The role of sulfate in the calciuria of high protein diets in adult rats

Blood, urine and semen Volatile Organic Compound (VOC) pattern analysis for assessing health environmental impact in highly polluted areas in Italy

Volatile Organic Compound (VOC) analysis is usually applied in pollution assessment by checking for toxic or harmful volatile compounds in air, water and soil samples. In this study, exogenous VOCs and their derivatives, metabolized by cells, were valued into specific body fluids. In particular, the VOC profiles of blood, urine and human semen samples collected from young men living in two high pollution areas in Italy, i.e. Land of Fires and Valley of Sacco River, were fingerprinted. The analysis is based on Headspace Solid Phase MicroExtraction (HS-SPME) followed by Gas Chromatography-Mass Spectrometric detection (GC-MS). The volatile composition of the three body fluids showed that some VOCs are in common between blood, urine and human semen samples, whereas others are present only in a body fluid. Some compounds, as well as also some chemical classes show a higher affinity for a specific body fluid. Statistical analysis allowed to discriminate the two contaminated areas and identify those compounds which significantly contribute to the two areas classification. Some of these compounds are toxic and found prevalently in Valley of Sacco River samples, correspondingly to sperm analysis results for young men living in this zona worse than those living in Land of Fires.

Bioavailability of Micronutrients From Nutrient-Dense Whole Foods: Zooming in on Dairy, Vegetables, and Fruits

In order to fully exploit the nutrient density concept, thorough understanding of the biological activity of single nutrients in their interaction with other nutrients and food components from whole foods is important. This review provides a narrative overview of recent insights into nutrient bioavailability from complex foods in humans, highlighting synergistic and antagonistic processes among food components for two different food groups, i.e., dairy, and vegetables and fruits. For dairy, bioavailability of vitamins A, B2, B12 and K, calcium, phosphorous, magnesium, zinc and iodine are discussed, whereas bioavailability of pro-vitamin A, folate, vitamin C and K, potassium, calcium, magnesium and iron are discussed for vegetables and fruits. Although the bioavailability of some nutrients is fairly well-understood, for other nutrients the scientific understanding of uptake, absorption, and bioavailability in humans is still at a nascent stage. Understanding the absorption and bioavailability of nutrients from whole foods in interaction with food components that influence these processes will help to come to individual diet scores that better reflect absorbable nutrient intake in epidemiologic studies that relate dietary intake to health outcomes. Moreover, such knowledge may help in the design of foods, meals, and diets that aid in the supply of bioavailable nutrients to specific target groups.

Environmental and stressful factors affecting the occurrence of kidney stones and the kidney colic

The first renal disease described from Hippocrates is nephrolithiasis with renal colic, which is the pain of stone passage and is also a common renal problem with easily recognizable characteristics. There has been much written about dietary factors, which have unequivocally been proved to play an important role in the formation of kidney stones. In this regard, it is of interest that the contribution of factors such as stressful events, life style, or occupation in the formation of kidney stones has not been well studied. This review examines the clinical evidence of the stressful events and other environmental factors affecting the occurrence of kidney stones.

Consumption of krill protein concentrate prevents early renal injury and nephrocalcinosis in female Sprague-Dawley rats

Female Sprague-Dawley rats provide an animal model for studying the role of nutrition in renal health due to their sensitivity to diet-induced alterations in kidney function. Nephrocalcinosis, a common renal abnormality found in rats, has been implicated in subsequent renal failure. Simple dietary manipulations, such as changing the source of dietary protein, may influence nephrocalcinosis. This study evaluates the consumption of krill protein concentrate (KPC), a novel and high-quality protein, on renal and bone health. Young female Sprague-Dawley rats (n = 10/group) were individually housed in metabolic cages and fed ad libitum diets consisting of 10% crude protein supplied as KPC or casein for 4 weeks. Diets were isocaloric, isonitrogenous, and matched for calcium (Ca) and phosphorus (P). Urinary n-acetyl glucosaminidase (NAG) was measured and kidney histology performed to assess kidney damage. Biomarkers of kidney function were determined by calorimetric assays. Ca and P balance and bone concentrations were measured using inductively coupled plasma mass spectrometry. Femoral strength was determined by three-point bend testing. Rats fed KPC had lower (P = 0.005) urinary NAG levels and minimal microtubular Ca deposition compared to rats fed casein. There was a tendency (P < 0.06) for higher glomerular filtration rates and lower proteinuria, and higher (P = 0.03) urinary output in rats fed KPC compared to casein. There were no differences in Ca and P balance or bone measurements of total bone mineral content, Ca, P or strength between rats fed KPC and casein. Based on the study results, KPC prevented early renal injury leading to nephrocalcinosis and potential bone loss.

Role of sulfur amino acids in controlling nutrient metabolism and cell functions: implications for nutrition

Protein synthesis is affected when an insufficient level of sulfur amino acids is available. This defect may originate from dietary amino acid deficiency and/or excessive amino acid utilisation for other purposes such as the synthesis of glutathione and acute-phase proteins during catabolic stress. Sulfur amino acids are recognised to exert other significant functions since they are precursors of essential molecules, are involved in the methylation process, participate in the control of oxidative status, and may act as mediators affecting metabolism and cell functions. Despite this increased understanding of the role of sulfur amino acids, many questions still remain unanswered due to the complexity of the mechanisms involved. Moreover, surprising effects of dietary sulfur amino acids have been reported, with the development of disorders in cases of both deficiency and excess. These findings indicate the importance of defining adequate levels of intake and providing a rationale for nutritional advice. The aim of the present review is to provide an overview on the roles of sulfur amino acids as regulators of nutrient metabolism and cell functions, with emphasis placed on the implications for nutrition.

Studies of a urinary biomarker of dietary inorganic sulphur in subjects on diets containing 1-38 mmol sulphur/day and of the half-life of ingested 34SO4(2-)

OBJECTIVE

Sulphites are widely used food additives that may damage health, hence limits are set on their use. They are excreted in urine as sulphate, along with sulphate derived from sulphur amino acids. Dietary intakes of sulphites are hard to determine, so we have tested the utility of urinary nitrogen:sulphate ratio as a biomarker of inorganic sulphur (IS) intake. Additionally we determined the half-life of ingested (34)SO(4)(2-) from its urinary excretion.

SUBJECTS

Twenty healthy adult subjects were recruited by poster advertisement, for a 24-h study where they ate specified foods, which were high in IS, in addition to their normal diet. The half-life of ingested (34)SO(4)(2-) was assessed in five healthy volunteers, given 5.9 mmols of Na(2)(34)SO(4) as a single dose and collecting all urine specimens for 72-96 h. Urine and duplicate diets from three previously conducted studies were analysed for nitrogen and sulphate content, thus expanding the range of IS intakes for evaluation.

METHODS

Duplicate diets were analysed for IS content by ion exchange chromatography, while IS intake was predicted from urinary sulphate (g/day S)-(urinary nitrogen (g/day)/18.89). (32)S:(34)S ratios were determined by liquid chromatography mass spectrometry/mass spectrometry.

RESULTS

The range of IS intake was 1.3-37.5 mmol S/day. Actual and predicted IS intakes were mmol/day+/-s.e. 9.2+/-0.65 and 7.0+/-0.45, respectively, and were correlated r=0.60 (n=108). The mean half-life of ingested (34)SO(4)(2-) was 8.2 h.

CONCLUSIONS

From a 24-h urine collection, IS intake from the habitual diet can be determined for groups of individuals. To predict individual intakes of IS, which may include high sporadic amounts from beer and wine, at least 48 h of urine collection would be required.

The effect of high salt and high protein intake on calcium metabolism, bone composition and bone resorption in the rat

The effects of salt (NaCl) supplementation of rat diets (50 g/kg diet), with normal (200 g/kg) or high (500 g/kg) dietary casein content, were studied in 3-week-old male rats over a 3-week period. Weight gain was reduced by dietary salt but was unaffected by dietary casein. Salt-supplemented rats exhibited a two-and three-fold increase in urinary Mg and Ca excretion respectively, irrespective of dietary casein content. Dietary casein had no effect on urinary Ca or Mg. Salt reduced femoral mass but not femoral mass expressed relative to body weight, but neither variable was affected by dietary casein. Femoral Mg and P contents and concentrations were unaffected by dietary salt or casein. While femoral Ca concentration was unaffected by dietary salt, the Ca content was reduced by salt supplementation, irrespective of dietary casein content. Neither the content nor concentration of Ca in femora was affected by dietary casein. Urinary pyridinoline and deoxypyridinoline levels were increased by salt supplementation, irrespective of dietary casein content, but were unaffected by casein. Net Ca absorption was unaffected by dietary salt or casein. In conclusion, these results show that salt supplementation over the short-term increased the rate of bone resorption in rats. This was as a consequence of Na-induced calciuria. On the other hand, a high dietary protein intake had no effect on Ca metabolism, bone composition or bone resorption, nor did it augment the Na-induced calciuria or increased rate of bone resorption.

Effect of the protein and oil contents on calcium utilization in the diets of female Fischer rats that were fed by three different feeding methods

We studied the effects of varying the protein and oil contents in the diet and three different feeding methods on the utilization of dietary calcium (Ca) in female Fischer rats. The experimental diets were based on the AIN-76 diet. Rats were fed one of nine experimental diets containing different levels of protein and oil. The experimental diets contained 10, 20 or 40% of protein (milk casein) and 5, 10 or 20% of soybean oil. The three meal feeding methods were ad libitum feeding, pair feeding and adjustable feeding. The experimental diets that were given by prepared feeding were supplemented with a mineral and vitamin solution. The effects of the protein and oil contents in the diet were analyzed by two-way ANOVA. Among rats that were fed ad libitum, the oil content in the diet affected the degree of mineral and vitamin intake. Among the rats fed ad libitum, the oil content in the diet had a significant effect on the level of Ca intake, although it did not have a significant effect on the level of energy intake. For pair feeding, the feeding volume was limited in each group; therefore, there was a significant difference in energy intake and there was no significant difference in Ca intake among each diet group. For adjustable feeding, there was considerable mineral and vitamin intake, which effected the reduction of feeding volume depending on the oil volume in the diet. There were no significant differences in the energy, Ca and other mineral and vitamin intakes among the nine groups that were fed using adjustable feeding. In analyzing two-way ANOVA, in which the parameters were the contents of protein and oil in the experimental diets, there were differences in Ca utilization among rats that were fed using the three feeding methods. This result was shown to reflect on the difference as energy, mineral including Ca, and vitamin intake. However, the protein content in the diet had a significant effect on urinary Ca excretion in all three feeding methods. In addition, it was clear that the intake of protein and oil affected kidney calcification in all three feeding methods. The AIN Experimental Diet Committee reported that kidney calcification was found among rats that were fed the AIN-76 diet and that one of the causes of kidney calcification was the Ca/P ratio in this diet. The protein and oil contents in the diets had significant effects on the degree of kidney calcification among rats that were fed by pair feeding or adjustable feeding. The results of this study suggest that the protein and oil contents in the diet play an important role in kidney calcification.

Consumption of a high calcium mineral water lowers biochemical indices of bone remodeling in postmenopausal women with low calcium intake

Many postmenopausal women have a calcium intake far below the recommended amount and, in addition to attempting to improve their diet, need a calcium supplement. The aim of the study was to assess the effects of the consumption of a high calcium mineral water (HCaMW) on biochemical indices of bone remodeling in postmenopausal women with low Ca intake. A 6-month randomized double-blind placebo-controlled trial was designed to assess the effects of a daily consumption of 1 liter of a HCaMW (596 mg Ca/l) on serum parathyroid hormone (PTH) and biochemical markers of bone remodeling in postmenopausal women with a dietary Ca intake lower than 700 mg/day. The placebo group drank 1 liter of a mineral water with a low calcium content (10 mg/l). One hundred eighty healthy women were recruited (mean age: 70.1+/-4.0 years); 152 completed the 6-month trial. The changes from baseline of biochemical indices after 6 months consisted of a significant 14.1% decrease of serum PTH, osteocalcin (-8.6%), bone alkaline phosphatase (-11.5%), serum (-16.3%) and urine (-13.0%) type-1 collagen C-telopeptide in the HCaMW group compared to the placebo group, where all biochemical indices increased after 6 months. The additive effect of a small vitamin D supplement (400 iu/day) was also evaluated. In women receiving vitamin D in addition to HCaMW, the decrease in bone indices was not found to be greater than in women drinking only the HCaMW. A daily supplement of 596 mg of Ca through the consumption of 1 l of HCaMW was able to lower serum PTH and the indices of bone turnover in postmenopausal women with a low Ca intake. This could contribute to the repair of calcium deficiency and to the reduction of age-related bone loss in this population.

Comparative effect of soy protein, soy isoflavones, and 17beta-estradiol on bone metabolism in adult ovariectomized rats

This study provided a comprehensive investigation on the effect of soy protein and soy isoflavones on both calcium and bone metabolism in virgin adult rats. The measurements included bone histology, calcium kinetic modeling, calcium balance, bone densitometry, and whole body densitometry. Results confirmed the bone-preserving effect of estrogen but did not support a bone-sparing role of soy isoflavones.

INTRODUCTION

Several animal and short-term human studies have indicated that soy protein isolate enriched with isoflavones may be used as an alternative therapy to estrogen replacement therapy. However, none of the previous studies have investigated this estrogenic effect on both calcium and bone metabolism in animals or humans, which is essential in ascertaining the mode of action of isoflavones.

MATERIALS AND METHODS

This study was designed to determine the effects of soy protein versus isoflavones on calcium and bone metabolism in an ovariectomized rat model. Unmated 6-month-old ovariectomized and sham-operated female Sprague-Dawley rats were randomly assigned to nine groups (16 rats/group) and pair-fed soy- or casein-based diets with or without isoflavones for 8 weeks. A reference group was administered estrogen through subcutaneous implants (20-35 pg/liter plasma). Bone densitometry, histomorphometry, and mechanical testing were used to study bone metabolism and quality. Calcium metabolism was studied using calcium tracer balance and kinetics.

RESULTS

After ovariectomy, estrogen prevented bone loss in trabecular bone and suppressed formation on both trabecular and cortical bone surfaces. Isoflavones given as enriched soy protein isolate or supplements did not prevent trabecular bone loss. Combining isoflavones with estrogen had no additional benefits over estrogen alone. There were no differences in response to isoflavones caused by protein source. None of the treatments significantly affected either total Ca balance or (45)Ca absorption. However, soy protein showed significant effects on reducing urinary loss of Ca in animals, irrespective of isoflavone level, perhaps because of the lower amount of sulfur-containing amino acids in soy protein.

CONCLUSION

Estrogen, but not isoflavones at the levels tested, suppressed bone remodeling in both trabecular and cortical bone after ovariectomy.

Higher calcium urinary loss induced by a calcium sulphate-rich mineral water intake than by milk in young women

It is well known that the intestinal availability of Ca from Ca-rich mineral waters is equivalent to that of milk Ca. However, the effect of associated anions on Ca urinary loss needs to be addressed. The aim of the current study was to compare, under ordinary conditions of consumption, milk and a SO4-rich mineral water as the Ca provider in a large number of subjects consuming the same quantity of Ca from the two sources in a crossover study lasting for an extended period. Thirty-seven healthy women completed a 12-week protocol, divided into four periods of 3 weeks (W). In the first (W1-3) and third (W6-9) periods, dietary Ca intake was restricted to 600 mg/d. In the second (W4-6) and final (W10-12) periods, either 400 ml/d medium-fat milk or 1 litre of a Ca- and SO4-rich mineral water, each providing about 480 mg Ca/d, was added to the diet in a random manner. Dietary evaluation, blood and urinary measures were performed during the last week (W6 and W12) of each Ca supplementation period. The urinary excretion of Ca was higher (0.5 mmol/d more) with water than with milk (P<0.001). An examination of all the dietary factors known to influence calciuria suggested that the acidogenic action of SO4 was responsible for this increased calciuria. Thus, despite an equal Ca intake and assuming an unchanged intestinal absorption, these results suggest that Ca balance is better with milk consumption than with CaSO4-rich water.

Contribution of dietary protein and inorganic sulfur to urinary sulfate: toward a biomarker of inorganic sulfur intake

BACKGROUND

Sulfiting agents are widely used as food additives. Limits are set on their use in foods because they may adversely affect health. Sulfiting agents are excreted in urine as sulfate, which is indistinguishable from sulfate derived from sulfur amino acids.

OBJECTIVE

The objective was to assess the contribution of inorganic sulfur to urinary sulfate excretion and of dietary protein to urinary sulfate and nitrogen excretion with the aim of developing a urinary biomarker of inorganic sulfur intake.

DESIGN

Nine healthy men were fed a sequence of 3 diets for 15 d (n = 7), 5 diets for 10 d (n = 6), or both. The diets contained 51-212 g protein/d (0.43-1.71 g S/d) and 0.17-0.27 g inorganic S/d; p-aminobenzoic acid-validated 24-h urine samples (n = 47) were analyzed for sulfate and nitrogen.

RESULTS

Dietary inorganic sulfur was efficiently excreted as sulfate in urine. Urinary sulfate derived from protein correlated strongly (r(2) = 0.86) with urinary nitrogen. Urinary recovery of protein sulfur and nitrogen decreased from 84% at average protein intakes (72 g/d) to 70% at high protein intakes (212 g/d). The nitrogen:sulfur ratio (in g) of the protein in the study diets was 18.9, which was maintained in urine (18.4 +/- 0.1) after dietary inorganic sulfur intake was subtracted from urinary sulfate. Therefore, inorganic sulfur intake (g/d) = urinary sulfur (g/d) - 0.054 x urinary nitrogen (g/d). For typical UK intakes of inorganic sulfur (0.25 g/d), this biomarker should produce mean (+/- SD) values of 0.24 +/- 0.10 g S/d.

CONCLUSION

Twenty-four-hour urinary nitrogen and sulfate values can be used to predict inorganic sulfur intake.

A long-term high-protein diet markedly reduces adipose tissue without major side effects in Wistar male rats

Although there is a considerable interest of high-protein, low-carbohydrate diets to manage weight control, their safety is still the subject of considerable debate. They are suspected to be detrimental to the renal and hepatic functions, calcium balance, and insulin sensitivity. However, the long-term effects of a high-protein diet on a broad range of parameters have not been investigated. We studied the effects of a high-protein diet in rats over a period of 6 mo. Forty-eight Wistar male rats received either a normal-protein (NP: 14% protein) or high-protein (HP: 50% protein) diet. Detailed body composition, plasma hormones and nutrients, liver and kidney histopathology, hepatic markers of oxidative stress and detoxification, and the calcium balance were investigated. No major alterations of the liver and kidneys were found in HP rats, whereas NP rats exhibited massive hepatic steatosis. The calcium balance was unchanged, and detoxification markers (GSH and GST) were enhanced moderately in the HP group. In contrast, HP rats showed a sharp reduction in white adipose tissue and lower basal concentrations of triglycerides, glucose, leptin, and insulin. Our study suggests that the long-term consumption of an HP diet in male rats has no deleterious effects and could prevent metabolic syndrome.

Evaluation of effects of dietary carbohydrate on formation of struvite crystals in urine and macromineral balance in clinically normal cats

OBJECTIVE

To evaluate effects of dietary carbohydrate on urine volume; struvite crystal formation; and calcium, phosphorus, and magnesium balance in clinically normal cats.

ANIMALS

21 healthy adult cats (15 sexually intact males and 6 sexually intact females).

PROCEDURE

Diets containing no carbohydrate source (control diet), control plus starch, or control plus fiber were given in a 3 X 3 Latin-square design. The diets were available ad libitum in study 1 (n = 12) and given under restrictions in study 2 (9) to equalize daily intakes of crude protein among the 3 groups. Formation of struvite crystals and balance of calcium, phosphorus, and magnesium were measured.

RESULTS

Urine volume was lower in the starch group and fiber group in study 1, whereas no differences were detected among the groups in study 2. Urinary pH and struvite activity product were higher in the starch group in both studies, and the fiber group also had higher struvite activity product in study 2. In both studies, urinary concentrations of HCl-insoluble sediment were higher in the starch group and fiber group. In the fiber group, a net loss of body calcium, phosphorus, and magnesium was detected in study 2.

CONCLUSIONS AND CLINICAL RELEVANCE

Starch and fiber in diets potentially stimulate formation of struvite crystals. Hence, reducing dietary carbohydrate is desirable to prevent struvite urolith formation. In addition, a net loss of body calcium, phosphorus, and magnesium during feeding of the fiber diet suggests that dietary inclusion of insoluble fiber could increase macromineral requirements of cats.

Toxicity and carcinogenicity of acidogenic or alkalogenic diets in rats; effects of feeding NH 4 Cl, KHCO 3 or KCl

The effects of diet-induced acid-base disturbances were examined in 4-week, 13-week and 18-month toxicity studies, and in a 30-month carcinogenicity study. Rats were fed a natural ingredient diet (controls), supplemented with 2% or 4% KHCO(3) (base-forming diets), or with 1% or 2.1% NH(4)Cl (acid-forming diets). Additional controls were fed 3% KCl (neutral diet providing K(+) and Cl(-) in amounts equimolar to those in the 4% KHCO(3) diet and the 2.1% NH(4)Cl diet, respectively). NH(4)Cl induced the expected metabolic acidosis, as shown by decreased base excess in blood, decreased urinary pH and increased urinary net acid excretion. KHCO(3) induced the opposite effects. KCl did not affect the acid-base balance. Clinical condition and death rate were not affected. The feeding of high levels of each salt resulted in growth retardation and increased water intake and urinary volume. Plasma potassium and urinary potassium excretion were increased with KHCO(3) and KCl. Plasma chloride was increased with NH(4)Cl, but not with KCl. Urinary calcium and phosphate excretion were increased with NH(4)Cl, but there were no indications that bone minerals were involved (weight, calcium content and fat free solid of the femur were not affected). Standard haematological and clinical chemistry parameters were not affected. Kidney weights were increased with 2.1% NH(4)Cl. Hypertrophy of the adrenal zona glomerulosa occurred with KHCO(3), KCl and NH(4)Cl, due to chronic stimulation of the adrenal cortex by either K(+) or by NH(4)Cl-induced acidosis. An early onset (from week 13) of oncocytic tubules was noted in the kidneys of rats fed KHCO(3) and, after 30 months, the incidence of this lesion was much higher than the background incidence in ageing controls. No progression to oncocytomas was noted. KCl showed only slight effects on the early onset of oncocytic tubules (from 18 months). In contrast, the severity of nephrosis and the incidence of oncocytic tubules were decreased with 2.1% NH(4)Cl, suggesting a protective effect of acidosis. The feeding of KHCO(3) resulted in hyperplasia, papillomas and carcinomas of the urinary bladder. With KCl only a slight increase in proliferative urothelial lesions was noted. Apart from these (pre-)neoplastic lesions in the urinary bladder there were no treatment-related differences in tumour response among the groups. We concluded that most of the observed changes represent physiological adaptations to the feeding of acid- or base-forming salts. Remarkable effects noted with KHCO(3), and to a far lesser extent with KCl, consisted of renal oncocytic tubules and (pre-)neoplastic lesions of the urinary bladder epithelium. NH(4)Cl-induced chronic metabolic acidosis was not associated with dissolution of alkaline bone salts in rats. Finally, a protective effect of chronic acidosis on tumour development was not found.

The effect of high intakes of casein and casein phosphopeptide on calcium absorption in the rat

The effect of the level or source of dietary protein or protein-derived peptides on Ca absorption is not well understood. We determined, therefore, the influence of habitual dietary casein level, meal casein and meal casein phosphopeptide (CPP) on Ca absorption in the rat. True fractional Ca absorption was investigated in male 7-week-old rats, Wistar strain, in three separate studies using a faecal 47Sc: 47Ca ratio method. In studies A and C, rats (n 8 per group) were fed on a purified diet containing 200 g casein/kg for 2 weeks. Rats were then given a 47Ca-labelled meal (10 g) containing (per kg) either 0, 100, 200, or 300 g casein (study A) or 0, 100, 200, 350 or 500 g CPP (study C). In study B, rats (n 24 per group) were fed on a purified diet containing (per kg) either 200, 350 or 500 g casein for 2 weeks. Each group was then further randomized into three groups (n 8 per group) and given a 47Ca-labelled meal (10 g of the same diet) containing (per kg) either 200, 350 or 500 g casein. Ca absorption from a meal was unaffected by increasing meal casein concentration from 0 to 300 g/kg (study A), but was increased with a meal casein content of 500 g/kg (study B). Fractional Ca absorption decreased with increasing usual dietary casein intake in the range 200-500 g/kg (study B), suggesting intestinal adaptation. Ca absorption was unaffected by inclusion of 100 g CPP/kg in a single meal but was significantly (P < 0.001) reduced by 200, 350 and 500 g CPP/kg meal, with no evident dose-relationship. Thus, while Ca absorption was enhanced by high-casein meals, the mechanism remains unclear.

The bioavailability of dietary calcium

This update focuses on the bioavailability of dietary calcium for humans. Fundamentals of calcium metabolism, intestinal absorption, urinary excretion and balance are recalled. Dietary factors, especially lactose and other milk components, influencing calcium bioavailability at intestinal and renal levels are reviewed. A critical examination of all the methods used for evaluating calcium bioavailability is made. This includes in vitro assays, classical and isotopic balances, urinary excretion, isotope labeling in the urine, plasma and bones, long term evaluation of bone mineralization and the use of biological bone markers. Importance and advantages of animal models are discussed. The state of the art in the comparative bioavailability of calcium in foods is detailed including a comparison of sources of calcium (dairy products and calcium salts) in human studies and in some animal studies, casein phosphopeptides, proteins, lactose and lactase and their relation with calcium bioavailability (in humans and rats). An update on the consumption of dairy products and bone mass is presented. Emphasis on peculiarities and advantages of calcium in milk and dairy products is given.

Parathyroid hormone may be a cancer promoter - an explanation for the decrease in cancer risk associated with ultraviolet light, calcium, and vitamin D

Epidemiological studies reporting an inverse association between sunlight exposure and risk for cancers of the breast, colon, and prostate, have not yet been explained. Since ultraviolet (UV) light promotes dermal vitamin D generation, studies suggesting that dietary calcium and vitamin D may likewise have cancer-preventive activity are potentially of relevance. UV light, calcium, and vitamin D have the common property of suppressing parathyroid hormone (PTH) production; these considerations raise the possibility that PTH may have promotional activity for certain cancers. PTH might function indirectly in this regard, by increasing hepatic production of the progression growth factor IGF-I, a likely cancer promoter. A more direct role is suggested by recent evidence that many cancers express receptors for PTH/PTH-related protein; these receptors mediate co-mitogenic and/or pro-invasive signals in some cancers. High risk for previous or concurrent neoplasms has been reported in patients with parathyroid adenomas. In light of the increase in cancer risk associated with hypertension, it is notable that PTH levels are typically increased in salt-sensitive hypertensives. Prospective case-control studies examining serum PTH in relation to subsequent cancer risk appear warranted.

Vegan proteins may reduce risk of cancer, obesity, and cardiovascular disease by promoting increased glucagon activity

Amino acids modulate the secretion of both insulin and glucagon; the composition of dietary protein therefore has the potential to influence the balance of glucagon and insulin activity. Soy protein, as well as many other vegan proteins, are higher in non-essential amino acids than most animal-derived food proteins, and as a result should preferentially favor glucagon production. Acting on hepatocytes, glucagon promotes (and insulin inhibits) cAMP-dependent mechanisms that down-regulate lipogenic enzymes and cholesterol synthesis, while up-regulating hepatic LDL receptors and production of the IGF-I antagonist IGFBP-1. The insulin-sensitizing properties of many vegan diets--high in fiber, low in saturated fat--should amplify these effects by down-regulating insulin secretion. Additionally, the relatively low essential amino acid content of some vegan diets may decrease hepatic IGF-I synthesis. Thus, diets featuring vegan proteins can be expected to lower elevated serum lipid levels, promote weight loss, and decrease circulating IGF-I activity. The latter effect should impede cancer induction (as is seen in animal studies with soy protein), lessen neutrophil-mediated inflammatory damage, and slow growth and maturation in children. In fact, vegans tend to have low serum lipids, lean physiques, shorter stature, later puberty, and decreased risk for certain prominent 'Western' cancers; a vegan diet has documented clinical efficacy in rheumatoid arthritis. Low-fat vegan diets may be especially protective in regard to cancers linked to insulin resistance--namely, breast and colon cancer--as well as prostate cancer; conversely, the high IGF-I activity associated with heavy ingestion of animal products may be largely responsible for the epidemic of 'Western' cancers in wealthy societies. Increased phytochemical intake is also likely to contribute to the reduction of cancer risk in vegans. Regression of coronary stenoses has been documented during low-fat vegan diets coupled with exercise training; such regimens also tend to markedly improve diabetic control and lower elevated blood pressure. Risk of many other degenerative disorders may be decreased in vegans, although reduced growth factor activity may be responsible for an increased risk of hemorrhagic stroke. By altering the glucagon/insulin balance, it is conceivable that supplemental intakes of key non-essential amino acids could enable omnivores to enjoy some of the health advantages of a vegan diet. An unnecessarily high intake of essential amino acids--either in the absolute sense or relative to total dietary protein--may prove to be as grave a risk factor for 'Western' degenerative diseases as is excessive fat intake.

The effect of dietary protein on the mineral status of vervet monkeys with special reference to the impact of milk solids on calcium excretion

This study assessed the impact of Westernised and traditional African diets on mineral metabolism in general and calcium status in particular in vervet monkeys. Twelve adult male vervet monkeys (Cercopithecus aethiops), with an average weight of 5+/-0.58 kg each, were divided into two groups of six individuals each and fed traditional diets containing largely maize + legumes (17.4%) or Westernised diets containing milk solids (17.2%) as the source of high crude protein for 8 weeks. Blood was taken at 2-week intervals, the animals were weighed, while urine and stool samples were collected over 24 hours. The monkeys on the milk solids diet had diarrhoea for 6 weeks post-dietary intervention, and produced significantly greater quantities (P<0.02) of stool. These animals also produced significantly more urine (P<0.02). There was no difference in the degree of calciuresis of the two groups, but the monkeys on maize + legume proteins absorbed significantly more calcium during weeks two and six (P<0.04). Furthermore, both groups of monkeys showed a significant decline in plasma calcium levels over the experimental period (P<0.001). The diets had no effect on phosphate levels in the plasma or urine. However, both groups of animals absorbed less phosphate (P<0.09). There was an increasing loss of urinary magnesium (P = 0.03) in both groups, with the milk solids group showing lower plasma levels of this element (P = 0.09). However, the milk solids group lost less magnesium through the stool (P<0.03). In addition, the animals on milk solids showed significant natriuresis (P<0.05), while plasma sodium levels in both groups declined over time (P<0.03). Both diets induced a state of urinary potassium loss (P = 0.0003) and decrease in plasma potassium (P<0.0002). Urinary pH and plasma urea were unaffected by the diets, but the monkeys on maize + legumes excreted significantly less (P<0.001) urinary urea. This study indicates that the milk solids diet compromised mineral homeostasis by interfering with gut and renal functioning, while the traditional African diet did not induce these effects.

Converting enzyme inhibition causes hypocitraturia independent of acidosis or hypokalemia

BACKGROUND

Angiotensin II stimulates the proximal tubular Na/H antiporter and increases proximal tubular cell pH. Because intracellular pH may affect urinary citrate excretion and enzymes responsible for renal citrate metabolism, the present studies examined the effect of enalapril, an angiotensin converting enzyme inhibitor, on the activity of renal cortical ATP citrate lyase and urinary citrate excretion.

METHODS

Enalapril was given to rats (15 mg/kg/day) for seven days and to humans (10 mg twice daily) for 10 days. Blood and 24-hour urine samples were obtained in both groups. Renal cortical tissue from rats was analyzed for enzyme activity.

RESULTS

In rats, enalapril decreased urinary citrate excretion by 88%. The change in urinary citrate was not associated with a difference in plasma pH, bicarbonate nor potassium concentration. However, similar to metabolic acidosis and hypokalemia, enalapril caused a 42% increase in renal cortical ATP citrate lyase activity. When given to humans, enalapril significantly decreased urinary citrate excretion and urine citrate concentration by 12% and 16%, respectively, without affecting plasma pH or electrolytes.

CONCLUSIONS

Enalapril decreases urinary citrate in rats and humans. This is due, at least in part, to increases in cytosolic citrate metabolism through ATP citrate lyase in rats similar to that seen with chronic metabolic acidosis and hypokalemia. The effects of enalapril on urinary citrate and renal cortical ATP citrate lyase occur independently of acidosis or hypokalemia but may be due to intracellular acidosis that is common to all three conditions.

The effect of dietary sulfur-containing amino acids on calcium excretion

The relationships between dietary protein and sulfur amino acid (methionine and cystine or taurine) intakes and urinary calcium excretion were examined both in animals and in young men. Thirty-two adult Wistar rats were divided into 4 groups, i.e., basal diet (group I), supplemented with albumin (II), methionine and cystine (III), or taurine (IV). During the 5-week feeding period, food consumption was recorded and 48 h urine samples were collected 4 times for each rat. Urinary calcium, creatinine and sulfate were measured. The results showed that the calcium and sulfate excretion in rats in group II and III were significantly higher than rats in the basal diet group. In contrast, supplementing a basal diet with taurine did not increase sulfate excretion and failed to induce hypercalciuria. The same result was also observed in the study carried out in Chinese young men. An increase in protein intake from 67 g to 107 g caused an increase in urinary calcium and sulfate. Supplementation with methionine and cystine in an amount to simulate those in the high protein diet had a similar effect. Adding taurine to the diet had no effect on urinary calcium and sulfate excretion. About 60 percent of the supplemented taurine in the diet was detected in the urine.

Dietary protein levels affect water intake and urinary excretion of magnesium and phosphorus in laboratory cats

The effects of dietary protein levels on food and water intake, and urinary excretion of magnesium (Mg) and phosphorus (P) were examined in cats fed dry-type diets. Four adult female cats were used for trials in a 4 x 4 Latin square design, and fed diets with increasing protein content (25.9, 38.3, 51.4 or 65.2% in dry matter) daily from 9:00 to 13:00. While daily food intake was almost constant regardless of the dietary protein level, water intake and urine volume increased with increasing the dietary protein. Daily urinary excretion of P increased in response to the increase in dietary protein level. The urinary concentration of P was positively related to nitrogen (N)-intake. In contrast, daily urinary excretion of Mg was not affected by the dietary protein level, and the urinary concentration of Mg was negatively related to N intake. A dry-type diet with a high protein content might be effective in preventing the deposition of Mg salts in the urinary tract of cats under the meal-fed condition without affecting food intake because of both the lower concentration of urinary Mg resulting from the increase in urine volume and, probably, urinary acidification.

Effects of a dietary load of acid or base on changes induced by lactose in rats

Feeding lactose or other slowly digestible carbohydrates to adult mammals may induce a variety of effects including hyperplasia and neoplasia. The most fundamental effect probably is the increased production in the large intestine of short-chain fatty acids (SCFA) resulting from increased fermentation of carbohydrate residues. To find out whether the increased production of these acidic compounds is involved in the induction of certain alterations caused by low-digestibility carbohydrates, the modifying effects of an acidifying (NH4Cl) or an alkalizing (KHCO3) diet supplement on lactose-induced changes in rats were studied. Three groups of 50 rats per sex were fed a 20% lactose diet unsupplemented or supplemented with 1% NH4Cl or 2% KHCO3, for at most 2.5 yr. One control group was fed the basal diet which contained wheat starch instead of lactose. Feeding lactose resulted in wet faecal pellets, reduced pH of the faeces, higher intake of food and water, lower body weights, increased caecal weights and fewer deaths. These effects were not significantly modified by NH4Cl or KHCO3. Feeding lactose increased urinary calcium levels, the effect being enhanced by NH4Cl and reduced by KHCO3. Lactose also tended to increase blood values of alkaline phosphatase and to decrease those for bicarbonate and base excess. These tendencies were generally more marked with NH4Cl, and less marked or absent with KHCO3. In addition, rats fed lactose showed decreased severity of nephrosis, increased mineralization and hyperplasia of the renal pelvic epithelium, and relatively high incidences of Leydig cell hyperplasia and neoplasia. NH4Cl supplementation was associated with a relatively small number of single and multiple tumours, with decreased incidences of hyperplasia and mineralization of the renal pelvis epithelium and with a markedly reduced incidence of proliferative changes in the adrenal medulla. With the KHCO3 supplement the incidences of Leydig cell proliferation and of bladder tumours were relatively high. These findings, in particular the differences between the diet groups in urinary calcium levels and possibly also the variations in blood levels of alkaline phosphatase, bicarbonate and base excess, suggest that the acidic end products of carbohydrate fermentation (SCFA) act as an acid load on the body.

Age and disease-related changes in the mineral of bone

Bone mineralization changes with age and disease. The distribution of mineral particles in a given bone (mineralization profile) has been studied using density fractionation as well as microradiography and electron backscattering imaging. The biological determinant of mineralization is the rate of turnover. During rapid growth and periods of high remodeling, mineralization is shifted towards lower mineral density (hypomineralization). During aging and periods of low remodeling, mineralization is shifted towards higher mineral densities (hypermineralization). Chemicals can also influence the mineralization profile of bone. Fluoride induces hypermineralization by stabilizing the apatite lattice and reducing bone mineral solubility, whereas strontium induces hypomineralization by loosening the apatite lattice and increasing bone mineral solubility. Drugs such as bisphosphonates induce hypermineralization by inhibiting resorption and acting as crystal poison. Finally, mineralization can be impaired by defects as in rickets and osteomalacia or made excessive by continuous accretion of mineral without resorption as in osteopetrosis.

Increasing intake of soybean protein or casein, but not cod meal, reduces nephrocalcinosis in female rats

Female weanling rats were fed diets with soybean protein, casein or cod meal at 171, 342 or 513 mmol nitrogen/100 g for 3 wk. The diets were isonitrogenous and balanced for fat, cholesterol, calcium, magnesium and phosphorus. Cod meal feeding at 171 and 342 mmol nitrogen/100 g diet produced lower kidney calcium concentrations than the feeding of either soybean protein or casein. Increasing protein intakes were associated with reduced kidney calcium concentrations in the rats fed either soybean protein or casein but not in those fed cod meal. The anti-nephrocalcinogenic effect of increasing intakes of soybean protein may relate to the lowering of urinary phosphorus concentration. Increasing intakes of casein probably inhibited nephrocalcinogenesis by lowering urinary pH and raising urinary magnesium concentration. Increasing cod meal concentrations in the diet lowered urinary pH and raised urinary magnesium and calcium concentrations, but the effects on nephrocalcinogenesis of these changes probably counteracted each other.

A review of postgastrectomy bone disease

Postgastrectomy bone disease was a term devised to describe the metabolic disorders of bone which may follow a gastrectomy operation. Although the use of this operation has declined drastically in recent years, this metabolic bone disorder is still with us and may escape and confuse the unwary. These disorders may take the form of osteomalacia, osteoporosis in excess of normal ageing, or a combination of both. For screening purposes, regular estimations of plasma alkaline phosphatase levels identify patients who may be developing osteomalacia which can then be treated with calcium and vitamin D supplements. Numerically, osteoporosis in excess of ageing is a bigger problem and its prevention and treatment is at present unsatisfactory. Screening procedures for osteoporosis are reviewed, including the more recent methods of bone mineral density assessment. Osteopenia or demineralization occurs in both osteomalacia and osteoporosis therefore osteomalacia must be excluded before attributing any loss to osteoporosis. The present situation with regards to the prevention and treatment of osteoporosis is also reviewed.

Effects of reducing dietary cation-anion balance on calcium kinetics in sheep

A Ca kinetic study with a four-compartment model being fitted to radioisotope and balance data using the CONSAM (conversational, simulation, analysis, and modeling) computer program was conducted to examine the effects of dietary cation-anion balance, calculated as milliequivalents [(Na + K] - (Cl + S)]. Twelve crossbred wethers were used as eucalcemic control (period 1); then Ca loss during lactation was simulated by continuous infusion of ethylene glycol tetraacetate (period 2). Dietary cation-anion balance was manipulated by supplementation of various mineral salts and was +339, +35, and -127 meq of kg DM-1 during period 1 and +429, +68, and -147 meq of kg DM-1 during period 2 for control and two treatments, respectively. Animals responded to the simulated lactational Ca loss (period 2) by increasing true intestinal absorption of Ca and bone resorption and by reducing Ca accretion by bone. No difference was observed in concentration of total Ca in plasma, but treatments produced increased concentration of plasma ionized Ca during both periods. Both treatments produced hypercalciuria during both periods, and the lowest cation-anion balance increased true intestinal absorption of Ca and reduced bone accretion during period 2. The size of total exchangeable Ca pool did not differ between treatments or periods, but amount of Ca movement between the pools increased with the intermediate cation-anion balance during period 1 and with both treatments during period 2 compared with control. These results indicated that feeding reduced cation-anion balance diets increased Ca flux through the exchangeable Ca pool with no changes in the size of the pool, particularly when Ca demand was increased.

Postprandial response of calcium metabolism in postmenopausal women to meals varying in protein level/source

The postprandial response of calcium metabolism to single meals varying in protein source and level was determined in eight postmenopausal women, age 51 to 65 years. Following an overnight fast, subjects consumed a liquid meal containing either 15 g or 45 g of protein from beef (B), cottage cheese (C), or soy isolate (S; 45 g only); one meal provided 0 g protein (basal). Blood was collected before the meal and at 30, 60, 120, and 180 minutes post-meal. Urine was collected every 30 minutes post-meal. Urinary Ca excretion significantly increased following 45-g protein meals when compared with basal meals, but not when compared with 15 g protein meals. Although glomerular filtration rate (GFR) was unaffected by diet, percent renal tubular Ca reabsorption was significantly reduced following C45 or S45 meals. No consistent changes in serum levels of parathyroid hormone (PTH) and calcitonin (Ct) were observed in response to diet. Serum phosphorus levels were significantly reduced following high-protein meals when compared with no-protein meals. Insulin response varied with protein level and source (C45 greater than S45 greater than C15 greater than B45 greater than B15 greater than basal). Significant associations found between insulin and calcium metabolism indicate a possible role of insulin in the mechanism of protein-induced calciuria.

Factors influencing the response of broiler chickens to calcium supplementation of canola meal

The present study was undertaken to investigate whether broiler chicks fed canola meal, as compared with diets of soybean meal, would respond to a higher level of supplemental calcium. Supplementing canola basal diets and soybean-meal basal diets with additional sulfur from sodium sulfate resulted in little or no change in broiler performance. However, supplementing diets with organic sulfur (cystine) caused a marked decrease in weight gain and feed intake, more severe with a canola diet than with a soybean-meal diet and which could be partially alleviated by increasing the calcium supplementation. A significant cystine-by-calcium interaction showed that feed intake dropped markedly, especially at the higher levels of calcium, as the levels of cystine supplementation increased. Part of the reduced performance, sometimes noted when diets supplemented with canola meal are used, may be due to a reduction in feed intake resulting from an interaction between dietary calcium and sulfur.

Sources of protein-induced endogenous acid production and excretion by human adults

The origin of the increase in endogenous acid production and excretion associated with the calciuretic action of high protein intakes was investigated in human adults. Eight subjects, 4 males and 4 females, aged 25-36 years, were fed a low protein diet (50 g/day) and a high protein diet (120 g/day in males and 106 g/day in females) for 7 days each. The high protein diet was formulated by supplementing the low protein diet with a mixture of four purified proteins. Increased protein intake was associated with increases in urinary Ca, sulfate, titratable acidity (acid phosphates) and ammonium, and decreases in urinary pH and bicarbonate. There was no increase in organic anion excretion. The increases in endogenous acid production (EAP) and net acid excretion (NAE) were entirely attributable to the oxidation of excess sulfur amino acids (SAA), which yields 2 moles of hydrogen ions per mole of amino acid catabolized. The results differ in this respect from those reported for studies on the effect of SAA loading, which indicate that non-SAA make a major contribution to the increase in EAP seen under these conditions.

Effect of dietary protein and minerals on calcium and zinc utilization

The utilization of most minerals can be altered not only by varying the dietary levels of protein, carbohydrate, fiber, fat, and vitamins but also by varying the forms of macronutrients fed. Interactions among minerals are frequent and sometimes complex. Thus, all assessments of mineral requirements should include discussions of the effects of interactions on mineral bioavailability. Some of these interactions occur in the gut and affect the absorption of minerals. Other interactions affect the metabolism, transport and storage of minerals, and ultimately their excretion in urine or in endogenous gut secretions.

[The effect of long-term increased protein administration on mineral metabolism and kidney function in the rat. I. Renal and enteral excretion of calcium, magnesium, phosphorus, sulfate and acid]

The influence of continuous imbalanced high protein intake on the metabolism of minerals (calcium, magnesium, phosphorus) and renal function was the subject of a long-term experiment with rats. In the first part of the study particular attention was directed to the contribution of protein-induced endogenous acid production and renal excretion of hydrogen ions and sulphate to the development of hypercalciuria. For 61 weeks 200 male Wistar rats in eight groups were fed isocaloric diets, whose protein contents were increased from 13 to 26 and 40 J% at the expense of carbohydrate intake. The fat content of the diets was 40 J%. In two groups with 13 and 26 J% protein the effect of different kinds of animal protein was also studied, replacing casein by beef. Mineral contents were kept constant in these diets. To examine the excretion mechanisms of calcium and phosphorus especially under conditions of excessive protein intake, the ratio of calcium to phosphorus was varied in three diets with 40 J% protein by increasing both minerals alternatively or together from 0.6 to 1.2%. An increase in dietary protein content from 13 to 26 or 40 J% produced a sustained hypercalciuria and also hypermagnesiuria over a period of more than 400 days (after 58 weeks: 3.3, 5.9, and 6.8 mg calcium/day; 2.2, 3.3, and 3.4 mg magnesium/day; p less than or equal to 0.05). No adaptation to high protein intake occurred. Hypermagnesiuria, which equally hasn't been described before as a result of high protein intake, was accompanied by a reduced fecal excretion of magnesium. With increased protein intake (casein and beef) hypercalciuria and also hypermagnesiuria were positively correlated with an increased formation and renal excretion of hydrogen ions and sulphate, which resulted from protein catabolism. The dietary protein source influenced the extent of hypercalciuria, irrespective of a constant phosphorus intake. Although leading to equal increases in renal total acid and sulphate excretion, beef as the main protein source caused a lower calciuria than casein. High phosphorus intake caused the highest total acid excretion of all groups, but resulted in a reduced hypercalciuria and hypermagnesiuria and counteracted the influence of an increased protein intake.

[The effect of long-term increased protein administration on mineral metabolism and kidney function in the rat. II. Kidney function and bone mineralization]

In the Federal Republic of Germany the average daily protein intake exceeds the Recommended Dietary Allowances for adults (0.8 g protein/kg body weight) by about 100%. On the other hand calcium intake is below the recommendations for certain age groups. Protein-induced hypercalciuria involves the risk of depletion of skeletal calcium stores, especially for older people who have a decreased absorption capacity for calcium. As a result of our study we postulate, that an altered renal function probably is one inducing factor of hypercalciuria. While urea excretion and serum urea concentration increased with an elevated dietary protein content from 13 to 26 or 40 J%, glomerular filtration rate remained unchanged. Fractional tubular reabsorption of calcium was significantly reduced by about 3% with increased endogenous acid production and renal excretion of hydrogen ions (first part of the study), which were accompanying a higher protein intake of 40 J% compared to 13 J% protein in the control group. Increasing the phosphorus content of the diet improved the reabsorption of calcium and magnesium. The kidneys of rats fed diets high in protein and phosphorus were hypertrophied. Histology of the kidneys showed signs of glomerulonephrosis. While the calcium content of the femora was slightly reduced with a higher protein intake of 40 compared to 13 J%, the magnesium content was increased (after 61 weeks: calcium from 261.4 to 257.1 mg/g dry fat-free wt [p less than or equal to 0.05]; magnesium from 3.2 to 3.5 mg/g dry fat-free wt [p less than or equal to 0.001]). Calcium and magnesium metabolism depends not only on the level of protein intake, but also on its interrelation with the dietary phosphorus content. With continuous high protein intake higher intakes for calcium, phosphorus and magnesium should be recommended, especially for older people.

Sulfite hypersensitivity. A critical review

Sulfiting agents (sulfur dioxide and the sodium and potassium salts of bisulfite, sulfite, and metabisulfite) are widely used as preservatives in foods, beverages, and pharmaceuticals. Within the past 5 years, there have been numerous reports of adverse reactions to sulfiting agents. This review presents a comprehensive compilation and discussion of reports describing reactions to ingested, inhaled, and parenterally administered sulfite. Sulfite hypersensitivity is usually, but not exclusively, found within the chronic asthmatic population. Although there is some disagreement on its prevalence, a number of studies have indicated that 5 to 10% of all chronic asthmatics are sulfite hypersensitive. This review also describes respiratory sulfur dioxide sensitivity which essentially all asthmatics experience. Possible mechanisms of sulfite hypersensitivity and sulfur dioxide sensitivity are discussed in detail. Sulfite metabolism and the role of sulfite oxidase in the detoxification of exogenous sulfite are reviewed in relationship to the etiology of sulfite hypersensitivity.