in the Brain

Many questions remain about the role of brain in synthesizing 20 4n-6 and 22 6n-3 from dietary precursors. Animal studies with radiolabeled 18 2n-6 and 18 3n-3 indicate that the brain is capable of desaturating and elongating 18 2n-6 and 18 3n-3 to 20 4n-6 and 22 6n-3, respectively (Anderson and Connor, 1988 Clandinin et al., 1985a Cohen & Bernsohn, 1978 Cook, 1978 Dhopeshwarkar et al., 1971a, b Dhopeshwarkar and Subramanian, 1976 Sinclair & Crawford, 1972). These studies of the brain fail to clarify which cell types within this tissue can provide 20 4n-6 and 22 6n-3. Studies with isolated brain cells provide evidence that both neuronal and glial cells may desaturate and elongate 18 2n-6 and 18 3n-3 to 20 4n-6 and 22 6n-3, respectively (Anderson & Connor, 1988 Clandinin et al., 1985 a Cohen & Bernsohn, 1978 Dhopeshwarkar & Subramanian, 1976 Yavin & Menkes, 1974).

Patient Preparation and Positioning

Bowel preparation is not routinely performed but a clear liquid diet is advised for the day prior to the procedure and a Dulcolax suppository is given on the day prior to surgery. One gram of cefazolin (Ancef) is administered preoperatively. In the obese patient or the individual with a history of deep venous thrombosis, 5000 U of heparin are administered subcutaneously 2 h prior to the procedure and continued on a 12-h basis postoperatively. At the outset of the procedure, just prior to any skin incision, 30 mg of ketorolac (Toradol) is given intravenously.

Gas Isotope Ratio Mass Spectrometry

Organic mass spectrometry provides the fractional abundance of various isotopomers of a molecule, but it does not provide the highest precision in the detection of 13C or other stable isotopes. For highest precision, a method is required that detects labeled atoms rather than molecules and avoids the problems created by the natural abundance of multicarbon compounds. The best known of these is GIRMS first developed in the 1940s. Current instruments can detect very small amounts of 13CO2 10 parts per million or less. GIRMS is important for the analysis of the oxidation of dietary lipids. To detect fat absorption and metabolism, 13C-enriched lipids is administered orally and breath samples are analyzed for 13CO2. In detecting 13CO2 enrichment resulting from the oxidation of 13C-labeled lipids, GIRMS is much more precise than standard organic mass spectrometry. Typically, GC MS may detect 13C with a precision of about 1 relative standard deviation. In contrast, GIRMS machines are...

Factors Underlying the Current Epidemic

As is discussed below, the key features of the global obesity epidemic mainly reflect the influence of environmental and societal factors on dietary and physical activity patterns. There has been a convergence toward increased consumption of an energy-dense (usually high-fat) diet and a transition to a more sedentary lifestyle. Several studies have shown that obesity is more prevalent among those of low SES in developed countries, whereas the reverse is the case in the developing world. Interestingly, as the less developed countries undergo economic growth and attain higher levels of affluence, the positive relationship between SES and obesity is replaced by the negative relationship seen in modern societies. It is not surprising that minority ethnic groups in developed countries are more susceptible to obesity since poverty is common in these populations. Families from the lower SES groups have more unemployment and live in unsafe neighborhoods, which could result in less physical...

Fungal Phytase Derived From Transgenic Alfalfa

Patents 5,824,779 and 5,900,525 describe a method for deriving phytase, dietary protein, and xanthophylls from alfalfa juice 43 and an application of this technique in the formulation of animal feed 44 . Transgenic alfalfa plants were produced by Agrobacterium tumefaciens-mediated transformation with binary vectors containing the phyA coding sequence that was fused to the coding region for a signal peptide of plant origin and placed under regulatory control of a series of different promoters. The three promoters described include the CaMV 35S promoter, an Arabidopsis thaliana Rubisco small submit promoter, or a hybrid promoter containing distal elements from the CaMV 35S promoter and proximal elements from the Agrobacterium mannopine synthase promoter. All three constructs achieved significant accumulation of phytase that was differentially glycosylated compared to the fungal enzyme. This is consistent with the observations of other plants. Constitutive expression of phytase...

Critical Periods of Increased Susceptibility

To assist with intervention strategies, certain periods of life at which an individual is especially vulnerable to weight gain have been identified. Prenatal based on the postulate that early undernutrition may alter regulation of food intake, thereby predisposing to later obesity. Adolescence obesity at this stage significantly increases the risk for adult obesity as well as adult morbidity (even if subsequent weight is normalized). Pregnancy wide range of weight gain after pregnancy.

Relationship Between UC and CD

Reports from developing countries on the incidence and prevalence of IBD are still missing as regards population-based studies. Regional studies from India 24 . may, however, suggest an increase over time in well-defined regions. Documented increase of incidence or prevalence in Japan would, however, be of particular interest, since Japan may be the only country in Asia with stable socioeconomic conditions over several decades. An eventual increase in frequency of IBD would then have to be related to other than direct socioeconomic factors, and rather to other changes in the environment or life style, such as dietary habits.

Bilateral Upper Urinary Tract Obstruction

The classic presentation of bilateral upper urinary tract obstruction often differs clinically when compared to unilateral obstruction. Bilateral upper urinary obstruction most commonly occurs on a more chronic basis, related to an extrinsic process that progresses slowly over time. In this scenario, signs and symptoms directly related to the extrinsic process often prompt the workup which ultimately leads to the diagnosis of bilateral obstruction. When bilateral chronic upper urinary tract obstruction progresses to the point of causing symptoms, manifestations of renal failure are also commonplace. A common presentation for acute bilateral upper urinary obstruction is related to bilateral obstructing ureteral or UPJ stones. The tip-off to this diagnosis can be the development of bilateral flank pain in the setting of anuria however, more commonly the bilateral stones will be only partially obstructing and the patient will maintain an adequate urine output. Urgent management of...

Strategies for Prevention

It is worth repeating the WHO position that obesity is a serious global public health problem, requiring urgent action. As a result of the very limited success of current therapies, prevention is likely to be more cost-effective and to have a greater impact in the long run. The overall goal, in simple terms, would be to help the public adopt a healthy diet and engage in an adequate amount of physical activity. A key element for a successful program will be early detection to facilitate effective intervention at a number of age BMI levels. First, primordial prevention would prevent individuals with desirable BMIs from developing obesity. Second, primary prevention would aim to prevent individuals at risk (overweight preobese category) from becoming obese. Finally, secondary prevention would attempt to prevent worsening of obesity and comorbidities in already obese individuals. A number of organizations, including WHO and the IOTF, have been examining this issue in recent years. Some of...

Endocrine Functions Of The Kidney

In addition to its role in the regulation of solute and water excretion, the kidney has several endocrine functions, including the synthesis of erythropoietin, the release of angiotensin I and angiotensin II, the conversion of vitamin D3 to its final form, and the production of several autocrine and paracrine agents. Vitamin D3 from the diet and that produced by the skin must be hydroxylated to be fully active. Enzymes in the kidney are responsible for the final conversion of vitamin D3 to its most active form 1,25-dihydroxycholecalciferol 1,25(OH)2D3 see chapter 43 .

Types Of Fatty Acids In Meat

The fatty acids in ruminant tissues are more complex than those in nonruminants, containing higher proportions of trans fatty acids, fatty acids with an odd number of carbon atoms (arising from rumen-derived proprionic acid rather than acetate as a precursor for fatty acid synthesis, e.g., C15 and C17), fatty acids with branched chains (derived from the amino acids, leucine, valine, and isoleucine, i.e., 4-methyl octanoic acid, C8 0 and 4-methyl nonanoic acid, C9 0) and fatty acids with conjugated double bonds (i.e., the bonds are on adjacent carbon atoms rather than being separated by a CH2 group). These variations are the result of the actions of enzymes present in microorganisms in the rumen that degrade plant structures and dietary fatty acids, producing a wide range of products, some of which are absorbed in the small intestine and incorporated into tissue lipids. An important group of fatty acids in ruminants are the conjugated linoleic acids (CLAs) with 18 carbons and 2...

Discussion And Future Outlook

Parameters such as body weight gain, phosphorus availability, and phosphorus excretion was equivalent for recombinant phytase derived from plants and the commercial fungal phytase, Natuphos . These results indicate successful accumulation of active recombinant phytase in transgenic plants. While transgenic canola seeds and alfalfa juice may provide economically viable approaches to phytase production for feed supplementation, transgenic soybeans are not ideally suited as a phytase source. Soybeans are normally roasted and processed to produce meal 52,53 , which would lead to inactivation of the recombinant phy-tase. It has been demonstrated that recombinant phytase produced in soybean does not exhibit sufficient thermal stability to withstand production of meal 22 . Enzyme stability during the manufacture of feed remains another hurdle to wider use of phytase supplements in animal production. The feed pelleting process requires elevated temperatures 10 that inactivate the phytase....

Current and future therapies

As discussed previously, the health and economic consequences of obesity are considerable to the individual patient and to society at large. It is therefore not surprising that clinical guidelines for the management of obesity have been published by several organizations including NHLBI, the North American Association for the Study of Obesity, the American Association of Clinical Endocrinologists, the Scottish Intercollegiate Guidelines Network, and the Royal College of Physicians of London. In general, treatment is recommended for individuals with a BMI of 30 kg m2 or more as well as for individuals with a BMI between 25 and 29.9 kg m2 or a high-risk WC if associated with two or more risk factors comorbidities. The recommended goal of therapy is the loss and long-term maintenance of at least a 5-10 reduction in body weight, as studies have shown that a modest reduction in weight is associated with a marked improvement in risk factors and comorbidities (4-6). Because of the complex...

Horizontal Transmission

Arthropod vectors, such as mosquitoes, feed on vertebrates to obtain blood which is used as a dietary supplement to stimulate and support egg development. If the vertebrate host is circulating a sufficient quantity of virus within its peripheral blood (i.e., is viremic) and if the arthropod is

Sources of Some Major Fatty Acids in Meat

The SFA in meat can be derived from the diet, produced in the rumen from unsaturated dietary fatty acids, or synthesized from glucose or acetate in liver or adipose tissue (Table 5.2). MUFA (e.g., 18 1cis-9) are mainly formed in adipose tissue from SFA by the action of desaturase enzymes, for example, delta-9-desaturase that forms oleic acid (18 1cis-9) from stearic acid (18 0) and palmitoleic acid (16 1cis-9) from palmitic acid (16 0). This same enzyme complex forms the main CLA isomer, cis-9, trans-11 CLA from 18 1 trans-11, which is produced in the rumen. Most CLA formation occurs in adipose tissue (the mammary gland in the case of lactating animals) but some occurs in the rumen. PUFAs are of the n-6 or n-3 type that describes the position along the carbon chain from the methyl end where the first double bond is inserted. The n-6 fatty acid present in the largest amount is linoleic acid (18 2n-6), which is an essential fatty acid, that is, it is derived entirely from the diet...

Indications And Preoperative Assessment

Several conditions make a patient less than ideal for initial attempts at hand-assisted cases. Obese patients can be a significant challenge because excessive adipose tissue can make dissection tedious and difficult. Multiple prior abdominal surgeries predispose to intraperitoneal adhesions that are time-consuming to lyse and increase the risk Morbid obesity

Drugs That Alter Metabolism or Nutrient Partitioning

Orlistat, an inhibitor of gastric and pancreatic lipases, is the second drug currently approved for the long-term treatment of obesity. It is a synthetic derivative of lipstatin, which is produced by Streptomyces toxitricini (146). Inhibition of lipase activity decreases fat absorption by about 30 , leading to maintenance of a caloric deficit over the long term, which would then result in a reduction in body weight. There is negligible systemic absorption of orally administered drug, and there have been no reported clinically significant interactions with several drugs including warfarin, digoxin, pravastatin, nifedipine, phenytoin, glyburide, and oral contraceptive pills (146). Obese patients with Obese patients with drug produced an 8-10 body weight loss, compared with a loss of 4-6 in the placebo-treated groups. In all these studies, the combination of orlistat and diet was more effective than placebo plus diet in inducing and maintaining weight loss. More importantly, the use of...

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